My service learning site continues to be the New Nurse Graduate Residency Program at St. Mary Corwin Hospital. As stated in my first posting, this grant-funded program supports new nurse graduates who are employed at both St. Mary Corwin Hospital, and their sister facility, St. Thomas More Hospital, as they transition into the professional nursing role.
I continue my service to the New Nurse Graduate Residency Program by offering the participants experiences with high fidelity simulation. I develop and implement case scenario simulation experiences specific to the nurse’s specialty unit. Since my last post, I have had an additional 9 new nurse graduates participate in the simulation experience. This past month, I developed and implemented scenarios for five new nurses; one who works in Emergency Department; one in the Operating Room; one in Endoscopy; and two on the Post Operative Unit.
The biggest challenge with this group of students was developing Endoscopy and Operating Room scenarios. I fretted the most over the operating room patient case, but it went very well. The scenario that I developed for this new nurse was of a patient with a urethral obstruction caused from a foreign object placed in his urethra. The nurse was called in at 2am for a cystoscopy procedure under local anesthesia. Following the case, the doctor left the OR suite and the nurse and OR technician were left alone with the patient for recovery. The patient began bleeding, the foley tubing and bag became full of blood clots and the patient became hypovolemic. I moulaged the blood clots in the tubing and drainage bag so the visual image was extremely real in the scenario. This new nurse did a great job of accessing support, resources and assisting the patient.
I believe this service learning opportunity is helping me to view the difficulties and struggles the new nurse graduates experience. I have been teaching undergraduate student for many years, and thus have been fairly sheltered to the realities of what the new nurse experience as they graduate and leave the safety net of the nursing program. I believe that new nurses are extremely vulnerable because the healthcare environment is a complex, rapidly evolving industry and the new nurse is often expected to handle urgent and emergent patient cases. Working with the new graduates in the simulation laboratory has provided me with a greater understanding of the demands and expectations of the new nurse, as well as the areas in which they are feeling incapable and uncomfortable. This experience will ultimately help me to be a better educator and better prepare my nursing students for the reality of clinical practice.
JoAnn Crownover
JoAnn,
ReplyDeleteI learn a little more about simulation each time I read about what you are doing with it. It makes me want to write more scenarios down and use moulage to make it real even with my low fidelity methods. I can see this as a service to our hospital in the future where nurses can sign up for a particular session they are needing work on. It would be a very good critical thinking exercise. I generally make up scenarios on the fly especially as I am teaching in ACLS.
You were able to incorporate what you do best into your service learning. Well done.
Margaret Orn
Joanne-
ReplyDeleteI am very impressed at your versatility in assisting different nursing graduates who come from various units all over the hospital. I especially liked your scenerio in the PACU. I was a new nurse in the PACU and was very intimidated by the ICU cases that I would have to recover. I was thrown into situations without a safety net. I always hoped that I made the right decisions as I was caring for this intense population. I think that you have to be very inventive to think of scenerios that will fit each unit. The nursing graduates are fortunate to have learning experiences that offer a safety net as they make decisions using simulations that will not impact a patient's wellbeing. I applaud your efforts with this exciting program! Krista
Joann,
ReplyDeleteI have read your posts and blog with excitement. Simulation is such a great experience for students as well as new graduates. As new nurses we had to experience “scenarios” in the real world and hope that we made the right choices. If not, our patients could suffer. I am amazed that in some facilities the sim lab is underutilized.
Years ago new nurses would not be placed in the areas you mentioned. They were required to have at least a year on the medical surgical floor where they could learn from experienced nurses. I know at the hospital I worked at each unit had a charge nurse. One of their duties was to assist the new nurses as they needed help. This was essentially their residency. I find it odd that in order to save money the charge nurse position was eliminated. Now a hospital may spend more money when a new nurse leaves after less than one year.
It is exciting to see projects such as yours improving the success rates of new nurses. I wonder how many nurses will remain in the profession as a result of these programs. The monetary and emotional savings will be great! I wish you the best of luck with this great project!
Nanc