Page 15

219126_NCS_Currents_March_2_eMag

NEUROCRITICAL CARE NURSING On-Boarding Neuroscience ICU Nurses - How it is Done Across the U.S. By Cynthia Bautista, PhD, RN and JJ Baumann MS, RN On-boarding refers to the process through Mary Guanci, MSN, RN, Neurocritical Care Clinical Nurse which new employees acquire knowledge Specialist at Massachusetts General Hospital spends a signifi cant and skills to become effective members of the amount of time on-boarding new hires. Mary and the Nursing organization. The on-boarding process for the Director meet with the preceptor for a formal evaluation of the neurocritical care nurse vastly differs across the orientee’s progress towards their goals every two weeks. Her U.S. In part, this variation can be attributed ability to coach the preceptor and orientee is of great value. to the experience of the nurse being hired, availability of educators and mentors to train the newly hired nurse, as well as continued Cynthia Bautista, budgetary constraints in the amount of time it PhD, RN takes to train new hires. A newly employed neurocritical care nurse can have variable education and experience prior to entering the Neuro ICU. Often, the employee has a bachelor’s degree, but could have an associate’s degree, a master’s degree, or doctorate. New hires can also have diverse nursing experiences. Recently graduated nurses are hired into the NeuroICU, although some institutions will hire only nurses with previous nursing experience. The selectivity JJ Baumann of previous experience will ebb and fl ow with MS, RN the availability of nursing positions. During periods of nursing shortages, institutions are more apt to hire new graduates. Often, there is a preference to hire nurses with experience in intensive care and/or neurological patients. When a Neuro ICU unit is short nurses for a limited time, traveling (contract) nurses are hired for several months to fi ll the position. Units often try to hire travel nurses with similar training and experience as their own unit. The on-boarding process may differ in a single institution based on experience with these various opportunities for nurses to on-board in the Neuro ICU. How an institution chooses to educate their staff can be impacted by availability of training personnel and fi nancial costs of on-boarding. Knowledge in neuroanatomy, physiology, and neuromonitoring are specifi c to the Neuro ICU. Instruction can be done via classroom lectures, on-line modules, simulation labs, skills training, and precepted clinical experiences. Faculty can consist of designated educators, preceptors, managers, advance practice nurses, or various members of a multidisciplinary team. Patricia Blissitt, PhD, RN, Neuroscience Clinical Nurse Specialist at Harborview Medical Center is an integral part of on-boarding and teaching the neurological classes at the Greater Seattle Critical Care Consortium. The course includes lectures on stroke, brain tumors, ICP, CNS infections, neuromuscular diseases, sodium disorders, and delirium. Harborview participants also attend Harborview-specifi c Critical Care Consortium days that include presentations on TBI, traumatic spinal cord injury, brain death and organ donation, and multimodality monitoring. Within the fi rst six months to one year at most, all new Neuro ICU nurses attend a three-day Neuro Core, eight-hour Nursing Management of the Stroke Patient course, and eight-hour Nursing Management of the Patient with Spinal Cord Injury course. They also must obtain or already have current BLS/ACLS and must take TNCC. A preceptor provides instruction to an orientee at The Ohio State University Wexner Medical Center. Continued on page 16 15


219126_NCS_Currents_March_2_eMag
To see the actual publication please follow the link above