Orientation program for hospital-based nurse practitioners.

The transition from student to practicing clinician is often a challenging and difficult period for many nurse practitioners. Newly graduated nurse practitioners commonly describe feelings of inadequacy in assuming clinical responsibilities, lack of support by team members, unclear expectations for the orientation period, and role isolation. This article describes the formal nurse practitioner orientation program implemented at the University of Maryland Medical Center, a large urban academic medical center, to facilitate the transition of new nurse practitioners into the workforce. This comprehensive program incorporates streamlined administrative activities, baseline didactic and simulation-based critical care education, ongoing and focused peer support, access to formalized resources, and individualized clinical preceptor programs. This formalized orientation program has proven to be one of the key variables to successful integration of nurse practitioners into our acute care clinical teams.

The expanding role of the nurse practitioner in an academic medical center and its impact on graduate medical education.

PURPOSE: Academic medical centers (AMCs) have used nurse practitioners (NPs) for the provision of direct patient care for many years. However, as more NPs are hired to fill in the void created by both the 80-hour work week and the increased demands on attendings' time, their role has evolved in terms of patient care and graduate medical education. We sought to evaluate the expanded role of the NP in our large tertiary AMC to help clarify the interrelationships with the patient care delivery model and GME. METHODS: Data were collected through interviews of NPs, nurses, attendings, and residents. Data were analyzed to identify trends contributing to successful models of practice and their impact on patient care and graduate medical education (GME). RESULTS: Interviews were completed with 58/74 (78%) NPs employed at our medical center. Anonymous written surveys were completed by 41 (55%) providers. In terms of perceived impact on the role NPs played in GME, 77% of NPs surveyed felt that their role complimented the resident training; 9% felt that their role competed with resident training; and 14% felt that their role had no impact on resident training. CONCLUSION: We believe that the presence of an experienced NP on a care deliver team can enhance the educational experience of residents as well as provide continuity of patient care in the era of the 80-hour work week.

Educating nurses for leadership roles.

As a result of the growing shortage of nurses and the dramatically changing role of the front-line nurse manager, leadership education for nurses is of critical importance. The purpose of the project described in this article was to design, implement, and evaluate an innovative model of nursing leadership development for students enrolled in registered nurse to bachelor of science in nursing or registered nurse to master of science in nursing programs. A guided "action-learning" course was designed that focused on both core knowledge and experiential learning. The course was developed with the assistance of an advisory panel of prominent nurse leaders with expertise in administration, health policy, informatics, and nursing education. The prototype course was offered for the first time as an elective in Spring 2003. Evaluation data indicated that the course was considered valuable by students and with modifications suggested by students, faculty, and advisory panel members, the course would be offered regularly as part of the curriculum. Recommendations also included adapting course content to a continuing education format.