A Shift in the Educational Paradigm: Building a Primary Care Nursing Workforce within a Veteran Healthcare Setting

Project description: The partnership between the university and the clinic serves to fulfill the nurse education, practice, quality, and retention (NEPQR) initiative sponsored by Health Resources and Services Administration (HRSA). In support of the growing need for BSN-prepared nurses in primary care settings, as well as the need for management of the increasing rates of chronic health conditions in the military veteran population, this initiative presents two main objectives: (1) to prepare university BSN student nurses to care for patients, specifically military veterans, and to transition directly into a primary care setting upon entering the workforce; and (2) to enhance clinical and psychosocial veteran care at the clinic through targeted professional development for existing nursing staff.

Methods: Commencing in January 2019, the first group of 64 university nursing students will enter a preview experience within the clinic’s primary care facility in order to observe and practice primary care for veterans. From this group, ten students will be chosen from each cohort to complete a two-year rotation in primary care, including specialized curriculum and veteran care education. When defining this curriculum, it became necessary to further understand the roles and responsibilities unique to a primary care RN practicing to the full extent of his or her training. Adapted from the research of Janice Smolowitz et. al., published in a 2014 article in ScienceDirect titled “Role of the Registered Nurse in Primary Health Care: Meeting Health Care Needs in the 21st Century,” the university and clinic have developed an RNPC nursing model to define the roles and responsibilities of a primary care nurse practicing to the fullest extent of the training within the lens of veteran care, military culture, and veteran identity. The model includes role contexts, functions, and care specific chronic disease management unique to veterans.

Analysis and results: Outcomes for nursing students will be assessed through clinical evaluation tools (Typhoon) and pre- and post-evaluations on veteran-specific knowledge with a minimum 90% competency level on primary and veteran care. Results from this preview experience will be shared and analysis will be discussed with recommendations for best practices outlined. The partnership presents a unique educational opportunity, among the first of its kind, for BSN students as well as primary care RNs to enhance experiences and training in primary care. As a result of this work, a first of its kind BSN curriculum and training in the coordination of a primary care workforce skilled in the evaluation and treatment of veterans is available.