1. Dresser, Susan MSN, RN, CCRN, CNS

Article Content


The clinical nurse specialist (CNS) given the responsibility for developing a new graduate nurse internship program faced the challenges not only of developing a program that would meet the desired objective of improving retention but also of doing so after recent hospital reductions in nursing educator positions.



Nursing turnover rates contribute to escalating costs and threaten patient safety. Studies have shown that most new graduates feel unprepared to provide direct care for multiple patients, to know when and how to call a physician, to synthesize data from multiple sources in making decisions, to manage time, to organize workload, or to prioritize tasks.



In an effort to increase retention of newly graduated nurses, hospitals are developing specialized internship/residency programs to ease the transition to the role of the registered nurse while ensuring patient safety. The cost of these programs can be expensive for hospitals to provide due to the length of the programs and utilization of resources.



Drawing upon the expertise of a network of CNS colleagues across a large metropolitan city, the CNS developed a unique program combining classroom and clinical practice components. Using the specialty knowledge and expertise of the CNSs allowed for the provision of evidence- based content on multiple critical topics. The 20-week program incorporated a weekly 2-hour clinical practicum under the guidance of a CNS. Objectives were to facilitate the development of nurse interns' skills in critical thinking, patient assessment, prioritization of nursing interventions, identification of short-term patient goals, and patient safety risks. Classroom content was organized around 3 components: body system pathophysiology and disease management, professional topics, and quality initiatives. Professional topics such as time management, critical thinking, and effective communication allowed interns an opportunity to reflect and share concerns. Quality presentations focused on specific hospital quality initiatives.



Outcomes of the program to be evaluated include participant perceptions of their competence, the degree to which the program prepared them, retention rates, and impact on patient outcomes.



Results of this program will be used to determine future orientation initiatives.


Implications for Practice:

Using the expertise of CNSs in a collaborative initiative allows hospitals to share scarce resources needed to implement a nurse internship program.


Section Description

The 2009 NACNS National Conference will be held in St Louis, Missouri, on March 5 to 7. More than 350 clinical nurse specialists (CNSs), graduate faculty, nurse administrators, nurse researchers, and graduate students are registered. This year's theme, "Clinical Nurse Specialists: Vision, Value, Voice," demonstrates the essential leadership skills of the CNS as well as the CNS role in implementing evidence-based practice.


Seventy abstracts were selected for either podium or poster presentations. Again, this year, there is a CNS student poster session. The abstracts addressed CNS practice in 3 practice domains (spheres of influence), emphasizing patient safety and quality care outcomes, leadership, evidence-based practice, and new ways to shape CNS practice. Topics include CNS work activities incorporated into 3 spheres of influence-patients, nursing practice, organization/system-including the development of clinical inquiry skills among staff nurses, use of simulation technology, strategies to maintain clinical excellence, CNS practice in end-of-life care decisions, and many new and thoughtful ideas to support CNS education, practice, and research. Collectively, the abstracts represent the breadth, depth, and richness of the CNSs' contribution to the well-being of individuals, families, communities, as well as to the advancement of the nursing profession.


The conference abstracts were published here to facilitate sharing this emerging new knowledge with those who were unable to attend the conference. As you read each abstract, appreciate the intellectual talent and clinical scholarship of your CNS colleagues who are advancing the practice of nursing and contributing to the health of society through improved outcomes for patients and healthcare organizations. We encourage you to contact individual presenters to network, collaborate, consult, or share your thoughts and ideas on the conference topics. Watch out for next year's call for abstracts and consider submitting for presentation at NACNS' next annual conference in Portland, Oregon, on March 4 to 6, 2010.