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NEUROCRITICAL CARE NURSING Continued from page 15 She has the freedom to assign preceptors based on evaluation Dorina Harper, MS, RN, ACNS-BC, Clinical Nurse Specialist at of learning needs during the hiring process with the Nursing The Ohio State University Wexner Medical Center has about 44 Director. Mary also has the ability to create a schedule and hours of classroom training for her neurocritical care nursing new coaches preceptors in choosing patient assignments which employees. They spend about 13 hours with on-line education meet educational goals that support the new learner. The new and about 12 weeks with their preceptor having hands-on employee also attends a six-day general ICU consortium in the experience with Neuro ICU patients. If the new employee has Boston Area which includes a review of neuroscience topics. They critical care experience, they can test out of some ICU classes. will spend about 12-15 weeks on the unit with their preceptor Each nurse attends Neuro I and Neuro II courses. These courses gaining neurocritical care skills. The ability to be clinically present consist of eight hours of foundational neurological injuries and to evaluate and set goals with the preceptor and nurse contributes diseases. As a developing unit with limited preceptors, they have to making this a very successful on-boarding program. supplemented clinical orientation with a rotation in the Surgical ICU, which cared for the neurosurgical patient population prior to Mary Kay Bader, MSN, RN at Mission Hospital in Mission Viejo, the opening of a dedicated Neuro ICU. The CNS/educator team CA does not use on-line education. Instead she uses local colleges collaborates with nursing management and the orientee-preceptor to teach the required classes in critical care nursing. They have dyad to provide biweekly feedback and support. budgetary limitations, but have a strong preceptor program lasting six to eight weeks for on-boarding their Neuro ICU nurses. A 16- Cynthia Bautista, PhD, RN, ACNS-BC, Neuroscience Clinical hour Neuro 101 program is held three months after the hire date Nurse Specialist at Yale-New Haven Hospital offers three which is a mandatory class for all new nurses in the critical care days (24 hours) of simulation classes for her new employees. environment. Following the fi rst year of employment, the new They also have 56 hours of on-line education using the ECCO ICU nurse attends more advanced level educational classes on program. New employees have 11 weeks with their preceptor to severe TBI, stroke, and hypothermia. learn the hands-on care of Neuro ICU patients. The preceptor, Mary King, ACNS-BC, RN at the Barrow Neurological Institute orientee, CNS, and nursing management meet every three uses the on-line “Essentials of Critical Care Orientation (ECCO)” weeks to determine the progress of the orientee and establish from AACN. In-person classes consist of a four-hour “Neuro 101” goals to accomplish the completion of on-board training. At and two two-hour neuroanatomy and physiology classes that Yale-New Haven Hospital, it is a challenge to have a successful are part of an annual eight-week CNRN Advanced Neuro Review on-boarding program within the allotted time (11 weeks) to course. Precepting occurs over 12 weeks. There are meetings complete the process. every two weeks with the new nurse, preceptor, and a member In summary, there are many methods to on-board a neurocritical of the management team to ensure the new nurse is getting the care nurse. Some institutions use classroom and some use on-line experiences and support needed to be successful. Preceptors and education. Local colleges and consortia are frequently used to orientees follow a goal-directed guideline that covers major neuro provide the education for new employees. All programs use the disease processes, illnesses, or injury. The guideline includes preceptor model to train the new nurse in the critical care setting. ‘milestones’ at weeks four and six that have proven effective The most important feature of a successful on-boarding program markers for establishing the orientees’ progress. Follow-up and is the frequent (every two to three weeks) meeting of nursing support is provided though formal meetings every three months management, preceptor, and orientee. The biggest challenge is to after orientation is completed to assess progress, discuss needs or fi nd the resources to train staff nurses in the allotted time frame concerns, and establish goals. given budgetary constraints. 16


219126_NCS_Currents_March_2_eMag
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