By Camille D. Ford | November 2025
Summary
At VA Tennessee Valley Healthcare System (TVHS), Amanda Docktor and Dr. Kanah Lewallen lead nurse residency programs that have become the gold standard for preparing new nurses and nurse practitioners to serve veterans. In fact, VA Tennessee Valley Healthcare System is the only VA medical center to offer all four of VA’s post-graduate residency programs , a rare feat among VA’s health care system. Through its Registered Nurse Transition to Practice (RNTTP) program and Post-Baccalaureate Registered Nurse Residencies (PBRNR), which offers three specialized health care tracks: mental health, primary care, and geriatrics and extended care (sometimes called GEC for short), they’ve built a culture where confidence grows, imposter syndrome fades, and new graduates become lifelong advocates for veteran care. Their retention numbers speak volumes: 14 graduates from early cohorts still serve at TVHS, with three from the very first 2021 cohort still caring for veterans today.
Three Generations of Nursing
Dr. Kanah Lewallen is a third-generation nurse. Her inspiration comes from her grandmother, who practiced in geriatrics, as her mother did. Both were leaders in long-term care.
“Unfortunately, my grandmother passed away last year,” Dr. Lewallen says. “But still, my mom, I bounce all of the things off of her. So, I have great examples of what it means to be a nurse and how that can impact your life, your career, your family, and everything. They both were amazing leaders and mentors and always were just encouraging people and supporting people in their journey, whether it was nursing or not.”
That legacy shaped everything. Dr. Lewallen earned her bachelor’s in nursing, then her master’s, then her doctorate. She’s a geriatric nurse practitioner by clinical training. “But what I love most about my job is supporting individual nurse practitioners in their journey to become the provider they want to become.”
A couple years ago, she joined VA Tennessee Valley Healthcare System to lead the geriatric residency. “It just was that next step in merging what I was exposed to early on as a child and how you are a true mentor. It doesn’t end at nursing school. Folks need that continued support throughout their career.”
The Only Nurse in the Family
Amanda Docktor came to nursing through a completely different door.
“I am the only nurse in my entire family, in my extended family,” she says. “There are no others.”
Nursing is her second career. She used to be a recruiter, a headhunter, then an on-site manager for a warehouse. She got involved in medical staffing and ended up running an at-home health office. “That is actually how I ended up deciding that I wanted to go to nursing school.”
Because she was a second-career nurse, she had a different perspective than most of her classmates. “Most of them were there for their initial degree. There was a little bit of an age gap, a little bit of life commitment gap that was happening.”
She came to VA Tennessee Valley Healthcare System as her first nursing job in 2014. “I had a small kid, and I needed a job, and I liked veterans. I had been working with veterans in other capacities for a long time. And so, I came here and just kind of fell in love.”
Residency was what she wanted when she went back to school. The whole reason she got a master’s in education was to impact nursing training. “There were so many ways that I thought we can do this better and we can equip people to be better and help me take care of our population specifically here.”
She’s been involved with VA Tennessee Valley Healthcare System’s transition to practice and post-baccalaureate RN residency programs since 2018.
When the Trenches Teach You What’s Missing
Before taking on their current roles, both women experienced firsthand what new graduates face when they’re thrown into high-stakes care without adequate support.
For Dr. Lewallen, it was her first nurse practitioner job. “There’s just so much opportunity to do things better, but I was thrown into it as a very new graduate. I had some nursing experience, which was invaluable, but not everybody gets to have that on their pathway to become a nurse practitioner.”
She found herself working in a high-acuity nursing home with no one else in the building. “It was all on me. That’s just not ideal. And so having that opportunity to have that additional training for those that want it was really what drew me to think that this type of development was needed.”
Docktor echoes the same challenge from the RN side. “You are hired as a new graduate nurse and it’s, you know, six, eight, 12 weeks of orientation, however in that spectrum you fall, and then we expect you to be able to do this. Nursing school does a great job of preparing you with book knowledge, but you need that hands-on. There’s so much that is on the job training of learning how to deal with people and how to interact and how to be the person who can apply all of that knowledge. And that’s really hard as a new graduate nurse.”
She was fortunate to have supportive people in those first couple years. “That is who I wanted to be for them, is to help with that development, help with that support and help them on the days when they’re like, I don’t, this was a mistake, right? Like, I don’t know that I can do this. You know, there’s a reason for it. You just gotta take a deep breath and keep moving.”
The Mentor Connection
Docktor’s relationship with her mentors runs deep. Darlene Hill and Jackie Odom, both retired now, were legendary nurses at VA Tennessee Valley Healthcare System who inspired her. And then there’s Dr. Lewallen herself.
“Honestly, Kanah has been such a huge support for me since she came to VA,” Docktor says. “Being able to bounce ideas of what should be happening, whether you’re an RN or an NP, like the goal is, how are we helping support you? And I think that’s really fantastic. We’re mentoring each other.”
