National Nurses Week 2025 - The Power of Nurses™

Welcome to a special Nurses Week episode of the Beyond Nurse Residency Podcast! In this episode, we celebrate the incredible Power of Nurses™, the heart and soul of healthcare. Hear from three program coordinators and their residents who utilize our all-online option, sharing their experiences and insights into our residency program.

SPECIAL GUESTS:

Family Health West Fruita, CO

Ashley Veik, RN
Current IONRP resident - April 2024 Cohort
Ashley Veik is an RN working at a critical access hospital. She has been out of nursing school for over a year. Before graduating with her bachelor's in nursing, she worked as an LPN for a year in long-term care and as a CNA for five years.

Jesse Moore, RN
Clinical Nurse Educator
Jesse Moore was born and raised in Wyoming. He obtained his first undergraduate degree from Colorado Mesa University and subsequently earned a second and a graduate degree from the University of Wyoming. Jesse has worked in health care for the last 20 years, between his time in EMS and as a nurse. He is a board-certified emergency nurse who works routinely in the critical access ED.

Floyd Valley Healthcare Le Mars, IA
IONRP News articles: Article 1, Article 2

Grace Schurr, BSN, RN
Current IONRP resident - April 2024 Cohort
Grace Schurr graduated from Iowa State University with a B.S. in biology in May 2022. She furthered her education and graduated from St. Luke’s College from their ABSN program in December 2023. Grace started as a nurse at Floyd Valley Healthcare in Le Mars, Iowa, in January 2024. She works mainly in the emergency department and is now learning labor and delivery.

Marlys Van Otterloo, BSN, RN, NPD-BC
Education Manager
Marlys Van Otterloo, BSN, RN, NPD-BC, is the education manager at Floyd Valley Healthcare in Le Mars, IA. Most of her 30+ years as an RN have been in the education and professional development role. She holds a certification in Nursing Professional Development, is an adjunct instructor at a local community college, and will begin teaching medical terminology to high school students in the fall. Marlys assists in workforce development through student placement at all levels. She has found her career in education highly rewarding as she can promote her belief in lifelong learning.

TRU Community Care Lafayette, CO
LinkedIn
Facebook

Katrina Hess, RN, BSN
Current IONRP resident - July 2024 Cohort
Katrina Hess graduated with her ADN in May 2024 and again in December 2024 with her BSN. She went into her educational journey knowing she wanted to specialize in hospice. Upon graduating, Katrina was informed that TRU Community Care had a new graduate program and knew she wanted to be part of it. Being a new graduate in specialty care is rare, but she feels completely in her element. She has found tremendous success with the training from TRU Community Care and the IONRP.

Rachel Stackhouse
Clinical Education Supervisor
Rachel Stackhouse, RN, BSN, is the Clinical Education Supervisor for TRU Community Care. With 8 years of experience in hospice and 12 years of nursing practice focused on elder and dementia care, she seeks to empower and educate nurses in providing exemplary care.

Supporting nurses is our priority. Visit https://nursing.uiowa.edu/ionrp to explore our resources for new graduate nurses and beyond.

Transcript

00:00:02 Nicole Weathers

Welcome to a special Nurses Week Spotlight episode of the Beyond Nurse Residency Podcast, where we celebrate the power of nurses. Nurses are the heart and soul of healthcare, providing compassionate care, expert knowledge, and unwavering dedication to their patients today.

00:00:20 Nicole Weathers

We have the privilege of highlighting the incredible work and stories of nurses in our program who exemplify the true power of nursing. We'll hear from three program coordinators that utilize the all online option of our program along with their residents as they share their experiences and insights. Let's dive in and celebrate the remarkable contributions of nurses everywhere.

00:00:48 Nicole Weathers

Our first guest today is Jesse Moore from Family Health West a Critical Access Hospital in Colorado. Jesse has an impressive background, having started his career in EMS in rural Wyoming before moving to the hospital setting.

00:01:03 Nicole Weathers

He has worked in both critical access hospitals and trauma centers, primarily as an emergency room nurse with multiple undergraduate degrees and a graduate degree. Jesse brings a wealth of knowledge and experience to his role. Let's get this interview started.

00:01:20 Nicole Weathers

Welcome, Jesse, and thanks so much for being here today. Why don't you start by telling us a little bit about yourself?

00:01:26 Jesse Moore

My name is Jesse. I have been with Family Health West for I believe a little over three years now. I started here as a House supervisor, transitioned into the clinical nurse educator role about two years ago. I've been working in healthcare for a little over 20 years now. I thoroughly enjoy sharing my experience with other staff as well as new graduates. We found this opportunity through the WINN program with Colorado Center for Nursing Excellence.

00:02:01 Jesse Moore

It's just a great fit for us. We otherwise would probably not be able to offer any sort of new grad residency as I am the only educator in our organization and it's just a lot. So we definitely appreciate the curriculum development and the expertise that you all have to share with us at the University of Iowa.

00:02:24 Nicole Weathers

Family Health West started their first cohort in April of 2024 and just graduated their first two residents in April of this year. They also have a third resident that started this past January and another currently in the program. Speaking of residents, let's meet one of Jesse's first residents that was nearing the end of the program at the time we recorded this interview.

00:02:47 Nicole Weathers

So Ashley, thanks so much for joining us today. Why didn't you tell us a little bit about yourself, your role there at Family Health West and what brought you into nursing?

00:02:58 Ashley Veik

I am currently an RN on the inpatient unit at the Critical Access Hospital where Jesse is, the main thing that brought me into nursing. I was in high school. I did a CNA class and it was the week of like free College Application Day and my CNA teacher was helping us all apply and I wasn't filling anything out and she asked me why and I told her I said, you know, I'm happy with where I am. Neither of my parents went to college like I don't need to further my education and she's like, no, you're going to go to nursing school. That's where you fit.

