Dual-Role Advancement: Creating Transferability of Clinical Expertise and Professional Advancement in a Sustainable Care Delivery Model

by Priya Meyer

Coauthors: Mariana Orozco, Jennifer Baird

Medical Devices & Digital Health

Hospital nurse understaffing’s poor consequences on patient outcomes and care quality has been well-documented preceding the COVID-19 outbreak. The pandemic brought forth additional influencing factors in both staffing and nurse burnout, to include but not limited to heightened anxiety and depression among nurses. Burnout and its associated negative effects disproportionately affect direct patient care roles who observe a high number of patients experiencing traumatic events. Nurses working in professional advancement areas such as 1) leadership, 2) research, 3) evidence-based practice, 4) quality improvement, 5) education, and 6) innovation show greater resilience to the negative effects of the highly emotionally charged practice of nursing.

Direct patient care nurses have clinical expertise and attributes essential in informing the work of the six identified domains of advanced professional practice. Nurses working in these domains have expertise in rigorous, systematic methodologies necessary to optimize patient outcomes. A dual-role care model offers promise for increasing resilience among important talent at the bedside through professional advancement opportunities that need the relevant expertise of clinically practicing nurses. The purpose of this dual-role advancement program is to create a staffing model such that clinically practicing nurses with a proclivity for a professional advancement track may maintain their role in direct patient care while partnering with advanced nurses to hone their professional skills in a specialty area of interest at a Magnet-designated freestanding children’s hospital on the west coast.

Data on full-time equivalents (FTEs), vacant FTEs, leadership structure, and advanced professional practice opportunities by department are currently being collected. Job descriptions for clinical-champion roles in the six identified domains are being drafted. Pilot program is due to launch in target departments and domains in early Fiscal Year 2024. The outcome of interest is clinical-champion nurse retention. Secondary outcomes include the number of successful projects translated into practice, clinical-champion satisfaction, competency by performance demonstration, and number who pursue graduate degrees upon assuming the role.