Dr. Lewallen has her own mentor who’s been essential since 2009. “Jennifer Kim is my mentor. She teaches on faculty at Vanderbilt University School of Nursing still, and so I get to work beside her in my other role. I also was her student in my graduate program and have been a friend and colleague.”
She pauses, then adds something important about mentorship. “She says the same thing about me, which I think that’s what’s so important about a mentor to mentee relationship. You both get the equal benefit from it.”
The Lessons That Never Leave
When thinking about their own first years as nurses, both women carry specific lessons into how they guide new graduates today.
“That today is just today, and tomorrow’s gonna be different,” Dr. Lewallen says. “We have challenging days, and sometimes they accumulate, but eventually, it gets better. So, the overwhelming stress, okay, but imposter syndrome.”
“Imposter syndrome,” Docktor agrees. “No day is repeated. Not in nursing. Never the same.”
Docktor adds another critical lesson: “Always ask the question, right? You should never be afraid to use your voice to speak up.”
Two Programs, One Mission
Docktor explains the structure. VA Tennessee Valley Healthcare System has two registered nurse programs with different purposes.
The Registered Nurse Transition to Practice program is employee-based, designed primarily for those who’ve already been employed at VA Tennessee Valley Healthcare System and are transitioning roles. “They’ve gone back to school for nursing, or they’re moving from LPN to RN.”
Then there’s the Post-Baccalaureate Registered Nurse Residency, a not-to-exceed 12-month program where residents rotate across the facility. “It’s very structured. Twelve months of going through all of these different acute care units, specialty care units, outpatient and inpatient critical care spaces.”
The goal for both? “We want to develop competent and confident registered nurses, and we want to help develop what their career looks like and give them something that’s going to help them wherever they may be. We hope that they’re gonna be at Tennessee Valley. We hope that taking care of veterans is going to be their passion. But even if they don’t stay at VA, veterans are everywhere, not just at VA, and so we hope that we’ve equipped them with skills and knowledge to be good advocates for those people out in the community as well.”
Dr. Lewallen leads the nurse practitioner residencies with a similar philosophy. They have three tracks: mental health, primary care, and geriatrics and extended care.
The 80-20 Model
Their approach blends clinical practice with continued learning. “We have a blended approach for our residency programs, and that’s how it was structured from the outset,” Dr. Lewallen explains. “We call it an 80-20 model, so 80% of their time is clinical and 20% of it is in the classroom continuing to learn together with a group of peers that are coming from different places.”
That cohort development becomes crucial. “They get to learn from each other and develop their own community of learning. I can’t be in a silo. I can’t do this alone. I have these clinical preceptors, I have these clinical mentors that are helping guide me, but I also have these peers that are in the midst of it too, and they just really support each other.”
The Preceptor Heroes
Docktor wants to shout out the real heroes of the program: the preceptors.
“If I was gonna shout out anybody, that’s who we need to shout out is all these wonderful people who are being those preceptors, who are taking that on because it’s not easy to be a preceptor. It can be very exhausting to be on and to be teaching. We have really great people who really want to and who really want to share what their passion is and share it with our residents and give them great learning experiences and expose them because the beauty of being in residency is that you are learning the whole time you’re getting these great learning experiences, but you always have somebody with you.”
The residents rotate through medical-surgical units, post-surgical care, critical care spaces. They’re assigned for four to six weeks in each area with matched preceptors.
“You really have this backup support for that entire year. You’re not being kind of pushed out there on your own,” Docktor says.
For the nurse practitioner residents, it’s similar.
“They’re paired with providers in their clinic, and the veterans are coming to receive their care and be mentored,” Dr. Lewallen says. “Some people are very protective of their patients, of their veterans that they’re caring for, but our preceptors are open and allow them in that space, and it’s great.”
Building Careers, Not Just Skills
The programs don’t just focus on clinical competence. They require residents to create career development plans – five and 10-year goals with specific steps to achieve them.
“Really specific coaching and mentoring in that pathway,” Dr. Lewallen says, “but also matching them up with professional organizations that align with their interest and their clinical area, and hopefully that are veteran-centric as well.”
Interdisciplinary Learning
The collaboration goes beyond nursing. “Interdisciplinary collaboration is a huge part of everything that we do,” Docktor explains. “We are working with different areas all the time, different skill sets to buy in to our program, to help with training, to welcome in our residents, to encourage them to be participating in things like grand rounds, to be participating as part of that team and speaking up to advocate for the patient.”
Dr. Lewallen gives a specific example: “We have a series for our NP residents that is provided by pharmacists, and some of them are resident pharmacists, some of them are chief pharmacists. So, they get that whole spectrum. Every session is valuable because we all need each other to provide the care that we need to provide to veterans, and we have to learn how to do that together.”
