NVA Health Group Adam Shandler
Training & Learning

How VNA Health Group Welcomes New Nurses with a Targeted Peer-to-Peer Residency Program

L&D leaders everywhere understand the challenges created by skills shortages. And when the market for talented individuals is tight, it’s more important than ever to make sure new hires have everything they need to succeed in their roles. 

So, how can L&D teams develop learning programs to welcome new hires into their organization? And how can they harness the knowledge of experienced staff to help newcomers thrive?

In my second interview as part of our healthcare L&D series, I spoke to Adam Shandler, Director of Learning & Development and Talent Acquisition at Visiting Nurse Association Health Group, about his three-step approach to welcoming skilled new hires through a targeted peer-to-peer nursing program. 

Adam’s insights and knowledge are inspiring–read on to find out more!

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The challenges of a skills shortage in the labor market

Adam began our conversation by telling me about the Visiting Nurse Association Health Group and the challenges they are facing in the home health and hospice nursing sector.

“The Visiting Nurse Association Health Group, or VNA Health Group,” says Adam, “is an organization that has been around since 1912. Our growth has really expanded over the course of the last five or six years with joint ventures and collaborations with partner companies.”

As Adam explains, the VNA Health Group is a holding company for seven different businesses and service lines focusing on home health and hospice care. They also have administrative partnerships with community health centers in New Jersey, and another with the Children and Family Health Institute focusing on at-risk families and at-risk youth.

“So,” says Adam, “VNA Health Group is a very diversified community health organization and rather unusual when you look at our competition.”

“As far as the challenges go,” says Adam, “one we are facing which was percolating long before COVID-19 is the nursing shortage. I read in a white paper by one of the regulating bodies in nursing in New Jersey that came out in 2012 a foreboding statistic that the state of New Jersey was going to be experiencing a shortage of 40,000 nurses by 2020.”

So, how did Adam and his team plan to get more nurses to come into the home health and hospice industry? And what L&D approach did they harness at the VNA Health Group to face this nursing shortage? 

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VNA Health Group’s 3-step peer-to-peer residency program

As Adam explains, VNA Health Group was able to cope with the nursing shortage by, amongst other things, developing a home health peer-to-peer residency program.

“The program was forged in partnership with the Rutgers School of Nursing,” says Adam. “It was kind of a scary proposition because nurses coming right out of college and being put into the field without a lot of supervision or training can be a risky endeavor. We needed to make sure we had the right systems and supervision in place.”

“The new hires need to be trained by experienced nurses, or preceptors, and those nurses already have a caseload. But we weren’t sure we were going to be able to sustain the business by taking them out of regular field duty to join them hip-to-hip with very junior nurses.”

So, what approach did Adam and his team adopt? First up: recruit new hires with the right school partnerships.

Related: How We Use Peer Learning to Keep Our Company’s Competitive Edge

We weren’t sure we were going to be able to sustain the business by taking our experienced nurses out of regular field duty to join them hip-to-hip with very junior nurses.

1. Recruit new nurses through school partnerships 

“We started small, “says Adam, “with six residents from five or six different schools. Rutgers was the flagship, but five or six different schools were represented in the Home Health Residency Program. As a result of hiring five or six residents, we only needed to pull five or six experienced nurses out of regular duty to partner with these nurses and train them.”

“So, we knew we weren’t going to solve a 40,000 nurse shortage by hiring six people, but we at least wanted to experiment with it and see if it would work. We wanted to see if we could sustain our business by training new nurses and ultimately growing the program year over year.”

VNAHG Adam Shandler

2. Equip new nurses with the right tools

Next, provide your new hires with the right tools through orientation. 

“When you first arrive,” Adam explains, “you get a new hire orientation like many of our hires, whether you are clinical or non-clinical, and then you go directly into a clinical orientation where our clinical education team provides you with all of the necessary tools.”

“I mean that literally,” Adam laughs. “You get a bag of tools you’re going to be using when you go out into the field. And after some compliance training and how to use the tablet and do documentation you are entering the field with that preceptor.”

3. Develop the leadership skills of the nurse preceptors

Finally, Adam prepared the preceptors for mentoring the new hires. The secret? Leadership education.

“One of the programs I ran with our cohort of preceptors was the leadership challenge,” says Adam. “We wanted to present some foundational leadership learning to this group. That’s the leadership learning system from Kouzes and Posner. These are the kind of tenets of leadership that these preceptors are bringing with them when they are educating these junior nurses.”

“That is one of the beauties of the residency program in that it doesn’t only solve a staffing problem or is just a training program for junior nurses. It also allowed us to do management training and leadership development for a cohort that really never received it but has a lot of management responsibility put upon them.”

The VNA Health Group’s three-step residency program highlights many of the advantages of Collaborative Learning. By creating a program that connects new hires with experienced staff, the company can make it easier to ramp up incoming staff while balancing the needs of the business. 

Related: The L&D Case for Peer Training: 3 Unignorable Reasons to Make the Switch

One of the programs I ran with our cohort of preceptors was the leadership challenge. We wanted to present some foundational leadership learning to this group.

Measuring the success of VNA Health Group’s residency program

So, that’s how Adam and his team developed their peer-to-peer learning residency program for new nurses. But how does he know the program is addressing the skills shortage in the medical industry?

“Six people is a very small data set,” says Adam. “But I’m very happy to say that around four out of those six that we hired are still with the VNA Health Group. They are now independent home health nurses, and they have their own caseloads.”

“They are able to be ambassadors for the program. These are the people we can tap on the shoulder to go out and help us recruit new nurses. They are energized by the experience and they can now represent the experience to other nurses who may not have thought that home health and hospice nursing was the direction they wanted to pursue.”

Adam has seen how essential that peer-to-peer learning is within those first 90 days. “This program is a workshop in peer-to-peer learning and knowledge sharing. You have the experienced nurses that are teaching these more junior nurses how to be more clinically sound and compassionate, and how to have a conversation with the family about the direction of the plan of care.”

“And what we’re learning from the junior nurses is how to integrate technology into plans of care. They are able to teach some of the more seasoned nurses who did not get into this business to be technologists how to work technology into their visit.”

On the question of scalability, Adam explains that they would certainly like to grow the program. “We’d love to double it from six to twelve, and as that group gets successful we’d like to expand and maybe do a much larger cohort–granted that we have the resources to do it.”

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Six people is a very small data set–but I’m very happy to say that around four out of those six that we hired are still with the VNA Health Group. They are now independent home health nurses, and they have their own caseloads.

Thank again to Adam for taking the time to share his experience and insights with us!

Don’t miss out on last week’s healthcare L&D interview with Christopher Lind of ChenMed about supporting value-based care through learning, and my interview with Jennifer Recla of Colorado Access about enabling innovation in healthcare L&D.

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