Beyond Nurse Residency

Nursing Professional Development (NPD) Week 2025

• Nicole Weathers, MSN, RN, NPD-BC • Season 2 • Episode 9

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What makes nurse residency programs truly effective? In this episode, we celebrate Nursing Professional Development Week by highlighting how two partner organizations—Mary Greeley Medical Center and UnityPoint Health Trinity—have customized the Iowa Online Nurse Residency Program to better support new nurses.

Paige Vance shares how guest speakers and targeted skills stations boosted retention from 75% to 90%. Brian Bedoun, a former residency "dropout" turned coordinator, emphasizes interactive, flexible sessions and real-time feedback to meet nurses’ evolving needs.

Both showcase how tailored support and professional experience projects empower nurses, reduce burnout, and drive lasting change. Tune in for practical insights on customizing residency programs to maximize impact.

SPECIAL GUESTS:

Paige Vance, BSN, RN, NPD-BC, CMSRN
Nursing Professional Development Practitioner
Mary Greeley Medical Center, Ames, IA

Paige Vance is a Nursing Professional Development Practitioner at Mary Greeley Medical Center in Ames, Iowa. She began her nursing career in telemetry, caring for patients with complex cardiac and medical needs, where she developed a strong foundation in clinical excellence, critical thinking, and patient-centered care. Driven by a passion for lifelong learning, professional growth, and development, Paige now focuses on supporting nurses—especially new graduates—as they transition into practice. She coordinates educational programs, including the Nurse Residency Program and Preceptor Development Program, with the goal of ensuring nurses have the best experience possible, grow into their full potential, and consistently strive for excellence in safe, evidence-based, and compassionate care.

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Brian Bedoun, RN
Clinical Professional Development Specialist
UnityPoint Health - Trinity

Brian Bedoun is a passionate and driven nurse educator with experience across various roles in both inpatient and community healthcare settings. He holds a Bachelor of Science in Psychology from the University of Illinois at Urbana-Champaign and an Associate of Applied Science in Nursing from Black Hawk College. Throughout his career, he has consistently sought opportunities to better support the communities he serves and the colleagues he works alongside. In his role as a Residency Program Coordinator, Brian has found it incredibly rewarding to work with new graduate nurses, witnessing their growth as they expand their skillsets and develop confidence in their clinical competence.

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

Nicole Weathers:

Welcome to this episode of the Beyond Nurse Residency Podcast. This month, we're celebrating Nursing Professional Development Week, and I can't think of a better time to highlight the incredible work happening across our partner sites. NPD practitioners are doing the hard, meaningful work of supporting nurses through some of the most critical transitions in their careers, and that deserves to be recognized. In this episode, we're shining a spotlight on two of our blended facilities, organizations that are not only implementing our nurse residency model but really making it their own. You'll hear from NPD leaders who are seeing strong outcomes, building innovative support and creating environments where new nurses can truly thrive.

Nicole Weathers:

My goal for this episode is for our listeners to walk away with actionable steps, ideas they can take back to their own organization. Whether it's a new approach to nurse residency engagement, a way to measure impact more meaningfully, or just a reminder of why this work matters so much, let's dive in and celebrate the creativity, commitment and excellence of our NPD community. So my first guest here today is Paige Vance from Mary Greeley Medical Center in Ames, Iowa. So, Paige, why don't you start off by telling us a little bit about yourself, your role and your organization?

Paige Vance:

Yeah, thank you so much for having me, Nicole. I'm really looking forward to talking with you today about the residency program at Mary Greeley and all that we do here. So, like Nicole said, my name is Paige Vance. I work at Mary Greeley Medical Center, which is a medium-sized organization in Ames, Iowa. We have 220 beds between various units and we have participated with IONRP since August of 2022. We run three cohorts a year typically, and each of our cohorts has anywhere from 15 to 25 residents. The most that we've ever had is 26 in a cohort and that's been quite a lot, but it's always fun to kind of watch them grow and see that conversation that they have.

Paige Vance:

So at Mary Greeley, I am a nursing professional development practitioner, but primarily oversee our nurse residency program. I've been in my role for about a year and a half now, and prior to starting in our education department, I worked on our medical telemetry unit. I did that for about three years and I absolutely loved the experience of supporting our new grad nurses through their orientation, of supporting our new grad nurses through their orientation, helping our preceptors develop, and so those things have also carried over to my current role. So I coordinate our preceptor development program and we're starting a mentorship program, which is really exciting, here at Mary Greeley. And then I do a lot with our continuing education providership Previously, of course, Iowa Board of Nursing providership, but now we're kind of navigating that with all of the changes that the Board of Nursing has had. So that's a little bit about our organization, my role in the department and, like I said earlier to Nicole, I just absolutely love supporting our new grad nurses through their transition to practice. It is by far the best part of my role.

Nicole Weathers:

I love that, so I have had such a great time, I think, working with Mary Greeley and all of you, as this program has been implemented and now sustained for three years, which is amazing. I know every time I talk to you, I learn a little bit more about your program and what makes it unique, so maybe we can hit on that next. So, when you think about the nurse residency program there at Mary Greeley, of course, yes, you use our curriculum, but you've also really made it your own, so maybe you can share a little bit about what are some of those unique or innovative elements that you've built in to support your new nurses, and maybe a little bit, too, about where you're seeing feedback from residents or just kind of enhanced your program beyond the online content and discussion.

Paige Vance:

Yeah, that is a great question and I think that's one of the beauties of this program.

Paige Vance:

It really allows us to customize to the needs that our organization has but still having that awesome program.

Paige Vance:

To fall back on content and the discussions that are kind of provided, we always have a guest speaker at every single one of our sessions and the residents absolutely love that.

