Nursing residencies strengthen practice

New nurse practitioners benefit from continued training as they transition into professional practice

By Sandra Gray

Nurse practitioners are primary health care providers for increasing numbers of patients. They undergo years of rigorous training before entering practice, as do physicians. And now, like physicians, newly graduated advanced practice nurses can engage in further on-the-job training as residents. The Tan Chingfen Graduate School of Nursing at UMass Chan Medical School has launched a family nurse practitioner residency program in partnership with community health centers across Massachusetts with federal funding. A fellowship for psychiatric mental health nurse practitioners in the same settings was also launched this year with state funding.

“The value of a residency is the mentor support and the time a resident has to come up to speed to care for a diverse community health center population with multiple needs,” said Jill Terrien, PhD, ANP-BC, associate professor of nursing and medicine, and principal investigator for the Massachusetts Community Health Nurse Practitioner Residency Partnership. “When they get a deeper look into the population they’re serving, and the many resources available in the community health center, nurse practitioners are more apt to stay at that center where they are critically needed.”

JILL TERRIEN, PhD

Photo by FAITH NINIVAGGI

The family nurse practitioner residency partnership was established at five sites with a four-year, $3 million grant from the U.S. Health Resources and Services Administration. The psychiatric mental health nurse practitioner fellowship is supported through the Massachusetts League of Community Health Centers.

Building on the model developed in 2009 by Family Health Center in Worcester, the 12-month, full-time residency prepares family nurse practitioners to provide comprehensive primary care. The residency is open to recent graduates with Master of Nursing or Doctor of Nursing Practice degrees from accredited programs nationwide.

Sites include the Family Health Center and the Edward M. Kennedy Community Health Center in Worcester, the Codman Square Health Center in Dorchester, Harbor Health Services in Boston, and Baystate High Street Health Center in Springfield. Also collaborating is the T.H. Chan School of Medicine Department of Family Medicine & Community Health. Unique to this program is the interprofessional education and collaborative practice model integrating primary Family nurse practitioners Heather care nurse practitioner Patrick, DNP’20, FNP-C, (left) and physician residents in and Amaryllis Teixeira, MS’08, teaching and practice.FNP, at the Edward M. Kennedy Community Health Center.

“I am a better clinician because of this program,” said Heather Patrick, DNP’20, FNP-C, who in 2021 completed the residency at the Edward M. Kennedy Community Health Center, where she continues to practice. “During clinical sessions we were precepted by a nurse practitioner who dedicated their time to us so we could consult with them as needed. Once a week we had didactic sessions, basically four hours of paid learning, which is an exceptional opportunity.”

UMass Chan nursing and family medicine & community health faculty and partner sites develop and deliver the didactic sessions in consultation with staff at the sites, including residency directors Amaryllis Teixeira, MS’08, FNP, at the EMK Community Health Center, and Kyla Biegun, MS’12, FNP-BC, at the Codman Square Health Center.

“The UMass Chan faculty have been instrumental in making the program what it is today,” said Teixeira. “We’ve also introduced case studies to allow the residents to bring difficult cases and offer different clinical insights.”

Another goal of the Tan Chingfen Graduate School of Nursing nurse practitioner residency and fellowship is to encourage practitioners to serve as future clinical educators for nursing school students and graduates.

“The program elevates not just the resident participants but the preceptors,” said Biegun. “In the process of teaching you realize how much you have to share.”

“Something that was very important to me was seeing how other people do things,” agreed Marta Escriu-Suñé, DNP’20, FNP-BC, who completed her residency at Codman Square. “It was good to be able to share concerns about patients that I was worried about with more experienced providers, especially while transitioning into practice during the COVID pandemic.”

Nurse practitioner residencies are an increasingly recognized approach to easing the national shortage of health care workers, especially primary care providers in underserved communities. There is a growing interest in psychiatric nurse practitioner fellowships due to a significant workforce shortage. By integrating fellowship programs into community health centers, access to behavioral health services for medically underserved populations is improved. Recent research indicates that nurse practitioner graduates of postgraduate training programs remain in primary care and underserved practices at higher rates compared with national averages.

The new psychiatric nurse practitioner fellowship, with didactic training under the direction of Mechelle Plasse, PhD, APRN, assistant professor of nursing and psychiatry, is based on the same model as the family nurse practitioner residency. Psychiatric nurse practitioner fellows are currently in training at Lowell Community Health Center and East Boston Neighborhood Health Center.

A collaboration of the Tan Chingfen Graduate School of Nursing and the Massachusetts League of Community Health Centers, the fellowship will provide protected time for enrichment, including certification to prescribe medication-assisted treatment for patients with opioid use disorder; simulations; didactic sessions on application of psychotherapy appropriate to the setting; evidence-based psychopharmacology and professional socialization to the role; group supervision from behavioral health fellows from the UMass Chan Department of Family Medicine & Community Health’s Primary Care Psychology and Medical Education Fellowship; and participation in the UMass Chan Department of Psychiatry grand rounds. ■