Beyond Nurse Residency
The Iowa Online Nurse Residency Program brings you the Beyond Nurse Residency Podcast. This interview series provides valuable resources for nurse leaders and educators interested in learning about onboarding, orientation, transition to practice, and ongoing role development of nurses. It is intended for all healthcare professionals supporting various aspects of nursing professional development. Each episode features an expert guest, providing listeners with valuable insights and guidance on relevant topics related to the professional role development of registered nurses.
If you're looking for more information about our program offerings, be sure to check out our website. Additionally, if you're interested in being a guest on the Beyond Nurse Residency Podcast, we invite you to fill out our guest request form. We're always excited to feature new perspectives and insights on the show!
Beyond Nurse Residency
Nursing Professional Development (NPD) Week 2026
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In celebration of Nursing Professional Development Week, host Nicole Weathers welcomes Keri Sickels and Alexandra Gover from Presbyterian Healthcare Services in New Mexico. Together, they discuss how Presbyterian transformed its nurse residency program to support a growing number of new graduate nurses, foster meaningful connections, and improve the transition into practice. From innovative seminar days and simulation experiences to lessons learned in flexibility, retention, and support for today’s nursing workforce, this conversation offers practical insights for anyone involved in nurse residency or professional development programs.
Keri Sickels
Program Director, Nurse Residency/Fellowship, Presbyterian Healthcare Services
Keri Sickels, MSN, RN, is the Program Director for the ANCC PTAP-accredited Nursing Residency and Fellowship Program at Presbyterian Healthcare Services in Albuquerque, New Mexico. She brings more than 30 years of nursing experience, including 20 years dedicated to hospice and palliative care within Presbyterian. Throughout her career, she has served in a variety of roles, including field and hospital registered nurse, manager, and clinical educator. After earning her Master of Science in Nursing Education in 2023, she assumed the role of Program Director in early 2024. In this position, she supports new graduate nurses as they transition into professional practice by creating learning experiences that build confidence, strengthen clinical judgment, and foster a sense of belonging and community within the organization. A native New Mexican, Keri is proud to serve nurses and patients in the community she calls home, and outside of work, she enjoys spending time with family and friends.
Alexandra Gover
Nurse Residency Coordinator, Presbyterian Healthcare Services
Alexandra Gover, BSN, RN, is a Clinical Professional Development Specialist and Nurse Residency Program Coordinator dedicated to supporting the next generation of nurses. Prior to becoming a nurse, Alexandra worked as a paramedic, and her clinical nursing background is rooted in emergency department practice, where she developed a passion for teamwork, critical thinking, and patient-centered care in high-acuity environments. With a focus on transition-to-practice, nurse residency programs, preceptor development, and professional growth, she works closely with new graduate nurses to build confidence, strengthen clinical judgment, and foster lifelong learning. Alexandra is passionate about creating supportive environments where nurses can develop into skilled, resilient healthcare professionals.
Supporting nurses is our priority. Visit https://nursing.uiowa.edu/ionrp to explore our resources for new graduate nurses and beyond.
You're listening to the Beyond Nurse Residency Podcast, an educational series where we interview experts on all topics related to the transition of new graduate nurses into practice and beyond. I'm your host, Nicole Weathers, Director of the Iowa Online Nurse Residency Program. Thanks for joining us. Let's jump in. During
NPD Week And Guest Welcome
Host Nicole Weathersthe month of September, we celebrate Nursing Professional Development Week, a time to recognize the educators, coordinators, specialists, and leaders who support professional development of nurses across the continuum. From onboarding and competency development to professional growth and lifelong learning, nursing professional development practitioners play an essential role in strengthening the nursing workforce and improving patient care. As part of that celebration, we like to spotlight the people and organizations doing that work every day. And this month's episode, I'm joined by nursing professional development practitioners from Presbyterian Health Services and Albuquerque, New Mexico. Presbyterian represents one of our longest-standing partnerships. They have been a part of the Iowa Online Nurse Residency Program since 2016. And while the program has changed hands several times over the years, their commitment to supporting new nurses and investing in professional development has remained steady. In our conversation, you'll hear how the residency program has evolved over time, what they've learned, and why they view their work as an ongoing process of listening, learning, and adapting along the way. I appreciate the honesty and thoughtfulness that's brought to this discussion. And my hope is that you'll find valuable insights, whether you're leading a nurse residency program, supporting professional development efforts, or simply thinking about how we can create better learning experiences for our nurses. Welcome to the Beyond Nurse Residency podcast. Can we have both of you just spend a little time introducing yourselves? So tell us a little bit about yourself, um, and then we'll talk a little bit more about your organization.
Alex GoverGood morning. Um, my name is Alexandra Gover. I am one of our nurse residency program coordinators. Um, I'm one of a main team of five that work under Keri. Really happy to be on your podcast this week. Um, I've worked for Presbyterian for the last going on 11 years, and I joined our nurse residency program team uh four years ago.
Host Nicole WeathersExcellent. Well, welcome and thanks so much. I don't know if we've I mean, I know we've exchanged a lot of emails. I don't know if we've met.
Alex GoverI bother you all the time, but I don't think we've ever actually met, at least virtually face to face. So very nice to finally meet you. Yeah, great to meet you too.
