Grace Guinoiseau, Clinical Nurse 1 on 6 Cathcart, reviewing patient orders with Clinical Nurse Ambassador Brianna Lynch
Becoming a clinical nurse presents both exciting opportunities and challenges. You get to apply your years of training to make a difference in patient care, but you now have to adapt to new workflows and processes specific to a hospital setting. And for some new nurses, that means adjusting to the unique challenges that come with a night shift. While this may cause apprehension for new nurses, Pennsylvania Hospital’s Department of Nursing Education is working to alleviate these worries with its Clinical Nurse 1 Support Ambassador Program.
Launched in December 2022 by Florrie Vanek, MSN, RN, NE-BC, director of Nursing Education, Professional Practice, and the Magnet Program, in collaboration with Karen Ulmer, MSN, RN, RNC-OB, NPD-BC, the residency program coordinator at PAH, and Elise Turnbach, MSN, RN, CEN, night shift clinical nurse education specialist, the Clinical Nurse 1 Ambassador Program is a pilot program that helps ease the transition from the classroom to the bedside for new-to-practice nurses, also known as Clinical Nurse 1s (CN1s), on night shift. Many are entering the nursing profession as a recent college graduate, while others may be new to hospital-based practice, shifting from clinics or other health care centers.
Due to an increase in CN1s on PAH’s night shift, Vanek set out to develop an initiative that would not only support the new nurses, but lessen stressors for preceptors orienting the influx of CN1s.
“Over the course of three years, we’ve seen the number of new-to-practice nurses more than double at PAH,” said Vanek. “We have to be innovative and creative to support this shift in the nursing landscape, especially offering support to the night shift, where CN1s typically start their careers and experience new lifestyle changes.”
Seble Tadiwos, Clinical Nurse 1 on 5 Cathcart, practicing IV skills.
A team of five Clinical Ambassadors, all clinical nurses from various units, rotates throughout the week to support a roster of new nurses at the hospital. “We often check in on how they’re feeling because it’s a huge change. I remember feeling stressed when I first started working night shift four years ago,” said Clinical Ambassador Ashley Mercado, BSN, RN, CCRN, a Critical Care Resource Pool nurse.
Creating a healthy sleep schedule is essential for those working the night shift – a common topic discussed between the program’s Clinical Ambassadors and CN1s. “[CN1s] will say they can’t sleep during the day after work, so we figure out ways to improve their sleep, like using blackout curtains or a sleeping mask,” said Mercado.
Along with sleep support, the ambassadors are available if a CN1 has any questions regarding technical skills, such as refreshing how to insert an IV or chest tube, problem solving and decision making in patient care, and offering other personal or professional advice for career development. Having seasoned clinical nurses serve as ambassadors forms more personal connections with CN1s, as the ambassadors understand what it’s like to be in that same position, explained Vanek.
“I am less anxious walking through the hospital doors because I know that I have a caring, kind individual who is there to help me through potentially hard times,” said Abigail Green, RN, a CN1 on 6 Cathcart.
Ashley Mercado, Outgoing Chair of Night Council and Clinical Nurse Ambassador, promoting the Night Shift Lending Library
“I am very grateful for this program,” said Grace Williamson, RN, a CN1 on 6 Cathcart. “Their advice has helped build my confidence as a new nurse.”
Although the program was created with CN1s in mind, other members of the night shift, including the ambassadors themselves, have benefited from the program. Ambassadors further develop precepting skills and put them on the path to becoming nurse educators in the future, while other staff now have more balance in their daily tasks.
“Prior to the ambassadors, I would spend most of my evenings focused on supporting new-to-practice nurses and [doing] a lot of shoulder-to-shoulder work with them on the floor,” said Turnbach. “I still spend time with the CN1s, but now I have more time to support all nursing staff at night.”
Because of its impact beyond CN1s, Vanek has proposed renaming the program to the Clinical Nurse Ambassador Program, to support all levels of nursing on the night shift. “Staff support and well-being are what I’m most passionate about in my nursing career,” she said. “To be able to offer this to our nurses makes me feel really proud.”