Creating Caring Learning Environment Practice Partnerships (CLEPPs)

Reports by the Institute of Medicine (IOM) and the Robert Woods Johnson Foundation (RWJF) (2010) call for nurse leaders to improve how nursing students are educated by improving the bridge between theory and clinical practice.  Such partnerships facilitate collaboration between academic and clinical practice settings for better utilization of resources and the development of creative ways to prepare nursing students in providing safe and effective patient-centered care to higher acuity patients in a complex healthcare systems (Glazer, Erickson, Mylott, Mulready-Shick, & Banister, 2011).  Creating new and innovative models that utilize the traditional dedicated education unit (DEU) model presents unique and valuable opportunities for nursing students and staff nurses. The utilization of existing philosophical frameworks within a baccalaureate nursing program and a large healthcare system serves as the guiding theory of establishing academic – practice partnerships in an effort to stabilize, structure, and strengthen relationships. Creating such relationships, based in the caring sciences offers both academic units and clinical sites rich opportunities to ameliorate learning opportunities for all stakeholders. This bi-directional learning model benefits nursing students, staff nurses and academic/clinical administration.

In August 2014, Nevada State College’s School of Nursing initiated discussions with two selected healthcare organizations, Dignity Health St. Rose Dominican Hospital’s Siena Campus and the VA Southern Nevada Healthcare System to gauge interest in creating caring learning environment practice partnerships (CLEPPs) anchored in Jean Watson’s caring theory.  The creation of caring science units (CSUs) offers a novel approach to the dedicated educational units (DEUs).  This innovative collaboration benefits nursing students and clinical units by offering a structured and consistent model of clinical experiences for all stakeholders. 

The two healthcare organizations were chosen due to similar values and ideals related to the environment for nursing care delivery. The chief nurse executives, the clinical educators, the Dean of the School of Nursing and a nursing faculty responsible for clinical coordination met to discuss the vision, structure, and outcomes of the caring science units and the practice-partnership. Meetings continued during the implementation of the CSU’s. The clinical liaisons from both organizations attended a faculty development workshop in January 2015 in which Jean Watson’s caring theory was explored for integration into both the curricular and the clinical settings.

Caring science units (CSU) are similar to the dedicated education unit (DEU) models described in the literature where the unit staff nurses play a role in the education of the nursing students by functioning as a clinical instructor. Specific units are designated as a CSU in each healthcare organization and the nurse manager and clinical educator identified clinical nurse mentors on those units. Each practice setting designated a clinical liaison that communicates with the Nevada State College (NSC) clinical instructor, the NSC nursing students, the nurse mentors at each organization and the NSC clinical coordinator to enhance communication and success of the CSU.

These practice partnerships create a caring learning environment that benefits both the healthcare organization and the school of nursing. The nursing students are in an environment that facilitates learning both the art and science of nursing care, as well as the transition from nursing student to new graduate nurse.  The team of leaders developing the new, innovative CLEPPs shares exemplars of how nursing practice grounded in caring science leads to improved patient outcomes and patient satisfaction.  The clinical nurse mentors receive education regarding the nursing curriculum, learning objectives for the course, teaching strategies to promote critical thinking/clinical reasoning, and effective feedback and evaluation.  This enhances education and professionalism of nursing in the healthcare organization and introduces nurses to the nurse educator role.