Keri SickelsAnd I'm Keri Sickels. I'm the program director for Presbyterian Nurse Residency. We also have a fellowship program right now. Uh I've been in this role for two years now, almost three. Before that, I was a hospice nurse for about 20 years. So I did all things hospice managed, was out in the field, and was clinical educator for hospice. So this was quite the quite the shift coming into something that was just totally different. I've um I've been a nurse for about 30 years, 31 years now. So been a nurse for a really long time. And this has been just probably one of the most um exciting ventures that I've been on so far. We have, like Alex said, a team of there's six of us total. And um this year in 2026, we we blew up our program and started something totally different with a brand new team and uh a brand new program. So we're really excited about what we're doing.
Host Nicole WeathersExcellent. Well, thank you both for being here. And I'm excited to um jump in to um talk a little bit about some of those things that you've blown up. Uh because I love kind of hearing how each organization sort of utilizes the program and the resources that we provide a little bit differently. So um let's talk now a little bit about your organization, um, maybe how long your organization, I know you've been, you know, here um four years and and two or three years, but we've been working with Presbyterian for a long time. So we'll talk a little bit about how long we've been working with you guys, if you know how many new grads you put through the program and things like that. So um why don't we have you give us give us a little bit of perspective and context about about what we're talking about here today?
Keri SickelsSo
Presbyterian Program Scale And Growth
Keri Sickelsoverall, Presbyterian Healthcare Services, we are a uh we're all over the state of New Mexico. We're only in New Mexico. New Mexico is a very rural state where we are in Albuquerque and Santa Fe, not as rural, more urban areas. Um, we have right now around nine sites that we are serving, three hospitals in Albuquerque, one in Santa Fe, and a couple of emergence, like standalone emergency rooms. We are also since our program has been around since 2015. Um, we started with our accreditation journey at that time, and we have been accredited with the ANCC PTAP organization since 2016. And that was the same time we started with the University of Iowa as our main content provider. Um, we've had 671 new grad uh RNs from 2016 to 2025, but this year, when we changed our program so far, um from January until right now, we've had 178 new grads. So we have um really increased our numbers exponentially at this point, um, just with our our restructure.
Host Nicole WeathersAwesome. And so so that growth in volume, is that because you've started working with multiple hospitals within your system um mainly, or are you just hiring that many more new nurses?
Keri SickelsI think it's a culmination of both. We historically, where we were before 2026 is we were interviewing people. So we had just um we had med surge and progressive care, OR, emergency department, PEADs, and critical care. And so I had care coordinators for each one of those areas, and we would interview appropriate candidates to come through. So we we were pretty picky about who we brought in. Looking at, and Alex brought up a really good point earlier, with the way things are going generationally and the changes that are happening in nursing schools and who we're seeing coming out. Um, our CNO came to us and said, How can we help new grads? And I said, Well, I've got a great idea. Um, I feel we felt really strongly that all new grads needed to come through our program because they weren't historically coming through our program. We were just, we were just interviewing. So she gave us the green light and we re-evaluate it, and now all new grad RNs are coming through our program. We opened up a couple of different units in our hospital system. So they are just hiring like crazy. They're trying to transition out travel nurses right now so that we can get more staff. So we are seeing just this huge influx of new grad nurses. Um, I don't know that we're seeing a lot of experienced nurses in the workforce right now. They're doing other things. So lots of new grad hires that are coming into the system.
Host Nicole WeathersSo it sounds like a lot of changes taking place internal to the organization. We've seen a big growth in the number of new nurses that we have coming through our program for a variety of reasons.
How The Residency Evolved
Host Nicole WeathersSo now I would love to shift and talk about kind of how this program has evolved. Uh, I mean, you might not know exactly what it looked like in 2015, 16 when you started with us. Um, but kind of walk us through some of the you know biggest shifts that you've seen with what you guys are doing.
Keri SickelsSo in 2015, um, I think the program started with the idea that we needed more OR nurses. And so they they built this program to really bolster the OR and bring in um new nurses to that area. I think that a lot of people want the OR, but it's such a specialized area. So they they kind of focused on that. And then as the 2016-2017, we started adding more areas uh that we were going to bring in. And that's where we went into the med surge for aggressive care and I think emergency department at that point. And then it was a little bit later that we went into PEADS and critical care. So I'll let Alex talk a little bit more about that.
Alex GoverYeah. So um when I initially came in, I came in in 2022. Um, I was supporting our emergency departments with another, I was co-coordinating with one of our other team members. And then that's when we were introduced the the need for a pediatric program. And it it was just a lot of, like Keri mentioned before, we were a little bit more selective of who we brought in because we were able to. So we were able to be a little bit more heavy on their skills and heavy on their specialties and be able to support them a little bit more one-on-one. So our program did look a little bit different then. Now that we've kind of transitioned, we still support all of these same specialty areas. We still have SMEs that look over every single one of those specialty areas, but our program has had to kind of take on a new form so that we could support bigger masses. And it's it's been a challenge, but it's been an awesome challenge because we've been able to look at our content and look at how we deliver that content in a way that's still meaningful to support these new grads that need it.
Host Nicole WeathersBecause we get a lot of questions too about, I mean, we work with a wide variety of organizations, a wide variety of sizes of organizations. Um, and you know, we've always felt pretty strongly that this program can be adapted in a lot of different ways to kind of meet the unique needs of your organization. So maybe now you can walk us through how are you, you know, utilizing the resources that you have available to kind of support this while at the same time meeting all these unique care needs that you guys are, you know, supporting through this program.