Paige Vance:

So, for example, in this most recent month that we had with one of our cohorts during month eight, where we talk about quality, we were really fortunate to have our quality director, Darla Hansacker, come and she talked to us about quality management and risk management and it was absolutely wonderful because she has such a large knowledge base and she's been a nurse for over 35 years, so for her to come and share the experiences that she's had with quality management in a court of law and really focusing on what it means to provide high quality care. The residents valued that so much and we were really able to see them kind of start to the gears, start turning in their head and that's so exciting. They also have amazing questions for those guest speakers when they come. We're very fortunate at Mary Greeley that we have the buy-in for our residency program that we can have some of those more experienced leaders and departments come and speak to our residents, so that's awesome.

Nicole Weathers:

I love when organizations can do that, when they can provide that guest speaker, that unique voice from the organization, because you know, as you said, the curriculum offers great foundational knowledge about these topics and then your guest speaker can come in and really talk about and this is how it relates to what's happening here at the organization.

Nicole Weathers:

These are the things we're working on, these are some of the experiences we've had with these different topics, and so I think it just adds that much more depth and breadth to the topics for the new graduates. And the other thing that I really love about when organizations invite those guest speakers is they get to like develop those relationships with those individuals that they might not actually come in contact with that much. So the new nurse might never have the time or the opportunity to sit down with that quality or risk manager to learn about that role, to learn about who they are, to now be able to put a face with a name, and so it's just, it's always so great to hear when organizations are kind of adding in that and able to customize the program really to meet those unique needs.

Paige Vance:

And that's such a great point too, nicole, because I think about Darla is she's kind of back behind the scenes and a lot of our residents haven't met her before, and you're so right. Now they have that relationship with her and if something were to happen, it's not so scary when someone from risk management is coming to talk to you.

Nicole Weathers:

Well, and I think she doesn't have to spend time like giving them the baseline knowledge either to be able to go into more detail on some of these topics. So for the most part, I think they've gotten a lot of that from the online content, from the videos and the podcasts that we offer, and then she can just build on that foundational knowledge, and I think that helps the residents too, that it's not such a like come sit, listen, be lectured at about you know what risk is, but it's more of like. This is what it looks like here.

Paige Vance:

Yes, absolutely so. The other thing that we've implemented recently is skills. I think that's something that we know sometimes our residents are really itching for. They want that development with some of those high risk, low volume skills that we have in nursing. So just two months ago now, we had three different skill stations during month six safety. That really focused on preventable harm and it was amazing. We had so many wonderful learnings from that. So we did a simulation on blood administration and a blood transfusion reaction. They also had the opportunity to go to a station on chest tube management, which was wonderful. That was taught by one of our past med-surg nurses who's so passionate and knowledgeable with that area, and then also had the opportunity to do some more in-depth respiratory management. So, thinking about how we manage CPAP by PAP heated high flow at our organization and they absolutely loved those skills sessions they went to.

Nicole Weathers:

I think it's really great to hear you talk about how these are not just random, right, but you're kind of leading them back and tying them back to the topic of that month. So when you're talking about safety, you're talking about some of those high risk procedures or skills that nurses are performing that there could be some safety concern there. You're bringing in a guest speaker that's talking about safety at the organization and so you know it sometimes can feel easier to just randomize, like just fit things in wherever. But I love that you're kind of trying to tie this up into a nice little bow for the residents so not only do they get that baseline knowledge that you know person and guest speaker perspective, but then also and then here's how it's kind of carried out on some of our units with those clinical skills. So kudos to you for that.

Paige Vance:

Yes, it was really exciting. We did an OLO needs assessment too. So, you know, you know those were skills that they were excited to learn about, which we know makes a huge difference from all of our NPD best practices. Love that.

Nicole Weathers:

So let's talk about. So you talked a little bit about the needs assessment. So on the front end, like what do we need to make sure we're including in this program? But then how about on the back end, or throughout the program? How are you evaluating success of your residency program? Both you know, I think, in terms of what the residents are getting, but also the organizational impact.

Paige Vance:

Absolutely. We are very fortunate at Mary Greeley to have an amazing data analyst who we work very closely with to get information on different trends that we're seeing in the organization. So obviously we look at that first year, our internal turnover rate, we look at our staffing information as far as like, are people going from one unit to another unit in that first year? So all of those staffing metrics really come into play. But I think where our evaluation really shines through is with that Casey Fink survey that we're able to use through the University of Iowa's Iowa Online Nurse Residency Program and then also through various needs assessments that I conduct through our knowledge checks, actually in the online modules. I am able to get so much great information from those knowledge checks because they're really embedded into how are they learning that specific topic and what can we do to support them through evidence-based practice, through quality. So I really appreciate that aspect of how we collect data as well.

Nicole Weathers:

So it sounds like you are measuring. So, yes, you're looking at retention and turnover and kind of some of those larger organizational metrics. You're looking at the Casey Fink so the individual nurse and the Casey Fink is looking at things like comfort and competence and job satisfaction across that year-long program. But then you're also going to more of like the micro level where each month you are sort of evaluating how they are using the content, where are they continuing to need more information, and so I think sometimes it's so easy to just look at retention, right, but you're really looking at where's. How is this program impacting them? And you're looking at it from various different perspectives, you know, across the course of the program, which I think is is hugely helpful to not always put all of our eggs in one basket and just sort of look at that one number.

Paige Vance:

That is so true, nicole, and something I think that I really think about too. In our organization we look at, we call them our big dot goals, and one of our big dot goals is eliminating serious preventable harm, and so as we talk about that, we can tie different activities we're doing in residency back to those metrics. Obviously, sometimes there's question on the correlation there, but most of the time we can see great impact on what we're doing and how we are impacting those preventable harm events.

Nicole Weathers:

And, I think, being able to tell that story to leaders across the organization and show that like, hey, this is something that came up, you know, related to safety events, right, and then this is how we are making sure we are including this in our residency program. And then here's where this measure is now. I think anytime we can share that at the broader level to organizational leaders, department leaders, unit leaders, that's going to continue to also feed into that buy-in and support for getting nurses to the sessions and, you know, of course, having them fully support what you're doing there in residency.

Paige Vance:

Absolutely.

Nicole Weathers:

So, paige, are there any like specific metrics or stories or trends, that kind of stand out that you could share with our listeners?