The Confidence Trajectory
When asked about changes they see from start to graduation, Dr. Lewallen points to data that measures something intangible.
“One of the tools that we use requires a reflective practice for the residents to perform like a baseline evaluation of their confidence. To see that trajectory of the increase of confidence throughout that year is amazing. When we report out to our stakeholders on that growth of confidence, that is what I’m most proud of, because I can assess, I can evaluate, I can do all of these things to determine their skill set, but it’s confidence. I want them to feel confident in the things that they do know, and also to know to ask the questions when they’re not. But I think that they even become more confident in asking questions, which is just great.”
Docktor loves watching the transformation in person. “Being able to watch and especially when they don’t necessarily know you’re watching, right? You come up to meet with them and they’re having conversations, and you hear them and they’re so well-spoken in what they’re saying and so compassionate, and you’re thinking, ‘yes, there you are. I remember when you didn’t want to go in a room and talk to somebody about yourself and you were so concerned about what might happen, and now you are just doing all the things.’ It’s really rewarding to see that.”
Hillary’s Story: From First Cohort to Residency Director’s Dream
Docktor gets animated talking about one particular success story. Hillary Briggs was in her very first cohort of the PBRNR program.
“We were just starting our program. We had a lot of ideas and a lot of vision, but we didn’t have anything to showcase to back us up that validated, ‘yeah, this is what you’re going to get out of it.’”
The timing was brutal as COVID was at its peak during 2021.
“We are starting a brand-new program where we’re telling them that we are going to equip you and train you and get you ready for practice in an environment that really had changed a lot since they started nursing school, that had changed a lot since I started nursing.”
Hillary bought in. She believed in the program. She was amazing throughout.
“She got a job in her preferred area. She went to work in medical ICU, which was very exciting because critical care is not always where we have opportunities for new grads. You’ve got to be the right fit, the right skill match.”
Hillary worked in the ICU for a while, then went back to school for her nurse practitioner degree. This year, she’s now in the Post-Baccalaureate Registered Nurse Residency program, coming full circle through VA Tennessee Valley Healthcare System’s training pipeline.
The Geriatrics Group
Dr. Lewallen can’t pick just one success story. “It would be absolutely impossible for me to tell you just one because they’ve all been so amazing, but I’m just gonna brag on them as a group.”
Since starting the geriatric nurse practitioner residency, she’s had eight residents complete the program. Six of them are currently working at VA Tennessee Valley Healthcare System.
“That is what I’m most proud of, is just that not only did they grow, but Tennessee Valley represented itself so well that these amazing providers wanted to stay and work with our veterans, and they’re doing amazing jobs. They’re just hitting the ground running.”
The Ones Who Come Back
Docktor shares another kind of success story.
“From all of our cohorts, like 14 are still here that have come through. We have a really solid track record of hiring our residents when they come in because they are really well-prepared and well-rounded at the end of their program.”
But even the ones who leave sometimes return.
“We had one who had taken a job and got to work elsewhere, and I saw him this weekend at new employee orientation because he’s back.”
Dr. Lewallen nods. “Another resident was gone for three years, and he returned. It was in his interview what he said about the lessons that he learned. It’s good to go away and know the grass is not going to be greener on the other side, but you may have learned something else that you want to bring back home.”
Improving Veteran Care Through Evidence-Based Practice
All residents work on evidence-based practice projects designed to improve care at VA Tennessee Valley Healthcare System.
The telesitter program – a virtual monitoring system that reduces falls – started with resident involvement. “Telesitter is a wonderful way to help reduce falls,” Docktor explains. Within a year, VA Tennessee Valley Healthcare System decreased falls by 30%.
Residents have contributed to antibiotic stewardship projects, sepsis awareness and recognition, and numerous other initiatives that impact veteran care across multiple spaces. “It’s not for one particular area, it’s across all of them. That’s really one of the huge things they’ve gotten involved in. Big picture impact.”
Dr. Lewallen’s nurse practitioner residents have completed seven projects since the program started.
“A few of them have gone on to nationally present on those projects. We also had one that published in a peer-reviewed journal article, which is just huge for someone that’s a new graduate, just out of practice.”
The Burnout Reality
The conversation turns to something sobering: burnout. New nurses are leaving within 12 months of starting.
“They didn’t have that foundational experience and orientation,” Dr. Lewallen explains. “It increased during COVID because they didn’t have the clinical experience that they needed in nursing school, but it was happening before that. It’s just hitting that orientation, that exposure, that entry to practice that you need.”
That’s why residency programs are becoming more critical.
“They enter that workforce prepared, whether an RN or an advanced practice nurse, and it’s going to reduce that burnout that they experience right at the beginning and want to leave nursing. That’s the last thing we want, someone to put all this effort into becoming a nurse and get burned out so quickly that they just leave it.”
