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N.J. Action Coalition launches LTC residency

Monday April 7, 2014
Susan W. Salmond, RN (left) and Edna Cadmus, RN
Susan W. Salmond, RN (left) and Edna Cadmus, RN
(Photo courtesy of Rutgers University)
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Loretta Kaes, RN
By Debra Anscombe Wood, RN

The New Jersey Action Coalition will prepare nurses to care for a growing geriatric population by creating one of the first long-term care nurse residency programs for new graduates in the country.

“There is a national shift in where healthcare will be happening,” said Susan W. Salmond, RN, EdD, ANEF, FAAN, coalition member and dean of the Rutgers University College of Nursing in Newark, which co-leads the project. “More and more healthcare will be in the community and long-term care, so preparing people for this setting is a priority.”

New graduates often seek employment in hospitals, but many cannot find positions. The coalition will develop an infrastructure for a smooth transition to long-term care.

“We are trying to promote the fact there are great experiences for nurses in long-term care,” said Edna Cadmus, RN, PhD, NEA-BC, FAAN, clinical professor at Rutgers and the state co-leader of the New Jersey Action Coalition, which works to bring the Institute of Medicine’s “Future of Nursing: Leading Change, Advancing Health” report recommendations to life.

The report recommended increasing the availability of residency programs in a variety of settings. Cadmus said she is working with nurses in two other states to set up programs.

The University of Wisconsin-Madison started long-term care intern and residency programs three years ago, but not all of the participating homes hire the residents.
“Residency programs are important because there is a huge transition for a new nurse from an education program to working in the workforce and being responsible for the coordination and delivery of care for a population of patients,” said Mary Anne Marra, RN, MSN, DNP,c, NEA-BC, a member of the state action coalition and vice president of patient care services and CNO of East Orange (N.J.) General Hospital.

After recognizing the need for long-term care residencies, Loretta Kaes, RN, BSN, B-C, C-AL, LNHA, CALA, an action coalition member and director of quality improvement and clinical services at the Health Care Association of New Jersey, applied for and received, on behalf of the coalition, a $1.6 million grant from the Centers for Medicare and Medicaid Services to fund the project.

Rutgers faculty will lead the initiative, in partnership with the Health Care Association of New Jersey, the New Jersey Hospital Association and about 20 participating facilities. The Horizon Foundation and New Jersey Chamber of Commerce also will provide support.

Nurses will manage the chronic conditions, and with better assessments and communication of changes to providers, they can intervene to prevent hospital admissions.

“The benefit will be first to the residents because the nurse will have the skills, knowledge and attitude to manage their care in a more effective way,” Cadmus said. “And it provides the new nurse resident with a safety net in having faculty support and a preceptor.”

Long-term care facilities nationwide suffer from a 50% RN turnover rate, according to the American Health Care Association’s 2012 Staffing Report. Hospital residency programs generally have reduced turnover. The University HealthSystem Consortium/American Association of Colleges of Nursing’s Nurse Residency Program reports an aggregate hospital turnover rate among participating first-year nurses of 5.6%, compared with the national average of 27.1%.

“Staff turnover equates to quality of care,” Kaes said. “This is an opportunity for our industry to seize the moment.”

Marjorie Cucciniello, RN-BC, regional clinical care coordinator for Hospicomm in New Jersey, agreed.

“It’s beneficial all the way around, not just for the individual nurse but for the facility and for the residents,” Cucciniello said. “Our times are changing. Our acuity of residents is higher, and nurses need the experience and competencies.”

Facilities will hire 50 newly licensed nurses for the yearlong program, which will include simulation and case-based training in the care of the geriatric patient and preceptorships with experienced long-term care nurses who have received specialized training as geriatrics resource nurses. The residents also will visit other settings and facilities, including hospitals, home care and hospice so they will understand issues related to transitions of care.

“We think it’s important that they understand the continuum so they can bring that back and build relationships in a broader healthcare system,” Cadmus said.
Preceptor education begins in May and resident education in June. The program will offer residencies to two cohorts of 25 nurses each.

“We’re excited about this opportunity to make long-term care desirable for nurses through this transition program,” Kaes said. “Nurses will be more confident and skillful in what they do.”

Debra Anscombe Wood, RN, is a freelance writer.


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