Helping new nurses build skills and confidence

To better meet the needs of our newest nurses in a post-pandemic world, nursing leadership made important changes to the UW Health Nurse Residency Program and Nurse Externship Program.

Nurse Residency Program

UW Health implemented the Vizient/American Association of Colleges of Nursing Nurse Residency Program for inpatient care in 2004 and added a nurse residency for ambulatory care in 2021. Through the residency program, newly hired nurses train for 12 months alongside experienced colleagues following graduation from an accredited nursing program.

This intensive training has become even more important in recent years.

“At the time COVID-19 was happening, we thought it was an intense in-the-moment experience,” said Kim McPhee, MS, RN, NPD-BC, who has coordinated the program for 17 years. “We thought we’d return to normal, but what was considered ‘normal’ has changed.”

Graduating nurses are much less confident about their skills and much more anxious. “It’s normal to feel anxious transitioning from student to professional nurse, but we were finding ourselves triaging acute distress situations we had never experienced before,” said Molly Daniels, MSN, RN, CMSRN, nursing education specialist, who supports the inpatient residency and externship programs.

UW Health is one of a handful of organizations in the country to offer a nurse residency for ambulatory care. A special focus on telephone triage training helps build assessment skills and a strong foundation for new nurses who may not always see patients in person. Terri White, RN, MSN, NPD-BC, nurse education specialist, supports the Ambulatory Nurse Residency Program. With feedback from their UW–Madison School of Nursing colleagues and recent graduate nurses, Kim and Molly made changes to the inpatient program to help nurse residents build stronger skills and a community of support. New resident orientation includes more skills-building training and is now offered in longer days, and monthly classes were moved so everyone could meet as one large group. Additionally, the well-being series was expanded and is now included in monthly classes.

In addition to receiving guidance and support from preceptor Carolyn Kerkhof, BSN, RN, Trent Briggs, BSN, RN, nurse resident, has found great value in the enhancements to the UW Health Nurse Residency Program designed to build confidence, skills and resiliency.

Nurse Externship Program

UW Health relaunched the Nurse Externship Program for student nurses in 2022 and made changes to improve the program experience. During the 10-week immersion program, student nurses work alongside an RN clinical coach and perform hands-on patient care in a variety of adult and pediatric inpatient and ambulatory settings. It’s become an important feeder into the nurse residency program and enrollment numbers more than doubled in 2023. New in 2024, UW Health will begin accepting associate degree nursing students who are internal applicants, and program onboarding will be streamlined to account for existing employees moving into the nurse extern role.

The results are positive

Data shows that the Nurse Externship Program has had a positive impact on recruitment.

YearNurse externsNurse residentsNumber of externs hired as nurse residents
202229 inpatient
1 ambulatory
203 inpatient
12 ambulatory
202363 inpatient
12 ambulatory
225 inpatient
16 ambulatory

The UW Health Nurse Residency Program benchmarks with other Vizient nurse resident programs across the country and our scores from 2023* are above the mean in many areas:

  • UW Health nurse resident retention is 94%, compared to 84.8% nationally
  • Nurse resident transition to practice has shown a consistent improvement in several areas, including comfort with clinical, organization and prioritization skills, as well as overall perception of their transition into a professional nursing role
  • Scores for perceived support from preceptors, nurse resident coordinators, facilitators and nurse resident seminars are above the national mean scores at year-end

* Data represents nurse residents who were hired in 2021 and completed the year-long Nurse Residency Program by December 2022.

Check out more stories featuring the great work of our nurses in the Nursing Year in Review 2023 (pdf).