00:03:33 Ashley Veik

And helped me fill out applications. I think I sent out like 6 applications to colleges that day, got accepted and worked as a CNA through nursing school and college. And at that moment I was really thankful that she pushed me and made me keep going and it really helped me find my passion for helping others and just helping people be taking care of helping them. When they're at their lowest and being such an important part in their healing process.

00:04:03 Nicole Weathers

Oh, I love that story. I mean, it's such a great reminder of how important those mentors are that we have along the way, how important they are to to kind of getting us to where we are, right. So I appreciate you sharing that story with us. And way to go and congratulations.

00:04:23 Nicole Weathers

You know, applying for college and going through a nursing program is no easy feat, and now you're nearing the end of your first year of nursing practice. So Can you believe it? Can you believe it's been a year.

00:04:38 Ashley Veik

No, it definitely feels like it has not been a year and it's crazy how fast it has gone by.

00:04:46 Nicole Weathers

I think a lot of people, when they're starting out, you know, day one at their organization, they're getting enrolled into this program. They think, wow, a year I have to be in this program for a year. That seems like forever.

00:04:58 Nicole Weathers

But typically when you talk to them at the end of that year, it's it's never as long as what they they anticipated it to be. So why don't you talk to us a little bit about your experience in the nurse residency program?

00:05:11 Ashley Veik

I feel like I have gained a lot of knowledge that I did not get in nursing school. You learn all of the nursing diagnosis is the right way to do things, but you don't learn how to deal with a difficult coworker, how to deal with the stress of nursing school, how to deal with those difficult situations that you know you're going to encounter, but they don't teach you that in nursing school and I feel like that's something that has this program has really taught me and has helped me in my nursing practice.

00:05:42 Nicole Weathers

So I think there are so many times where we encounter things for the first time right in our first year of practice, just like you described and having a little extra support along the way to figure out how to navigate these first time experiences, how to cope sometimes with the social emotional. Components of those experiences, I think are just completely valuable. So what has been your favorite part of the program?

00:06:11 Ashley Veik

My favorite part has been getting to interact with the other residents and kind of getting to hear their stories. There's only one other new grad on my floor, so I don't really get to interact with other people who are going through the same thing as me. So hearing those stories. And hearing other people talk about that and just being able to be like, Oh yeah, I've been there. And yeah, that is an unfortunate thing. And I know how you feel and kind of being able to feel a little bit validated about those things is really helpful.

00:06:43 Nicole Weathers

How about the support from your site coordinator? Jesse, can you talk a little bit about what that has looked like for you?

00:06:49 Ashley Veik

He has really helped, you know, get the program going and get us enrolled and has dealt with all of that and that was one of the biggest things that made me want to come work where I work is the nurse residency program and how much help it bring.

00:07:04 Ashley Veik

He's also been very helpful with other teaching things at the hospital, as he is the nurse educator. So if there's something that we don't know how to do or haven't seen, he's really good at being able to help teach that and help us feel more comfortable.

00:07:17 Nicole Weathers

That's great. I mean, I think one of the things that when we first get an organization up and going with the program, you know, we talk a lot about our online curriculum and the professional skills and the well-being components that we talk about and even the professional experience. But it's so important for the new grad to have somebody in that organization to kind of help them think about, OK, what does this look like in our organization? How does it apply here? And then also some of those additional skills, so some of those hands-on clinical skills, equipment, policies, procedures, I'm sure all the things that Jesse has been working with you on throughout orientation and nurse residency. So what would you say has been your big like, your top take away or kind of your biggest piece of learning?

00:08:03 Ashley Veik

Being able to learn how to handle those difficult situations, how to handle the difficult coworker, the difficult interaction with the doctor, just those skills to help me succeed and help me not feel so scared. And it is a normal thing. Yes, it's scary the first time you encounter it. But once you do it, you feel better and you get through it and you move on. And I think that's been one of the biggest takeaways that I've learned.

00:08:28 Nicole Weathers

Any words of advice for maybe a new grad who's just getting started?

00:08:33 Ashley Veik

Don't give up. Keep going. It's going to feel horrible at times and you're going to wish that you wouldn't have chose nursing, but keep going. It gets better. Just having that perseverance to get through it and keep going. I know I went through that at one point and I was like, I don't know why I'm doing this. Why I think nursing was a good idea and I went to my nurse residency meeting and I was like, OK, I can do this. I can get through this next week. Then I just feel like I've kind of been on the steady incline and that's one thing that the program really talks about is like these slumps and these highs of nursing. But it gets better, I promise.

00:09:12 Nicole Weathers

Yeah, I mean, we talk a lot about what to expect as far as what does a normal transition look like. And I know we've talked about this on the podcast before, this idea that there's two critical points in the first year. You know when you're first sort of getting probably started within those first two to three months, you kind of have that thought of.

00:09:31 Nicole Weathers

You know, I'm not sure I'm cut out for this. I'm not sure I can do this, and that is maybe like the start of that reality shock, if you will. And then there's this very distinct moment where it switches from, like, I'm not sure if I can to. I'm not sure if I want to like the realities of healthcare and nursing kind of sink in and it's at that point that people are really maybe making a decision on. Is this something that I want to continue to do so it's so.

00:10:00 Nicole Weathers

I'm so glad to hear that being a part of this program, it sounds like having somebody like Jesse at your organization sort of help you work through that, because it sounds like that was a very real experience for you this year.

00:10:13 Ashley Veik

Yeah, it's definitely been helpful to have somebody there and have a group of people there to help keep me going.

