Hiring new employees can be expensive. A 2022 study from the Society for Human Resources Management found that the average cost of hiring one new employee was about $4,700. In nursing, it can be more than ten times that amount.

Female nurse with elderly female woman

Bloom Healthcare provider visits a patient.

What if a company could reduce those costs while giving potential employees a “trial period” before starting a new job? A potential employee could see if he or she was a good fit, and the company could see how the person works and interacts with other employees. The process would also save the company money because less training would be required and less time spent on interviews.

The University of Colorado College of Nursing has partnered with Bloom Healthcare to provide a “trial period” while advanced practice students earn their degrees. COMPACT (Community Optimized Mentoring for Practice Accelerated Transitioning) was launched two years ago and is geared toward advanced practice nurses studying adult-gerontology.

Bloom Healthcare is based in Lakewood, Colorado, and focuses on older adult patients. Bloom provides home health care, telemedicine visits, and primary care in facilities throughout the Front Range, helping seniors maintain their independence. Bloom empowers patients and their families by providing individualized care in the home and focuses on a patient-centered care model.

Kim Paxton, assistant professor of nursing at CU, DNP, APRN, ANP-BC, LHIT-C, founded COMPACT because it was difficult for students to find internships.

“COMPACT has two goals: it helps the student and it helps the company,” Paxton says. “Students get an internship in a high-quality healthcare system. Students get to try out the environment to see if it’s the right place for them, and Bloom gets to see if the student fits into their system.”

Job interview for a job

Megan Graeser

CU Nursing alumna Megan Graeser, DNP, GNP-BC

Students complete two semesters (six to seven months) of clinical hours at Bloom Healthcare.

The average number of clinical hours for advanced nursing programs at one specific location is 90-135 hours.

Students typically enroll in their second semester of the AG program, but complete the COMPACT program in their third and fourth semesters. They will be interviewed by Paxton and CU Nursing alumna Megan Graeser, DNP, GNP-BC, who is director of clinical development at Bloom Healthcare.

At least four students have completed the COMPACT program and Bloom Healthcare has accepted all but one.

“The student chooses to be a candidate because COMPACT is the type of healthcare system, career path, and patient population that they are looking to work in as a nurse practitioner,” Paxton said. “At the end of COMPACT, when the student graduates, Bloom Healthcare can see and determine if that student is a good fit and offer them a position.”

Students will be interviewed by their team leader to ensure they are a good fit for an open position.

Chelsea Goston

CU Nursing alumna Chelsea Goston

Chelsea Goston, a CU nursing alumna, was enrolled in the university’s Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP) program when she applied to COMPACT.

“I was inspired to apply to the program because I heard it offered more training and resources,” she says. “That was important to me because as a new nurse practitioner, I wanted more support, and a potential job after the program was very exciting to me.”

Graeser compares the program to medical school.

“Students get a taste of what our practice looks like,” Graser says. “They ideally get a few semesters where they see the variety of patients that we see, the complexity of patients that we see, and realize that our providers, particularly nurse practitioners, are really operating at the highest level of their practice. It allows us to see how great a nurse practitioner can be and how independent they can be.”

A typical COMPACT day

Students will have a wide range of experiences in the COMPACT program that are not normally seen in a typical primary care practice. They will be paired with and mentored by one of Bloom Healthcare’s nurse practitioners.

Goston shadowed her nurse practitioner at the beginning of COMPACT to get an understanding of procedures. Eventually, Goston took charge and did things like ask patients questions and work on charts.

Female nurse with elderly man going through computer notes

A nurse discusses healthcare with a patient at Bloom Healthcare.

“As I got more experienced, my preceptor would sit outside of a patient’s room to give me more independence with the patient, so I could do things on my own. Then I would report my findings back to her and she would confirm that information with the patient,” she says. “We would talk privately about the care plan and she would ask me what I would do for a patient. I would tell her and she would give me feedback, so it was a great learning experience. It gave me a good, strong foundation as a nurse practitioner and it gave me the ability to work independently.”

