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On-line version ISSN 1982-0194
Acta paul. enferm. vol.22 no.6 São Paulo Nov./Dec. 2009
Residence program: a model for newly graduated nurses
Programa de Prácticas de Estudiantes: un modelo de administración para formar y capacitar enfermeras recién graduadas
Valéria Zadra de MattosI; Marluci Andrade Conceição StippII
IPhD in Nursing. Coordinator Nurse
at the Continued Education Service of the Hospital Pró-Cardíaco
Rio de Janeiro (RJ), Brazil
IIPhD in Nursing. Associate Professor at the Nursing Methodology Department of the Escola de Enfermagem Anna Nery of the Universidade Federal do Rio de Janeiro - UFRJ. Rio de Janeiro (RJ), Brazil
This study describes the experience with a residency program of the continuing education department of the Pró-Cardíaco hospital in Rio de Janeiro, Brazil. The hospital provides care for a highly complex clientele that require specialized cardiac and critical care nursing. The residency program was created six years ago and has been training new nurses under the mentorship of nurse educators from the continued education department. The mains goals of the residency program are to train and qualify newly graduated nurses and to facilitate their entrance into the workforce.
Keywords: Education, nursing, continuing; Job market; Nursing education; Nursing staff/education.
Relatar la experiencia de un programa de entrenamiento, titulado Programa Trainee, perteneciente al Sector de Educación Continuada del Hospital Pro-Cardíaco localizado en el Municipio de Rio de Janeiro; el hospital atiende una clientela de alta complejidad, que requiere cuidados de enfermería especializados en la área de cardiología clínica y de terapia intensiva. El programa Trainee fue creado hace seis años y viene ofreciendo entrenamiento durante la prestación de servicios, bajo la supervisión de enfermeras que monitorean la educación continuada. Presenta una propuesta de capacitación de enfermeras recién graduadas, al mismo tiempo en que busca crear espacios para intercambio de conocimientos y formación de una política institucional de inserción de la joven enfermera en el mercado de trabajo.
Descriptores: Educación continuada en enfermería; Mercado de trabajo; Educación en enfermería; Personal de enfermería/educación.
Professional qualification and people development should not be limited to the formal education technical knowledge of a profession. This is a particularly true assumption when we think on nursing work, for this is rooted in a dynamic body of knowledge of technical-scientific and socio-humanist nature, which demands the confrontation of new ideas, from the institutional philosophy, the conditions of work, the assistance model and the professional who wants to glimpse into the profession.
Within this context, nurses must keep a continued improvement, given the speed with which technology develops and the challenges and expectations of society and institutions in relation to their work.
Our profession path is complex relating to the learning mechanisms along the professional career; we need to maintain ourselves constantly updated, always incorporating new knowledge tools, diagnostics and therapeutic solutions. From this perspective, today as ever, the concern of continued education and people management became relevant.
With the perception of this growth process, we have structured a model of recruiting talents called "Trainee Program". This program is designed to create suitable conditions for inserting, adapting and specialized training of newly graduates within the institutional context.
In this sense, the objective of this study was to report the experience of developing a training program for the Continued Education Sector of the Hospital Pró-cardíaco, which assists a clientele of high complexity requiring specialized nursing care in clinical and intensive care cardiology.
This study is part of the PhD thesis titled "Trainee program for nurse's professional initiation: a model for people management"(1).
TRAINEE PROGRAM STRUCTURING
The Coordination Office of the Continued Education Service not satisfied with the selection process of newly graduates competing with more experienced professionals made an alliance with the Human Resources Service and the Nursing Management of the hospital and jointly resolved to create a program specifically designed for newly graduated nurses, which offers the opportunity of entering the job market through professional updating and qualification. With such proposition, a specific training has been organized not only to insert them in the care model of the institution, but also to enable a better technical-scientific training.
The objective of the Training Program is to expand the theoretical-practical knowledge, clinical reflexive judgment, allowing a better emotional balance, decreasing anxieties, simultaneously broadening the technical-professional competence, also serving as a human resources capturing model for other specialties within the institution itself.
This program was created in the year 2000, pioneer initiative in the city of Rio de Janeiro for training and education of newly graduated nurses. It has a statute oriented by the prevailing standards in the country's employment by the Consolidation of Labor Laws, and benefits such as health insurance, uniform, food vouchers, meal tickets in the institution and secured parking. This statute was approved by the Department of Nursing, preserving the uniqueness of care in critical situations, in order to be given opportunities to learn patient-oriented high complexity.
It is worth noting the support of the Board of Directors of the institution in building this program, which considers essential the investment in nurses, enhancing human capital and engaging with the development of skills required to ensure quality in service delivery.
With respect to new proposals for personal development, it should be noted that a new concept of relationship and leadership emerges today. In this concept, the leader is the mentor who helps trainees to achieve a certain result, promoting their skills and increasing their knowledge through a monitored work, which in managing people is called "coaching"(2).
We approximate this nomenclature entitled, within this scenario, as teacher or mentor for continued education, as in a hospital environment this role is represented by the figure of the professional who will guide daily, the care and decision making regarding nursing care.
