Beyond Nurse Residency

Collaboration in Nursing Education: Advancing Preceptor Proficiency

• Nicole Weathers, MSN, RN, NPD-BC • Season 1 • Episode 11

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Discover effective collaboration in nursing education with Heidi Keeler, PhD, MSN/MBA, RN, lead principal investigator of the Midwest Clinical Instruction Regional Network (MCIRN). Heidi shares her journey from clinical care to professional development, highlighting how regional partnerships are enhancing preceptor proficiency and patient outcomes across Nebraska, Iowa, Missouri, and Kansas.

Learn about the vital role of preceptor development in retaining new nurses and how MCIRN’s Process Precept program is leading the way. Discover the collaborative efforts of stakeholders like the Nebraska Hospital Association and Nebraska Rural Health Association in creating a sustainable nursing education structure. Heidi explains the importance of realistic, application-based training for mastering preceptorship and the difference between mentoring and coaching in nursing.

Explore the innovative training resources MCIRN offers, including live sessions, multimedia content, and interactive videos. Heidi and Nicole discuss plans for a comprehensive fellowship program that emphasizes leadership and practical challenges. Tune in to see how their efforts are enhancing nursing education and fostering a professional identity that addresses issues like incivility in nursing. This episode is essential for anyone interested in the future of nursing education and professional development.

SPECIAL GUEST: Dr. Heidi Keeler is an associate professor at the University of Nebraska Medical Center (UNMC). She received her BSN from the University of Massachusetts in Amherst, MA, a dual MSN/MBA from Liberty University, Lynchburg, VA, and her PhD in nursing research from the University of Nebraska Medical Center in Omaha, Nebraska.

Dr. Keeler is interested in the nursing workforce and professional development using entrepreneurial and innovative solutions. She is the director of the UNMC College of Nursing Continuing interProfessional Development and Innovation (CiPDI) office, which specializes in producing live and online educational products for the healthcare team. She serves as lead faculty on the Gerontological Nurse Prep Course, designed to train nurses to attain board certification in gerontological nursing. This has increased the number of board-certified nurses by over 6 percent nationally.

Dr. Keeler serves as the UNMC assistant vice chancellor for community engagement and ensures that UNMC provides a supportive system for maintaining reciprocal and mutually beneficial community partnerships. Dr. Keeler is interested in aligning professional development with academic continuums and community engagement to address the nursing workforce, with her most recent funding targeting preceptor and clinical faculty systems regionally.

She is the Program Director of a four-year grant to improve preceptor and clinical instructor training, awarded by the Nurse Education Practice Quality and Retention: Clinical Faculty and Preceptor Academy project within the Health Resources and Services Administration. This grant has produced the Midwest Clinical Instructor Regional Network and provides Process Precept training to nurses across Region 7 (IA, NE, KS, MO).

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Nicole Weathers:

You're listening to the Beyond Nurse Residency podcast, an educational series where we interview experts on all topics related to the transition of new graduate nurses into practice and beyond. I'm your host, Nicole Weathers, Director of the Iowa Online Nurse Residency Program. Thanks for joining us. Let's jump in.

Nicole Weathers:

Collaboration is not just a buzzword. It's the cornerstone of delivering comprehensive and effective patient care. In addition, ensuring that nurses and other health care professionals possess the knowledge, skills and abilities to perform their roles is fundamental to improving patient outcomes. By working together, healthcare professionals can leverage their diverse expertise to innovate and enhance their work. This will improve how we educate our nursing workforce and help them continue to develop throughout their careers, ultimately improving patient outcomes. I often wonder how much further we could go if, instead of working in isolation to tackle the challenges we face, we came together to build on our existing knowledge and share resources. Imagine the possibilities if we collaborated more closely. Where could that kind of unified effort take us?

Nicole Weathers:

In today's episode, we spotlight the power of collaboration in healthcare education and nursing professional development, learning how one group has come together to focus on advancing preceptor proficiency. Our guest is Heidi Keeler, the lead principal investigator of the Midwest Clinical Instruction Regional Network, or MCIRN, as you will hear us refer to it. Throughout this episode, we will share what MCIRN is all about, who is involved, why they are working on advancing preceptor proficiency, what they have accomplished so far and where they plan to go in the future. My goal for this episode is that our listeners will learn about this collaborative group and inspire them to think about actionable ways they can leverage collaboration to innovate and improve their work today and in the future. I have with me our guest today, Heidi Keeler. So welcome, Heidi. How are you doing today?

