From the Desk of Deb Burton

December 20, 2019

What does it mean to choose nursing as your profession, your vocation, and your calling?

Steve Jobs, founder and CEO of Apple, experienced firsthand the impact of nurses on his intense journey through cancer care, and summed it up best:

“Becoming a nurse is one of the most selfless acts a person can undertake.
In a society of so many different races, cultures, customs, and beliefs;
nurses are a universal gift to all. The dedicated work they do and kindness they deliver
on a daily basis should serve as a reminder of the fundamental humanity inside us all.“

Yet all that selfless giving, immersion in suffering, boundless compassion; combined with the intensity of highly-skilled and complex nursing practice, comes a very real risk for burnout or leaving the profession altogether. This ethical and professional challenge is ours to fix and to manage. Every nurse who comes to work with us should expect and experience career-long satisfaction, advocacy and career support. We must protect every nurse’s love for the work, reflected in their noble career choice in the first place. How do we do that?

Welcome to the Providence St. Joseph Health Clinical Academy!
In 2015, Providence St. Joseph Health was experiencing greater than 26% first-year turnover rate for new nurses. That meant more than one in four new nurses we hired were leaving us in the first year. At the same time, the health system was spending close to $150 million annually on external agency nurses; mostly in perioperative, perinatal, emergency department, medical-surgical and critical care areas. The solution: a system wide, single program, grounded in evidence and best practices, designed to launch the new nurse graduate’s professional career with us--in the clinical practice specialty they seek. We convened the experts from across the system in 2016 and started with those very five practice specialties.

How does the program work?

  • Nurse Residents, new BSN graduates with less than 12 months experience, are hired directly into Clinical Academy specialty tracks. The first 12-18 weeks are focused intensely on specialty practice, and transition to professional practice. Each resident is assigned a trained preceptor, who works alongside the Resident.
  • Following this initial phase, the Resident is assigned a professional mentor to support career, personal, clinical and professional development. This phase lasts for the remainder of an entire year. During this phase, resident peer groups meet together regularly and the residents are brought back for advanced transition-to-practice sessions focused on professional development and peer support.
  • Now, three years later, 6400+ RNs have completed our Clinical Academy programs, and we are now offering 24 clinical specialty programs. The tracks include over 40 standard clinical simulation sessions.


How do we know this program works?

  • First-year turnover for nurses who completed the Clinical Academy is more than 50% lower than for nurses who did not enter the program, at 8 to 9% (which is below the national average and almost 60% lower than the average first-year turnover rate for all PSJH caregivers).
  • We have reduced our utilization of external agency nurses by over 2/3, now below $50 million annually.
  • Nurse leaders (managers and educators) report nurses graduating from the Clinical Academy demonstrate being well-prepared to meet the demanding needs of their new career and their new practice role.
  • Nurse Residents report feeling prepared and supported for their new practice, and much more confident and dedicated to staying with PSJH.
  • In 2018, our program was the largest in the world to achieve a system-wide accreditation: Practice Transition Accreditation Program (PTAP) with Distinction from the American Nurses Credentialing Center (ANCC).
  • The Clinical Academy programs have been featured at more than 20 national and international nursing and education conferences, and numerous national webinars and publication aimed at best practice initiatives.


Why does the Clinical Academy work so effectively, in contrast with other new graduate orientation programs?

  • The Clinical Academy is the result of a dedicated team of local and regional professional development specialists, working hand in hand with system-level specialty practice program leaders. This team, led by nine Masters prepared RNs (including a clinical simulation program manager) and a senior business manager, is dedicated to creating high quality curricula that support local teams to deliver consistent, evidence-based programs to RNs across the system. The program managers pride themselves on creating active learning events that provide meaningful experiences for the Residents, as well as the preceptors, mentors and educators. The partnership between the Clinical Academy and the local and regional nursing education teams is invaluable to the success of all our Residency  tracks.
  • Most of all, both the evidence and feedback from our own nurses tell us the Clinical Academy programs provide all the essential tools a new nurse must have for career and practice success. Want to experience the Clinical Academy yourself? Click here for a first-hand look at how it really works!


Our deepest gratitude to the incredibly talented, dedicated and courageous leadership team that made this all happen. And most of all, for the reason this all happens: our wonderful and inspiring new nurse residents--the next generation of PSJH Best in The West nursing care!