Westfields Hospital & Clinic, New Richmond, 2023 Workforce Report

New Graduate RN Residency

“Code Blue and You” Day at Westfields Hospital

Westfields Hospital & clinic is a Critical Access hospital in New Richmond, Wisconsin, located approximately 30 miles east of the Twin Cities. This close proximity creates a hiring challenge for us.  Experienced nurses can work in a higher level of care setting and earn more money for a short commute.  

Historically in a small hospital we could support one or two new graduate nurses, but not more than that in order to retain a good mix of experienced, skilled nurses and new nurses using our orientation model. When we had positions posted, we found that our applicants were all new graduate nurses. In order to hire nurses to fill our open positions we needed to be creative and figure out a way to bring new graduate nurses to our team. 

We have also experienced a higher average daily census (ADC) over time. Moving from an ADC of 8 to 12 over a year we needed to do something different.   

Our department nurse educators got busy figuring out how we could create our own New Graduate Nurse Residency program to help us bridge this hiring gap.   

This team looked at several models that are published. They took what they thought could work in our setting and built a program. They wanted to ensure that they not only covered topics like skills development and competency assessments, but also critical thinking, effective communication skills, time management, socialization within the team. They provided a place where new nurses could feel safe in expressing their fears, their successes and their moments of feeling really dumb. This program was created to span the first year of employment for the new graduate nurse.     

We were very fortunate in having five certified nursing assistants who were completing RN school in the spring. They were willing to be the pioneers in this program. They all went through a panel interview and were hired. We had five new grads on our team!  

These new nurses established a close bond with each other and the education team. The department educators ensured that the new nurses had consistency in preceptors, they tracked their competency progress and made sure that they were continuously being exposed to learning opportunities. The piece of the program that really makes a difference is the “residency days” where they meet as a group. There is structured learning, sharing of experiences, team building tears and laughter shared.   

We have been able to retain all five RN’s. One now has a casual position with us as she wanted to pursue experience in a larger organization. I credit the strong residency program for this success. These nurses are fully integrated into the team and are viewed by their peers and physicians as highly qualified RNs and great team members. The department educators have instilled the lifelong learner mentality in them and it brushes off on our other staff. We now have seasoned staff asking if there are sessions within the New Graduate program they could attend.   

This program has been refined over the past year to meet our needs. We have six new graduate nurses preparing to start this program in mid-January. We continue to be excited about where this program will take us in the future and we know that our new team members enter the nursing profession with a new level of support and confidence.   

The photo is of the “Code Blue and You” Day. This included discussion, education, simulation and debriefing in a controlled setting. The graduate nurses in the residency had the opportunity to work with a couple more seasoned nurses. The learning and teamwork were irreplaceable.