Heidi Keeler:

Hi there, Nicole, I'm doing great. How are you?

Nicole Weathers:

I am fantastic, so why don't you start off by telling us just a little bit about yourself?

Heidi Keeler:

Sure. So I am faculty at the University of Nebraska Medical Center College of Nursing, and I have had an interesting path in nursing where I started nursing wanting to do ER and all I ever wanted to do was acute emergency type nursing emergency type nursing quick, moving, high stakes. And somewhere along the line I started realizing, hmm, there's more to this than just the tasks, there's more to making all of this work than just what I'm doing here in the moment, and I started looking at systems levels to see how does all of this work and how can I make a difference. And, long story short, I ended up leaving clinical care and going into education because I really thought that I could make a difference, and found myself from there, moving from a traditional faculty role into continuing professional development.

Heidi Keeler:

And here is where I fell in love, because this is where you have the opportunity to bring education to practicing nurses, what they need, when they need it. And so I have been practicing in this space since 2011. So I have been practicing in this space since 2011. And I have served as the director for our Continuing Interprofessional Development and Innovation Office and, if that title tells you anything, we are really engaged in trying to push the delivery of education further, to use the burgeoning technology and systems that you know change every day, to harness those things in ways that make learning easier, faster and more effective for our patients. And so I've been in this role as director since 2016 and have enjoyed every minute of it, and so, interestingly, this is where our paths crossed, and so I will be talking a little bit more about that in a minute.

Nicole Weathers:

Thank you so much for being here with us today and sharing your expertise on this topic, so I'm really excited to jump into things. But before we get too far, I think it would be important to just set the stage a little bit for our listeners, to get them up to speed on exactly what this Midwest Clinical Instruction Regional Network is all about. So why don't you start with sharing what this actually is and maybe who's all involved?

Heidi Keeler:

Absolutely so. Two and a half years ago, approximately, the HRSA the Health Resources and Services Administration put forward a notice of a call for proposal. They were looking to address the issue of preceptorship and clinical instructor preparation in nursing and, truthfully, this was not necessarily a place that I had been spending a lot of time. My focus, as I just mentioned, was in extending and expanding continuing professional development for nurses and the extended healthcare team, but when I saw this notice of funding, I thought this is really interesting. This is a grant where it's not only our own state but it's also our region, and it's focused primarily on education of the educators, and so, as somebody in my position, this seemed like it was too good to be true. We decided that, wow, rarely in nursing do we see monies dedicated for practicing nurses. There's a lot of grants out there scholarships to get people into nursing and maybe to get them started in nursing, but, as we know, nursing education tends to be the first to get hit when it comes to budget cuts and things like that. So to have dedicated monies to do this work was beyond amazing at not just the educational components but the delivery and then the barriers and facilitators around preceptorship and clinical instructor preparation into our proposal and we're very fortunate to win the award. You know, there's the initial feelings of being elated and this is amazing, I can't wait to get started. And then the reality hits and we recognize that, yes, this is an institutional award. This is provided to our College of Nursing at UNMC.

Heidi Keeler:

However, we had a much bigger charge, and if we were going to reach out and touch as many nurses as possible in our region, then we were going to reach out and touch as many nurses as possible in our region then we were going to have to put together a structure that made it warm, inviting, welcoming and collaborative.

Heidi Keeler:

And so I loved your intro, because collaboration truly is the only way forward in this issue, in nursing and in many others. So, in the spirit of collaboration, we worked really hard for the first year, just imagining what this should be, what it should look like I mean literally what it should look like, what it should sound like, what impression people would get when they heard about our initiative, and so, after many iterations and many sketches and many failures, we finally came up with the name the Midwest Clinical Instruction Regional Network, or MCIRN for short, and we love that name because it's a nod to registered nurses, our profession, that MCI RN portion, but it also recognizes the interprofessional nature of clinical instruction and preceptorship, where every profession has, to, you know, onboard their new clinicians. And so, although this is nursing focused now, our name indicates that we're welcoming for other perspectives and professions in the future.

