Sofia Abreu’s clinical placement days began at 6:45 a.m. After a brief check-in with her clinical instructors and classmates, she was at her assigned nursing station by 7 a.m. for “morning huddle” at Jackson Memorial Hospital (JMH), the anchor academic medical facility of Miami-Dade County’s nonprofit Jackson Health System.
Abreu and her nurse preceptor—an experienced nurse responsible for training and supervising students—listened closely while the nurse manager reported on the patient census. Then they began their shift, participating in the handoff report with the night shift nurses and preparing to care for their patients—going over medications, checking vital signs.
To an outside observer, it may have looked like the start of a typical day for a nursing student. But during her year as a student in the intensive accelerated Bachelor of Science in Nursing (ABSN) program at the University of Miami School of Nursing and Health Studies (SONHS), Abreu, ABSN ’23, was part of a new clinical training initiative called the Dedicated Educational Unit (DEU). The DEU is an academic-clinical partnership that SONHS and JMH launched in 2023 with a grant from the State of Florida Department of Education’s Linking Industry to Nursing Education (LINE) Fund.
“The DEU offers an innovative approach to clinicals for our accelerated BSN students. The initiative builds on our long-standing community partnership with Jackson Memorial Hospital to provide students with intensive, individualized clinical experiences,” said Nichole Crenshaw, DNP, APRN, AGACNP-BC, ANP-BC, CHSE, FAANP, associate professor and associate dean for Undergraduate Nursing Programs at SONHS, who serves as the program’s director.
In addition to practicing bedside care skills, Abreu and the other students often found themselves engaged in training activities that aren’t usually available to nursing students: observing a surgery in the operating room or a procedure in interventional radiology, working with a physical therapist to practice moving a patient safely, or talking with a pharmacist to learn about medications. They met with a respiratory therapist to learn about rapid response to patients in distress, and walked the hospital with an infection control nurse to learn how they ensure units are complying with protocols for keeping their areas clean and infection-free.
“Just having the opportunity to have all these different specialties come in and teach students is something unique to the DEU,” said Abreu.
“We were able to see a side of nursing that students in regular clinicals don’t always have the opportunity to see,” added Brianna Lohnes, ABSN ‘23. “It's been great becoming part of the team and learning the skills you'll be doing day-to-day when you start as a nurse in a few months.”
DEU participants also rounded on the units with an interdisciplinary health care team that included nurses, physicians, case managers, social workers, and physical and respiratory therapists. “The interdisciplinary team came together and everybody contributed something,” said Abreu. “The Jackson philosophy is that even students have a role to play in the patient’s care, and I really appreciated that.”
Even after a busy 8- or 12-hour shift, Abreu’s day still wasn’t over. The 16 students gathered again for a post-conference with their clinical instructors, Rachael D. Rivers, MSN, RN, and Anthony Alicea, APRN, FNP-BC, the DEU program coordinators. The group discussed their day and patients—a process that reinforced and consolidated what they had learned.
Both long-time Jackson nurses, Alicea and Rivers were drawn to the DEU program because it offered an opportunity to take a leadership role in launching and developing an innovative clinical training initiative for students. Rivers found the possibilities so intriguing that she came back from retirement after 33 years at Jackson to help train the next generation of nurses.
“If I were to sum up the DEU program in one word, it would be immersion,” Rivers said. “They learn nursing skills while immersed in the nursing culture; they become a part of the nursing family. Students don’t often get that in the traditional approach, but here you get the fullness of what it means to be a nurse. And the torch is passed on.”
From the onset, Rivers and Alicea formulated supplementary educational experiences that aligned with the students’ SONHS courses, bringing in guest speakers and ensuring students were exposed to the larger Jackson environment.
“I enjoy teaching because I understand where they're coming from,” said Alicea. “My students are great, they’re bright, motivated, they want to learn. Nursing has given me opportunities I never would have dreamed of, and I'm very grateful. So for me, it's all about giving back.”
The students have expressed great admiration and respect for their DEU instructors as well. “Rachael and Anthony have been amazing,” said Lohnes. “They gave us their knowledge. They really shaped the program for us, and they found opportunities for us to learn about different parts of the hospital.”
“Working with Anthony and Rachael was a very positive experience,” added Abreu. “They put a lot of effort into making sure students had the most well-rounded experience. When we brought up something we were interested in learning as a group, they would try their best to accommodate us. They did a great job finding new things for us to learn.”
After two semesters working with neurosurgical patients on Jackson’s West Wings 6, 11, and 12, the students were able to request a specific placement for their third and final semester of the ABSN program. These requests led to students being placed in Jackson’s various ICUs—trauma, surgical, medical, neurology, pediatric, neonatal—as well as in the adult and pediatric emergency departments, and labor and delivery. Lohnes opted to work with newborns and their families on the NICU.
Now celebrating their well-earned graduation, both Lohnes and Abreu hope to return to Jackson as registered nurses—a core goal of the program amid the nationwide nursing shortage. “I’m very surprised at how much I was able to learn in a year,” said Abreu. “I saw what it's like to work on different floors, to work on a team and to be a Jackson nurse, and it allowed me to make a more informed decision about where I want to take my career.”
That’s one of the beauties of the DEU program, said Rivers and Alicea. It shows students how vast the world of nursing is while helping guide their journey of self-discovery through that world. “The DEU gives you an opportunity to try your hand at what you think you might want to do until you find what really suits you,” said Rivers. “It's only limited by your imagination. How do you see yourself fitting in? What do you think is going to be the lane for you to make the biggest contribution to this field? That's the fun of discovery the DEU provides.”