Alex GoverCurrently, or at least that we're we're still built in for this first year, but what we have found has been working with this current cohort is we we kind of now shape our seminars and our meetings with our residents around the Iowa content. So it used to be that we would deliver the Iowa content kind of as a supplement along with the other things that we were doing. Now a lot of our focus is around what Iowa is covering that month. Um, so we it it has been really helpful because there is kind of a theme for the month, whether it's you know, habits and routines or managing critical conditions. We provide that content that's kind of universal regardless of what specialty that individual is in. And then we provide additional organization specific content to kind of help them in their transition, not just to nursing, but to our organization as well. So we we focus heavily on the big themes that Iowa provides, and then we come in and supplement with the organizational specifics. Um, and then we add in some simulation and some skills to that, and it it just creates a really well-rounded, meaningful day for them.
Host Nicole WeathersSo I know um kind of traditionally or historically you guys were um you know doing some more of like weekly, weekly versus monthly um type of approach as well. Has that it sounds like that's shifted um too with your your current version of your program?
Alex GoverYes.
Monthly Seminars Over Weekly Overload
Alex GoverSo it used to one of the the honestly the biggest dissatisfiers that we saw with the way we the program used to run is it was a very immersive 16-week program. So within those first 16 weeks, they were in residency for a year, but that first 16 weeks weekly, we were just jamming this information into them. We would provide them the Iowa content, we would talk about professional development, we would debrief, but everything was within an eight-hour period every single Monday. So then they were just kind of, it was all a fire hose, but it was, they were just trying to absorb as much as they could. Um, when they would get to the end of their program, it was pretty evident that they didn't really have context to really speak to what we were talking about. They hadn't managed their first codes yet. They hadn't had a lot of these like missteps, they hadn't honestly reached that six-month mark where they start to go into kind of or they can go into that crisis stage. They we weren't following them in the way that that we should because it was all so immersive in those 16 weeks. So now we meet with each cohort. We have currently we're about to start having three running cohorts. We meet once a month. Every single cohort meets on a separate day, and we are able, it's still an eight-hour session, but we're able to use context from that entire month for them to be able to speak to. We are still being able to follow them closely when they hit that six-month mark, when they hit those milestones, when they're starting to spiral a little bit, and we can then offer better support rather than relying on them just reaching out to us three months later after not meeting with us regularly. We have them in front of us in person, and we can we can help better guide and better support truly for that first year of transition.
Host Nicole WeathersAnd you know, we do see this a lot, and it and rightfully so, right? I mean, there's so much that new nurses sort of need within that first year. And it's like we want to get it to them so they have it when they need it. Um, but I do think you've sort of hit on something here, like it can be so overwhelming sometimes. I mean, it's so overwhelming in those first few months anyway, just like, how do I navigate this new organization? How do I survive my shift, let alone taking in all of that information on top of it? So um I think we see a lot of organizations that are kind of pushed a little bit in this direction to get it all done within the first three, four months, if they can. Um, and so it it's interesting to kind of see you guys pull back a little bit and try to do this a little bit differently. So walk us through sort of what that eight-hour day looks like for you guys.
Keri SickelsWell, that just depends. Um, we're we're kind of building as we're as we're flying, really right now, but it uh typically we wanted to make sure that it was an all-inclusive day so that we don't give them any extra homework. So we bring them in and um we like to welcome them, let them kind of get established. We usually have some snacks for them, and then we will start our professional development. So we take uh we take the concept that Iowa has each month and we talk about where they are in their transition because it's one of the things that we didn't address as much prior was the actual transition theory. What is transition shock? Where are we and and how um and where you are right now as normal? So we kind of start off with something like that, and then we talk about their professional development. Um, we've started incorporating games into that. So we might take the content and put it into Kahoot and have a game, and so that we're delivering the content, but we're also, you know, they're on their phones and they're they're answering questions. So we try to make it fun and engaging because a lot of their feedback is we need we need more engagement, we need more activity. After that, we either try to do like a guest speaker, um, and again, somewhere along the lines related to whatever the theme of the month is. Um, we've had pharmacists come in, we've had the wound care team come in, we had our board of nursing come in and talk about diversion. Um, that was an excellent one. And everything has a little bit of a wellness edge to it with um with PTAP right now. Wellness is a huge thing. And so we want to make sure that we're incorporating wellness. And you guys do a great job. That's always in the content. So it reminds us that wellness is really important. And then we try to give them time in the computer lab so that they're working on their monthly content here, that they don't have to do it at home and they can ask us questions. Um, and while one group is in the computer lab, we probably have another group sometimes doing simulations. Uh, we've got a brand new simulation center here with our hospital system. It's the only accredited simulation center in the state of New Mexico. Uh, it's gorgeous. So we're really fortunate that they can go in and we can we can run some really cool um simulations as well. But we try to change it up every every month and have something new and exciting and engaging because they don't always like coming in. Like they kind of roll their eyes, and but when they get in here, we've got food, we've got activities, and and I think for the most part they're really engaged.
Alex GoverAnd I I think just to add, I I think our group has also tried to be very intentional about listening to their needs. Um, and one of the things that we're finding is like early on, our group is really big on like let's have jam-packed full days, let's have activities, let's have all of these, let's deliver them meaningful content. And then some of the the feedback that we get is we just want to debrief. We just want more time to talk to each other. And we'll be a little bit like surprised because we're like, oh, you guys, you guys don't want structured activities, you guys just want to vent to each other. Fantastic, we can do that. So as it's awesome to see as they're progressing through their year and as they have more to talk about and as they build relationships with each other, having the ability to give them that space to be able to talk to each other, to vent with each other, to see that they're all facing the same struggles, regardless of department or specialty, and building the program in a way where we can offer that to them has been really great.