Paige Vance:

Yeah, I'm really glad you asked that, Nicole, because I think something we've learned throughout our implementation process of IONRP is that we do the best work when we can actually customize the program to meet our needs. So when we first started our program, we very much ran it like by the book with all of the materials that are provided, which is awesome. That provides, like you said earlier, that strong foundation for the residency program. But when we really started working at that unit level support from the leader, from the learning champion and then also started thinking about really beefing up those in-person sessions to really focus on the needs of our nurses here at Mary Greeley, our retention rate has since like skyrocketed. We are really fortunate. This last year, I think, we had a 90% retention rate, which was up from a 75 percent first year RN retention rate. So that is something that we're really proud of. That goes back to the whole concept of making those customizations and personalizing the program to meet our specific needs, and I just I love that we have that ability with IONRP.

Nicole Weathers:

You know one thing that we talk to a lot of our new organizations about. You know I always explain it like a Lego right? Like a Lego kit that you buy for yourself or your kids or whoever. You can put this program together exactly as the booklet tells you to put it together and you can have a great product at the end of the day. Or you can mix and match and put it together in a way that really is creative for you and fits your needs and you can have, you know, even that much more of an exceptional product.

Nicole Weathers:

So I think sometimes it comes down to what the organization can do who do they have available, how much time do they have? And you know. The other thing is like you don't implement a program and then it's just the way it is, forever and ever and always. You implement it. You figure out what works, what doesn't, what do you want to add, and that's going to change over time. So what this cohort needs in 2025 is probably going to be different than what your 2027 cohort needs, right? And so just knowing that that's like an ever-changing and evolving process and we can add and we can take away and we can do things differently, I mean having that flexible freedom. I think is what really makes the program unique. And again, we can provide you a lot of guidance on what you do, but at the end of the day, you know what works and what doesn't.

Nicole Weathers:

I love that is so true and I have so appreciated the guidance we've received from you guys, because you do give us that flexibility and it's wonderful because you do see that growth when you can tailor it so it's awesome shows that you've got a really good combination of things working in your favor right now and that you really are meeting the needs of what those new nurses are meeting as they come into practice.

Paige Vance:

Absolutely, and all of that goes back to that support they're getting on the unit. That buy-in we have now with our unit educators, our preceptors, our leaders, that buy-in is what makes that difference and it's been wonderful Well because you know we talk about yes, we're talking about nurse residency.

Nicole Weathers:

So in a lot of times people think of nurse residency as what happens in the classroom with the residency coordinator. You know much of what we've talked about today, but when we think of retention as sort of this broader piece of the puzzle, it's really about the full experience. It's about what's happening as they come into the organization with HR, their orientation, their preceptor, you know relationship, the leadership, support and what you're doing with them in the program. But it's all of those things. It's just not one of those things, and so I really, I really do think that it's important to kind of draw attention to that. So we're thinking about this as a full experience.

Paige Vance:

Absolutely All right.

Nicole Weathers:

So since this episode. So we're shining a spotlight, of course, on some partner organizations that we work with, but we're also really wanting to honor and spotlight the incredible work of NPD practitioners, because here in the month of September we celebrate NPD week, which is all about the hard work and the dedication that goes into growing nurses across the career continuum. So maybe you could share now maybe a moment or you know success story from your time working in the residency program that really reminds you why you are doing this work in the first place, maybe really captures the heart of what it is that you do.

Paige Vance:

Absolutely, Nicole. I think two situations come to mind when you ask that question and first thing I want to say is that I could not do what I do without the support of my organization and my leadership. They really allow us to encourage the residents to have the best experience possible in that first year of their practice. First thing that really stands out to me is an example I have of residents as they were doing their nurse residency project. We had two residents from our ICCU who really identified a huge gap in practice and how we were handling extubation for our patients who are intubated, and they had so much passion and drive around this problem because they saw that it was negatively impacting that patient experience in that care. So they decided for their professional experience they were going to do a change project focused on a nurse-driven extubation protocol and just seeing the passion that they had behind that, even having had been nurses for six months, was amazing, and I love when I can see that passion shine through for change in nursing.

Paige Vance:

We know that part of being a nurse is having such having that critical inquiry and really thinking about what can I do to improve the care that I am providing for my patients, and so that was something that happened recently that I'm just so proud of.

Paige Vance:

I'm so proud of those new nurses for asking those hard questions and really pushing forward with something they were passionate about, and then also the support that they received from their leader and their nurse educator on their department was overwhelmingly positive. So I'm really appreciative of that, and I think those types of stories really sell how incredibly wonderful it is to have the role I do as a nurse residency coordinator in their transition to practice, because I can kind of foster that critical inquiry in a space that's safe off of their unit, and so that just that story in particular has really made me proud of the work that we do Well, and I think one thing I just want to point out with that story is great, great for you to be able to support that work and give them that safe space and help them sort of work through that process, but how amazing for your organization.

Nicole Weathers:

I think this is maybe builds on our last question of stories or successes that really have organizational impact, and it sounds like this is one of those professional experiences that, at the end of the day, your organization is benefiting from. They're benefiting from the you know, 15 to 20 hours or whatever it took these nurse residents to focus on this topic, and it's going to continue to impact the organization forever and ever and always.

Paige Vance:

Yep, yep, it is, it's wonderful. Yeah, yeah, it is, it's wonderful. And those projects where we really see implementation take place and we can really measure the success. It's so exciting. I love evidence based practice. I think it's a huge part of why I really enjoy being an NPD practitioner, because we get to share that then with others in the organization in such a unique way.

Nicole Weathers:

Great.

Paige Vance:

And then you had another story that you wanted to share. Yeah, so something else that I always tell people the best part of my job is watching the growth that our nurse residents have in that first year. I would like to tell a story about a resident who I had. She started out in month one. She was very, very anxious. She was having a really, really hard time with her transition.

Paige Vance:

The way that our program is laid out in cohorts, sometimes people have been off of orientation for a month or two before they come to their residency kickoff and we had multiple one-on-one meetings in those first few months and then, all of a sudden, I just started to see a huge change in her In session.

