Health & Wellness

Holding the Front Line With a massive shortage around the corner, LGMC’s Nurse Residency Program aims to keep first-year nurses from fleeing.

by Christiaan Mader

Photo by Robin May

When the last boomer punches out for retirement, more than 77 million people will have left the American workforce for pasture. That means a massive increase in demand for treatment associated with an aging population. More hospital visits, more surgeries, more accidents and more complicated inpatient treatment regimens will stretch an already thin primary care workforce. It’s the cost of living longer. The glut of new demand for care will arguably lean hardest on registered nurses — the front line of the medical workforce, and one already facing a long term shortage caused by high rates of turnover and ballooning demand.

Photo by Robin May

Hospitals like Lafayette General Medical Center are trying to close the gap with residency programs designed to acclimate new nurses to the evermore-complicated world of modern ailments.

While the shortage hasn’t hit home yet — the boomer shortage isn’t set to roost for a few more years — LGMC has attacked turnover aggressively. LGMC just enrolled its first class of 11 nurse “residents” this past April. They are set to graduate in February of 2017.

The program pairs the recruits with mentors for guidance and professional support. Nurse applicants operate day to day as full-time, paid nurses, but the residency workshops and mentorship elements give the recruits essential coping tools.

“We focus on topics that matter at the bedside,” says Crystal DeCuir, LGMC’s nurse residency director. “Our goal is to help them transition from being a novice nurse to being more confident and competent.”

Residency promotes a live clinical setting rather than working around the proverbial drawing board, enabling nurse recruits to get crucial “clinical reasoning” skills like stress management for themselves, pain management for patients, and to develop trust and rapport with veteran co-workers.

Most nurses who leave the profession struggle to adapt to clinical realities for which the classroom simply didn’t prepare them. Patients report to American hospitals with increasingly complex systems of ailments and consequently gruesome or trying treatments. Long hours spent unraveling tangles of disease account for most of the burnout seen in the nursing workforce.

With simple support elements like peer-supported journaling, experiencesharing sessions or workshops covering issues of practical import, residency programs like LGMC’s ease new nurses into the trying hospital environment.

The Bureau of Labor Statistics projected that the U.S. will be looking to hire 1.2 million new nurses in 2025 due to demand growth and loss to retirement of experienced nurses. A 50-state report card produced by the University of Nebraska estimated that Louisiana would be short 213 nurses per 100,000 citizens by 2030. That earned the state a predicted “D” grade for 2030.

DeCuir says shortages and high turnover have real cost to hospitals. She estimates that each nurse lost costs the hospital system around $88,000. LGMC lost 13 percent of its 2015 recruits, well below the national average but still not where LGMC wants to be. Long term, DeCuir says LGMC hopes to achieve accreditation and open its residency program to nurses incoming to the other six Acadiana-area hospitals in the greater Lafayette General Health system.

Nationally, residency programs like this have been very successful at addressing turnover. Programs at schools like Johns Hopkins University in Baltimore — which uses the same curriculum at work at LGMC — have seen retention rates skyrocket to close to 95 percent. Hospitals without this kind of training typically hover around 75 percent retention of first-year nurses.

Given how successful these programs are, it’s a wonder that more hospitals have not adopted them. DeCuir points to cost as the primary obstacle to adopting residency programs for many hospitals, but says that LGMC sees the added expense as a worthwhile investment in quality of care.

“It’s an investment of time and resources,” she says. “But it’s the right thing to do.”