00:10:21 Nicole Weathers

So Jesse, now I wanna talk to you a little bit from your perspective. I know you. This is kind of your first year in the program as as well and you've had just a couple of new nurses that are just getting getting ready to complete and you've got another one that started here recently. But so far what's your initial sort of thoughts or perspective on how this nurse residency program is impacting your new grads like what are you seeing in these new nurses as a result of their participation in this program and how is it impacting your organization?

00:10:55 Jesse Moore

Yeah, absolutely. Like you said, it's been a challenging situation. I think it's probably that way with every organization who does this for the first time, we don't really know what to expect every time when we're looking for options for a residency program, you know, there was a lot that goes into kind of screening you know which direction we want to do, how much involvement, what are we able to contribute as an organization? But it was great to to find this match that essentially provides everything for the residents that they need that education component to that interaction component. Where we don't have to develop all of those things ourselves.

00:11:39 Jesse Moore

So, I think that you know, as the residents have gotten into the program and I would kind of follow the curriculum month to month on my end to kind of see how things were going and I would get feedback from Jess primarily and Amanda and I think that was helpful to me and kind of just that security that everything is going well regardless of if I'm hearing a lot.

00:12:05 Jesse Moore

But it was really interesting to see how the nurses were developing in real time and I think, you know, having that correlation between the development of the program and the progression from month to month as well as them just getting involved in nursing, working full time, interacting with all their patients and their coworkers. But then also having all those resources that they're getting from having everything in the residency program really helped them develop, whether they recognized that they were or not.

00:12:39 Jesse Moore

So I think even with our second well, our second cohort, our third resident, I see it the same thing with her, although they came from diverse, you know backgrounds, whether they had any prior history as a LPN or maybe they were just brand new into nursing in general, you can kind of see the wheels turn.

00:13:00 Jesse Moore

As they were dealing with all of those interpersonal matters, as well as taking on nursing as a profession in general, that growth in the way that they do those things from day-to-day, the way that we get feedback from their peers as to how well they're doing and then seeing you know how great of nurses that they've become. It's really rewarding for me, especially knowing that I play such a small portion in their development. But to be able to offer a program like this that can help address all those things that Ashley was talking about.

00:13:36 Jesse Moore

That they're not getting in a core curriculum while in the nursing program that they can get over time as they're getting used to being in the workforce and becoming really great nurses. You know, over this first year.

00:13:51 Nicole Weathers

That's great, you know, and we have residents sometimes who talk about the fact that it just seems like the curriculum will line up with whatever it is that they're experiencing, right. So maybe they have their first situation where they have a difficult encounter with the coworker and that happens to be the month that we're talking about conflict. Or maybe there's a safety event at their organization.

00:14:13 Nicole Weathers

And and that happens to be the month that we're talking about that. So I think it never fails that there are many times where the new grad will see these things play out in real life, and it just makes that curriculum even more meaningful to them as they progress through the program.

00:14:34 Nicole Weathers

So can you talk to us a little bit about some of the professional experience activities that your current residents have engaged in and how maybe those are impacting your organization?

00:14:49 Jesse Moore

Absolutely. So as they have progressed through their program, they have kind of found both intermittently and as influenced through the the residency program, ideas of how they would love to see their workplace evolve and.

00:15:08 Jesse Moore

And seeing how they have jumped into their change projects and recognized that there's a lot of things that we can implement at a even departmental level that can really change their workflow from shift to shift, so.

00:15:24 Jesse Moore

Ashley came, you know, really had a passion for the topic that she picked, had already gotten a lot of back history was all already very well educated on the topic and just needed the resources here in our facility to really implement the changes that she wanted to do that.

00:15:45 Jesse Moore

She saw the issue and you know could foresee a resolution to the problem, which has been great and to Sabrina's credit as well, our our other resident that's finishing this month, absolutely the same approach. Recognize that you know we have something even in our department that may seem benign, but that impacts so many different people and that can have such a positive impact on patient care from day-to-day that it, it's really nice to see nurses that are relatively new in their careers.

00:16:18 Jesse Moore

Kind of spearhead projects like that because I know that their peers will see that and will also recognize that, hey, these are things that we can do, you know, here on our our unit that will make our workflow better and make our patient outcomes even better.

00:16:34 Nicole Weathers

And I love the idea of that sort of ripple effect. Ashley, anything you want to add about your participation in the professional experience component?

00:16:44 Ashley Veik

I feel like Jesse did a great job touching on how passionate I was about it. Having the resources both from the nurse residency program as well as the people that I interact with at my facility there to help and there to make a change and it's really been beneficial. Yes. There's road bumps that come up along the way, but that just helps you learn that change isn't something that happens overnight and it is a process. I think that's really been helpful.

00:17:11 Nicole Weathers

I love it. It's so great to hear. So, Jesse, Ashley, thank you so much for being here with us today on this episode of the Beyond Nurse Residency Podcast. We are so excited to celebrate both of you and especially Ashley as she is finishing up her first year of practice just in time for this episode to air. So any parting words for our listeners before we go.

00:17:40 Jesse Moore

I really appreciate your time, Nicole, and all that you do for the residency program, for our residents. I think it's a it's a valuable thing that we can capitalize on. And I think a lot of other facilities would benefit from using this sort of program as well.

00:17:58 Ashley Veik

Thank you so much for the program and the curriculum and helping us along the way because I wouldn't be here without you guys.

00:18:09 Nicole Weathers

Wasn't that interview with Jesse and Ashley so powerful? Their story truly exemplifies the power of mentorship and nursing. Now let's shift.

00:18:18 Nicole Weathers

Focus to our next facility spotlight, Floyd Valley Healthcare.