Host Nicole WeathersI really like to see the combination and how you are building uh the program sort of around that core content without replicating the core content. So one of the challenges I think sometimes is you know, that we have them go online, do the online content that's available, and then it's hard to not then shift to, and then when we have them in person, kind of re-delivering some of that. So I love that you're pulling in guest speakers that are related to, but not a duplication of what's happening online. Um, that is one area where we have seen other organizations sometimes struggle a little bit, is doing that. And then, you know, the feedback from the participants is well, what are we doing with this online stuff if if we're just gonna, you know, have it again when we're in person. So that's really neat to see. I love building in the simulation, giving them time to do some of that online content um while you have them there in person, I think is great. We see a lot of organizations at least offering that. Um, you know, even if it's the last, you know, hour or two of their day together, you know, maybe they choose to leave anyway. And if that's the case, then, you know, just making sure they have that done before they get back. Um, so a lot of really, I think, neat, um, unique things that you guys are doing to really make this work for you.
Reaching Residents Across Nine Sites
Host Nicole WeathersHow are you bringing? So you talked about you said at the beginning you have nine sites that you're currently supporting. So talk to me about that. Are they all physically coming in person to you at one main campus, or what does that look like?
Keri SickelsThey so when we built, when we started building, we reached out to all of the managers, all of the senior leaders, all of the managers, and told them what was going on. Um, explained all of the things, met with them, we had meetings with them to explain to the the nursing leaders what we were doing. And we felt really strongly that it would that they should be here in person. And so we right now, even though we have people all over the state, we're focusing on the greater Albuquerque area and Santa Fe, which is drivable, so that we can bring everybody to um our location. And we're located within the simulation center, so it's our clinical education department. And in the in the area that we're in, we've got um we've got auditoriums, we've got the this the education rooms, we've got all of the things we need here. So we bring everybody here, um the computer labs, all of all of the things. Um, and then we just commute make sure that we are continually either rounding on the units that we serve. Um, and I'm constantly communicating with the managers. We're we do back and forth feedback just to make sure that we are trying to meet the needs. Um, it's hard to meet everybody's needs when you're building. So um that's something that once we get it built and we have the content relatively stabilized, then we start adding the layers of support that need to come in after that.
Alex GoverWe also have a really awesome data analyst that has helped us create a lot of like virtual platforms where we can have folks reach out to us. Because one of our, like Keri said, there's six of us total and there's nine sites, and there's like dozens and dozens of folks coming to us every single two weeks. So sometimes it is a little bit overwhelming for us to feel like we can give adequate support and we can build in a way where we can provide support in the way that we're promising them. Um, so Shiloh and some of our team members have built a function where they can report issues, just they can log in, they can report it, it'll come to all of us. And then we can partner really closely with their unit educators. So if there's any issues with their preceptors or there's any issues where they feel like they're just not thriving in the environment that they are, we can then kind of collaborate, we can set up Appointments with them so that we can still support them and they can still alert us of things going on without us being able to always physically be there. We can still provide that support. And it's been really helpful. That's amazing.
Host Nicole WeathersI mean, I think one of the biggest challenges with um new grads sometimes is getting in front of them when they need you, right? So um, yes, I'm always here, but if there's not an easy way to access me, then I don't find out that you're having issues for a month or two months. And then, you know, sometimes um too much time is maybe passed to salvage that. So I think that's really cool that you guys have something where they can be a little bit more proactive about reaching out to you guys. Do you find that they're using it? I mean, do you find that they're quick to use that tool?
Alex GoverSo I think the the folks who need it are definitely using it. I think it's it's I always kind of joke that it's kind of like a Yelp review. So if they have something that they need to escalate, they will absolutely escalate it. But then the folks who are are doing well and don't need it, we won't necessarily hear from them until we see them again during our monthly visit. But I I guess that's the purpose of it, right? If you're thriving and you're doing well, we hear about it from other avenues. But if you do need somebody to check in, we're glad that there is a platform to do that and that they know how to access it. That's great.
Host Nicole WeathersI know. And that's one of the challenges, I think, as we talk about, you know, evaluating our programs is um, you know, we hear from the people who, you know, the all-stars, right? The people who are loving everything and they're, you know, A plus sort of participants. And then we hear about the people who are maybe struggling, but like that, that quiet sort of majority there in the middle, um, we tend not to, I don't want to say pay as much of attention to them, but they're just not as vocal. So we don't necessarily hear from that. So that's great that you have that sort of setup and in place. So it, you know, I mean, you really, your program has evolved from, you know, an intense 16-week focus mostly on OR nurses to now this sounds like very comprehensive, robust, more sort of extended year-long. I know it's been year long in both versions of kind of what you've talked about, but just kind of spreading that support out throughout that entire year a little bit more evenly.
Keri SickelsI think my favorite part that I'm seeing so far is really watching the evolution of the nurse. You know, when they first came in the first day, they're all usually pretty excited and they're all smiling. And it's just, it's refreshing to see these new faces. You know, month three, month four, it's not so much like that. There's not a lot of smiling. There's, you know, it that's the hard period when they when we actually when you can see the transition shock that is actually happening in front of you. And then you get into to month six, month seven, where they're starting to feel a little bit more comfortable and they start to smile again. Um, and so I think that it's just been a really fascinating um way to to support them. And I I'm we're I think we're all learning so much. I listening to the evaluations, um, we really do take everything that they write and we look at the and we decide, hey, next month should we do this, should we do that? Because this is this is what we're seeing with the feedback. So we really want to be intentional about this is for them. This isn't for us, this is for them, and we want to make sure it's what they need.