Paige Vance:

She was asking better questions. I started hearing really positive feedback from her on how things were going on her department and then by the end of the program she actually came back to me and said I'm so thankful that I had this program because it supported me through times when I was really struggling and I was thinking about quitting nursing altogether, and it just warms my heart to think about her now. She is a phenomenal nurse. She is doing amazing things on her department. She's precepting, she's functioning as lead, she's got amazing critical inquiry, and she has probably some from what I've heard from her leaders some of the best patient-centered care on their department, and so I'm just really proud that we were able to guide her through that, through a platform like residency, because I think if we wouldn't have had our program in place, she would have potentially left the nursing professional.

Nicole Weathers:

Yeah, and so not only are you impacting that individual and your organization by retaining them, but you're benefiting the profession by implementing these programs right and having this type of support in place.

Nicole Weathers:

So and we all know that that is something that we continue to need to do as a profession is to support and bring up those that are coming in, because transitioning into practice is hard and it's difficult and there's a lot, not just from like applying my knowledge I've learned in school in the real world, but all the social, emotional things that sort of come into play.

Nicole Weathers:

You know, in some of our previous podcasts we've talked about first time experiences and how sometimes they can bring past traumas to light. So a lot of nurses get into nursing because of history of you know, like maybe my mom had cancer or maybe I had a sibling who you know died at a young age or whatever, and this was kind of my calling into nursing. And then when I get into nursing and I have my first patient die or you know a patient who's been diagnosed with cancer, it brings a lot of that past sort of trauma to the forefront and I think that adds an extra layer of complexity in the first year of practice, and so anything that we can do to support them through those first-time experiences are beneficial for sure.

Paige Vance:

I have goosebumps listening to you talk about that, because it is so true. Sometimes I think, as NPD practitioners, we forget that, although we're not necessarily directly serving patients, we're serving the people who take care of our patients and by fostering those relationships and really helping them come to terms with what they are feeling helps them succeed and provide better patient care.

Nicole Weathers:

All right. So what advice would you offer NPD professionals or organizations who are really looking at strengthening their residency program? So you know, obviously not everybody who listens to this podcast uses our nurse residency program. So these could be, you know, broad lessons learned, creative strategies, or you know even some must-try ideas.

Paige Vance:

The first thing that I would tell anyone starting your nurse residency journey is to think really critically about what is it that my nurses in the organization need.

Paige Vance:

And then the other thing that I would say, a huge lesson that I learned as an NPD practitioner. Coming into the role, I was very worried about what others would think of the program and also about my experience as a facilitator. I had not had a ton of bedside nursing experience when I did come into this role about three and a half years, and something that I've realized has actually been a benefit for me is that I'm able to relate to those residents so much more than maybe someone who's been away from the bedside for an extended period of time. And so I think that something I always tell people when you are leading residency sessions lean into those experiences that you have and then also tell stories. I think our residents love to hear stories about situations that you've had, and something I work really hard to do is like really remember those stories and remember where I was at when I started in the nursing profession so that I can relate to them better.

Nicole Weathers:

I think that shared experience, or you know, a lot of these new nurses probably look up to you, Paige, and they're like you know, this is only something I would do. This would have probably never happened to Paige, because Paige is this great nurse with all this experience and you know, so on and so forth, and so I think anytime that you can be very authentic and real with them, they appreciate that. So, whether that is, you know, sharing your own experience, or maybe a colleague that you were working with, or what it felt like to be a new nurse yourself, I think all of that is very valuable to them yourself.

Paige Vance:

I think all of that is very valuable to them. Something else, too, that I would encourage people to do is really reach out to the NPD community. I have learned so much from my peers in NPD and I just I really love the platform that ANPD gives us to grow and develop and use innovative ideas and strategies. I have learned so much by attending conferences, webinars and really hearing what other people have done. Something that I'm really excited to start doing is incorporating more simulation into our program, and I think that when you're able to open your eyes to all of the possibilities that we have in nurse residency and try to figure out, oh yeah, I think that might work for our organization and then just try it. If it doesn't work, it's okay, you can always modify. Like we've talked about earlier, you can always modify anything that you do.

Nicole Weathers:

Just because you don't get it perfect that first time doesn't mean that it's a complete waste of time Right, because I think every time you implement something new, it's valuable information Again what works, what doesn't and what best meets the needs of the new graduate nurses that you have in front of you.

Paige Vance:

And, like we talked about too earlier, Nicole, we have needs that are different than they were in 2020 when COVID was on the rise. Like the nurse, residents at that time needed something completely different than they do now in 2025. And they're going to need something different in 2030. So just being flexible, I think, is really important in morphing your program so that it continues to meet the needs. I think something I'm really proud of is in our organization. We're constantly looking at how can we be better. It's great. At times it can be a little bit exhausting, but it challenges us to think outside the box and continue to make those improvements so we can be the best that we can be.

Nicole Weathers:

I mean, I think that's a sign of a seller organization too, and probably an employer of choice for people who are coming out, you know, people who are willing to continue to work towards improvement, even though what they have was probably fine. Knowing that there's that incremental getting better each and every month, each and every year, I think just really speaks to the type of organization that you have there at Mary Greeley.

Paige Vance:

Yeah, we are so fortunate All right Paige.

Nicole Weathers:

Well, we have talked about so much. I so appreciate you taking the time to come and join us for the podcast, share your insights with our listeners, and we value you as a partner of the Iowa Online Nurse Residency Program.

Paige Vance:

Thank you so much, Nicole. It was so wonderful to sit down with you and I am so excited I had this opportunity.

Nicole Weathers:

All right. Well, now I have with me our second guest, Brian Bedoun, from UnityPoint Health Trinity, Quad Cities and Muscatine. So, Brian, welcome and thank you so much for joining us today.

Brian Bedoun:

I'm honored to be here. Thanks for having me.