00:18:23 Nicole Weathers

Floyd Valley is a critical access hospital located in northwest Iowa and joining us today is Marlys Van Otterloo, the on site coordinator, and her resident Grace. Just a fun side note, LaMars is actually the ice cream capital of the world, so all you ice cream lovers out there are. Be sure to look Marlys up and visit for some world famous ice cream if you're ever in the area.

00:18:46 Nicole Weathers

All right. Marlys, could you start by telling us a little bit about yourself, your organization and your role with the program?

00:18:54 Marlys Van Otterloo

OK, my name is Marlys Van Otterloo. I've been a nurse for over 30 years. I started in a small rural hospital, and then it transitioned to another small rural hospital, again on the Med surge unit, and then moved into the training and professional development role. So I've been doing that for the last 26 years. As education manager, I'm the site coordinator.

00:19:15 Marlys Van Otterloo

And we use the all online option at our facility. We started with two residents in 2019. We have had 13 since then. Currently we have 4 which I think is the most we've had at one time. Two, which we'll be graduating next month, one of which is Grace, who is with us this morning.

00:19:34 Nicole Weathers

Excellent. And a funny little side note here about Marlys is when I first made the jump from bedside nurse to being more in this education space, Marlys was one of my mentors that I went to and I was like, I have no idea what I'm doing. Can you please help? And so I've known Marlys for a long time, and I feel like she was really instrumental in helping me get my feet under me in the space of, you know, nursing professional development. So just want to take a minute to recognize Marlys for that great mentorship.

00:20:09 Marlys Van Otterloo

Thank you.

00:20:09 Nicole Weathers

So you told us now a little bit about your organization, the program, how long you've been using it and how many you guys, I I'm actually kind of surprised to see the number 13. I don't remember all thirteen of those new graduates that I guess it has you know time just goes by so fast. So it's been about six years now, so you're probably are right that it has been that many and so so excited that you have 4 currently in the program. So you said Grace is the resident that you have with us today. And congratulations, Grace, on. Sounds like you're finishing up your first year, so why don't you tell us a little bit about yourself and how you got into nursing?

00:20:49 Grace Schurr

Yeah. So I'm Grace, this my first year of nursing just finished my first year of nursing and I guess kind of how I got into nursing when I started on my undergrad, I was, I thought nursing was what I was going to do. And then I kind of explored other health careers. Ended up graduating with my biology and psychology degrees from Iowa State and then I went on and applied for PA school. I was debating between PA School and Med school.

00:21:13 Grace Schurr

And I got waitlisted for PA school, so I would have had a break for a year and I knew a couple of good nurses and figured it'd be a good career. And so I kind of did an accelerated BSN program, and I've loved it since. So I think it was the right course for me. Yeah. Now I work in Med/surg. A little bit Med/surg, mostly work in the ER here at Floyd Valley and dipping my toes in the OB unit now as well.

00:21:42 Nicole Weathers

Awesome. Well, that's the beauty of rural hospitals. I think is that you get the opportunity to experience all different types of nursing sometimes whether you would like to or not you you get volume told that you're going to go to some of these different departments. So how has the first year of nursing been for you so far?

00:21:59 Grace Schurr

Yeah, it's been. It's been good. It went by so fast. Which I've heard. I heard that when you graduate nursing school that it goes by so fast, but I've lots of good mentors and it's been a good year. I've learned a lot and they say that too that you learn a lot when you graduate. And that is true. So yeah, it's been a good year. Definitely had some learning moments, but there were good learning moments. So.

00:22:22 Nicole Weathers

Good. Why don't you talk to us a little bit now about your experience in the nurse residency program?

00:22:29 Grace Schurr

I think my biggest take away from the program is taking a moment for yourself while you're going through this first year, I've learned to. Usually I set my car about 10 minutes before work and just kind of reflect on my day and what I want to accomplish throughout that day. And it just gives me a moment to relax for 10 minutes before you walk into the door and you know, so when you work in the ER, sometimes you just don't know what to expect. So I think it's.

00:22:53 Grace Schurr

Good to take those little bits of moments and I think every month we kind of did that during the session too. So I thought that was one of my biggest takeaways and then also working with the other residents and seeing their struggles and their accomplishments and seeing that you're kind of right there with them, that you can relate with other people going through their first year too.

00:23:14 Nicole Weathers

And we hear that a lot from new graduates is, you know, the curriculum's good and, you know, we learned a lot from the discussions, but it's not having that sort of network of support that's really been valuable, I think, for a lot of new nurses. And I think this is especially important again, when we're working in rural hospitals where, you know, like you said, you're 1 of maybe 4, that are currently within their first year of practice. And so that can kind of feel a little bit isolating, especially if you are.

00:23:42 Nicole Weathers

On the same unit, so you don't know each other very well. So I think that that is a a great part of this program and I think a great benefit for rural hospitals is helping your new nurses to kind of have that peer support network when you know they it it's not the same when you're working with nurses who have been doing this for 20 or 30 years. Right. Because they're so far sort of removed from that, what's the new favorite? I mean, you talked about the connection with the new graduates, any other favorite parts of the program?

00:24:15 Grace Schurr

I guess I liked when we first started that episode. We always got to do like a fun activity before we started on kind of what we were going to do. And then it was always good. At the end they asked like what fun things do you have for the next month? And it was always fun to see what people had planned next and it just kinda seemed like we got to know each other a little bit, even though we really only broke out a couple of times and we had a discussion. So it was good to kind of get to meet other people that way. I guess I thought that was cool.

00:24:46 Nicole Weathers

How is the support from your site coordinator and or if you had other mentors at your organization sort of influenced your journey this year?

00:24:54 Grace Schurr

Yeah Marlys reached out to me a couple times, well, multiple times throughout the program, so it's good to know that you, she we had her support. She was checking in with us and then I worked really close with my peer mentor and she kind of checked in with me frequently too. And so it was good just to know that they were there supporting you through the program and you could reach out to them if we had questions. It was just, yeah, good to have them.

