by Colleen Claffey, RN, MSN, CEN

The hospital ED has become the major diagnostic and resuscitation site of the American healthcare system. As noted in the September ENA Connection newsletter, a publication produced by the Emergency Nurses Association, ED visits rose 18% from 1994 to 2004–from 93 million to 110 million–whereas the number of 24-hour EDs declined by 12%. Serious overcrowding has put emergency medicine in crisis, challenging ED nurses to meet the surge in patient care needs and advancing technologies.

To recruit and retain ED nurses while fostering personal and professional growth, employers must be aware of the gap between the skills and knowledge acquired in school and those gained through experience. To help ease the transition from school into practice, issues and challenges for existing staff members, new graduates, and educators must be overcome.

To help meet these nurses’ educational needs, Jackson Health System in Miami created an internship program in emergency nursing with the goal of improving outcomes by focusing on best practices and quality patient care.

One hospital’s line of defense

The program begins with hospital and general nursing orientation and is followed by a comprehensive 12-week orientation to emergency nursing, which includes two days of classroom instruction and two days of clinical experience each week.

Participants have to take some prerequisite courses before beginning the program, including those about arrhythmia recognition, pain management, disaster awareness, and moderate sedation.

Program participants have weekly debriefings and open forum discussions with program instructors, which allow participants the opportunity to share clinical experiences and ask questions in a supportive, nurturing, and nonjudgmental environment. They are also given the opportunity to practice hands-on skills in class and in the simulation lab, the ability to ask “why” questions without judgment, and the chance to interact with staff nurses across all of the hospital campuses.

In addition, as part of the internship, each student takes a trip with emergency medical services, completes advanced cardiovascular life support certification, and takes an eight-hour nonviolent crisis intervention training course.

Creating a buzz

Jackson Health System’s Emergency Nursing Internship has generated interest nationwide, with other hospitals expressing interest in implementing such a program, given the demand for emergency-trained nurses.

The ED nursing directors and managers report that they appreciate the program’s routine instructor evaluations and the performance reports that measure a student’s motivation, participation, and attendance.

Perhaps the biggest piece of the program’s success, however, is its ability to offer clinical experience, didactic information, and support and encouragement to new nurses. This greatly assists nurses in making a smooth transition into the specialty nursing practice.

Source: The Staff Educator, an HCPro publication.