Nicole Weathers:

So I thought we could start off your portion of this episode of the podcast with just having you tell us a little bit about yourself, your role, your organization and anything else you think we should know, kind of to help set the stage for who you are and sort of where you're coming from.

Brian Bedoun:

Yeah, so I am a clinical professional development specialist is my official job title. Here in the Quad Cities I work for a health system that sits right on the Mississippi River on the Illinois-Iowa border. We have three campuses in the Quad Cities, hence the Quad Cities and Muscatine, and I lovingly and jokingly refer to our market as sort of a sub-rural community. You drive about 10, 15 miles in any direction and you'll be in corn and soy. We have a beautiful patient population with a lot of nurses coming from a lot of different places. I work in my role primarily as our nurse residency program coordinator here, along with a smattering of other odd jobs to help some of the other recognition activities we use to support our nursing staff.

Nicole Weathers:

Excellent, and so I know you didn't start in this role when the organization started with the program. But maybe you could tell us a little bit of a history here on. You know the nurse residency program and getting started with our curriculum.

Brian Bedoun:

Absolutely so. Full disclosure I am a nurse residency program former dropout. I was a baby nurse not too long ago, so I am not one of those nurse residency program coordinators with plenty of or an abundance of experience under their belts, but I have found in the last couple of years that I've been running the program that lack of extra experience has been a little bit of a benefit, because I can see where my residents are coming from. That being said, I started in my nursing career it's my sort of second or third run at a healthcare career back in 2021, working on a cardiac step-down unit on our Bettendorf campus, and I heard about a month after I started on orientation that we were going to have a nurse residency program and it sounded interesting and like an option to get support.

Brian Bedoun:

I had done an associate's degree nursing program after having already gotten my bachelor's at University of Illinois. Bachelor's was in psychology, so I'm not qualified to provide group therapy, but I know enough to get myself in trouble. So I was really, really interested and when I got into our program at UnityPoint at the time it was being run through the IONRP program, but it was a very different model and structure than I was fortunate enough to be able to get off the ground when I came back in this role and it just was not. I didn't find it very supportive. The content was wonderful but it was just really overwhelming to try to figure out how to navigate that plus working at the bedside. Overwhelming to try to figure out how to navigate that plus working at the bedside. So I did end up leaving that program about four or five months into the program, right around that transition shock slump when I came back my primary goal when because I Be careful, what you wish for right I heard from my former assistant manager because I had stepped away to go PRN and work at an endoscopy center just to get a change of pace after about a year and a half at the bedside, and she was like Brian, I think you'd be perfect for this.

Brian Bedoun:

And I did some digging and turns out it was. They were looking for someone to run our nurse residency program that was going to be the primary responsibility for the CPDS role that I was coming back for. So I said you know what I didn't like the way they did it when I was in it, so I might as well try to make it better if I say that I didn't like it and that I think it could be different. I should put my money where my mouth is.

Nicole Weathers:

I love that. So you are. I always love visiting with you and I always love that you are a self-proclaimed nurse residency dropout and that you have just a little bit again different background, different take on the program, what you experienced, what you liked, what you didn't. So I think that that is just such a great perspective to honestly walk into being the coordinator because you've experienced it recently from the other end, which I think is just really. While some may see that as kind of a drawback, it really is an asset in this case. So thank you so much for sharing that background.

Nicole Weathers:

So I know that sometimes when organizations begin implementing the program, they have an idea in mind of what they want it to look like. If they've had something existing in place prior. It can sometimes be hard to make that transition because our model is quite a bit different than some of the more traditional models that are out there. So maybe now you can share a little bit about what makes your residency program shine. So whether you've got some unique or innovative elements that you've sort of added in or built around the curriculum that you think is really making a positive impact for your residents.

Brian Bedoun:

So I don't know that I'm doing anything extraordinary or special. I don't know that I'm doing anything extraordinary or special, but I know I just kind of followed my instincts and I was lucky enough to be given kind of free reign to say you knew what you didn't like, Make the program you would have actually preferred to participate in. So I worked really hard to keep a focus on. I always tell my residents that there are two things. I want them to get out of the program by the time they're done. I want them to develop a greater sense of confidence in their skills and to feel comfortable exercising the clinical skills that they are competent to perform, because they already know how to practice safely. That's what nursing school prepared them to do. But this first year where I'm working with them in residency, my goal is to give them opportunities to work through things and see how they are making that impact, to grow truly into their shoes in a bedside nursing role, Because that's the leadership position in my opinion.

Brian Bedoun:

What I do is help to disseminate information and provide support as the landscape changes. My residents are the experts, so I tried to build a program that would put them in touch with all of the resources they would potentially need to interact with. I was given the opportunity to expand our program when I was going through it as a baby baby nurse. It was an hour long meeting once a month. I've expanded that to three hour meetings once a month and those three hour meetings are pretty interactive. We do use the IONRP slide content at the beginning of every meeting. I really, really love and I've pulled it for pretty much every single meeting. We have that transition shock model because it's such a great litmus test to see where people are, and I have found that and this is purely anecdotal, but I have found that my residents better contextualize. Oh wait, maybe life doesn't suck, I'm just overwhelmed right now, and maybe there is light at the end of the tunnel and we continue to check in on that. So I also folded in some case studies, some ways for us to review different high-level concepts, critical thinking and clinical judgment for those various situations that we come to.

Brian Bedoun:

That don't necessarily matter as far as what, the specific care area you're working in, so much as what skills as a nurse do you need to be harnessing? Are you focusing and are we taking things a little bit too seriously, or do we maybe need to take that chill pill as well as some ways for my residents to connect with their various team members. On the healthcare team we have panelists come in pretty much every single month for the first six months of the program and then by the time they're working on their professional experience project, they know who they need to get in touch with and they're running the show. I may be there to give them gentle reminders, but we spend part of that residency meeting time connecting and working through those benchmarks.

