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Transition to Specialty Practice Programs – by RN Laurie, currently in a TSPP


My Health Career would like to thank Laurie Bickhoff for writing this article! If you want more from Laurie, check out her blog Defining Nursing.

“Graduate nurses will soon be approaching the mid-point of their first year of practice.  Some will be charging full steam ahead, leaping patients in a single bound.  Some will still be struggling to find their feet in an environment that is constantly shifting under them.  Sadly, some will have already left the nursing profession.  Hopefully though, most will be finding their stride and settling into their role as registered nurses.  However, around this time in their so far short careers, the question starts popping up – what comes next? – and the answer may be a Transition to Specialty Practice Program (TSPP).

The need for nurses with specialised training
Historically, the provision of health care has always been categorised.  Maternity patients were kept separate to geriatric patients who were kept separate to surgical patients.  However, as health care became increasingly complex and specialised, designated speciality units were required, along with health care professionals with the specific skills and education appropriate for these areas.  The National Review of Nursing and Nursing Education in 2002 recognised this need for nurses with specialised training, and recommended the development of TSPP.

TSPP provide a structured pathway into specialised nursing, providing nurses with the knowledge and clinical skills necessary to provide safe and effective care to patients within specialty units.  There are a number of areas which now offer TSPP, including emergency, ICU, cardiology, nephrology, peri-operative, acute medical, acute surgical and mental health.  Paediatric TSPP are also offered in these same areas.

TSPP generally include an extended orientation, beyond a simple ‘where is everything’ walk around, study and education days, and preceptorship by other experienced nurses.  Many TSPP are affiliated with universities and completion of the program can award you credit towards post-graduate qualifications in these areas.  TSPP can also involve rotating through different wards within the speciality, and even to different hospitals within the health district.

Transition to Specialty Practice Program structure
To give you a little more insight, I am currently completing a cardiology TSPP.  This program has four 13 week rotations, including a medical cardiology ward, cardiac cath lab, and coronary care units at a district land tertiary level referral hospitals.  We complete training days with cardiac assessment nurses, the community heart failure team and in cardiac rehab.  We have education days focusing on specific cardiac policies, procedures and guidelines, ECG and rhythm strip interpretation, cardiac anatomy, physiology and medications, common cardiac conditions and interventions.  During the program, we also complete clinical training in areas such as cannulation and venepuncture, and advanced life support, give a case study presentation to the cardiology department and interpret about a million ECGs.  Ok, I might be slightly exaggerating that last one, but you get the point.

The structure and content of a TSPP can vary greatly, and is determined by the hospital and health district offering the program.  It is important to realise, you will not be an expert in your speciality at the end of your TSPP.  However, you will have gained crucial experience, knowledge and skills, which will hopefully lead to providing a higher level of care, and set you on the path of continuing your career, education and training within this area.

Entry into a TSPP
TSPP are offered across Australia, within a wide range of health districts.  Many will start advertising for these positions in August / September and interview in the month afterwards.  While for other programs, these dates are closer to October / November.  Traditionally, applications for TSPP were only open for RN2s; that is nurses who would be going into their second year of practice.  However, more and more TSPP are widening their eligibility to include any nurse who has a minimum of one year post-registration experience.

For those interested in applying for TSPP, a good place to start is with your current hospital or health district.  Ask your nurse educators if there are TSPP available and their advice on applying.  Keep an eye out on your state’s online recruitment system for when the programs are advertised, and, if interested, look at other states as well.  A quick Google of “Transition to Speciality Practice Nursing programs” can give you an idea of the hospitals which offer TSPP and information specific to their programs.

Positions within TTSP are generally hotly contested, with one program I know of regularly receiving over 400 applications each year with only 10 positions offered. 

The competition is tough, so you need to be prepared as each program will have its own selection criteria and application process. Interview questions for these positions will often be based around the speciality area, while still being aimed at the knowledge of RNs working outside these departments.  For example, for an emergency TSPP, you may be asked what action you would take if a patient became unresponsive whilst you were transporting them to another department.  For cardiology, the question might instead focus on how you would respond to a patient who is having chest pain, and its possible causes.

While TSPP certainly are not the only way to gain employment within speciality areas, they can be a gateway to careers in areas which often have ‘previous experience necessary’ when advertising for positions.  TSPP do provide structure, a high level support and education to make the transition to these speciality areas easier and safer for all.

Morphet, J., Considine, J. & McKenna, L. 2011. Transition to specialty practice programs in emergency nursing – A review of the literature. Australasian Emergency Nursing Journal, 14(1), 45-49.”

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