1. RN Transition to Practice (RNTTP) Program
Jenni Schnable, MSN, RN
Clinical educator
Indianapolis veteran affairs
medical center

2. Why? High turnover of newly graduated nurses (as high as 60%) =costly
VHA Fiscal year month turnover for 291 new RNs totaled $2.52 million*
Large percentage of RNs in VHA are close to or currently eligible for retirement=need to attract and develop nurses capable of providing the best care to our veterans
More schools are now using simulation to supplement clinical due to placement issues
Schools recommending a 5th year internship or hospitals offer programs like RNTTP
*VHA Directive
The program is based on:
-Research that demonstrates improved outcomes when care is provided by a competent professional nurse
-Need for education, training, and support for new nurses to fully develop professional practice and skills critical to patient safety
-Demand for professional nurses, driven by the aging nursing workforce, increased societal need, and diverse career opportunities
-High turnover rate of new graduates

3. Program Goals*
Transition from entry-level novice nurse to competent professional nurse (Benner’s Novice to Expert)
Develop effective decision-making skills related to clinical judgment and performance
Provide clinical leadership at the point of patient care
Strengthen commitment to nursing as a professional career choice
Support new RN with < 1 year experience
*VHA Directive
I refer to this as the “Hug” throughout their entire 1st year.

4. Mission & Vision*
Provide the new RN with an experience that will give additional training to enhance patient care at the bedside and to support development of professional behavior and leadership in the nursing profession
Program to be recognized as a program that will attract and retain new RN graduates to VHA facilities
*VHA Directive

5. History of Indy RNTTP Program
Cohort Group I: July 2013-July 2014
National Curriculum
Phase I: Intensive upfront time was both labor and resource intensive
Phase II & III became less intensive as the months went on
Feedback from leadership resulted in program changes

6. Frequency of Program Today
Ongoing support during 12 months of practice
Meets twice a month:
One Didactic day-8 hours
One Clinical Immersion day (1st 6 months) 8 hours
One EBP Day (2nd 6 months) 8 hours
New Cohort ONLY Twice a Year
February & August

7. CORE CURRICULUM 1. Care Clinical Practice 3. Professional Role
Falls into 3 categories:
1. Care Clinical Practice 3. Professional Role
-Management of Patient Delivery Ethical Decision Making
-Management of Changing Patient Condition End of Life Care
-Pain Management Cultural Competence
-Evidence Based Skin Practice Stress Management
-Fall Prevention EBP
-Medication Administration Patient & Family Education
-Infection Control Professional Development
2. Leadership Development
-Resource Management
-Communication
-Conflict Management

8. How do we meet the Objectives?
Mentorship
Simulation Lab (assessment, skills, mock codes…)
Off site cultural immersion
ACLS
Phlebotomy & IV class
Nurse Leader Series
Stress management exercises
Conflict Resolution activities/Hot potato
Clinical Immersion Days

9. Evaluations Casey-Fink Graduate Nurse Experience Survey
Initial, 3,6,9, and 12 months
Preceptor Evaluation
Mentor Evaluation
Program Survey Evaluation

10. Indy VAMC Retention 1 Year Retention-98% 2 Year Retention-89%
Cohort 2-Nancy left in 2015 transfer to another VA
Cohort 5-Osbertina moved out of state, Heather took position as a IU Cancer Care RN (dream job), Jeffrey moved to FL, Dom took a equipment rep job in 7/17
Cohort 6-Andrew took a job at Eskenazi mental clinic; Jordan became the Marian County epidemiology RN

11. Questions??