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(Editor’s Note: This is the second of a two-part series on the nursing shortage. In last month’s issue, we covered how to retain nursing staff. This month, we cover nurse internship programs and recruiting.)
Is your ED short-staffed due to the nationwide nursing shortage? Are you finding it hard to recruit qualified nurses to your ED? Progressive EDs are thinking ahead and "growing" their own.
At Robert Wood Johnson University Hospital in New Brunswick, NJ, an ED training program was developed in response to a tremendous shortage of ED nurses and expansion of services. "We tried to get experienced nurses to work in the ED, and there was little response to our recruitment," says Kathleen Evanovich Zavotsky, MS, RN, CCRN, CS, CEN, CNS, C, ED clinical nurse specialist. "The responses we did get were from many nurses who did not have ED experience, but had either telemetry experience or prehospital experience."
The program was designed to help develop those nurses into ED nurses, says Zavotsky.
Here are some benefits of ED nurse training programs:
• Less use of agency nurses.
In addition to lower vacancy rates, there is less utilization of temporary help such as agency nurses and traveling nurses, says Zavotsky. This helps to ensure that nurses have an understanding of the hospital’s services and operations.
• Nurses are given a chance to change career paths.
Since there is a shortage of experienced nurses for specialized areas, it’s necessary to train nurses from other areas, says Amy Atnip, RN, MSN, director of emergency services at Medical Center of Plano (TX). "An internship gives them their best start and hopefully result in a successful career transition."
Nurses from areas such as a cardiac or telemetry floor, cardiac cath lab, or other specialty area usually make good ED nurses because they already have a cardiac background and sense of urgency, says Sandy Vecellio, RN, BSN, ED clinician at Gwinnett Medical Center in Lawrenceville, GA. "The biggest asset that an ED nurse must have is organization and knowing that certain things need to be done first."
• Vacancy rates are reduced.
Currently, the internship program is assisting in filling vacant positions, Atnip reports. "However, ED nursing is still in a state of change in which many long-term nurses are leaving the field completely, and enrollment in nursing schools is down."
Unfortunately, for each nurse hired, sometimes one is lost, says Atnip. "However, with the continuation of an internship, programs will continue to become better known with more nurses wanting to gain ED experience, and also allow for the training of nurses without emergency nursing experience," she adds.
The interns also feel a sense of belonging to the hospital, so they are more likely to stay, says Vecellio. "They also sign a two-year contract with us, so we know they usually will stay or they have to pay the hospital back a certain amount of money," she says.
Last year, six interns filled holes in the nursing staff, says Vecellio. "This helped, since at the end of the summer we actually had 14 nursing vacancies," she reports. "So with the six new interns, that almost cut that vacancy in half."
The cost of the internship is significant, since the ED pays the nurse candidates’ 12 weeks of salary, in addition to salaries of instructors and preceptors, says Vecellio. "But with them signing a two-year commitment with us, it helps with our vacancy rates. So the money spent on them to do this was well worth it."
• Nurses receive a better orientation.
An internship program allows for an extended clinical orientation period ensuring that the new nurse receives enough training, says Atnip. "The ED does not always allow for a smooth orientation process due to patient load," she explains. "This way, we are assured that the new nurses are better prepared for their own patient assignment when released from orientation."
• Clinical experience is improved.
If you take two nurses who have never worked in an ED before and place one in an internship program with classroom time and extended orientation and place the other nurse directly into the clinical area for orientation only, the nurse who went through the formal internship program is much more likely to succeed, says Atnip.
Classes that are taught by practicing ED nurses, physicians, and ancillary staff are much better able to relate lecture materials to real-life situations and give those needed "pearls" about watching out for potential problems in certain situations, says Atnip. "This type of practical knowledge is more reality based, and can benefit the new nurse much more."
For more information about ED nurse internship programs, contact:
• Amy Atnip, RN, Emergency Department, Medical Center of Plano, 3901 W. 15th St., Plano, TX 75075. Telephone: (972) 519-1505. E-mail: Amy.Atnip@LonestarHealth.com.
• Sandy Vecellio, RN, BSN, Gwinnett Medical Center, 1000 Medical Center Blvd., Lawrenceville, GA 30046. Telephone: (678) 442-3243. Fax: (678) 442-4581. E-mail: email@example.com.
• Kathleen Evanovich Zavotsky, MS, RN, CCRN, CS, CEN, CNS,C, Emergency Department, Robert Wood Johnson University Hospital, 1 Robert Wood Johnson Place, New Brunswick, NJ 08903. Telephone: (732) 828-3000. Fax: (732) 418-8416. E-mail: Kathy.firstname.lastname@example.org.