NICU Virtual Hybrid Internship Slashes Nurse Turnover From 38% to 0% at UW Health
Image source: UW Childrens
American Family Children's Hospital is making waves with its groundbreaking approach to supporting new neonatal intensive care unit (NICU) nurses. Since rolling out a virtual new grad internship in July 2024, the hospital has seen its turnover rate for new-to-practice NICU nurses plummet from a staggering 38% to zero in just one year. Yes, you read that right: zero turnover! For a specialty as notoriously high-stress as the NICU, this is nothing short of incredible.
So, what’s the secret sauce? Spoiler alert: It's not just about fancy tech. This program is all about creating a smoother, less panic-inducing transition for brand-new nurses stepping into the fast-paced, high-stakes world of NICU care.
Easing the NICU Learning Curve: Virtual Shifts to the Rescue
If you’ve ever worked in or floated to a NICU, you know it’s not exactly the easiest unit to get your bearings. Tiny patients, complex equipment, and high-emotion situations can make even seasoned nurses sweat. Now imagine being a new grad in that environment—it’s no wonder so many newbies likely tap out early.
To tackle this, the hospital developed a hybrid approach. New NICU nurses divide their time between bedside shifts and virtual shifts. During the virtual portions, they monitor patients remotely, handle documentation, and even communicate with families via secure platforms. This setup gives them the space to breathe, process what they’re learning, and build confidence before diving into the deep end of bedside care full-time.
Let’s be honest—most of us would’ve loved something like this when we were new grads. Remember those moments when you were trying to figure out how to prime TPN at 2 a.m. while your preceptor seemed to have 15 hands and nerves of steel? This program gives new nurses a chance to build those skills without the heart-pounding urgency of bedside crises.
How the Virtual NICU Nursing Program Works
- Leadership: Developed and led by three experienced NICU bedside nurses—Morgan Kuhl, Grace Long, and Hailey Madson—who together have nearly 20 years of NICU experience.
- Structure: Each virtual nurse works two six-hour virtual shifts per week in addition to regular bedside shifts.
- Technology: Virtual nurses connect securely from home using laptops, while bedside nurses use tablets to communicate in real time.
- Support role: The team answers clinical questions, reviews challenging cases, and provides emotional support during difficult shifts.
- Education: Virtual nurses offer protected time for orientation discussions, supplement toolkits with PowerPoint presentations, and review topics such as mechanical ventilation and wound care.
- Mentorship: About 15 new-to-practice NICU nurses are currently assigned mentors, but any nurse on the unit can access the program’s support.
- Family engagement: The program has expanded to include virtual conversations with families about admissions and what to expect during their NICU stay.
Saving Big (In More Ways Than One)
Beyond keeping new nurses on board, this program is saving the hospital a lot of money. Replacing a single NICU nurse costs about $88,000 when you factor in recruitment, orientation, and training expenses. Multiply that by the number of new nurses the unit was losing annually—over a third of its newbies—and the savings quickly climb into the hundreds of thousands of dollars.
But the benefits go way beyond the budget. NICU care thrives on continuity. When nurses stick around and develop expertise, patient outcomes improve. Dr. James Wilson, a pediatrician at the hospital, put it perfectly: "Continuity of care is especially critical for NICU babies and their families. When nurses stay and develop expertise, patient outcomes improve. This program creates stability that benefits everyone involved in these complex cases".
It’s not just about the babies, though. Families also get the emotional support they need when they can build relationships with a consistent care team. And, as nurses, we all know how much easier it is to work with families when they trust you and feel reassured by your presence.
Brandy’s NICU Story: From Clinicals to a Calling
For me, this story hits close to home. I’ve been a NICU nurse for 23 years, but I still remember the exact moment I knew the NICU was where I was meant to be. During nursing school clinicals, I stepped into the unit for the very first time—and something just clicked.
My preceptor could tell how lit up I was, and she introduced me to the NICU manager at my dream children’s hospital. The manager looked me in the eye, smiled, and told me they were hiring—and to put in my application as soon as I graduated. Just a few months later, I walked across the graduation stage and straight into my dream job.
That moment changed everything for me. The NICU became my calling, my passion, and my professional home for more than two decades. And I can’t help but think how many new grads today might find their own footing and calling with the kind of support programs we’re now seeing rolled out.
A Model for the Future
The timing of this program couldn’t be better. According to the American Nurses Association, nearly 500,000 experienced RNs are expected to retire by 2030, and we’re looking at a projected deficit of 1.1 million nurses nationwide. Specialties like NICU, which require highly specialized knowledge and skills, are likely feeling the recruitment and retention squeeze even harder.
Other hospitals are starting to pay attention. In the past year, representatives from a dozen children’s hospitals have visited American Family Children's Hospital to learn about the program, with some already planning to roll out similar models.
The program’s leaders point out that while the tech is helpful, the real magic lies in rethinking how we support new nurses as they step into challenging specialties. It’s not about rushing them to full independence; it’s about giving them the tools, time, and confidence to get there at their own pace.
For all of us in nursing, this could mark a shift in how we train and retain talent. Whether you’re a seasoned NICU nurse, a new grad, or someone working in a completely different specialty, this model shows what’s possible when we prioritize support and mentorship.
So, could virtual nursing internships be part of the future of onboarding in other high-stress specialties? It sure looks that way. And if it helps keep nurses in the profession and reduces burnout, sign us up. After all, a supported nurse is a happy nurse—and a happy nurse makes for happier patients.
September is NICU Awareness Month, a time to recognize the resilience of babies and families and to honor the dedicated staff who provide specialized care.
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