Brian Bedoun:

One because it helps to really reduce the overwhelm the residents are feeling. It doesn't feel so homeworky to do that evidence-based practice project. And two because it helps me guide them and show them how they're thinking correctly and maybe redirect where I need to. They're going to figure out how to do this on their own. We have professional ladder programs at the organization and this feeds directly into those, but I think that we have a really nice sort of training wheel system through residency to funnel folks into that professional ladder program to continue furthering their practice and to get recognized for that our listeners.

Nicole Weathers:

So one of the things that Brian spoke about was kind of bringing in some of our slides, I think you said, into the program. So, just so our listeners know, we do provide each of our sites with what we call our ultimate program planner. This is like all the ideas and concepts that you could pick and choose from to create that cohort discussion together, and along with that we go ahead and provide slides that we've created for our online discussions that we're having with our all online option of the program. So you don't have to reinvent the wheel, and so I think that's what you were sort of referencing with that.

Nicole Weathers:

So we have lots of opening activities where we're sharing highs and lows. We're talking about the well-being content. We pull in that transition model I think a lot too to give them that visual, and I would say our all online participants really appreciate that visual as well, because it reminds them again, like you said, like oh, it's not, there isn't something wrong here with me. It's part of this experience, and I think that continual reminder throughout the program is really important.

Brian Bedoun:

I would be remiss if I didn't say I should be giving better credit because that ultimate program planner, as I was designing this program or this version of the program, was extremely helpful and made my job incredibly easy. I would find myself thinking, oh well, maybe this topic would make sense here. And then going to that ultimate program planner only to see, hey, this is one of the recommended guests to have included. So definitely made my life a lot easier and I felt a lot more confident as I was putting our program together when I was using that.

Nicole Weathers:

And then the other thing you talked about is for the professional experience, the benchmarks, and so again just a little context for the listeners.

Nicole Weathers:

We have sort of reframed our residency project as a professional experience, because we do give a few different options so they can do a change project, a case study, or get involved in some committee work and with each of those options we have step-by-step benchmarks or like sort of short worksheets I guess would be another way to frame that that guide them through step-by-step exactly what it is that they need to do each month, and so it's very bite-sized and manageable. They're not staring down the barrel at a giant project that they have to figure each month, and so it's very bite-sized and manageable. They're not staring down the barrel at a giant project that they have to figure it out, like we really do guide them through. So I love that you brought that up and I really love to hear that you're giving them some designated time, in conjunction with your discussion time, to work on those things right and to maybe pull in, you know, in quality people or get connected with different people. So I think that is just great and I really appreciate you sharing that.

Brian Bedoun:

I will say one other thing that I have started doing with my most recent bunch of cohorts is, I added, in a little bit of a feedback form, because I was hearing a lot of things and getting a lot of like one-off conversations but I was really struggling to see sort of getting a lot of like one-off conversations but I was really struggling to see sort of where the final source of truth was. So one thing that's been really really helpful for me has been getting a QR code. Just on the last. We use the slide deck as just a way PowerPoint to guide the meeting to keep us on track, because I can talk all day if I'm not corralled a little bit. But having that QR code and just a quick, it's a very simple.

Brian Bedoun:

I want to say it's three questions with one open-ended what would you change, what would you do differently or would you do anything different at all? And I've gotten some really, really great feedback about what is working and what's not working, which is also, I will say I am lucky to have a great unit education team to collaborate with because they're very invested in all of their nursing staff, but they do pay some special attention to the feedback they're getting about residency, and they're never shy about sharing it with me, so that's always very, very helpful, and I think it's only made our program stronger.

Nicole Weathers:

Well, I think, real-time feedback. So, especially in like a residency program where it's 12 months, if we wait till the end to get feedback from participants, oftentimes it's probably like short right participants. Oftentimes it's probably like short right, Like they don't really take the time to give you much valuable feedback and they've kind of forgotten what happened a year ago. So you know, that is another thing that we do in our online option is, at the end of every one of our cohort discussions, let's get a little bit of feedback, and it doesn't have to be long or extensive or take them a whole bunch of time, but you know what are the key things that you liked? Where could we improve? So I just love to hear that you're you're doing that in the blended version as well.

Brian Bedoun:

It's super helpful because the QR code makes it so that everybody can just hop on and do it. My residents will get laptops out for the second half of the program to be working through the benchmarks or working through their project, regardless of the format they're using. But everybody's got a smartphone anymore, so it's a lot easier for them to just whip that out and take the picture instead of having to go through the. Every system has it.

Nicole Weathers:

I'm sure those 14 steps of authentication, security, security to get to that same form forum anything else that you think really makes your residency program unique or different that you'd like to share.

Brian Bedoun:

I think the only other thing that I would say is that it's it's a really pretty loose program. I have the tools that I need thanks to the ultimate program planner, the, the content and the materials that are already available on SharePoint and on Canvas, but the thing that I'm consistently getting feedback about from my residents is that they appreciate having things be open and sort of freeform enough that they can be in charge of what they need, and that's always sort of the expectation that I set. I'm not hoping to have you guys come in prepared to give me a dissertation on the topic du jour, right, I just want you to show up and be willing to engage, even with the Q&As and the folks that we have come in as guest speaker, panelists or the case studies. It might be a dedicated activity, but the conversation is going to go where the conversation goes. There's not a whole lot of scripting, and I think that's been one of the other things in the feedback that I get that is continually highlighted.

Nicole Weathers:

And I really love to hear you say that, because I do think sometimes where organizations struggle is if they go from a program where it was kind of lecture-based and they had their experts coming in and sharing content, to a flipped classroom where they're going online and they're getting some of that baseline content through the online podcasts and videos, that they're going online and they're getting some of that baseline content through the online podcasts and videos that they're doing, but then when they come to that speaker, that panelist, they don't have to spend time talking about all that stuff. Right, it could be where the conversation takes them, building on what they've already done in that online content for that month.

Brian Bedoun:

And I will say I think that's another conversation that's come up repeatedly I have some residents that really love the online content and I have some residents who just say it just feels like too much for me. So my go-to with my residents anymore when it comes to some of the Canvas and the self-paced content is I'm not asking you to pay careful attention and take meticulous notes. My goal for you with that is to take it as food for thought and to use it as a way to prep for maybe trying something new in between meetings to connect that back to your day-to-day practice as you're working.