Nicole Weathers:

I love that. And I want to just go back and you know you talked about how. You know you were really focused on the professional development aspect, innovation. How are we getting nurses in practice the education they need when they need it? How are we getting nurses in practice the education they need when they need it?

Nicole Weathers:

And I think this idea of preceptorship right is so key because, yes, we can develop the curriculum and we can do all the things, but when nurses are taking new roles, it's really that preceptor who's charged with helping them learn the role at the end of the day. So they can sit in a classroom, they can get that education online, they can do all of the things, but that one-to-one sort of relationship that we use in nursing so frequently to teach people how to do their job I mean, that's really where I think the magic happens. So I love that your path brought you here. And then now we're actually able to focus on how do we help develop those individuals to really do the work that we need them to do, and preparing our nursing workforce for the listening and I haven't talked about this before.

Heidi Keeler:

So this is an exclusive for this podcast when we think about the onboarding of clinicians and the professionalism of nursing. I had a much different experience onboarding than most nurses, so I went into nursing and my first role was as an Air Force nurse.

Heidi Keeler:

When the nurses were onboarded in the Air Force at the time, there was a transition program established and essentially it was a preceptor program with all the surrounding support systems. And so that was my experience moving into the profession is that there was a built support system, there was a built culture, there was a built curriculum, there were dedicated personnel that were interested in our success, not just as clinicians but as officers. And this is the component that I think is not to be ignored with nurses. Yes, we want them to have their clinical skills. Yes, we want to grow their clinical reasoning and critical thinking. However, there's another component to this, and that is the professionalism and the leadership. And how do we tackle hard situations? And I received that training and in fact, we were professionals first, we were leaders, we were in charge from the moment we stepped on the floor, we were the charge of the team, and that was the culture.

Heidi Keeler:

And so, in getting this grant and establishing MCIRN, and we started to really dig into what do we know about preceptorship, what do we know about the preparation and the onboarding?

Heidi Keeler:

Well, you and I both know that this is not a new idea.

Heidi Keeler:

This has been around for decades and MCIRN was not going to roll in and like recreate the wheel right, but we did notice something. We noticed that in performing a needs assessment across our state and eventually the region, and in really digging into the literature, there wasn't a whole lot written about the entire package like I just described. That I experienced, and I think the biggest part that was missing was this professional identity piece. That's a term that I didn't know existed until doing this work, but we tripped upon the work by Dr Nelda Godfrey down at KU, and the professional identity of nursing is definitely a concept that is not only in line with the onboarding of nurses by preceptors, but also in line in every component of professional development and in professionalism and in wellbeing, and and and and. To further push this point forward, if you were to ask other colleagues and other professions their views on preceptorship, you'll find out that they're a lot different than nursing, and so therein lies one area that can definitely better support our new nurses.

Nicole Weathers:

Excellent. So you've talked a little bit now about what the Midwest Clinical Instruction Regional Network is. So tell us again who's involved in this. So it's UNMC, but you spoke to how it's maybe broader than that, right, and you wanted to really look to collaborate. So tell us a little bit more about, kind of the current stakeholders that are working on this initiative.

Heidi Keeler:

Right. So I think that one of the things that differentiated our proposal from others was that we really knitted a very strong community engagement component into our grant, in that we talked about having a true regional collaboration, and we started in Nebraska, where we partnered with our Nebraska Hospital Association, our Nebraska Rural Health Association, our area health education centers. We connected with our Nebraska Organization of Nurse Leaders, our Nebraska Nurse Practitioners, and had a little bit of conversations with our Center for Nursing too, and so in really talking through all of this, we were genuinely interested in creating an entity that could collaboratively address the issue of onboarding of new nurses and preceptorship and clinical instruction, because we were very aware of the fact that we couldn't do this alone and no amount of money that was coming from the federal government was going to change that. We needed to create something with this grant that was going to sustain well beyond the initial push, and so with this structure, we kind of replicated it with the rest of the region.

Heidi Keeler:

Not every region has entities that are structured the same.

Heidi Keeler:

That was something that we had to learn that each state puts their structures together in a different way, and this is why creating something that was mutable and accessible, regardless of how you structured your nursing, professional development, your oversight, your board of nursing, your collaborators, et cetera that we needed to create something that worked for everyone your oversight, your board of nursing, you know, your collaborators, et cetera that it was that we needed to create something that worked for everyone.

