Program Helps New Patient Care Nursing Assistants THRIVE on the Job

Increasing job satisfaction and reducing turnover

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Patient care nursing assistants (PCNAs) are a vital part of Cleveland Clinic’s inpatient care team, with hundreds of PCNAs supporting nursing care throughout the Nursing Institute.


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To ensure their success, Cleveland Clinic’s Nursing Education and Professional Development team launched a robust training program called THRIVE for newly hired PCNAs in June 2019. This summer, the program’s first PCNA cohort successfully completed the year-long program and received their training certificates and lanyards.

“Many of our PCNAs are new to the field of healthcare and we want to give them the training, tools and resources they need to be successful,” says THRIVE Education Manager Shannon Pignatiello, MSN, RN. “The program set out to support new PCNAs throughout their first year on the job, helping them to work through challenges and barriers that impact retention.”

Cleveland Clinic PCNAs work with nurses to provide direct patient care, which includes patient transport, responding to call lights, assisting patients with self-care, eating and more. The entry level position attracts people of diverse age and educational backgrounds, with requirements for the job being strong people skills, a good work ethic, a desire to provide patient care and a high school diploma or GED.

In 2016, after identifying opportunities to better support PCNA retention as a priority, Cleveland Clinic’s Nursing Education team created THRIVE, an enrichment program focused on teaching new PCNAs life skills and providing coaching for success in their role. Under a three-year grant from the Ralph C. Wilson Foundation, two partners from Buffalo and Detroit were welcomed. Nursing Education worked with the Buffalo and Detroit sites to align operational and curricular aspects of the program in preparation for the THRIVE Program launch in 2019.


How it works

Upon hire, new PCNAs attend the four-day THRIVE core program prior to completing their eight-day clinical orientations and unit-specific orientations. The THRIVE core curriculum focuses on foundational life skills and knowledge, including prioritization, caregiver communications, time management and resiliency skills. To provide ongoing support, new PCNAs are paired with a success coach who provides one-on-one guidance with regular check-in meetings throughout the first year on the job. PCNAs can call on their coach at any time to help them through barriers and concerns.

“Success coaches are such an important part of the THRIVE program,” says Pignatiello. “That time with the coaches is meant to help PCNAs develop the work and life skills they need for a challenging job, and it gets them off to a strong start. The goal is to set them up as well-rounded caregivers.”

Seeing results

“We were so pleased to see how well our first year went,” says Pignatiello. “We developed a comprehensive program and we saw our retention numbers improve. Our new PCNAs tell us the program really helped them.”

In late June, Nursing Education analyzed program results and found that retention of new PCNAs has improved when compared to the previous year. In fact, the program was so well received and successful that three more success coaches are being hired, Pignatiello reports.


“This is a revolutionary intervention designed to support these caregivers who are so important to the success of patient care at Cleveland Clinic,” says Joan Kavanagh, PhD, RN, NEA-BC, Education and Professional Development Associate Chief Nursing Officer. “This program achieves so much. It helps the PCNA caregivers to be successful on their path, it enhances patient care, and it gives our nurses the support they need to do their jobs better.”

She notes that it is a win-win situation, adding: “Bringing new caregivers on board takes time and training. The THRIVE program provides PCNAs with the strong foundation they need to be successful, and in the process, it reduces costly caregiver turnover.”

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