Clinical Focus Program: Enhancing the Transition of Senior Nursing Students to Independent Practice
Format of Original
Lippincott Williams & Wilkins, Inc.
The Journal of Nursing Administration
Original Item ID
The Clinical Focus Program was designed to prepare senior nursing students for the transition to practice in the hospital setting. Through a series of 1:1 precepted clinical experiences, the students developed a broad base of clinical competencies and self-confidence in their nursing skills. Hospitals experienced reduced costs related to orientation and recruitment of new graduate nurses. The program also was valuable in building a network of collegiality and scholarship between education and practice environments.
According to the National Center for Health Workforce Analysis, the supply of nurses will be 29% less than what is needed by the year 2020, based on a projected increase in demand of 40% and only a 6% increase in supply.1 One of many factors contributing to this shortage is nurses leaving nursing. Between 1996 and 2000, the number of nurses leaving the profession grew to almost 500,000. Although little is known about this population as a whole, 30% to 54% of new graduate nurses change jobs or leave nursing during their first year of practice for reasons that include feeling inadequately prepared for the fast-paced acute care setting, caring for high-acuity patients, and lacking a supportive work environment. Improving the transition from student to professional nurse might reduce these stressors and increase satisfaction, ultimately resulting in fewer nurses leaving the profession. This is supported by a recent report on the American nursing shortage published by the Robert Wood Johnson Foundation, in which one of the chief areas identified as needing improvement was in preparing students adequately for the reality of work as a professional nurse.
One way to facilitate the transition from student to practicing nurse may be to provide additional clinical experiences for senior nursing students. Clinical experiences are rich learning opportunities for working with patients with clinical entities about which students may have only read or studied theoretically. Specifically, mentored clinical experiences before graduation are extremely valuable. Such programs bridge the gap between the idealism of nursing education and the reality of the workplace. Students begin to identify with the professional role and to think and perform like nurses. Providing mentored clinical experiences requires academic and service leaders to share the responsibility of creating these opportunities.
This article describes the development, implementation, and first-year outcomes of the Clinical Focus Program (CFP), a partnership between the University of Wisconsin-Oshkosh College of Nursing (UWO) and 2 tertiary care institutions, ThedaCare (TC) and Children's Hospital of Wisconsin-Fox Valley (CHW-FV). The driving force behind the program was the Wisconsin Nursing Redesign Consortium, a collaborative partnership of academic and service organizations formed to address the nursing shortage within the state of Wisconsin. At a conference sponsored by this consortium in 2002, nursing professionals across the state were invited to form service and academic partnerships and submit proposals for projects that would address the growing demand for professional nurses. The CFP was one of these pilot projects.