00:25:21 Nicole Weathers

You know, because that is something that with the online option of the Nurse residency program, you know, we do a lot for the organization as far as helping you through the curriculum. And we're meeting with you and getting you together with those peers. But it's always so important that there's still somebody in the organization that is, you know, connected to the program and connected to you and checking in so I think that is really important that you've got somebody on site that you can go to for questions or if you're running into any, you know challenges and they can also help you learn to navigate the organization a little bit better as well.

00:25:57 Nicole Weathers

So what words of advice would you give to a new graduate that's maybe just getting started in the program or just getting started in their first year of practice?

00:26:06 Grace Schurr

I would say just take it day by day. It can get overwhelming at times, but just take it day by day, you'll get. You'll get through it. People will be there to help you through your like, critical patients. Still, you'll have more nurses there. So I think that was my first critical patient. I was so scared to have them, but then it was like, ohh here's another nurse to help me here. And then another nurse. So you'll have plenty of hands to help in those situations. Just take it day by day.

00:26:34 Nicole Weathers

I love that. Take it day by day. I think that's good in all facets of life sometimes, right. That just one day at a time. And before you know it you're finishing the program, you're finishing your first year it doesn't seem like it's been that long.

00:26:49 Grace Schurr

No, it hasn't. Not at all. Went by so fast.

00:26:53 Nicole Weathers

It really does. It really does. All right, Marlys. I want to kind of go back to you for a minute and talk a little bit about your perspective on how the nurse residency program has really, how you, how you've seen it sort of impact your new graduate nurses and your organization as a whole.

00:27:11 Marlys Van Otterloo

Yeah, I I'd say a lot of the things grace touched on actually and yourself, just the content. You know, the content is obviously educational and useful just with variety of topics that you cover, but that well-being and the resiliency not in only the professional role, but in your personal role and it can extend beyond this one year residency timeline but.

00:27:31 Marlys Van Otterloo

Something you can use all day, every day for that matter. And then the others in the cohort for that networking and that connection and feeling like it's not just me.

00:27:40 Marlys Van Otterloo

But we also use the program as a recruitment piece like we go to job fairs, nursing job fairs and the local schools, colleges, whatever. So it's this piece for recruitment. So it's another benefit we can offer. So that list could go on and on, but I was just going to give a couple of examples of organizational impact and really patient impact we've had.

00:28:02 Marlys Van Otterloo

One of our previous residents was a surgery nurse.

00:28:05 Marlys Van Otterloo

And her change project was implementation of the EASE app. So it's a an application that cloud based, it's a secure app that staff can send messages to patients or to family members or friends or whomever the patient designates.

00:28:22 Marlys Van Otterloo

It's a secure app, so they can be kept up to date on how the surgical procedure is going, where they're at. In the process, they can send texts, photos, you know, videos. So everything is secured and it's only who the patient designates. But it's a great communication tool. So that was one of our residents project, and that's been a couple of years already. But it's been very well received both by the patients and their families and staff. It's just a great way to communicate. And then we had a home health nurse that was a resident and her project looked at quality indicators and specifically the Dyspnea management program. So she found that some of the quality numbers were a little bit low.

00:29:03 Marlys Van Otterloo

So she did a more of a deep dive into the program and saw that some of the questionnaire or the questions from the Oasis Questionnaire Assessment piece were could be improved and then some coding issues. So she implemented staff education, they did some audits, continual auditing, essentially, and then patient wise they focused on some breathing strategies and experimenters. So ultimately overtime because of the project actually extended beyond her residency, but the numbers increased significantly. So the quality improvement piece of the puzzle was improved, but then ultimately the patients obviously had improvements as well. So those are just some examples of in our organization you know positive impacts, but also kind of highlights how home health and surgery, you know, may not be your typical, so to speak, med surge units, but so this program is applicable in quite a variety of areas.

00:30:08 Nicole Weathers

I love that you share that and I think you know really sort of hitting home too on how patients are being impacted. Had your organization maybe not adopted this program potentially these these two examples, they could have still happened. You know, in one way shape or form but probably wouldn't have engaged to that new nurse as early on in the career in this type of work and I love to hear that, that home health example and really the EASE application both have extended far beyond the residency program and continue to have impact on patients today. So I think those are two really great outcomes that I appreciate you sharing with our listeners.

00:30:52 Marlys Van Otterloo

Yeah. And I don't know. I haven't spoken to either of the nurses, but it kind of makes me think like, so they've done those two projects, it makes me wonder like, what else do they have in their brain that they might be contemplating?

00:31:02 Nicole Weathers

And you know, are they thinking about, you know, new or different ways? Are they contributing in other facets? Might be a great follow-up survey or evaluation.

00:31:13 Marlys Van Otterloo

True, very true.

00:31:15 Nicole Weathers

Well, I think we've talked about a lot of great things today. I love this opportunity to kind of shine a spotlight on our residents and site coordinators and partner organizations that are doing amazing work to support their new graduate nurses. So I really appreciate both Grace and Marlys being here with us today to talk about what Floyd Valley has been doing to support their new grads.

00:31:39 Grace Schurr

Thank you. Thank you for having us.

00:31:43 Nicole Weathers

Wasn't that an inspiring conversation with Marlys and Grace, showcasing the power of resilience and nursing for our final spotlight of the episode we'll hear from Rachel Stackhouse and her resident Katrina at Tru Community Care. Tru Community Care is a hospice organization that also provides palliative care and PACE services across a large region in the Denver, Co area.