Surveys Retention And Resident Belonging
Host Nicole WeathersSo, talk to me a little bit about how you do evaluate the program. What does that look like for you guys?
Keri SickelsWell, like Alex said, we have an amazing data analyst. I I really can't um brag about her enough. And then just the support from our senior leaders and our managers and our clinical education team. And so we're looking at a lot of different things. And then you all, the support that we get from you guys is also really amazing. So we've got Casey Fink when we've got um another survey that is a pro qual survey. So we look at, you know, where they are at the beginning and in the middle and then at the end. Um, and with your help and and Shiloh's help, we're able to kind of take some of that data. We do a stakeholder survey as well. Um, some of the metrics that we look at, everybody looks at retention. So we want we really want to see what retention looks like. And then our month-to-month surveys that we do. Hey, how did how did you like it today? What did you learn? You know, the guest speaker that was here, what was your favorite part about that? Can you take away something, at least one thing with everything? Um, and overall, for the most part, we're seeing lots of positive um feedback. There's always going to be the naysayers that are just like, you know, their hands on their head and they're rolling their eyes at you or whatever. What we're seeing here in New Mexico is we're getting a lot of people from all over the country and all over the world that are coming into our organization now. And so we're looking at statistics on that as well. Where is everybody coming from? Are you coming from New Mexico? What schools are you going? Did you go to? Um, what is your degree? We want to see just like who stays, how long are they staying? What are they trying to get from here? I think at the beginning of the year we were looking at about a 20% rate of people coming from across the country. And now we're at like 50-50, where 50% of them are from New Mexico, and about 50% of them are from around the country that are coming to our program, which has been very exciting. I they're coming to our organization. Uh, they have to come into the program. Uh, we we changed our policy and and said all new grads have to come into the program. So um they get to come into our program, uh, but they're coming to our our hospital system, they're coming to our organization, they want to work with us. So that's exciting. So we're looking at um now that we see some of these changes, what is going to be the long-term effect of that? How are they doing? You know, what are they saying about the orientation? What are they saying about the program? Um, all of those things.
Host Nicole WeathersWell, and how does our program need to evolve to meet some of these unique needs, right? So just a couple months ago, we had a guest on the podcast who talked about supporting internationally educated nurses as they come in. And, you know, his conversation was super interesting. But what my one of my takeaways was like, this is all great. And I think it could be applied even if we're not talking about internationally educated nurses, but just people like if you've got 50% of your new nurses coming from outside of just your state, you know, there's a lot around community and um sort of helping them become a little bit more embedded so that they want to stay. And and, you know, there's always this fine line of like, is this an organizational issue that needs to be addressed? Is it something that the residency program is really responsible for? You know, but I do think that all of those factors kind of matter when it comes to retention. So always kind of keeping that in the back of your mind, right? And thinking about, you know, how could we maybe um, because one of the things he talked about too was kind of connecting like groups of people. So if you've got somebody who's from this country or, you know, whatever, kind of making sure they know who are other people within the organization that are kind of similar, um, have similar backgrounds and things like that. So they feel a little bit more connected.
Keri SickelsWe're seeing that a lot of these people that are coming from across the country are international. And so, and and there's a network, they seem to know each other when they come in, which is really nice. And so they kind of are developing their own community within our community and they're reaching out and they're meeting new people. It's been really interesting just how the integration comes with the people who are from here and we're meeting new people and different cultural aspects of that. It's been really awesome to see the changes and what is coming to our system.
Alex GoverIt's been really fun to be in a position to kind of help keep empowering those connections. One of the things that we do in their first week, they have one day for their first orientation week that is kind of a free day for them. But being residents, we send them on scavenger hunts in their organization. So, like Keri mentioned, a lot of them are already coming in knowing each other, or they moved here from other states and they're living together and they're sharing apartments and they're already building a community. So we offer them a day where we pay them to go and get lost in their hospital systems and drink some coffee together, have some lunch together, be able to continue to build those connections and all in hopes to bring down some of the anxiety of this new place that they're going to be working in the following week, trying to get lost together and make some memories together, I guess, in a way, but still be able to kind of encourage that connection has been really great.
Host Nicole WeathersYeah. I mean, I we had another podcast guest come on and talk about the importance of social connectedness and belonging at work. And, you know, we see loneliness and social connectedness and belonging outside of the workplace as a major issue across the US, right? And so it only makes sense that those would be important things to focus on inside the workplace as well. So I love that you are, you know, providing that day and providing that time to just build those relationships because they are so important. Absolutely.
Keri SickelsAnd that's part of the reason that we bring them together into seminar in person, because then they also have not only their hospital community, but they've got their residency community. And a lot of the people who are from here went to nursing school together. So they can get back with the people that they went to school with. And so you we we're seeing lots of just really cool bonds that are being formed with the groups that are coming in.
Host Nicole WeathersSo I get questions all the time about retention. Do you have any retention data that you could share with us?
Keri SickelsWe look at it like three, two, one. Um, and we're on average above 90% with new grads because we're so different right now. We haven't looked at that just quite yet, but we're we're in the 90% range, above 90%. It's been a tough year for us, and I and I don't know what it's going to look like exactly. But we've got when you get rid of your travelers and you're bringing in a bunch of new grads. So when you have change in the hospital system in general, there are people who are going to stay and thrive. And there are people who I think that they didn't really understand what nursing was. And so we've had some of those people that come in and they're like, this is not what I thought it was. And so we're seeing some people that are leaving just early on, um, that regardless of how much support or resources or anything that you offer them, they're just this just isn't what they thought. Um, so we don't have any new data yet for what it's going to look like since we started our new program.
