Structural empowerment

Nursing Professional Governance

Goshen Health has a long history and strong culture of empowering all Colleagues to use their voice for positive change.  Nursing Professional Governance supports an environment where nurses make decisions that impact their professional practice.  Participation in professional governance empowers nurses to advance practice, strengthen their work environment and improve patient care outcomes.

Due to the COVID-19 pandemic, live monthly meetings were cancelled to focus on the increased patient care needs and to minimize risk of exposure.  Nurses explored innovative ways to engage, including using Zoom to meet virtually, combining similar councils and committees to increase efficiency, and trialing new technology to gather feedback.  Despite the challenges, nurses continued to advance practice through the professional governance structure.

Several accomplishments include:

  • Increased awareness of self-care and provided resources for nurses to create self-care plans
  • Updated policies, prepared documents and provided education to remain prepared for the Joint Commission
  • Invited input and communicated practice changes related to the COVID pandemic
  • Solicited feedback on plans for the new patient tower building project
  • Improved efficiency and resources for evidence-based practice projects
  • Provided support for implementation of the new clinical ladder program
  • Sustained the professional nursing certification rate above 50%
  • Provided opportunity to share the challenges and successes experienced during the COVID pandemic

Certification and Degree Advancement

Professional certification as a public demonstration of nurses’ expertise and professionalism is a highly valued accomplishment at Goshen Hospital. Nurses are supported through the application process and are acknowledged for achievement of certification through public recognition and an annual bonus.   Annual certification goals for the overall organization and individual departments are identified and progress is tracked throughout the year.  Nurses at Goshen recognized the benefits of certification and not only met but exceeded the goals to have at least 51% of nurses who meet eligibility requirements achieving specialty certification.

Degree Advancement
Nurses at Goshen Health continue advancing the profession as they work to achieve bachelor’s and master’s degrees.  Goshen provides support for degree advancement through tuition reimbursement, loan repayment, and the option of full tuition payment for select programs.  At the end of 2021, 84% of Goshen Hospital nurses had a BSN or higher.  We are thrilled to continue meeting our Nursing Strategic priority to have at least 80% of nurses with a BSN or higher. This goal aligns with the Institute of Medicine recommendation for a nursing workforce that is academically prepared to deliver the highest quality patient care.

RN Residency
Twenty-one (21) newly licensed RNs joined the Goshen Health nursing team in 2020 with an additional 38 joining in 2021.  Lisa Helfrich, MSN, RN, and Michelle Lambright, BSN, RN, welcome newly licensed nurses as coordinators of the Goshen Health’s Vizient/ AACN Nurse Residency Program™. The 9-month program is designed to ease the transition of newly licensed nurses from the classroom setting to the clinical practice environment.  Lisa and Michelle facilitate the monthly sessions, providing a supportive environment for the new nurses to learn and share.

The new nurses learn from experts in a variety of disciplines during the monthly residency sessions and have opportunity to share their experiences during a debriefing time.  Receiving support from experienced nurse mentors, building relationships with peers and participating in engaging learning experiences helps new nurses gain confidence and increase competence during their first year.   Residents report that the sharing and support is beneficial as they navigate through their first year of professional nursing. 

Nurses at all levels of Goshen Hospital recognize the importance of building relationships with new nurses through both formal and informal mentoring. Mentoring is built upon a relationship between an individual with potential (mentee) and an individual with expertise (mentor). The mentor role is to advise, guide, encourage, and role model.

The first formalized clinical nurse mentoring program at Goshen was developed in 2018 by clinical nurses on The Birthplace Unit Practice Council (UPC). Newly hired nurses in The Birthplace are paired with an experienced nurse mentor.  The mentor connects with the mentee at least every 2 weeks for the first 3 months of employment to build a relationship and ease the transition into their new role.  The remaining 9 months of mentorship are determined based on the needs of the mentee.

During the Nursing Strategic Planning Retreat in December 2019, nurses identified the need to expand and standardize the mentoring program as one of the Nursing strategic Priorities for 2020-2023.  Using The Uncommon Leader (TUL) tools, nurse educators and managers formed a Do-It-Group (DIG) to establish guidelines based on the successful program established in The Birthplace. These guidelines provide a consistent and accountable approach for the mentoring program. 

Due to challenges related to the COVID-19 pandemic, the group agreed that the new mentoring program would focus primarily on newly licensed nurses and would be implemented in each department as mentors became available.  One successful solution to the challenge was engaging the Professional Development Specialists in Colleague Education to mentor the newly licensed nurses hired into departments where the program was not yet implemented. 

"I had Courtney Brickner as my mentor and she was amazing! She brought me gift cards, gifts, and misc. pick me ups for anniversaries (6 months, 1 year at Goshen) and she got to know me well enough to give super personal gifts. I know I can go to her for any questions or concerns I have, during shift change now, but also when I work the occasional day shift." Brianna Andrews about Courtney Brickner as a mentor. 

Clinical Ladder
A clinical ladder is a designed to enhance professional development, promote excellence in practice and provide formal recognition for direct-care nurses.  The benefits of a clinical ladder are documented in literature.  Clinical ladder programs are associated with improved nurse satisfaction, promotion of quality nursing practice and enhanced retention efforts.

Goshen Health nurse leaders recognized the opportunity to implement a clinical ladder at Goshen and invited clinical nurses, nurse educators, nurse managers and directors to explore the idea using The Uncommon Leader (TUL) tools.  The TUL project team reviewed literature, analyzed a variety of clinical ladder models, and provided recommendations to incorporate into the design of the Goshen Hospital Clinical Ladder Program. 

Nurses qualify for specific ladder levels based on tenure, degree, and certifications.  Nurses interested in this voluntary program can apply to participate during the application period and select which level they intend to achieve that year.  A financial bonus is given after successful completion of the clinical ladder program to recognize their achievement.   

A few of the program elements include:

  • Program advancement directly tied to years of service
  • Recognition for degree and specialized certifications
  • Recognition for precepting, engagement in professional governance and mentoring
  • Recognition for investments in personal skills development

 The Clinical Ladder Program proposal was approved in 2021 with plans to implement the new program in 2022.  One hundred ninety-seven (197) nurses submitted applications in December 2021 to invest in their professional growth through participation in the 2022 clinical ladder program.