Heidi Keeler:

Now, admittedly, nebraska Medicine was another one of our partners, in fact, our closest partner. We operate across the street from one another and we share the same institutional logo, so they are definitely our close partners and they have a lot of experience in preceptor development, onboarding of new nurses, and so we really looked to them to help us get started and to serve as experts. But then we realized too, as we moved our work across the state and across the region region that every clinical facility is different and needs a slightly different structure and needs to edit to fill their needs. That said, we know that there's common components to training that are needed regardless of your setting, but those need to be applicable to where you're practicing. So we've learned a lot and this collaborative approach has really benefited the final product.

Nicole Weathers:

Excellent. And when you say region, what is the region that you're talking about? So, outside of Nebraska, who else is involved?

Heidi Keeler:

Yes, so we're operating according to the HRSA regions, and this is Region 7, which includes Nebraska, iowa, missouri and Kansas.

Nicole Weathers:

Okay. So I think we've got a little bit of the lay of the land here, what it is, who's involved. You kind of started to get into this where you were talking about, maybe, why we wanted to focus on the development of preceptors. But maybe we could get into that now a little bit more. So the grant was out there. You applied for it because you knew how important it was. Maybe in general, let's talk a little bit about why do we have to worry about preceptor development? So in our program, you know, really focused on the development of new nurses, and one thing that we identified several years ago too, was a nurse residency program alone isn't going to solve all the problems with new grad retention. Right, there's a lot of moving components to helping them to be successful. So let's get into that now.

Heidi Keeler:

So, again being Nebraska-based, we initially had a pretty small circle of vision. We looked across our own state to see what we had, and we did not have a statewide preceptor or clinical instructor product. This was how we were entering into this development of our initiatives. However, when we expanded our vision regionally, what we found is that we, as Region 7, are extremely strong in developed preceptor products and expertise, and so this is why we're talking today, because of the fact that you have this developed program, you have this podcast that came out of these initiatives, and the essential nature of having something accessible to nurses is well established. And similarly, in Kansas and Missouri there is a preceptor academy that kind of looks at the same things.

Heidi Keeler:

That said, we also know that one-time training doesn't necessarily work, nor does didactic training work without application.

Heidi Keeler:

So as we looked around, we could see that the development of training for preceptors and clinical instructors kind of stopped after the initial training.

Heidi Keeler:

So we know that we need to repetitively expose nurses to situations so that they can figure out how to respond, so that they can apply the knowledge that they had received to real situations, and so we have started to create a series of application challenges so that nurses kind of artificially get exposed to these situations before they happen, so that nurses can figure out okay, how would I respond? What concepts would I apply here? How can I make this smooth and as comfortable for my new orientee as possible? And not only using the mental concepts, the didactic concepts, but also knowing how to respond emotionally, being able to have self-regulation and role modeling, professionalism as you're responding to these situations. So we decided to create these, and this, I think, is the addition to the regional resources that MCIRN will offer, in that it follows the principle of repetitive training, it uses application level information and delivery mechanisms and it extends training over time to push nurses towards preceptor mastery.

Nicole Weathers:

You know, I think in practice sometimes what happens and I don't think I know in practice what happens is we have a really good clinician and we say to ourselves we have this new nurse person, new to this role. They need to learn how to do the job. This person's really good at their job. Let's just put them together and one will teach the other what to do. And what we know now is that just because you know how to do a job doesn't mean you're necessarily great at teaching somebody else how to do the job.

Nicole Weathers:

And so this idea of actually focusing on some of that didactic knowledge of what does it actually mean to be a good preceptor is key and, as you said, it can't be a one and done. Just like we don't learn how to be a nurse perfectly the first time, we're not going to learn how to be a preceptor perfectly the first time, and so we need that opportunity to practice, to come back to the concepts, to apply the concepts, etc. So I just love that this group is focusing on that and they are helping others in the region have the resources to do the same, because I know for us, for instance, we were able to develop our initial preceptor training, which is a great solid foundation, and we had funding, much like yourself, to do that. But then, moving forward, it's like, okay, what do we do and how do we get more of this? So this is a great, great solution and I'm really excited that it does exist for us as well here in Iowa.

