ANA\C The Nursing Voice Summer 2019

18  . The Nursing Voice . Summer 2019 A New Approach to Onboarding Public Health Nurses In March 2019, the County of San Diego (CSD) kicked off its first cohort for the Public Health Nurse Residency Program (PHNRP). We are very excited to expand the opportunity to practice Public Health Nursing by offering a program that is evidence-based and supports professional nursing practice. The CSD employs approximately 225 public health nurses (PHNs). The PHNs work in a variety of programs including home visiting, maternal child care, foster care, aging services, preparedness, communicable disease control, California Children’s Services, epidemiology and immunizations. While each program or location is unique and requires specific skills and knowledge, there are many common learning needs. Recent indicators show there are enough nurses to meet the overall demand; however, the number of qualified PHN applicants remains insufficient (Spetz, 2018). The supply of PHNs does not meet current demand. The slow recruitment process and the recent in- crease in the cost of the California PHN certification all contribute to the difficulties in attracting qualified candidates. Registered nurse (RN) residency programs have demonstrated success in hospitals and ambulatory settings to increase recruitment and retention. New RNs are attracted to residency programs that offer additional support and training during their transition to practice. The Institute of Medicine (2010) listed residency programs as a key recom- mendation to improve the delivery of healthcare services by ensuring a well-prepared RN workforce. In review of the current issues with hiring PHNs, including the cost of the CA PHN certificate, we examined the various options for creat- ing a pipeline for PHNs. Due to many nurses not wanting to pay for the high cost of the certificate prior to securing a PHN position, we created a PHNRP that allows nurses to enter as staff RNs and then promote to a PHN position after successfully completing the program and obtaining their California PHN Certificate. The journey began with the impetus to expedite hiring PHNs. It has evolved to creating a program that will introduce nurses to their first professional PHN role. The PHNRP provides a comprehensive learning experience to foster a defined transition to public health practice. Furthermore, it is anticipated that the PHNNRP will result in cost-sav- ings, improved job satisfaction and retention, and increases in critical thinking and leadership skills. Newly licensed nurses and nurses who are new to public health need support for successful transition to professional practice. The litera- ture suggests nurse residency programs meet that need (Cochran, 2017). The PHNRP builds on the principles of adult learning using a Registered nurse (RN) residency programs have demonstrated success in hospitals and ambulatory settings to increase recruitment and retention. Denise Foster DNP, RN, PHN, NE-BC Chief Nursing Officer, Medical Care Services DivisionNursing Administration, County of SanDiegoHealth&Human Services Agency competency-based approach. The Core Competencies for Public Health Nurses (Quad Council Coalition, 2018), and the 10 Essential Services for Public Health (Centers for Disease Control and Prevention, 2018) were used to develop a comprehensive curriculum that incor- porated simulation, case studies, didactic and experiential learning to create a valuable and supportive learning experience. The program goals were: To create a standard onboarding process to ensure consistency and to reduce redundancy during the orientation process; Increase the number of applicants from which to choose to increase diversity; Decrease the onboarding time by having a team of PHNs ready fill positions; Improve role socialization and transition to public health nursing practice; and Develop a team of professional nurses who are prepared to take on challenging new roles. We will measure success in meeting the participants’ learning objectives using a pre- and post- residency survey, interviewing hiring supervisors, measuring the time to fill positions, and examining turnover rate. We are still collecting and analyzing data collected so far during the first cohort, and it would be premature to call it a total success. How- ever, the anecdotal reports from the participants and program team indicate that the program has delivered even more than promised. As the completion of the first cohort nears, the residents are prepar- ing to be placed in their first nursing jobs in public health. They have already expressed their eagerness to support the next PHNRP cohort by acting as mentors. We cannot think of a greater compliment to the program than the graduates wanting to pay it forward to ensure the future of public health nursing is supported. References Centers for Disease Control and Prevention. (2018). The public health system & the 10 essential services of public health. www.cdc.gov/publichealthgateway/publichealthservices/ essentialhealthservices.html Cochran, C. (2017). Effectiveness and best practice of nurse residency programs: A literature review. MEDSURG Nursing, 26(1), 53–63 Quad Council Coalition, (2018) Community/public health Nursing [C/PHN] competencies. Retrieved from www.quadcouncilphn.org/documents-3/2018-qcc-competencies/ Spetz, J. (2018). Regional forecast of the registered nursing workforce in California. Healthforce Center at UCSF. Received from www.healthimpact.org/wp-content/uploads/2018/12/Forecast-summary- report-2018-12-03.pdf PHN Corner