Docktor adds: “They’re learning boundaries and coping skills as well as how to actually practice and how to create that work-life balance so that it’s going to hopefully help them the rest of their career. It’s hard to see somebody struggle when they have worked so hard to get to that point because it’s not easy to go through nursing school, whether it’s for your initial licensure or whether it is for an advanced degree.”
Advice to Future Residents
Their advice to nursing students hoping to enter VA Tennessee Valley Healthcare System is simple but profound.
“Apply for residency,” Dr. Lewallen says. “It’s the entry point. It is the way that you come in, but we are going to be your number one advocate for you when you do make that decision. But be sure that you’re doing it for the right reasons, that your interests align with VA Tennessee Valley and you want to be there because we’re there to serve the veterans.”
Docktor gets more specific: “You have to have a passion for our patient population, and I cannot teach you to have that passion. Some of the people who have come through our programs were not the most stunning resume that you’ve ever seen, right? But they had the passion, and it came through in their interview, and they have made some really amazing nurses. It isn’t just about your grades. Grades matter, it’s important, but what is driving you and that why and that passion, that’s what we’re looking for.”
Dr. Lewallen describes what makes someone stand out in an interview. “Being able to thread nursing practice into your why and being able to say, ‘this is why I want to do this,’ and it to be genuine. We can tell if you’re not being genuine. That inspiration that you’re carrying of your why, those are the things that are going to make you a great nurse.”
For geriatrics specifically, she lights up.
“Not everybody wants to work in geriatrics, so I get really excited when I have someone who’s like, oh, you really, really do like taking care of older adults. Last year I had four that I wanted in the program. We typically only accept three residents, but I asked for additional funding and we got the fourth. Because if there’s someone who wants to do geriatrics, we need to let them do geriatrics and extended care.”
What It Means to Them
When asked in one sentence what nursing residency at VA Tennessee Valley Healthcare System represents to them personally, both women get emotional.
For Docktor: “I think nursing residency at Tennessee Valley for me represents an opportunity for us to really impact nursing training and the way we do nursing practice and orientation in order to really overall benefit our organization and ultimately our veterans, because well-trained and happy nurses, they’re gonna stay. That’s retention, and retention leads to better outcomes long term because you have this experience and this knowledge base that you’re able to continually elevate the level of care that you’re giving.”
For Dr. Lewallen: “I think I’m just exceptionally honored to be able to mentor these new graduates and influence the impact on their career as a whole and every veteran they touch. I feel such pride that I influenced how they cared for an older adult in a specific way because of my ability to show them, this is how we are veteran-centered or patient-centered.”
Veterans Day is Every Day
When the conversation turns to what Veterans Day means to them and how that shows up in their work with new nurses, Dr. Lewallen doesn’t hesitate.
“Veterans Day is every day at VA. I think it’s great that we pause and celebrate in a more formal way on that day, but I really feel like we celebrate them every day.”
Docktor expands on that. “That’s what we’re trying to teach here, right? That’s the culture that we’re promoting here, is that Veterans Day is every day and that we are here to honor, respect, and to provide that assistance to the veterans who trust us with their care, who trust us to come to Tennessee Valley in whatever capacity they’re here for, and to show them that appreciation and that respect for what it is that they have done for all of us.”
Resources for Veterans and Healthcare Professionals
VA Health Care Services
- VA Health Care Enrollment: How To Apply For VA Health Care | Veterans Affairs
- My HealtheVet: Home – My HealtheVet – My HealtheVet
- Veterans Crisis Line: Dial 988, then press 1 | Text 838255 | Veterans Crisis Line
Tennessee Valley Healthcare System
- TVHS Main Site: VA Tennessee Valley Health Care | Veterans Affairs
- Nashville VA Medical Center: 1310 24th Avenue South, Nashville, TN 37212
Nursing Career Information
- VA Nursing Careers: Nursing jobs
- American Nurses Association: American Nurses Enterprise | American Nurses Association
About the Program Leaders
Dr. Kanah Lewallen, DNP, AGPCNP-BC, GNP-BC is a geriatric nurse practitioner and leads the Geriatrics and Extended Care Nurse Practitioner Residency at VA Tennessee Valley Healthcare System. A third-generation nurse, she earned her bachelor’s, master’s, and doctorate in nursing and teaches on the academic side while leading the geriatric residency program.
Amanda Docktor, MSN, RN is a second-career nurse who leads the Registered Nurse Transition to Practice program and Post-Baccalaureate Registered Nurse Residency at VA Tennessee Valley Healthcare System. She came to VA in 2014 and has been transforming new nurse training since 2018, with a master’s degree in education focused on improving nursing training.
Veteran Excellence Magazine celebrates outstanding leadership in veteran healthcare and services.