Heidi Keeler:

It goes back to your original statement of collaboration. So we do not have unlimited resources. We don't have the luxury of having everyone on this issue that needs to be on this issue to change, to create transformational change in the onboarding of nursing. But we tend to be siloed and we tend to do the best that we can in our silos and we end up doing repetitive work.

Heidi Keeler:

One of the true missions of MCIRN is we don't want to just recreate the wheel. We know that there are experts across the nation that have a handle on. What do you need to know to be a good preceptor? So we very intentionally shifted a lot of our resources towards extending what this region already has and hopefully extends what nursing as a profession has across the nation, in not just the didactic but in the application of the skills.

Heidi Keeler:

Like you said, we're trying to use the same principles that we use with our students when they're learning nursing, with the preceptors who are learning preceptorship. And you're right, it is a different skill set and it is definitely something that some people are born with it, but they're actually, if you're born with it, you're practicing certain skills that you have innately picked up, but other people can pick them up when they're delivered to them in this way and I'll give you just one short example, because it's something that preceptors talk about all the time, like when do I just jump in and when do I let them struggle and possibly let the patient get irritated or whatever, and so the difference is the concept of mentoring versus coaching.

Heidi Keeler:

You know, a mentor can come in and take over and show you how it's done and really take charge of a situation, and then the preceptive wants to be like them, they want to be like their mentor. It's like role modeling Now. A coach, on the other hand, is someone who asks you the questions, asks the preceptee the questions how do you handle this? Let's dig into your knowledge base. Let's put two and two together. It's just a different mindset. Nurses are trained to take care of issues and to take care of them quickly, efficiently and to the best experience of our patients. That doesn't apply when you're bringing a new nurse into the fold.

Nicole Weathers:

You need to take a different approach, and so something as simple as that just being made aware of the difference and how you can shift intentionally makes a world of difference for the person who's being onboarded, shift intentionally makes a world of difference for the person who's being onboarded, absolutely so in the last few months, you know, we've had a chance to visit and I'm I always feel like I could learn a little bit more about your group. But if I remember correctly, you received this grant you said about two, two and a half years ago, and you've been really busy ever since developing this. So tell us maybe a little bit more detailed now what you've done in the last two and a half years. That is kind of out there and has been available.

Heidi Keeler:

Right. So I mentioned the evolution of MCIRN earlier and and I told you that we thought a lot about what it sounded like and what it looked like, and so what it looked like is actually important. You can't really see this on a podcast, but we worked a long time on our logo too, and our logo, which I invite you to check out on MCIRNcom it looks like like a chat box, only it's got three colored nurses on the inside of the chat box and the chat box itself is made up of the earbuds of a stethoscope. So we really love that because, again, it indicates collaboration, the learning together, the stronger together, all the concepts that we know are going to make nursing be able to join hands and address these issues together to get to success.

Heidi Keeler:

So our first step, like I told you, was we didn't have an accessible training program in Nebraska, so we created our first product, which is MCIRN Process Precept. And Process Precept is aimed towards the preceptor level orientation of new nurses updates. And we called it that because we knew that there were nurses that were already precepting. They might have already gotten training, but they didn't know what the state of the science or the developments in precepting may have been, since they received their initial training themselves, whatever that looked like. If they didn't receive any training, well, this would serve as that. If they didn't receive any training, well, this would serve as that. But this also was designed just to bring everybody to the same place and the same thinking and the same recognition of the concepts that would lead to success. That Sigma, theta Tau had a book out called Mastering Precepting and inside it had a model which Beth Ulrich crafted and put together using all of the literature up to date in that book and in that model, and since then it's had several editions published, with the most recent one being last year. Then we noticed that the ANPD, the Association of Nursing Professional Development they picked up the model and did a nationwide survey on what are the roles and the jobs and the tasks and what does the job of precepting really look like? And what they were doing is comparing the model the all rich model with what was coming in from the field, and with that they developed competencies. We also looked for what is the standard for the expectations of nursing to bring up the next generation versus eating our young and I hate that expression, but it's true. Incivility in nursing is a real thing and we had to find a way to ensure that the preceptors weren't doing that unintentionally, and that's when we found professional identity in nursing. As I explained earlier, we put all of those together into our first product and it resulted in a six-hour live training that our hospital association and rural health association and Nebraska Medicine help us to deliver across the state. This process Precept Need to Know Skills Update is available for any of our regional partners. However, we're very respectful of what's already in place.

