• An aging workforce,
• A pending wave of nurse retirement,
• A high number of novice nurses who hold only Associate degrees,
• Few opportunities for nursing education and an increased demand for inpatient care due to the aging population.

This situation reflects the unprecedented outflow of knowledge in the nursing profession as senior nurses begin to retire in large numbers. Moreover, traditional approaches to on-the-job training and education for newly credentialed nurses cannot keep pace with the immediate need for nurses with well-developed clinical judgment and skill. New hire nurses require extensive on-the-job training to acquire the clinical judgment and skill necessary to function autonomously with patients.

To address these challenges PBH proposes to develop new models to transfer tacit knowledge from the experienced nurse to the novice nurse, such as interdisciplinary training, resource or clinical nurse leader mentorship, simulation, Medical Emergency Teams, and crisis teams. The project design adopts action learning and involves apprenticeship and mentoring, a systems approach to communication, team performance assessment, after action learning, and human factors training. Improvement in the quality of patient care will be an ultimate outcome of this effort.

The proposed project will develop a new model for nursing education, practice, and retention that is collaboratively based, building learning communities that link novice nurses with more experienced nurses at the bedside and in real-time learning situations. This new approach will have significant impact on nurse confidence, patient care, job satisfaction, and lead to a higher performing organization.