Supporting the Learning and Transition Needs of Novice Registered Nurses in a Float Pool

Purpose:
To provide a passageway that fosters the development of critical thinking skills and nurse competence, promotes leadership thinking and nursing excellence, and facilitates a smooth transition to the organization's culture.

Relevance/Significance:
At a time of high patient acuity and complex care delivery, new nurses are entering an environment with many stressors and demands. In addition to attempting to successfully adapt to working on a different unit every four weeks, novice nurses face an overwhelming list of milestones that they are expected to accomplish in their first year of practice. If nurses are mandated to float from unit to unit, it is essential they are supported and competent in the areas to which they are assigned.

Strategy and Implementation:
This program focuses on the nurse graduating from the internal Medical Nurse Residency Program, transferring into the Medical Float Pool. Leadership approval was obtained pre-implementation. Nurse Managers and Staff Development Specialists offered suggestions for program content. Program curriculum was developed based on Patricia Benner's Novice to Expert model, focusing on quality outcomes, evidence-based practice, patient safety, and development of leadership skills. A learning needs assessment is administered. Curriculum is implemented through monthly structured classes, which include interactive teaching methods, content customized to the unique needs of float pool nurses, and reflection to facilitate learning from practice. Monthly staff meetings are held to ensure nurses' are informed on current organizational information. Time is set aside for discussions about patient care situations which serves as a vehicle to enhance socialization as well as reflect on clinical experiences.

Evaluation:
Eighteen nurses successfully transitioned from the float pool since 2011. Of those 18, 15 have remained on medical units. Two are current chairs of unit based Shared Decision Making Councils and eight are members of unit and/or system-wide councils. Seven have returned to school or obtained an MSN. Four obtained professional certification. Success is attributed to clinical guidance and mentoring.

Implications for Practice:
Establishes clinical competency, offers provision of a support group during the transition of novice to competent nurse, and facilitates retention of skilled nurses. Clinical competence and management of multiple transitions effect the care of patients, the organization, as well as the new nurse.