Host Nicole WeathersSure. Well, and I think just having this larger influx, putting more in the program, I mean, those numbers are going to change simply because you have more people, right? So um, but that's great that historically, you know, looking at, you know, 90% or above, especially since you've been, you know, with us for 10, 10 plus years at this point. Um, so that's that's great to hear. And I'm eager to see again how that continues, you know, to evolve into the future, because really, you know, having that support more spread out throughout the year. I mean, to me, it seems like it's only going to help with that for sure. Okay. So even obviously with well-established programs, the work is never really finished, right? I mean, I think your story so far has kind of showed that. Like as your needs evolve, your program evolves. And and I know it would be lovely to say, hey, we're done, we're here, but there's always going to be um influences that make us kind of think and rethink things. So where's some of your attention right now? Where are you continuing to kind of refine things as as you continue to move this forward? I think we're
Scaling Cohorts And Modern Learning
Host Nicole Weathersrefining 24 Dead in.
Keri SickelsWe had a concept when we went into this new structure uh in the first. So we have organized our cohorts where we're gonna have three a year. And so anybody who starts and they can start anytime. Anybody who starts in the months prior to that cohort is in that cohort, right? So they could have been with us for three months before they actually start their first seminar. So we have to look at all of the aspects of where is everybody when they start? What time are they gonna start? Um, our first cohort had 49 people in it, our second cohort had 89 people in it, and our third cohort right now is looking at over 100. So we not only are we looking at making sure that, you know, we just did this seminar day with cohort one and it went like this, and we kind of need to make some adjustments. We have to make adjustments to incorporate more people than like if we're gonna do this sim and we did it with 40 people now. How do we do the sim and we do it with 80 people? How do we get that many people into a computer lab that only holds 40 people and you've got 80 people? So we are constantly having to kind of rethink not only content if we need to change content, but logistics. Um, and so we meet regularly. The team, um, I I I can't the team that we have right now is the most amazing team of women I've ever worked with. They they come together, they collaborate, everybody is just uh the ideas that come up just amazing. Everybody is so passionate about the new graduate experience. And so we're just constantly writing ideas down and figuring out what's going to work and trying to engage and not step on each other's toes because everybody's so passionate about what they do. So, like it's we're forming as a team. My team is brand new. Um, at the end of kind of the middle of last year, uh, we had a complete team makeover. Um, and so Alex and I uh we hired four new people to be on our team. And so not only are we building the program, but we're also forming as a team. So we're kind of doing all of the things all at once. Um, but it's been an amazing experience.
Alex GoverYes, to everything Keri said. It's been it's been a lot, it's been a challenge, but it's been an awesome challenge. And I honestly, at least for me, I think when we look at just where our focus stays, I think our focus just stays on remaining, like providing meaningful content. And that changes with every cohort. A lot of the the struggle is logistics. A lot of the struggle is just, you know, how do we we know that a lot of them, this is like their fourth shift for the week that they're coming to us. Some of them are in overtime. Everyone has their own lives, every resident has stuff going on outside, they're having to balance their switch in from night to day shift or their child care needs or whatever that looks like. So we never want them to feel like they're coming in because they have to. Um, one of my favorite things that Keri says is you get to come to our seminar. And we we truly try to build days that empower that idea. So it's it's just focusing on trying to remain meaningful, trying to deliver meaningful content, trying to deliver information that's going to help them on the floor, like they can take it and directly implement it in their practice. That makes our months a little bit challenging sometimes because we we never just want to have them sitting in a room doing nothing. We want to make sure that while they're with us, they are receiving information that's that's relevant to them.
Keri SickelsAnd we have a lot of specialties, right? So we have to be really careful not to be too specialty specific. It has to be the content has to be general enough so that it that everybody gets what they need for their specialty without being specialty heavy. That's been an interesting thing to maneuver around.
Host Nicole WeathersYou know, one of the soapboxes I've been on lately too is about sometimes it can be really easy to design a program for what the organization needs. Um, and in that we kind of lose sight of what the new grad maybe needs. And so as you're describing this, I can't help but think about how, I mean, you are really keeping your eye on this new graduate and what it is that they need from us and designing your program to meet those needs. And I think that's where some of the logistical nightmares can come in, right? Because it could be, it could be maybe a little bit easier to say from an organizational standpoint, this is the easier way to do it. So this is how we're going to deliver it, versus from the new grad perspective, and this is this is how it could best fit them. And then we'll figure out the logistics as we go. Um, so I want to commend you for doing it that way because I know that if in my head, anyway, if we do it this way, retention, engagement in our organizations is going to be a byproduct of what you're doing.
Keri SickelsWe are passionate about these new grads and we really we do want them to succeed. And we what we're seeing, Alex brought up a really good point earlier today, too, about just the generational needs and where we are now isn't where we were even a couple of years ago, with what are their expectations, how long can they sit? And Alex brought up a good point about your content evolved with the where we are, shorter, little snippets of learning snippets where when they're when they're doing their computer work with with the Iowa content, it's shorter, it's more, it's easier to listen to. It's because their their attention is so scattered, they can't pay attention for a long period of time. Um, and so we see that you guys are meeting their needs where they are as well. And and we're taking that and trying to to really mimic that to where we're not having them doing any one thing for a long period of time because it's not it's not super doable.