The theoretical referential supporting the structure of the program is Peter Senge's, who believes that building real organizations capable to promote learning it is necessary to incorporate five new technology tools: personal dominium, mental models, shared vision, team learning, and systemic thought(3).
TRAINEE PROGRAM FOR PROFESSIONAL INITIATION
The Trainee Program, in our view, represents a contribution to the young professional who wants a place in the labor market and a possible hiring contract within a relatively short time since the institution has, over the years, absorbed the trainees who have better performed by the end of the program.
It is a nine-month program, accepting newly graduates with up to six months after completing their graduation, without prior professional experience, registration with the Conselho Regional de Enfermagen RJ (Regional Nursing Counsel RJ) and availability to dedicate 40 hours per week.
The trainee nurse always works under the guidance of the continued education monitor and/or the clinical nurse. The selection of candidates is done based on the analysis of transcripts, curriculum vitae, a written exam, practical exam, interview with the coordinator of Continued Education and the outcome of group dynamics. Medical examination and psychometric tests are also performed under the supervision of a psychologist of the Institution.
Job positions are offered in the intensive care unit, coronary care unit, intensive care unit for cardiac surgery of adult and pediatric, surgical center, cardiac emergency department, interventional cardiovascular laboratory and clinical unit.
The trainee nurses are initially allocated in the range of day laborers in the first four months, then moving to the day shift scale with performance evaluation monthly for nine months. This evaluation is done by the sector head nurse and the nurse educator from the Continued Education. We emphasize that, for the evaluation of the activities developed, we aligned to practice, the theoretical knowledge acquired and refined during the program.
In daily care the ideal is to bridge the gap between theory and practice, respecting the reality of the operation of each Institution, referring to philosophy, organization, healthcare model, human resources management and budget planning(4). Believing this statement, we offer the trainees a care monitored by the nurse educator from the Continued Education, daily participation in discussions of client cases, participation in nursing monthly journal clubs, with discussions about the articles, clinical cases presentation, participation in training nursing, clinical sessions and lectures, among other activities.
Since the twentieth century, the world has experienced a paradigm shift with regard to the so-called "information age" and competitiveness combined to the process of economic globalization brings significant unemployment rate and multiplicity of labor relations. In health, as authors Gelbeck and Smith(5) depict the downsizing of public spending since the 90s, leaving the worker to be in increasing development in relation to the skills and seek for innovative practices, enhancing both the profession and professional.
The dynamics of the health job market is characterized by supply and demand of labor force whose configuration is given according to a set of policy, economic and institutional determination. Noteworthy is yet another fundamental element, the movement of work force, because the rotation implies in decreasing productivity and quality of services(6).
The Continued Education is an eternal challenge for nurses who need to seek means and opportunities for improving their skills, given the competitive job market. The professions in the health, in the vision of technological development, are distinguishing themselves in constant search of discoveries and treatments tied to the development of machines, allowing technical approaches increasingly invasive.
It was found out in a research involving those hospital trainees, that they feel satisfied with their positions in nursing care; the great majority is employed in the private network, and is satisfied with their own salaries considering them compatible with the job market
Every year we have conducted analysis on the experience in order to propose improvements and since the year 2007 we have reviewed the duration of the Program which currently lasts 11 months. It was yet observed that former trainees when not absorbed by the Institution were employed within four months after completing the program.
1. Mattos VZ. O programa trainee como iniciação profissional da enfermeira: um modelo de gestão de pessoas [tese]. Rio de Janeiro: Escola de Enfermagem Anna Nery, Universidade Federal do Rio de Janeiro; 2007. [ Links ]
2. Chiavenato I. Treinamento e desenvolvimento de recursos humanos: como incrementar talentos na empresa. 4ª ed. São Paulo: Atlas; 1999. [ Links ]
3. Senge PM. A quinta disciplina: arte e prática da organização de aprendizagem. 16ª ed. São Paulo: Best Seller; 2004. [ Links ]
4. Lima MADS. A formação da enfermeira e a prática profissional: qual a relação? [dissertação]. Porto Alegre: Faculdade de Educação, Pontifícia Universidade Católica; 1993. [ Links ]
5. Gelbcke FL, Pires D. Transformação do mundo do trabalho e a Enfermagem: transformações e oportunidades no mundo do trabalho. In: Anais do 53º Congresso Brasileiro de Enfermagem, 2001, Curitiba(PR), Brasil. Curitiba: ABEn-PR; 2001. [ Links ]
6. Anselmi ML, Duarte GG, Angerami ELS. "Sobrevivência" no emprego dos trabalhadores de enfermagem em uma instituição hospitalar pública. Rev Latinoam Enferm. 2001;9(4):13-8. [ Links ]
Corresponding author: Article received on 07/11/2008 and approved on
Marluci Andrade Conceição Stipp
Rua dos Jacarandás, 1160/1302 B.4. Barra da Tijuca
Rio de Janeiro (RJ), Brazil
Article received on 07/11/2008 and approved on 23/03/2009