Longer application increases security for everyone

New nurses can now get into this profession in a safer way at Södra Älvsborg Hospital in Borås. The extended application period has brought peace of mind to everyone – employees and managers.

There's no doubt about the sound here. Malin Johansson, head of the unit at Södra Alfsborg Hospital, SÄS, made the positive assessment as soon as we met in the hospital corridor.

– This may be the best thing SÄS has ever done. I have long thought that the four- and five-week introduction in the past was too short. More time is needed for new creatures to land.

Newly graduated nurses on her unit now receive a twelve-week induction program on site, through a special schedule, developed by the senior nurses on the unit. The working group has become safer, and Malin Johansson now enjoys more peace in both the neurological unit and the stroke unit, where she was interim unit director until March.

– I've also been able to let go of stress and anxiety about what tomorrow will look like, whether we have coverage in our passports or not. We are fully equipped to “stroke” nowadays because of this.

“We have time to properly deepen our knowledge”

In the Stroke Unit and Neurology Unit, two senior nurses were instrumental in shaping the local program for new graduates. In the stroke unit, there is a weekly schedule on how to develop competence during the first 12 weeks.

In neuroscience, the introduction is laid out a little differently, says specialist nurse Johanna Svanberg.

During the first weeks, new patients receive in-depth theoretical knowledge about neurological diseases at the reception desk, before they come to the care department. For example, they can attend some doctor's appointments, become familiar with terminology, and learn how to handle documentation.

– Then they learn other steps in the department, such as inserting needles and other practical things, says Joanna Svanberg.

What is the advantage of the new way of working?

– New nurses don't get a lot of neuroscience from their training, but they've only scratched the surface. Now we have time to properly deepen the knowledge and allow them to become more secure in their role. It would be safer when they knew more about what they might encounter in the department.

The introductory program has two tracks

At the turn of the year, hospital management changed the introduction of newly qualified nurses throughout the hospital. The Clinical Foundation Year, the joint delivery program of the Västra Götaland region for professional groups of the Swedish Healthcare Association, now has two different programs at SÄS. Both career paths have a quieter start, with all newcomers going beyond the usual timeline by three and twelve months, respectively. At the same time, all newcomers, regardless of path, must take on a great deal of personal responsibility early on. But this is done in a personalized and safe way, with the support of experienced nurses.

When Vårdfokus visits the hospital, many different key people come together to talk passionately about their role in working through improving introduction pathways, which is strongly grounded in the Karolinska Institute's research on 'rehabilitation', which Vårdfokus has spoken about previously.

The purpose of the change was summarized by HR specialist Evelina Lindberg.

-We want to attract more new graduates to apply here but we also want to encourage them to stay. This is a way to create a more sustainable start for them. At the same time, it is also a way to secure the supply of skills and enhance the work environment.

Of course, there are also obstacles and difficulties in such large-scale change. When it's already difficult to put together a schedule due to a tense staffing situation, it can be easy for the manager to cut the introduction short, explains Evelina Lindberg.

– But we also hear that many managers are experiencing the new system positively. This is a priority, because research shows that it gives the best results in the long term, says Evelina Lindberg.

“A big step to be taken from education.”

In a remote house, there is now a break between simulation exercises. In the corridor of the Clinical Training Center, newly hired nurses and AT doctors snooze next to each other on a couch. There's a quarter of an hour left until the next exercise, and it's nice to sit down with a cup of coffee.

Wilma Sjoqvist, one of the nurses, puts the apple down and says she really appreciates the opportunity for a more peaceful start in the profession.
– It is a big step to take from education. A lot of it is new. You don't want to start your nursing career suffering from burnout.

Across from her sits Amal Abdel Dayem, who worked for several years as a nurse in Tunisia. She has now obtained a Swedish identity card and started working in the stroke department. She is also happy to get a proper introduction.

-It feels safe. There is a lot that is new to me here in Sweden, and a lot that varies from country to country. We didn't have home care or short-term housing in the same way, for example. So it's great – to learn something new every day.

New steps during the first year

No more could be said before Stephanie Listervelt, specialist nurse and training lead responsible for the clinical foundation year, invited the whole group back to the training room. Stephanie Listervelt herself describes the work with new tracks as large-scale and successful.

– We see that new nurses come to training and reflections in a different way now than before. Only illness or VAB can keep them from here.

Clinical foundation year training efforts have also evolved a lot over the past two years, says Stephanie Listervelt. Some concrete examples of new activities are, for example, clinical simulation in early detection of deteriorating patients, both in children and adults.

Another exciting initiative we introduced this year are lectures and workshops on the topic of sustainable working life. Then we start with what's called an intervention, developed by psychologist and researcher Ellen Frugelli, to prevent stress-related ill health among new nurses. As far as I know, we are the only ones in Sweden who have experienced this now.

Stephanie Listervelt believes that having several support functions around recent graduates, in addition to managers, is also a success factor for greater calm.

– They may not dare to tell their boss everything, so the rest of us are also there to provide support. Both the senior nurses and us in the teaching unit are here for them.