Alex GoverAbsolutely. One of the um, at least with with like younger generations of nursing nurses that we're seeing come out of school and join our organization is they are they they very much want the information now. They want it brief, they want it concise, tell me what I need to know and only what I need to know. And in nursing, that can be really difficult and really challenging and honestly really unsafe. So being able to find a way where we can still keep them engaged, offer that information, but then still develop critical thinking skills has been quite a juggle for us. Um, so in the the conversation that Keri and I were having prior to this about the shift that even your content has had through the Iowa platform, it's been really nice and really well received because it previously had been longer sessions that required a lot of attention versus now it's micro learnings. It's short snippets, short, concise, like this is what you need to know. This is like how you can you can take the information and then you can kind of run with it. And it's incredibly well received since we have kind of seen that since I have been here to see that that shift from what it was to what it is now. It kudos. It was really great. And people really like it.
Host Nicole WeathersI mean, and that's why we did it, right? I mean, we were looking at I feedback again from participants that, you know, 20 minute, 20, a 20 minute module, a 30-minute module is is too long. And you have to have it at a you have to be at a computer. And so um, you know, I know that you guys are still having them, you know, in the computer lab doing some of this, which is great. And and you can definitely do it that way. Um, but we also wanted to design it in a way that was a little bit more flexible for them. So we know that these nurses aren't sitting at computers every day in their office, like maybe some of us. Um, and so how could we deliver this in maybe a mobile-friendly sort of format? Um, and we've had a lot of great feedback about it as well. So I'm glad to glad to hear that you guys are are seeing that and that's working well for all of you.
Advice On Building A Residency
Host Nicole WeathersSo you guys have been doing this a long time, or your organization's been doing this a long time. Um, so for organizations who are maybe a little earlier in their journey, maybe they're just getting started. What words of advice do you guys have? What do you wish maybe you would have known? What took a little bit longer than you expected? What do you guys think?
Keri SickelsI think that it's okay to know that you as an organization might be going through transition shock too. Um, anytime you start something new, you've got like this. I'm gonna do these great things, it's gonna be amazing. And then the the the work starts and the work is hard. And so it seems almost insurmountable, kind of as you start getting into it. And then you hit a point where like, okay, we can do this, we can do this. And it really follows transition shock. Um, what I appreciated as a new person into this was knowing where my resources are. I'm a firm believer in who are your resources, where are they? And if you understand who they are, then they can help you with other resources. And so one of the things that I was really fortunate to have when I first started was uh was you guys. Like I reached out to you and said, hey, this is kind of what I'm thinking. And you put me in touch with other organizations who are doing the same thing that I was thinking about. And so reaching out to those connections, finding other people who are either in the same boat, who have been there, and just talking to them. Um, we went to the ANCC PTAP conference. I went last year, I went this year, meeting people again in those arenas and then and having having the resources that you can reach out to, networking with people, finding out what works and what doesn't work with small organizations and big organizations. Um those are all super, super important. I think one of the really, really important things also is understanding your organization. What are your organizational needs? Who are your stakeholders? Not even just within your organization, but in the state, like the Board of Nursing, the schools, those types of things. But I didn't understand when I first started. I mean, it was just enough to keep our heads above the water at that point, right? And then listening to your team, having a good team that you work with, whether whether you are blessed enough like I am to have coordinators that work just for the residency program that are that this is all we do. And it I can't stress enough how much of a blessing that is. Um, but also your your partners in clinical education or your partners in all around. I think that it's just important to know who those resources are and where you can go to find the help that you need and not being afraid to ask when you do need help or when you don't know where to go. But there are so many people who are willing to help. This platform and this arena, right? Everybody is so gracious and so willing to offer help when it's asked for.
Host Nicole WeathersI think we all have the same goal in mind. We want nurses to have a good first year so that they continue to be nurses, right? They continue to show up. Um, and so I think having that common goal, it's really easy to just you know share, right? And and I agree, networking is a huge piece of it. Um, so glad we are able to support you, glad we're able to connect you with um people who could kind of help you think through some of this and and learn from them and what's working and what's not. So appreciate that.
Alex GoverI would say be flexible. And I know that that sounds so silly, but being that almost everyone on our team is very type A, we come in to every single plan thinking we have it figured out. We think it's gonna go perfect, we have an agenda, we have like time slots for everything. And then inevitably somebody throws a curveball at us and we end that day where we're like, we didn't anticipate 30% of that day happening the way that it did. Um, and that that doesn't mean it's a failure. That doesn't mean that it was, you know, that it needs to be scrapped and completely rebuilt. It still has good bones and we just need to adjust some things to to better meet the needs, which is why we're here, right? We're here to to meet those needs of our new graduates. Um, but going into it knowing that you need to be flexible, knowing that we we laugh because the like word around our office is pivot. We are master pivoters. Um, and our our eyes twitch a little bit as we are pivoting, being open to that and knowing that that's part of the process takes so much stress off of just your workload and off of the plan. Because it's it's a big build, it's it's a big lift. But going into it knowing that you're going to have to be flexible, you're going to have to make adjustments. And you may think that it's all built at the end of the day, but you're gonna need to rebuild, and that's just part of the process. It was a big moment when I, for me, when I realized it. I struggled a lot before I realized that it's just part of the process and it's part of ensuring that your program remains beneficial, being able to constantly look at the work that you did and and edit it and revise it to make it even better.
