Rush Nursing Residents Navigate COVID-19 Pandemic ‘With Compassion and Grace’

Rush nurse residents practice clinical skills in the Rush Center for Clinical Skills and Simulation

As we all know, this year has demanded enormous adjustments from everyone who works in health care. And it’s required special adaptability from the new graduate nurses who recently completed Rush University Medical Center’s Nurse Residency Program, who have found themselves suddenly plunged into a radically different health care environment than what they anticipated when they began the program.

The goal of the Nurse Residency Program is to support new bachelor’s or master’s degree-prepared graduates throughout the first six months of clinical nursing practice as they transition from recently graduated nursing students to competent professional nurses.

So far this year, over 100 new Rush nurses have completed the residency program. These nurses work in various hospital areas, including Rush Rehabilitation and other inpatient units, psychiatry and perioperative services.

“These amazing nurses began their nursing careers in the throes of the COVID-19 surge, and we could not be more proud of them for navigating their way as new nurses during a global pandemic. There has not been a generation of new graduate nurses who have done this in the last century,” says Mary Smith, MSN, RN-BC, NPD-BC, C-EFM, CCE, education quality coordinator at the Medical Center. Smith co-leads the Nurse Residency Program with Adriana Rumoro, MEd, BSN, RN, NPD-BC, LSSGB, in the Department of Professional Nursing Practice.

Technology helps create ‘a community of faces’

As part of the residency program, new graduate nurses participate in six months of residency meetings as part of their regular work assignment. Expert nurses lead the new graduate nurses in residency activities, emphasizing topics that integrate real-world experience with the application of evidence-based practice. 

Because of COVID-19, the Nursing Residency Program went virtual this year. To ensure the residents could meet patient needs and continue their skills development, the program paused many of the in-person residency program meetings in March and April. They switched to individual, optional check-ins for residents and resumed program meetings in May — this time via the videoconferencing platform Zoom. 

The program also uses Canvas, an online learning platform, to supplement the virtual meetings with program information and other information that is helpful during the pandemic. Canvas allows the nurse residents to access this content outside the meetings whenever they want it. General guidance for newly licensed nurses, such as time management, mental health and wellness resources and professional development resources are housed in Canvas, as well as specific skills-based knowledge for Rush’s COVID-19 precautions and patient emergency response management.

To allow for the changes, program leaders added more time to the meetings for open dialogue between the nurse residents and a facilitator. The program leaders felt it was crucial to provide a safe space for nurses to talk about their experiences during the COVID-19 crisis. They also made sure to cover safety precautions such as personal protective equipment (PPE) and universal masking — which have become increasingly important at Rush during the pandemic.

“Participating in the virtual meetings was a great way to build community. Though we went from a community of bodies to a community of faces, taking part in the open dialogue in the meetings helped us to feel less alone, which was a huge help during the beginning of the COVID-19 crisis,” says Samuel Gaines, MS, RN, one of the nurses who graduated in July and who now works in Rush Rehabilitation.  

A sense of camaraderie when new nurses need it most

Clinical nurse residency programs at most hospitals organize residents into groups, or cohorts. The Medical Center’s program previously followed this model, but switched to a rolling start model in March 2020, in spite of the changes caused by the COVID-19 pandemic.

The rolling start model, a unique aspect of the Nurse Residency Program, allows new graduate nurses to become immersed in the nurse residency community during their very first week at Rush, and to move through the program without waiting for a cohort to start, which was often months after they began working at the Medical Center under the previous model. The new arrangement allows the nurses to create a sense of camaraderie and support one another when they need it most — in their initial months of being a new nurse. 

Nurse residents have their first meeting in person (consisting of the group starting that month and usually fewer than 10 people total) so they can meet their colleagues face-to-face and practice hands-on skills. At that first meeting, the nurse residents have the opportunity to practice responding to a medical emergency in the Rush Center for Clinical Skills and Simulation. Subsequent  meetings with the larger group are then conducted via Zoom.

“Hearing each other’s stories was very important,” says Ahmad Shuaibi, BSN, RN, RRT, another nurse in the program, who graduated in August and now works in the medical intensive care unit. “It really helped to be able to see how other units were handling the COVID-19 crisis. The program also emphasized to us that help is always around and gave us the resources that we needed. That took a lot of pressure off of us and was immensely valuable.” 

Gaines echoes this sentiment: “What stood out to me was that the program leaders consistently brought in people from all different areas of the hospital to talk with us. That helped us learn quickly what resources we had, and that there was always someone to go to if we had questions.” 

Compassion and grace

“The nurse residents are adjusting to this unprecedented environment with compassion and grace, and with the mindset of continuous learning and adaptation,” Smith says. 

Some of the nurses have had their units flipped from their normal patient populations to COVID-19 units. Nurses working in Rush Rehabilitation were called upon to treat the aftereffects of COVID-19 months after the initial wave. Other nurses have seen their roles change completely, such as the perioperative services nurses who switched to other units to train staff on PPE use after non-emergent surgeries were paused back in March. 

“Our nurse residents continue to play a key role in our response to the COVID-19 pandemic,” Smith says. “In the process, they are learning so much about this disease, about nursing and about how critical nurses are to providing the best possible care for our patients during the pandemic.”. 

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