00:32:08 Nicole Weathers

Rachel has been with TRU Care since 2016 and the on site coordinator for this program since its launch in 2022. In addition to the residency program, as the Clinical Education Supervisor, Rachel also is responsible for onboarding and supporting nurses from new graduates to experienced nurses across the career continuum.

00:32:30 Nicole Weathers

The interesting thing about this organization is that they didn't even hire new graduate nurses until they partnered with the Iowa Online Nurse Residency program in 2020.

00:32:41 Nicole Weathers

While many of our listeners are familiar with our program in various capacities, I wanted to include TRU Community Care in this month's podcast facility spotlights because of their unique setting and how they've adapted the program to fit Hospice care, specifically. Let's jump into this interview as Rachel share more about customizing our nurse residency program to meet their unique Hospice specialty needs.

00:33:09 Rachel Stackhouse

My name is Rachel Stackhouse. We are a Hospice organization primarily. We also do palliative care and pace, but our new grad residents are focused in on the Hospice side of things. We started taking new grads around the time that we started partnering with you in 2022. Prior to that in Hospice, a new grad residency is a really rare thing to find.

00:33:31 Rachel Stackhouse

The University of Iowa is kind of our foundation that we've built the residency on.

00:33:36 Rachel Stackhouse

And so that is just one piece of what our new grads get. We are enrolling our new grads into an ELNEC curriculum, which stands for the End-of-Life Nursing Education Consortium. And so they get really specific teaching on the end of life, pain management, kind of the existential pain considerations that are unique to our specialty.

00:33:56 Rachel Stackhouse

We also enroll them in a NICHE program - NICHE stands for Nurses Improving the Care of Healthcare Elders. So it's specific to elder care and getting more knowledge around the differences between dementia and delirium and fall risk and those topics that are popular amongst the elders because most of our population are elderly and then our program has built out basically to follow the new grad through that first full year. They've got four months where they're with a preceptor out in the field.

00:34:25 Rachel Stackhouse

Which is home care and facility visits, and then four months that they're at the inpatient unit, which is like the intensive care unit of Hospice. So it's patients who are in crisis and they need a higher level of titration of medication to get symptoms under control.

00:34:41 Rachel Stackhouse

And that's really where the new grad can get those clinical skills down of working with pumps and sub queue sites and wound care and family dynamics and all of the things that happen when you're in crisis. And then after those two, four months rotations, they start to get their caseload on their own. We start with a small case load so that they have time to work through things and figure things out. And as their confidence grows, their caseload will grow into a normal sized caseload for any nurse.

00:35:07 Nicole Weathers

Excellent. And I appreciate you sharing that with us because I think sometimes when people are looking at our program and they're really trying to figure out how this could work and maybe they're unique setting. So I think it's always great to hear from our site coordinators about how they are really like you said, using this as the foundation, but it's not the only thing that the new grads.

00:35:27 Nicole Weathers

Getting because definitely there are a lot of specialty specific skills and knowledge that these new nurses are needing when they're going into something as highly specialized as Hospice. So I appreciate you taking the time to share that.

00:35:42 Nicole Weathers

We were also joined by Katrina, a resident that was just finishing up her first year as a nurse and was a little over halfway through the program when she joined us for the interview. Let's jump into the interview where Katrina tells us more about her decision to join TRU Community Care Nurse residency program.

00:36:01 Katrina Hess

I have not really known any other Hospice companies, especially in this area, to hold any type of new graduate program. And I think as a new nurse and a new graduate, having a new grad program is extremely important. I think just for just for success and trying to stave off any type of burnout. So I actually kind of like Rachel said, I did four months out on the field. I did only a month at our IPU, which is our inpatient unit, just because I felt very comfortable with what I had learned on my basis of in home. And I was ready to get out on the field and start seeing my own patients.

00:36:38 Katrina Hess

So, yeah nine months into the University of Iowa, I have a patient load of about 12 right now and I just feel like I have been given a lot of steps to be able to be successful with this stage I’m at right now.

00:36:52 Nicole Weathers

Excellent. So first of all, congratulations on your coming up on your you know, one year of practice, you're sort of anniversary for graduating nursing school. So that has to feel pretty good as you're sort of coming through this first year. So tell us what's been kind of some of your favorite parts of the program.

00:37:11 Katrina Hess

As far as I think, the University of Iowa, some of my favorite parts about this is normalizing that initial fear that happens, you know, in nursing school, everything is very.

00:37:24 Katrina Hess

It's very laid out for you and it's kind of just a it's kind of like someones holding your hand. So I do feel like being able to have the University of Iowa with me has been a good way to kind of bridge the gap between nursing school and professional working. So I I think it's just a, a really great way to be able to have someone to normalize the process. And kind of just be with you and make you feel like, OK, this is what I'm going through is normal. All of these things are part of the trajectory to success.

00:37:55 Nicole Weathers

And I think, you know, having other new grads, whether they're in Hospice or other care environments, they're also experiencing the same thing that you are. And I think that sort of Peace of Mind can be helpful. And I think especially when you're maybe picking a specialty like Hospice to think like, oh, maybe if I would have went a different route.

00:38:16 Nicole Weathers

I wouldn't have felt this way or thought that these things or experienced this, and so I can really see where even being with other new grads and other care settings can really give you that little bit of Peace of Mind too, that it doesn't matter where I go or what specialty I I choose, there's that little bit of like first time.

00:38:35 Nicole Weathers

Experiences during that first year that can really, you know, make you a little bit stressed to make you second guess yourself, that sort of thing. So talk a little bit now about the support from your site coordinator, Rachel. So how has that really worked between the two of you?

00:38:55 Katrina Hess

Rachel has been really just wonderful in this whole process. I truly feel like rather than her facilitating a lot of the things that we're going through is she's an advocate for helping us get through it and really providing a lot of first hand knowledge. And what we're learning. I like the fact that she is able to take the things that we are learning in the University of Iowa and reiterate them and reinforce them. We have meetings once a month and we go through these things.

