Rhode Island Launches Innovative Nurse Residency Program

State Action Coalition also makes progress in areas related to nursing practice and data.

    • July 10, 2013

A new nurse residency program in Rhode Island is making waves in the Ocean State—and supporters hope its ripple effects will be felt across the country.

In April, the Rhode Island Action Coalition for the Future of Nursing—a group of nurses and nurse allies who are working to transform health care in the state through nursing—and other organizations launched an innovative nurse residency and mentoring program designed to ensure that the state’s nurses are able to meet future needs in all practice settings.

The Rhode Island program is unique because it educates nurses in settings beyond hospitals and health care agencies, where most nurse residency programs are based. Under the Rhode Island program, participants will have opportunities to practice not just in acute care settings but also in community health clinics, visiting nurse services, long-term care facilities, behavioral health hospitals, and developmental disability providers. It is the first statewide program of its kind.

Providing educational opportunities for nurses in non-traditional settings is critical, according to Lynne M. Dunphy, PhD, FNP, FAAN, the founding nurse co-lead of the Rhode Island Action Coalition and an alumna of the Robert Wood Johnson Foundation (RWJF) Executive Nurse Fellows program (2009-2012). Action Coalitions are the driving force behind the Future of Nursing: Campaign for Action, a national effort backed by RWJF and AARP that is advancing recommendations from a report on the future of nursing by the Institute of Medicine.

As the population ages and as more people become insured under health reform, demand for nurses will intensify at long-term care facilities, visiting nurse services, and community-based clinics, Dunphy said. She is a professor and associate dean of external affairs at the University of Rhode Island’s College of Nursing, where she holds the Routhier Chair of Practice.

“The residency program will enable new graduate RNs to be instrumental in leading change and transforming health care settings,” she wrote in a blog post about the program.

Unemployed and underemployed nurses and new nurse graduates in Rhode Island are eligible to apply to the program, which is now accepting applications. Each participant will practice at a minimum of three different sites during his or her residency; will receive a small stipend; and will have the opportunity to attend seminars on subjects such as leadership, evidence-based practice, and quality and safety.

The program is funded by an RWJF Future of Nursing State Implementation Program grant, with support from the Governor’s Workforce Board in partnership with Stepping Up, and from other public- and private-sector groups. “Initiatives such as the nurse residency project should help us better prepare our workforce for high-growth economic opportunities in our state,” Rhode Island Gov. Lincoln Chafee said.

The program has other benefits too, according to Michael Paruta, MS, director of workforce development in the human resources division at Care New England Health System and co-lead of the Rhode Island Action Coalition.

He said it will encourage more nurses to get baccalaureates—an increasingly sought-after degree by health care employers. And it will help diversify the nursing workforce because it requires applicants who attended associate or diploma programs to enroll in baccalaureate nursing programs, he added. Nurses prepared in diploma or associate-degree programs are more likely to come from underrepresented backgrounds in nursing; supporting them will help them get jobs and put them in a better position to become leaders in the field.

The nurse residency program will also help the state retain new nurse graduates, who might otherwise leave to pursue opportunities outside of Rhode Island, and it will help employers find and hire more highly trained nurses, Dunphy said. “We all thought of the program as a way of helping our graduates in the state and retaining them during a period when they could continue to develop their competencies and look for a job.”

Dunphy hopes the program will serve as a model for others across the country. “Rhode Island and the nation need a well-prepared nursing workforce, ready to meet patient needs in all settings,” she wrote in her blog post.

Capstone Achievement

The nurse residency program is the Rhode Island Action Coalition’s biggest achievement yet. The Coalition was officially recognized in 2011 and, in addition to Dunphy and Paruta, its co-leads are Sandra S. Phillips, MS, RN, NE-BC, director of education at Kent Hospital, and Donna Policastro, APRN, executive director of the Rhode Island State Nurses Association. Maureen Sroczynski, RN, DNP, a fellow with Rhode Island Center for Nursing Excellence, also works with the leadership team.

The Action Coalition has identified five priorities: advancing nurse education; allowing advanced practice registered nurses (APRNs) to practice to the full extent of their knowledge and education; cultivating nurse leaders; collecting more comprehensive data about the nursing workforce; and promoting interprofessional education.

The Action Coalition’s work groups meet regularly, and a summit is planned for September. It has made an impressive fundraising start—raising $323,000 in its first two years.

A challenge, however, has been engaging the business community, Dunphy said, adding: “We’re really making the point that health care is our ‘No. 1’ industry.”

Apart from the nurse residency program, the Action Coalition is supporting legislation that would advance the practice rights of certified registered nurse anesthetists. Another work group is collaborating with partners to build a “minimum data set” that would shed more light on demand for nurses in the state.

One of the Action Coalition’s biggest advantages is that it is operating in the smallest state in the country—at least by geographical standards. “We can get things done,” Paruta said.

Another advantage is the leadership team’s strong ties. The Rhode Island Action Coalition’s co-leads have worked together in the past, including on another unique innovation in the state: a nurse “middle college.” It offers participants the chance to attend a fifth year of high school to strengthen basic skills in math, science, and English. Students then move on to nursing schools and are more mature and more likely to succeed because of the additional year of preparation.

“We all know each other, for better or worse, and we’re able to leverage a lot of funds and a lot of initiatives,” Dunphy said. Action Coalition co-leads have also been able to build partnerships among organizations that have had more competitive relations in the past. “In some places, there are still some turf battles, but our work has also encouraged some collaboration,” she said. “The big win has been the creation of a forum to work on some shared issues.”

Learn more about the Future of Nursing: Campaign for Action and its state Action Coalitions.