Western’s Arthur Labatt Family School of Nursing is responding to increased demand for more practice ready registered nurses (RNs) with enhancements that include a new 19-month program for registered practical nurses (RPNs) to obtain a Bachelor of Science in Nursing (BScN) degree and immersive one-on-one clinical placements.
The COVID-19 pandemic exacerbated what the Ontario Nurses’ Association describes as an existing, decades-long registered nurse (RN) understaffing problem, which began as a large wave of baby boom born nurses reached retirement age.
Acting director of nursing Yolanda Babenko-Mould said addressing the immediate need for nurses falls within the context of the school’s overall mission to advance leadership in health equity.
“Focusing on transforming education, practice, policies and systems that mobilize change for more compassionate and equitable care is present in all areas of our coursework, from the undergraduate to graduate level, and is embedded in all clinical aspects of our teaching,” Babenko-Mould said.
Increasing nursing grad numbers
Resources to support the program enhancements were integral, including a recent provincial funding initiative, which allowed the school to increase the number of spots in its compressed timeframe (CTF) BScN program.
The CTF program offers a 19-month pathway to a Bachelor of Science in Nursing degree for individuals who have previous university education.
“This is an intense program, focused on both the theoretical and practice-based aspects of nursing,” Babenko-Mould said. “It enables learners to move through the process of earning their BScN quickly.”
New 19-month RPN to BScN pathway
Also, within the CTF program, the school created a new RPN to BScN pathway. This program, the first of its kind in Ontario, offers a shorter timeframe for RPNs to obtain a BScN degree.
Available to those who have graduated from Fanshawe College’s RPN program, the pathway allows RPNs to transition to RN practice within the compressed 19-month period, as compared to the typical three to five-year bridging programs.
Babenko-Mould said the RPNs bring experience that enhances learning for everyone.
“We are hearing positive feedback about the RPNs contributing to the discussions, pulling and drawing from real-life scenarios within the various practice contexts.”
In 2022, the number of students in the CTF BScN program grew to 232, a dramatic increase from 100 in 2020, and 135 in 2021. Of the 232 students in 2022, 21 are in the RPN to BScN pathway.
One-on-one clinical placements
Starting in May 2023, the School of Nursing will be introducing an even more immersive practice placement model, where third-year students will be paired, one-on-one, with nurse preceptors.
Students will practice with the preceptor on a variety of shifts to gain an even stronger real-world understanding of the dynamic nature of practice throughout a day. This experience will further enhance knowledge and skills about relational practice, interprofessional practice, and ensuring the person/family is at the centre of care. This will replace the previous learning model that involved eight students with one clinical instructor. In the new model, students will also have a faculty advisor, similar in nature to the fourth-year integrative practicum model, where an advisor is connected to approximately 16 dyads of students-preceptors in practice.
“We think the one-on-one model creates learning moments you can’t capture in the higher ratio model,” Babenko-Mould said. “Where some settings couldn’t accommodate a group of eight, it is more possible with only one or two students.” Students will continue to learn in settings that include hospitals, public health and long-term care, as part of a dynamic interdisciplinary team.
Similar to the current fourth-year integrative practicum (IP) experience, students will engage with their preceptor in a scaffold model of teaching and learning where the preceptor provides a lot of early support, articulating knowledge and demonstrating skills in the practice setting.
“The students will build knowledge, skills, and confidence for engaging in person-centered care in a methodical and thoughtful way as their trajectory to practicing with more independence increases across the year,” Babenko-Mould said.
Fourth-year student Jade Ritter said the one-on-one integrative practicum preceptor model has offered an “incredible” learning experience.
“Spending 456 hours together really allows us to build a meaningful relationship,” Ritter said. “The preceptors get to know our learning style and use this knowledge to customize their teaching. They also seek out learning opportunities for us.
“I’ve learned so much and have experienced a lot of positive growth and progress. I can see where my clinical judgement has grown.”
Additional hands-on learning experiences take place in several different contexts outside of traditional clinical placements, including in the School’s expanded simulated education suite. Standardized patients who have lived experience with a number of physical and mental health concerns, and a case-based learning model are also key to students’ professional development.
As the province continues to provide resources to address the challenges in health care, the School is having discussions about:
- Expanding its primary health care nurse practitioner program to accommodate an additional cohort in 2023.
- Preparing future nurses through the Ontario Learn and Stay program, which will provide full, upfront funding for tuition, books and other educational costs to nursing graduates who commit to practicing in an underserved community for two years.
- Exploring the potential of creating a post-RN to BScN pathway for internationally educated nurses.
As with current program enhancements, Babenko-Mould said future changes will be successful through thoughtful, collaborative planning.
“We are definitely open to expansion, and we will continue to take an approach that is mindful of having enough resources to support any changes. We will also continue to give primacy to our practice partners in acute care, public health, community health, and in long-term care. It’s very important for us to continue to build, advance, and nurture those relationships.”