Heidi Keeler:

Then we upgraded process precept using our own iExcel building, which is dedicated towards simulation and virtual learning, and we created videos that we incorporated into our live training. And my favorite part about this, nicole, is it includes voices, like from your colleagues, and there's just a series of preceptors and preceptees that kind of talk about their experience, and then the learning comes from dissecting what concepts are actually truly underpinning what's coming out of their mouths. It's really fun, and the same goes for the situation videos. We extended further. We did another batch of videos with the intention of creating these oh no situations in preceptorship.

Heidi Keeler:

This is our advanced concepts training, and so for every video we have a couple of concepts associated with that video that you can apply to the situation and we have a couple of expert preceptors like talking about the situation and the learner learns through this very interactive, multi, multimodal type of training module. In the future we're looking to create a fellowship where we string all of our trainings together to include a component on what to do when you're precepting a student, some deep dives into a few concepts such as leadership, and then knitting it all together with an application challenge at the end. So it's been a very busy. We're coming to the end of our second year and we're entering into our third year come the 1st of October. But we've been busy. We've built a lot, but we have a whole lot more to do.

Nicole Weathers:

It sounds like it.

Nicole Weathers:

I just love the idea of hearing from real life preceptors out there in the field, having experts talk about those themes that are coming out of their testimonials, if you will, and really focusing on that application piece, because I think that's one thing that sometimes we miss is it's not just about the content, right, but it's about how do I actually apply the content when I'm out there in front of a patient with a new nurse, trying to help them learn their role.

Nicole Weathers:

So you've done a lot of really amazing things. I think you've got a lot of really amazing things in the next couple of years that you're going to get done, and I can't wait to kind of see the end result of all of this. So I really appreciate you sharing about this great initiative and all the great things that you've done so far. So if we have listeners in Iowa, nebraska, kansas or Missouri and they haven't heard about you, or they want to learn more about what you have to offer, or they want to get maybe involved in what you're doing, where should they go or who should they contact?

Heidi Keeler:

Well, first of all, I want to make sure that all of the listeners know that this is not necessarily a Nebraska thing. Yes, we are overseeing the construction of the products and things like that, but we definitely are interested in bringing anyone who is interested in helping. We're interested in knitting together the existing products. For example, I know that you have a preceptor program here in Iowa. We're certainly interested in bringing nurses through that program and into some of the advanced challenges that MCIRN has. I fully expect that partnership is the way that we train ourselves into a better workforce.

Heidi Keeler:

If you want to find out more information, you can go to MCIRNcom. We don't have everything posted on there yet, but we do have some basic information. You can see that logo and we also have worked really hard to highlight what every state in the region is doing. So no matter what state you are in the region Nebraska, iowa, kansas or Missouri you've got a spot in MCIRN and you can highlight the good work that you've been doing. Our vision also is for experts and anyone who really is interested in preceptorship.

Heidi Keeler:

If you want to contribute to this. We don't want to steal your intellectual property. We definitely want to give attribution where attribution is due. But if you want to share something on this website, you can do that, and also we're setting up a community where we can come together and discuss these issues, kind of like a listserv blog kind of thing to create a community, because sometimes, especially across our more rural places across the region, you feel kind of alone and you feel like you don't have the resources that you need or want or dream about, and so we want, again, it's that collaboration.

Heidi Keeler:

That's the underlying theme of all of this, and we definitely invite new ideas, new thoughts about collaboration and new direction in this too. We do know that we have experts in our region who are working on the technological aspect of this how to better deliver education, what are the preferences of preceptors when you know, when trying to get the information that they need. So there's just so much talent in this region, and so MCIRN just wants to bring it all together and bring a huge spotlight into these solutions for all of our nurses.

Nicole Weathers:

Excellent. Well, we have talked about so many wonderful things today. We you shared with us you know us the basics around MCIRN, who's involved, why we are looking at advancing preceptor proficiency, and what you've done so far and plan to do in the future. So thank you for sharing all of that with us. But before we go, I do have one last question, and I tend to ask this of all of our guests.

