"I was banking on the clinical training," said the former social worker, 39, who hoped the real-world experience would boost her skills and confidence en route to a new career as a registered nurse.
As it turned out, Brooks got less than half the clinical time she expected in school — a situation not unusual for pandemic-era graduates. She emerged unsure what kind of nursing she wanted to practice and even if she was ready to begin.
She found the clarity and direction she needed in Novant Health's RN residency program for new nurses.
Since 2017, the nationally accredited program has helped nearly 3,000 nurses launch their hospital careers. Brooks, who quickly found sure footing at Novant Health Forsyth Medical Center in Winston-Salem, is among 600 participants this year.
Each receives extra support during what can be a stressful transition from student to professional.
"They get out of nursing school and … they're so excited, and then about six months in, they're like, 'I'm a nurse, it's hard, what have I done?' " said Tracey Whitley, co-manager of the program. "If we can get them to the year mark, if we can help them navigate that current, then typically they will soar and do really, really well."
Of note, an independent review of Novant Health's Nurse Residence program ranks it among the nation's best.
It is accredited with distinction as a practice transition program by the American Nurses Credentialing Center. Just one other health care system in North Carolina has received this extra vote of confidence.
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Finding the perfect fit
During that time, residents get regular training on the job and online, and each is teamed up with an experienced nurse preceptor, or mentor, who serves as coach, counselor and cheerleader. The partnership helps ensure new nurses aren't afraid to admit what they don't know and ask for help: For some, it can be harder to be vulnerable with a supervisor.
In addition, residents are invited to rotate every 12 weeks within their specialty area to different units in the hospital or market they are hired into. For many, it's an ideal way to find a perfect fit. Specialty tracks include adult acute care; cardiac; critical care; emergency; behavioral health; women's and children's; and surgical services.
"We're finding that this generation really likes options and flexibility, and this gives them that," said Lindsay Horne, program co-manager. "We want to make it a great experience, and ultimately, to retain these amazing nurses."
And that's smart business. Nationwide, competition for the best and brightest RNs is intense, because more are leaving the profession than are coming in.
The exodus dovetails with a major demographic shift that is straining the nation's health care system: The population of aging and chronically ill Americans is growing fast. Through 2030, the U.S. Bureau of Labor Statistics forecasts 194,500 openings a year, on average, for registered nurses.
That's why "we really want to retain these team members and make sure they're successful," Horne said.
The investment is reaping big dividends, she said.
About 86% of nurse residents hired at Novant Health stay at Novant Health, according to Horne. And though that's down some from pre-pandemic levels, when the retention rate consistently topped 90%, it far outpaces the rate across the Southeast, which hovers in mid-70s.
Current and former nurse residents are thankful for the firm foundation the residency program provides.
"Nursing school just teaches you the basics — it doesn't really teach you the day-to-day reality," said Brooks, the Winston-Salem nurse.
Though she started work unsure what nursing specialty to pursue, her first rotation, in the medical intensive care unit, turned out to be just what the doctor ordered. Brooks finds great satisfaction in treating seriously ill patients and comforting their families.
Her preceptor, or mentor, regularly steers her to units where something she needs to learn more about is unfolding in real time — how hospital teams respond when a patient codes, for example, or learning details about a form of cardiac arrest treatment called targeted temperature management.
"I'm still learning, and I'm now a year in," said Brooks, who graduates the residency this summer.
Learning to master pressure
Anderson Moore, 27, who completed his residency last year, practices in the neuroscience intensive care unit at Novant Health Presbyterian Medical Center in Charlotte.
He started the first of his three 12-week rotations in February 2020 during the initial wave of COVID-19. Back then, it wasn't clear how SARS-CoV-2 spread, death rates were staggering and hospital beds would fill as soon as they emptied.
Just getting through his daily to-do list was a grind, never mind finding time to calm a panic-stricken patient or just catch his breath and reflect, Moore said.The pressure could have destroyed an inexperienced nurse.
"Coming out of school, I was very task-oriented," he recalled. "If I could check off the boxes, I felt like I had a successful day, but if things deviated from that list or things got added to it, I could get overwhelmed."
His preceptor's prescription: Pause. Look at your patient. Is he or she OK? Do you need to do anything? And then, depending on what you see, take action. "The worst thing you can do is just stop and freeze," Moore said, "because nothing's going to get done."
It's a proven stress-buster that he still relies on in his current role as a charge nurse.
Why become a Registered Nurse at Novant Health in North Carolina?
- Named one of the nation’s 150 best places to work in health care by Becker’s Hospital Review.
- Leapfrog grade A ratings.
- Leadership development programs.
- Eight Magnet-Designated medical centers.
- Designated as Best Places for Diverse & Women Managers to Work by Diversity MBA Magazine.
- Team Approaches in Quality Improvement Award Recipient from the Society of Hospital Medicine.
- Recognized by CMS for quality and safety with six 4-star and two 5-star Acute Care facilities.
‘These things stick with you’
Cailyn Negus, who works on the same unit, was so pleased with the coaching she received during her 2018-19 residency that she became a preceptor herself.
"There are little references I will use to help residents remember something more easily. After saying it aloud, I think to myself, 'Oh my gosh, this is literally what my preceptor said to me when I was in training,'" she said. "It just shows that these things stick with you, and they help you in your everyday practice, which is so important."
Negus, 26, moved to North Carolina from upstate New York, where she grew up and was educated. Though Novant Health wasn't the only health care system that interviewed her straight out of school, the welcome she received proved impossible to resist.
"It seemed like Novant Health had rocking chairs on their front porch, and just wanted to welcome you in and get to know you," she said. "I knew that for my first job, especially, I wanted to be somewhere that valued me as a person, not just an employee."
Viva Matthews, 24, is among her most recent mentees.
Matthews said she is grateful not only for the classes and support she received early on but also for preceptors like Negus who gave her more freedom as her skills grew and she became more adept and at ease in her work.
Best of all, Matthews' residency made up for something she missed out on in nursing school.
"I never actually got a critical care rotation in nursing school, so that was definitely a deficit, because I knew I wanted to do critical care," she said.
Tools for now … and the future
The residency aims to fill significant educational gaps like those, to reinforce what newcomers have already learned, and then to school them in the "Novant Health way," program co-manager Horne said.
"We strive to make sure that we're giving our residents tools not only to be successful at the bedside, but also to be successful as a nurse for their career," she said. "After all, nursing is not just a labor task, it's a profession."