Host Nicole WeathersAnd that was something I was just talking to another um organization about, you know, who's looking at wanting to implement this program. And I said, I'm just gonna be straightforward with you. The first year is going to be the hardest because you're doing just that, right? Like you're figuring it out. And as nurses, I think we like we follow policy, we follow procedure, we do uh, that and get an end product. And with this, there's so many things that influence this program or whatever you're putting together that you are constantly needing to revise and needing to improve. And and that can be a little overwhelming, I think, at times. And it sounds like you've you've described that pretty well there. And I think the other thing that's maybe unique to nurse residency is it takes a year to get through it, right? So it takes a whole year to see this program from start to finish to really be able to evaluate. I mean, yes, you you're doing this as it goes, but sort of kind of that end product. And so it takes that much more time then to to tweak it for the next group and then see that through. And so I think that does kind of magnify that process a little bit more because I mean, if you think about a year-long residency program, that is a huge, that has a lot of moving parts and pieces and things that we need to be thinking about. It's a lot.
Keri SickelsAnd then when you've got three concurrently going on at the same time, it's it's even more.
Host Nicole WeathersYeah,
Meaningful Work And Next Steps
Host Nicole Weatherslike sometimes it's like what way is up, right? We're trying to keep all of our wait, who what day are who's who's this? Uh-huh. All right. So since this episode is part of our nursing professional development week and we're celebrating all of our amazing nursing professional development practitioners that we work with, we want to, of course, recognize the two of you as well. So as you kind of think about your role as an MPD right now, what feels, you know, most meaningful about the role that you're playing right now?
Alex GoverMy favorite part of my job is being able to be present to see things click for them. They will come in and it'll be the smallest things to us, right? We will think we we had one um resident a few months ago who sat down with me and was just kind of like, hey, Alex, so I I don't think this is for me. I think I want to quit. I think I want out. And I was like, tell me, you know, tell me more. Tell me what's what's going on. And she was like, I get really anxious on my way to work. And I sit down in front of my computer and I can't really like, I can't even focus on receiving my report. And I just, I just think this isn't for me. For lack of better words, it's funny to see how they just aren't, they don't see it. To them, they think that they failed, they think that this isn't for them, that they shouldn't be there. So being able to just have that conversation and say, hey, you know, like this is normal, this is expected. You are going through that normal cycle. Let's talk about that same like transition cycle that we talked about on day one, and realize that right now your body doesn't know the difference between getting report and being chased by a bear. Like it's it's the same thing to your nervous system and having her look back at me and her eyes widen and be able to say, Oh, like you're right. And then come back the next day and have good debrief sessions and have good moments with her peers and be able to share the stories of what she's going through and not give up. It's the most rewarding part of my job because I I truly think that the position that we're in allows us to be able to encourage these new graduates to stay, to see that this is normal, to be that support that maybe some of us didn't have when we first joined this field and to just kind of help them keep pushing on. That is to me the most rewarding part of this job.
Host Nicole WeathersThat's a beautiful story. And I think sometimes we just need a little perspective. And I think that new grad coming to you and you being able to provide that perspective to them about their experience and and how they're feeling in their own body right now. I mean, I would give anything to go back to me as a new nurse and have some of that support available.
Keri SickelsAnd I think that that's where we all kind of come from, right? Like what how can we we just have a heart to help and to want to support. And so my favorite things that my passion is built around not only the new nurses that are coming in and watching what Alex said and just watching the growth. I just, you know, from day one all the way through month seven, it's been such a a journey, but really very cool. Um, but also watching my team grow together and seeing the changes and seeing the thoughts that come through and the growth that comes from learning, because not only are the new grads learning, but we're learning and we are building connections and doing different things that you know, everybody that came to the team had their own strengths and they were amazing in their field, but we're just doing different things than we used to do. And I I love watching that. I love watching the teamwork, I love watching how they work with the new nurses. I I can't get enough of watching Alex talk to these people. I it I'm just in awe of the things that come uh to her and the things that she says to them. It's just like I would love to be a new nurse with Alex as my mentor. Like, oh my gracious, it's amazing. Just and in picking up those tidbits from everybody's little thing, you take all of those pieces and then you build your practice. And I think it's just really, it's just a such a blessing overall.
Host Nicole WeathersWell, nursing professional development is is really an amazing role to be in, right? You get for the most part kind of taken away from the bedside. And so sometimes you feel like, am I even making a difference in in in our patients? But really, your influence has now been multiplied by, you know, 671 uh nurses that you got your program has touched. And so all the patients then that they've cared for. And, you know, again, sometimes it takes a little bit of perspective, um, but really is just amazing that you have the power to influence so many new nurses, so many new nurses in their career and subsequently the patients that they care for. So I just, on behalf of our nurse residency program, um, the University of Iowa College of Nursing, we greatly appreciate you guys as partners in this effort. We are so happy that we're able to support you and help you do what you do. Um, and so thankful that you are here for your new graduate nurses and you're continually working, you know, to improve your programs and help your new nurses improve their practice. Thank you for all of you guys do as well.
Keri SickelsWell, thank you. We we really appreciate the support and the collaboration with you all. It's been an amazing journey that we are continuing on, and we're grateful for you guys too. Thank you.
Alex GoverThank you so much for constantly triaging all of our crazy questions and everything that we reach out about for Canvas and for everything. Your team is always so, so gracious and patient with us, and just such a wealth of knowledge and such wonderful, wonderful people. And our team is so incredibly grateful to be able to partner with you guys.
Host Nicole WeathersWait, 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. 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.