Nicole Weathers:

So, when it comes to this topic so preceptors and we could be talking about either students, new grads or even advanced practice registered nurses I know we haven't talked a lot about that today, but that's also kind of a piece of this potentially moving forward, piece of this potentially moving forward. So what is one thing that maybe you often see organizations either doing wrong or wasting resources on that you really don't feel like is making a difference, and what would you tell them to do instead? Or, on the flip side, if you want to take more of a positive approach because I kind of like to take a positive approach what's one thing that you are seeing that seems to be making really significant impact for these organizations when it comes to this idea of preceptors?

Heidi Keeler:

I think there's I know you say one thing, but this is one thing. That's kind of an interconnected combobulation of a couple of things. We have such a push in the nursing profession to get clinicians out on the floor as fast as humanly possible because we are the link that patients have with getting care for their very complex situations. Nurses are always in demand. There's, I guess, an exodus of nurses from the bedside that has been kind of systemically influenced and I think part of it is because there needs to be. We need to slow down and we need to ask ourselves as a profession how do we make sure that we successfully onboard new nurses and get them to a place where they feel comfortable and prepared and resilient to continue to do the work that it takes to be a bedside nurse or a clinical nurse or any nurse that is involved with patient care, because patients are difficult to take care of, just due to the complex needs that they have and the emotional states that we have to deal with, just the very difficult nature of the job. And we can't just think that getting them clinically prepared is enough. We have to give them onboarding by preceptors that know what they're doing and have the skills themselves, to be able to bring up these skills clinical and professional and resiliency in our new nurses.

Heidi Keeler:

Now this is a systems problem. This isn't only a nursing problem. This is a hospital administrator issue, this is a nursing education issue, this is a payor issue and this is a patient issue. So I think when we talk about collaborations, it's not going to be just us that solves this issue. We have to start reaching out and extending into those areas and getting buy-in that this is important and this needs to be funded and this needs to be supported, because everyone will be a patient at one point or another and they want to make sure that their nurse is prepared in all ways to handle whatever their medical condition might bring up at the time.

Heidi Keeler:

So, I know that was a really long answer and it wasn't a simple solution, but I think this initiative is the start to that. You did talk about APRNs. When we talk about preceptorship with that demographic it's even more dire than the RN level, and MCIRN does have an initiative to look at preceptorship in APRN training, but that's for another day. But the principles are the same. This cannot be an issue that a couple dollars get thrown at it and the solution will find itself. It has to be a systems level change. So that's what we're trying to do and we're just going to keep marching on towards that dream, because our patients deserve it. We deserve it as nurses and society truly deserves that too.

Nicole Weathers:

Well, thank you so much, Heidi, for sharing your expertise with us today and sharing all the great things that you've been involved in with the MCIRN.

Heidi Keeler:

Well, thank you, Nicole, and I'm going to say the same to you Thank you for your over a decade of work paving the way for the rest of us and making sure that nurses in Iowa have the very best. So hopefully we can learn from you and again better together, right.

Nicole Weathers:

Absolutely. Wait. Before you go, I want to make sure you know all about our suite of resources you can use to support your new graduate nurses. This includes our academy, a coaching program designed for organizations as they prepare for the implementation and ongoing sustainability of a nurse residency program. Work one-on-one with residency program experts to make sure your organization is residency ready. Our clinician well-being course is an asynchronous online course that aims to enhance the well-being and resiliency of healthcare professionals, equipping them with the necessary psychological capital to navigate challenges inside and outside of work.

Nicole Weathers:

Supporting nurses is another asynchronous online course for preceptors, mentors and coaches to learn the skills they need to support any new hire. Both of these offerings can be used as a standalone professional development opportunity or to augment any nurse residency program. And we can't forget about the program that started it all the Online Nurse Residency Program. This includes a comprehensive curriculum designed to support new graduate nurses, applying all the knowledge they learned in school to their practice. We focus on professional skills, personal well-being, competencies, and new graduate nurses even get the opportunity to create real change in their own organization. Offered completely online and in a blended format, this program is highly adaptable to all clinical practice settings. You can learn more about all of these programs and more of what we offer using the links in the show notes below.