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A nursing accelerator program, conceived during some of the worst months of the coronavirus pandemic to add extra hands in University of Maryland Medical System hospitals, is ramping up and expanding — even as some of the demands of the public health crisis scale back.
That’s because the health care workforce in Maryland and elsewhere continues to reel from staff shortages, particularly in the nursing field, where staffing deficits have been slow to recover since COVID-19 swept into the state three years ago.
Hospital administrators say the Academy of Clinical Essentials initiative — which pairs small groups of nursing students with a hospital-based nurse for 12-week intervals each semester — represents one potential solution to the ongoing nursing shortfall. It already has branched into more nursing schools and college departments in Maryland, including at Towson University, Harford Community College and the University of Maryland School of Nursing at Shady Grove.
University of Maryland Medical System Chief Nursing Executive Lisa Rowen said more than two dozen health systems around the U.S. also have inquired about adopting the clinical skills training course for their hospitals.
Rowen developed the idea for a fast-tracked nursing practicum in December 2021 after reading guidance from the American Association of Colleges of Nursing that recommended more experiential learning to prepare students for the workforce. Meanwhile, the fast-spreading omicron variant of the coronavirus continued to ravage the state and much of the nation, overwhelming hospitals.
Rowen put two and two together.
“I just thought, what can we do to marry the needs of our students and our hospitals and our staffing needs, and ultimately the profession of nursing?” said Rowen, a registered nurse.
Rowen’s innovation assigns students early in their nursing school careers to small groups with a hospital-based clinical instructor, who in turn receives a pay bump for taking trainees under their wing. The groups of four spend full shifts with the nurse and are each assigned to care for a patient, which can entail taking vital signs, helping distribute medication or simply making rounds and asking patients how they’re doing.
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“There are things they don’t teach you in nursing school,” said Barbara Bosah, a nurse manager in the thoracic and surgical intermediate care unit and vascular progressive care unit at University of Maryland Medical Center. “You can see the difference in having an ACE [Academy of Clinical Essentials] student and a traditional student.”
University of Maryland Medical System, at its peak in June 2022, saw as many as 27% of its bedside nursing staff leave their jobs, on par with the national average, Rowen said. Many of those who left the system cited feeling burned out from the demands of the public health crisis or fears of bringing the deadly virus home to their loved ones. Others left the hospital network for travel nursing jobs with much higher pay. “As nurses left, the burden became more extreme,” Rowen recalled. “And it created a cycle of people leaving.”
Several health care professions have seen high staff turnover since the start of the pandemic, making access to medical care in Maryland more difficult for some patients and contributing to the long wait times in emergency departments. Statewide, the number of registered nurses declined by about 5% from 2018 to 2021, according to the latest data from the U.S. Bureau of Labor Statistics.
Nurses, who fill jobs in hospitals, doctor’s offices, schools and assisted living and rehabilitation facilities, are considered crucial to the flow of a functioning health care system.
More than 350 students have been selected for 12-week rotations across University of Maryland Medical System hospitals since the program began, with 59 cohorts of four this spring. About 100 clinical instructors have participated. The students have been placed in surgical, labor and delivery, mother-baby, and behavioral health units, and have worked overnight shifts.
Rowen said while the nurse shortage at the University of Maryland Medical System has improved, the percentage of bedside nurses who have left their jobs still stands at about 18.2% — and remains at about 22.5% nationally. At the same time, she thinks the nurses-in-training program has helped ready more professionals for the workforce, and more than half of the 355 nurses trained across University of Maryland Medical System hospitals have been hired as paid student nurses.
“It feels like additional staffing,” Rowen said. She thinks more will apply for full-time jobs down the line as a result of making connections with the staff.
She thinks students also will have a better sense of what a career in nursing demands after spending full shifts in a hospital and caring for patients, which standard clinical training in nursing schools usually doesn’t provide.
“It [standard clinical nurse training] teaches you how to do tasks, but doesn’t give you the same critical thinking skills as staying with a patient for a full shift, and seeing them improve or get sicker, and really understanding the dynamics of what’s happening,” Rowen said.
Patients seemed to enjoy the added presence, too. “She’s really been the one taking care of me,” said Cassandra Cole, a patient at the University of Maryland Medical Center who spent a day recovering in the surgical acute care unit with student Katie Strine earlier this month. Strine helped check Cole’s vitals and asked questions about Cole’s pain levels, with clinical instructor Kerstin Koorey chiming in with the occasional follow up.
Several other attempts at alleviating the statewide health care worker shortage are underway.
State legislators passed a bill this year that provides more support from the Maryland Department of Health to the Maryland Board of Nursing, where a monthslong backlog has prevented nurses from renewing their licenses or getting them approved. State health officials and lawmakers also have pushed for tuition reimbursement and other perks for nurses who practice in Maryland after graduating. And on Tuesday, Notre Dame of Maryland University and Mount St. Mary’s University signed a joint agreement allowing eligible health science graduates from the Mount to enroll in Notre Dame’s accelerated nursing program, which starts this fall.
hallie.miller@thebaltimorebanner.com
Audience engagement editor Krishna Sharma contributed to this article.
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Hallie Miller covers housing for The Baltimore Banner. She's previously covered city and regional services, business and health at both The Banner and The Baltimore Sun.
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