Nicole Weathers:

Because the point with this online content isn't I mean, shouldn't be teaching them brand new things. They should have heard all of this in nursing school, right? This is just like. Here's a refresher on the topics that we're talking about. Here's some best practices to kind of think about that you should have learned in school, and are you? Are you using them now that you're? In practice and then that panelist or that guest speaker sort of helps bring things full circle and connect it back to your organization specifically. I love that and I love that you're using.

Nicole Weathers:

So you, you, you basically have like a roadmap planned of like this is where the cohort discussion or today's meeting with them is going to go, but also know that we might have to take a detour and we might have to spend a little bit more time on this, and it's very flexible and unique to the group of residents that you have in front of you at the time.

Brian Bedoun:

I will say so. We meet on Tuesdays.

Brian Bedoun:

I had my first cohort that started back in January of this year meet yesterday and we were talking about evidence-based practice and we took a long, probably 30, 40-minute detour to talk about a recent change that had been implemented around our consent forms.

Brian Bedoun:

Some of the change was motivated by some accreditation requirements and some of it was motivated by a need for a clearer process outline, but there was some really great communication that was happening around well, why and where is this coming from?

Brian Bedoun:

And we were able to connect back to both that, hey, we make these adjustments because there's evidence that suggests having certain folks sign a document for consent helps to ensure that it's being reviewed by all of the appropriate parties and at the appropriate times. And also we had evidence from our organization that indicated that the lack of these particular individuals' involvement was increasing the risk for fallouts. So, showing both evidence from a primary source, more academic perspective, and also from sort of the real world stuff I like to talk about a lot of the time how we say this stuff in nursing school and it feels very fluffy and academic. The real world is a lot less high tech. In my opinion, we're not looking for at least four sources within the last five years. Right, we're looking for a reasonable body of evidence from reliable sources that tell us what we need to know so that we can move on.

Nicole Weathers:

Well and I think we've talked about this before too Like it's not always about the research article, right? That patient preferences, expert opinion. Those things are part of evidence-based practice and we oftentimes forget about that 100%. I love that. Okay, so Moving on talking a little bit about measuring success, so I know that your program has changed over the years, and so I'm curious how are you currently measuring success, both in terms of resident outcomes but also organizational impact? Do you have anything specific that you could share around that?

Brian Bedoun:

Yeah, One of the big things that as an organization, we've been really focused on for the last few years has been first year retention and turnover, and I think that we are not alone or unique in this position either. There are a lot of especially acute care and inpatient settings. There's a lot of post-traumatic stress in the occupation from my perspective. So I think what we've seen is a reduction in that first year turnover with the renewal of our program.

Brian Bedoun:

I don't want to necessarily say that we never had a nurse residency program, but it definitely sort of petered and then came back with greater emphasis after I moved into the role. I would also say we keep a really careful eye on feedback from residents in real time and from the organization. I actually have it pinned on my board so that I have it for tough days. But I think one of the things and this is mostly just for me I don't know that this is a measure that the organization is using, but hearing from third parties that they are seeing the impact our residency program is having on the unit is a huge deal for me. So, to paraphrase, there was a provider that was speaking on a risk, meeting in confidence. But they essentially brought up the residency program and said I don't know what's changed. It used to be a joke, but it really seems like they're doing something different there and it's working.

Brian Bedoun:

So having that visibility and seeing that change, I think the other thing that I would use as a measure of success is the integration of those evidence-based practice, QI, professional experience projects, enculturating those into our units. We're in the very, very early stages of pursuing a magnet journey eventually, and one of the things that magnet is a beautiful piece of paper but I think that the philosophy that magnet embodies makes a huge difference for everybody involved in that healthcare experience. So evidence-based practice and continuous improvement is a core tenet of any magnet accreditation or reaccreditation. And already having that built into our residency program and seeing that change and that shift where folks are, instead of saying this sucks, I'm having residents go. You know I'm really frustrated about this. I wonder if there's something we can do. And hearing nurses vocalize that agency makes me feel like I'm doing my job.

Nicole Weathers:

Absolutely. I mean, I think you know we get questions a lot too about the professional experience, because it takes a little bit of work to get these residents doing this and just implementing this from an organizational standpoint it's not always easy, and so we do sometimes get the question of like well, could we just take that part out? Do we really need that part? And you know, I always highly advise not doing that because of exactly what you said. Like this, the whole purpose is yeah, we want to teach them about change, we want to show them that they can have an impact, but we really want to empower them to continue to do this work, because we need nurses doing this kind of work and engaging in these sorts of ways, because they are closest to a lot of these challenges and so they're going to be closest to the solutions. And so I think the fact that, like you, are seeing those sort of outcomes because of your program and it's setting you up really well for that magnet journey, I just think that that is amazing to hear.

Brian Bedoun:

I will say it might sound kind of unorthodox, but my hot take about the professional experience is that, when it's done right, I think it's actually the best way to prevent burnout for bedside nurses, because it gives you an outlet.

Brian Bedoun:

I think so much burnout happens because we have immense responsibility as nurses, working with patients at the bedside, and when we see a problem, there's no time, space or capacity to be able to make impacts and you can see the potential for solutions. So having that professional experience and having it be protected so that we can show them how they can do it Because what my residents come back to sometimes is actually this doesn't take that much extra work. They figure out how to do it during the program and then suddenly they go. Instead of having to say, either I want to find something new to work on or I don't think I can keep doing something like this, they go. Instead of having to say either I want to find something new to work on or I don't think I can keep doing something like this, they go oh, I've already got the ball rolling, I'm already passionate about this, we haven't solved this problem, I'll keep going. And that's the thing that I find most empowering and impactful about that professional experience.

Nicole Weathers:

Absolutely, and I think it gives them that outlet to do something about the frustrations. But it also allows them to connect back to sort of meaning and their values and what they find as important, and we know that that is a huge component of well-being and preventing burnout.