Students will have the opportunity to spend hours with wound care nurses and learn about integrating hospice and palliative care into primary care. Students will also gain a better understanding of the role of clinical pharmacists and psychiatric nurses within the Bloom Healthcare organization.

“I think that’s the biggest thing about this COMPACT program: showing advanced nursing students an area that they don’t always see in some clinical rotations,” Graeser says. “It allows them to see what kind of medical care can be provided in the home — whether it’s in a patient’s home or in a nursing home, we want them to see what we (at Bloom) can do for primary care.”

Students typically spend two days per week at Bloom Healthcare. They typically see 10 to 12 patients per day with their preceptor, which is different from an outpatient practice setting where advanced practice nurses may see upwards of 18 patients per day. Bloom Healthcare understands the need for its primary care providers to collaborate with a patient’s family members and other partners in patient care to ensure that patients receive quality medical care in their home.

“A lot of what we do is not just taking care of the patient, but also communicating well with the people who are taking care of those patients,” Graeser says.

A win-win situation

Another bonus of the COMPACT program: Students learn the ins and outs of Bloom Healthcare’s system and procedures during the program. Bloom Healthcare says COMPACT reduces orientation time. There’s also a lower cost for orientation, which is estimated to be around $60,000.

Advantages of COMPACT

For CU nursing students

  • Builds nursing knowledge
  • Long-term with preceptors and patients
  • Learn all about Bloom before applying for an open position

For Bloom

  • Reduces the cost of hiring staff
  • Can see if students are suitable for vacancies
  • Providing students with a quality clinical experience

“COMPACT gives students a better understanding of what the expectations are,” Paxton said. “They can start self-directed care sooner. Students have been at Bloom for seven to nine months when they’re hired, so they’re going into this new nurse practitioner role knowing all the processes, how to document things, and how to understand the patient population.”

Thanks to the intensive guidance and learning process, students feel more confident when looking for a new job after graduation.

“Students trust themselves and their ability to tap into intuition and understanding, knowing and being, is at a higher level than a recent graduate who hasn’t had that experience. It’s phenomenal,” Paxton says.

Goston says she enjoyed her experience with Bloom so much that she applied for a nurse practitioner position after COMPACT, going through the traditional application process before accepting the position.

“It was easier to jump right in because I had all that experience and knowledge. It felt like a great fit,” she says. “One of the biggest challenges (starting the job) was learning the Bloom electronic system, but I had been using it for a semester. So knowing how to use it already made me feel more comfortable and confident, and it helped me ease into a job as a new nursing graduate.”

An evolving program

The COMPACT program is expected to evolve as the partnership with Bloom Healthcare and CU Nursing continues, focusing on the experiences students need to gain and the different roles that nurse practitioners fulfill in primary care settings.

Another aspect is the number of students selected per semester. Bloom Healthcare is a large practice and wants to ensure that students still gain quality experience.

“The learning curve from nurse to nurse practitioner is huge, and no one told me how hard it is,” Goston said. “I appreciated COMPACT because I felt like I was getting a good foundation so I could really focus on the care and treatment of a patient. COMPACT definitely helped increase my learning curve and confidence compared to a more traditional clinical setting.”

“I’ve done preceptorships during my NP program, but normally I would spend a semester with just one preceptor and then go to another healthcare facility,” Graeser says. “But with COMPACT, students get to spend more time with patients, do primary care, and see different aspects of primary care from a different perspective.”

Graeser says the COMPACT program is demonstrating a shift in primary care for older adults, with quality medical care also available at home.

“We’re trying to keep them home longer and provide that quality of care with a tremendous amount of support,” Graeser said. “We have 73 caregivers and 74 non-caregivers on Bloom’s primary care side, so it helps us realize how unique the experience is for students for CU Nursing students to be a part of our organization.”

“The University of Colorado is the birthplace of the nurse practitioner and is the birthplace of innovative thinking and societal application. Our leadership at CU Nursing wants us (faculty) to think outside the box and find ways to maximize opportunities for students,” Paxton said. “This program can have such an impact on a larger scale.”