00:39:26 Katrina Hess

And kind of just touch base with kind of how we're feeling through this process, if there's any questions if we need any extra support? And I think because she's been in this position because she has done my job, she is very understanding and can be empathetic to not only the stress of learning a new technique, but also the stress of loss with the field of Hospice. So I love that she reaches out. I love that she will send it out an e-mail.

00:39:53 Katrina Hess

And you know, I think just even the simple reminder to breathe and be take a deep breath, to slow down, you've got this. I mean, it's just, it's wonderful to have someone in your corner who's cheering you on even on the days when you are not cheering yourself on.

00:40:06 Nicole Weathers

Rachel, maybe you could talk a little bit about how you support Katrina from your perspective. So Katrina mentioned that you do a really great job of reiterating and helping them think about how some of these concepts that we covered in our curriculum are applied in your specialty. So maybe share a little bit more about what that looks like.

00:40:26 Rachel Stackhouse

Yeah. So one of the things that we've learned from doing this residency with you guys over the years. Is that although it may seem clear to us of how your topics translate to Hospice, it's not always clear to the new grad, and so we have to lay that out a little bit more and probably even more so as we go forward. But you know if we're, if your guys topic is changing condition, right. The patient is changing through conditions. Then we're bringing that back to decline in Hospice. And how are we titrating meds and providing comfort? And so it's a little bit different than if you're in a hospital situation.

00:41:03 Rachel Stackhouse

And so every month we grab, you know, the notes that Iowa sends us about what our residents are experiencing and talking about that month, and we bring that to that monthly meeting and really dive into what does this look like in our organization with our patient population. And then we always have time, almost always we will do a resident lunch. So for that meeting, we start by going out to lunch together. And that is just it's fun. It's team building, but it's also where a lot of that stress.

00:41:33 Rachel Stackhouse

Is out right the stress of a caseload, the stress of this one patient who did the thing. And you know it's getting to share that experience and being able to share you know, like I've had those patients too. And this is what I did. And this is an idea that you could try. So we get to have fun with it. And then as I hear things going on throughout the organization because I am in somewhat of a leadership position.

00:41:58 Rachel Stackhouse

And I hear when things are going on, I can have a sense of what's going on in Katrinas's team and know that, you know, we're having some change up in staffing. And so maybe her caseload feels like it's tight or stressful or she got that admit that is just, you know, maybe one of the more complex high acuity admissions and so you know sometimes I'll just check in through e-mail. I think like 2 weeks ago I sent out a list of words that were on a spectrum of like I'm feeling under stimulated to feeling over stimulated and asked my new grads to choose one of those words, and they're both feeling that high stress and it's totally normal for where they're at, right? This is 6 to 9 month period is what we call the Grow or Go stage. And so we know that just you've seen a lot at this point. You've seen a lot of death, you've seen a lot of suffering, you've seen a lot of things not work.

00:42:52 Rachel Stackhouse

And after a while, it feels like things never get better in Hospice, and so really it's learning how to frame your mindset and frame the help that we do bring to our patients and learn how to grow through that instead of choosing to feel like, you know, maybe you made a mistake or or whatnot. So really guiding them through that phase because it is, it's real and it's intense.

00:43:15 Nicole Weathers

I love that Grow or Go. I've never heard about this like 6 to 9 month mark being referred that way. Is that like a Hospice thing or is that something you came up with?

00:43:24 Rachel Stackhouse

No, that's a Hospice thing. Bernice Harper has a whole framework for the Hospice worker. In their first year. I pull it from a program that we had previously called our Thrive program, which is supporting any new clinician to Hospice through their first year. And that grower go stage is very common for that first year of Hospice.

00:43:42 Nicole Weathers

Excellent. Well, I was just thinking back, we had a podcast earlier this year with Judy Duchscher who has her stages of transition and she talks about two really important points like around month three, you make that decision of like or you have that question. I'm not sure I can do this in that like 6 to 9 month mark you make that decision of like I'm not sure I want to do this, which I think aligns nicely with this idea of Go or Grow, right? I have this decision to make on, am I going to leave? Am I going to do something else or am I going to work through these tough times and make it to the other side? So I appreciate you sharing that.

00:44:21 Nicole Weathers

OK. Katrina, maybe now you can talk a little bit about sort of what some of your top takeaways from the program have been.

00:44:29 Katrina Hess

Honestly, I think the biggest thing that I have really taken away from this is normalizing how a new grad feels. And you know, I think that, you know, you always hear fake it or make or fake it until you make it and it is. It's one of those things where it's, you have to just go through the hard times and kind of just be uncomfortable to in order for you to grow and understand that you're gonna make mistakes and understand it's OK to ask questions but I think just overall the biggest sense of you know, the biggest take away I've gotten is a sense of relief, and that other people are going through what I'm going through and it is kind of it's just a normal feeling. You're going to feel insecure, you're going to feel like you don't know what you’re doing and you know, I think that's the most comforting thing because I think most nurses are all type A and we are all hard on ourselves. So being able to have empathy and sympathy towards the process just makes it easier.

00:45:31 Nicole Weathers

Any words of advice you'd maybe give somebody who's just starting this program or just kind of starting their first year of practice?

00:45:38 Katrina Hess

I think just it's OK to feel uncomfortable. I think that's the biggest thing that I have really had to learn is to relinquish control and go with the flow and understand that not all things are going to be controlled. And that's OK. So you know, we're all on the same page, we're all going through it together and it's nice to have that camaraderie, and it's nice to have that grace within it so, you know, I just think, just go with the flow.