Brian Bedoun:

Mm-hmm.

Nicole Weathers:

Anything else in terms terms of metrics, stories, trends that stand out.

Brian Bedoun:

So I will say some of the other metrics that we use if we want to talk hard facts and figures.

Brian Bedoun:

Beyond retention measures, we're also looking at attendance rates and how that impacts retention. Maybe this isn't super surprising, but we do have a pretty strong correlation between a lack of attendance and turnover, either right before that one-year mark or right after completion of residency. I'll put completion in air quotes there, because when you're not able to make it to the meetings you tend not to get the benefit. Some of the other things that we look at are those Redfin surveys that the IONRP program does send out. That's been really really informative data to help us see, maybe, where we need to adjust the program and also see where that positive impact is showing up exactly over time, over time. We don't have a lot of data to trend yet, but early trends have been really really useful in identifying where our residents are starting to experience that reality shock, how that transition is working and then, when they get to the other side, are they truly coming back better or are we going back to baseline?

Nicole Weathers:

And I think you so. I think another guest that we had on the podcast maybe it was last year for the same September episode, but they talked about too, so they had really great data around. If they completed the program two, three, four years down the road, they were much more likely to still be here than, obviously, somebody who didn't complete the program, and so in their case they did have some individuals who stayed employed but didn't keep attending the program for whatever reason, and so to be able to show that information, I think, does also speak volumes to how helpful it can be if they show up and do the work.

Brian Bedoun:

I don't quite have three, four year data just yet, but I did have a cohort complete the program in January of this year and I was pleasantly surprised to see several of them come through at skills days today.

Nicole Weathers:

Excellent, excellent. Okay, so you know I think you kind of spoke to this a little bit already I like to think of it as like my feel good file. So when I'm getting positive emails from people you know, those third party sources, as you said those really remind me again why I'm even spending all this time, energy and effort in the first place. So, since this episode is not just about shining a spotlight on you and in your program, but also honoring sort of the work of the NPD practitioner because this is, we're celebrating NPD week this month anyway so do you have any memorable moments or maybe other success stories from your time as this residency coordinator that just really remind you how important this work really is?

Brian Bedoun:

At the risk of being super corny and I think I actually got this from one of the podcasts from residency where we talked about the self-care, the feel-good file. About the self-care, the feel-good file. I may or may not have a filtered category in my inbox specific to those positive pieces of feedback Just off the top of my head. Following our first residency program completion celebration, we combined that last month into sort of a combo celebration and presentation fair where our residents put together posters. This is just how they're presenting their projects at the end of the year and we invite everyone and when I say everyone, I mean all of unit leadership, all of the quality team, our senior administrators are attending and we get a lot of really positive feedback. And it's not even really me, but I am so incredibly grateful and deeply proud of the work that these residents are doing.

Brian Bedoun:

Phenomenal work in the inpatient unit in Bettendorf putting together a simple little tool to help remind folks about fall precautions. Or we get an ask from our quality director hey, can you send that to me? I want to make sure it's available to all of our units. I'm going to get that uploaded to our print shop. Little things like that, I think, really connect the dots all the way, and those are the things that help me come back to work on the hard days, because it shows that not only me, but it shows the residents, most importantly that what they're doing does matter, it does make a difference and their efforts are not in vain.

Nicole Weathers:

Well, and they're noticing, like clearly leadership is noticing this work and you know, sometimes it does feel like that reward and recognition can be kind of hard thing to really find meaningful ways to show that. And little notes, emails hey, we see you and you're doing a great job. It's amazing how much that can really be all that it takes.

Brian Bedoun:

We have a system called Honoring U's at UnityPoint. It's just a little online blurb in our intranet for folks to submit sort of positive recognition, and I occasionally will get tagged on something for a resident, and more so than sometimes getting feedback for myself. Those are the things that make my day, because I'm like, yeah, you guys are doing awesome, work, awesome.

Nicole Weathers:

Anything else.

Brian Bedoun:

I don't think so right now. I just I'm really, really excited to continue using the program and it's been a really great support for us.

Nicole Weathers:

Awesome, okay, so words of wisdom. What advice do you have for any other NPD professional that's out there, or maybe organization that's looking to strengthen their nurse residency program? Maybe you have some lessons learned, creative strategies, things that you just think like every residency program should be doing.

Brian Bedoun:

I don't claim to be an expert by any stretch, but I think the thing that has been the most helpful for me has been really consciously listening, paying attention to the things that people are asking for and doing what I can to make those things show up in the program, because, at the end of the day, this isn't for me, it's not for some accreditation standard. Those are things that, if I'm doing my job right, should just be happening. The goal for me with this program is to help prepare other humans doing a job that I care deeply for to do that job as well as they can.

Nicole Weathers:

Excellent and you know now so earlier we interviewed Paige and now you, of course, Brian, and I think that has been a theme across both of your interviews is that it's really about one continuous improvement, like we probably didn't get we're not going to get it right the first time right and that flexibility to show up and meet your learners where they are, no matter who they are and what they're asking for. So again, kind of going back to the idea of like we have a plan, a potential, you know, roadmap of where we're going, but if these learners need X, y and Z, we're going to figure out how we can add that in so that we're really are here for them or meeting their needs. And I think that it just having you sort of summarize that and wrap that up, it became very clear to me that those are two similarities between both of these interviews today is that those are things that both of you are doing really well.

Brian Bedoun:

Well, thank you. It's definitely an ongoing process, but I appreciate the feedback that it sounds like we're doing okay.

Nicole Weathers:

Excellent, excellent. Well, Brian, we have had such a great conversation today. I am so glad that you were able to join us. I love that we can shine a spotlight on your program and all the great work that you're doing as an NPD. In your practice setting. You really are making a difference for new graduate nurses and the profession at large, so I really appreciate you.

Brian Bedoun:

Thank you so much for asking for the time. I'm happy to chat. Thanks, Nicole.

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 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.