00:46:06 Nicole Weathers

I think flexibility in nursing is one of the tough lessons that you learn when you're first starting out. I think in school everything is so controlled a lot of times you're clinical placements are pretty controlled. The hours that you're working are pretty controlled. And then when you get out into the real world, we realize nothing is really controlled, right? And life happens all the time. So I think that's great. Just great advice to really keep in mind.

00:46:36 Nicole Weathers

So Rachel, back to you a little bit now. So from your perspective, how have you seen this nurse residency program impact the new graduate nurses and also your organization?

00:46:48 Rachel Stackhouse

Yeah, there's so many things that come to mind. You know, one of the things that the students do at through the University of Iowa is a change process project that Katrina is currently working on. But some of the great things that come out of that is that it's an evidence-based need that the company has that can really impact the way things work. A few years ago, one of our new grads had a template that she built out just to help increase communication between the field and the inpatient unit. That really helped for that season and where our organization was. Another one of our new grads is putting together some spiritual guidelines.

00:47:23 Rachel Stackhouse

Or end of life, you know, depending on what the patient's spiritual beliefs are. What do we, as nurses, need to be aware of as far as when the patient passes? Can we touch the body, things like that, that you just don't really think about until you're in Hospice?

00:47:38 Rachel Stackhouse

And so those projects really have benefited us as a company and then you know it's the amazing things of how timing works out so well. So we bring these new grads in and we they go through four months at the IPU and four months in the field and you know nursing is full of staffing changes. And so the nurse is leaving.

00:47:58 Rachel Stackhouse

And then my new grad steps in and says. I think I'm ready for a caseload. I'm like, wait, that's perfect timing.

00:48:04 Rachel Stackhouse

So like it's just it's so nice to have that nurse who I know has a good foundation, has some really good training. And you know, we have to be really mindful as an organization to go slow with them because we don't want to overwhelm them. And it takes time to gain your skills. It takes time to become that expert, especially in Hospice when you're in the home on your own.

00:48:24 Rachel Stackhouse

There is a high level of autonomy and so we need these new grants to really know what they're doing and be ready.

00:48:30 Rachel Stackhouse

For it. But when we invest in them, it's not just investing for true and for our nurses, it's really an investment to the nursing community as a whole, because now we know that these nurses who have gone through a program are solid like they've got the skill, they've got the knowledge really to go anywhere and they have that growth mindset. So when they come up on hard times, they can work through it and be successful.

00:48:52 Nicole Weathers

And I think that's one of the things that I really like to stress about the curriculum that we provide is it really is adaptable regardless of where your practice takes you? So when we're talking about things like time management or you know dealing, we're becoming flexible, right? And dealing with those changing patient conditions or you know, whatever the topic might be to this day, I still apply many of those things to my practice even though I'm not necessarily at the bedside.

00:49:20 Nicole Weathers

So I think the lessons sometimes that we learn that first year really kind of continue to carry us forward in our career.

00:49:28 Rachel Stackhouse

I just want to go back to what Katrina said about realizing that there's really no controlled environment and just being flexible. And I was just sitting in a nurse this morning in a room this morning with several nurses doing nurse orientation. Two of them have been nurses in Hospice for over 10 years, and both of them were like, I've never seen a trach. I don't know how to do that?

00:49:48 Rachel Stackhouse

And so it's just, it's so normal to have your nursing practice be unique to you and the situations and the patients that you've seen, there's this misconception that when you graduate nursing school, you got to know all the skills and know all the things. And the truth is you're going to learn as you go, depending on what you need to do and you can adapt in the future for what comes your way.

00:50:07 Nicole Weathers

I think sometimes it's about I think teaching that too or teaching. Like if I don't know something, this is where my resources are. So a lot of times when we talk to new grads, it's about knowing what your resources are, knowing who you can go to being comfortable and confident in that communication with those individuals so that you can provide the best care possible to your patients.

00:50:28 Nicole Weathers

Thank you both for joining us today on this episode of the Beyond Nurse Residency Podcast. Any last things that you want to share with our listeners before we let you go?

00:50:38 Rachel Stackhouse

I just want to thank you and your whole team for supporting our new grads. It's really a crucial foundation to what we're doing with our new grad resident program. So thank you for the support that you give to us.

00:50:50 Nicole Weathers

Well and thank you for your partnership. So I just love getting to know all of our different organizations that we work with and seeing how each organization really provides and creates their own unique spin on what it is that we're doing so and I and I really do appreciate you investing in your new graduates because as you said, it's yes, it's an investment in your organization. It's an investment in the individual, but it's an investment in our profession knowing that no matter where their career goes, they have the tools now to be successful.

00:51:18 Rachel Stackhouse

Yeah, absolutely.

00:51:21 Nicole Weathers

Wasn't that another wonderful testament to the power of support and nursing today? We've heard inspiring stories from Marlys, Rachel, Jesse and their residents, highlighting the profound impact of their nurse residency program.

00:51:36 Nicole Weathers

These stories have showcased the power of mentorship, resilience and support and shaping the careers of new nurses and enhancing the quality of care and their organization. Thank you for joining us for this special Nurses Week Spotlight episode of the Beyond Nurse Residency Podcast. As we celebrate nurses week, let's take a moment to appreciate and honor the dedication and hard work of nurses everywhere. Remember the power of nurses is truly transformative.

00:52:10 Nicole Weathers

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.

00:52:34 Nicole Weathers

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. Supporting nurses is another asynchronous online course for preceptors mentors and coaches.

00:52:55 Nicole Weathers

To learn the skills they need to support any new hire.

00:52:59 Nicole Weathers

Both of these offerings can be used as a stand alone 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.

00:53:19 Nicole Weathers

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.

00:53:29 Nicole Weathers

And 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.