ED nursing is a demanding specialty requiring core knowledge across the age continuum. The depth and breadth of this knowledge and the rapid pace of the emergency department often are overwhelming for the novice or less-experienced nurse. In addition, some states, such as New York, have department of health regulations that require new graduates who seek employment in the emergency department to have a minimum of 1 year's experience in nursing prior to being hired, unless the organization offers a state-approved nurse residency program for new graduates. We developed and implemented an ED residency program for recent graduates in nursing because our institution, a 433-bed community hospital in Suffolk County, NY, did not have an approved nurse residency program in place.
Implementation
A written proposal to establish an ED nurse residency program was submitted to the state department of health and received final approval in April 2004. New graduates were selected, based on an interview, prior academic performance, and previous patient care experience. After attending a standard hospital orientation, ED orientation was initiated, which included didactic learning coordinated with clinical experience. The didactic portion was based on standards of care established by the ENA utilizing the ENA Emergency Nursing Core Curriculum and the ENA Orientation to Emergency Nursing program. Additional training in basic dysrhythmias, critical care, trauma nursing core curriculum, Advanced Cardiac Life Support, Pediatric Advanced Life Support, and the Emergency Nurse Pediatric Course also was available to nurses who participated in the residency program.
Outcomes
Two new graduates in nursing were selected to begin the program in August 2004 and currently are enrolled. As of December 2004, the nurses had completed 18 weeks of clinical and didactic training. In addition, they were certified in Advanced Cardiac Life Support and Pediatric Advanced Life Support and experienced multiple level II traumas and cardiopulmonary resuscitation efforts. At this time, they are progressing as expected and are receiving biweekly evaluations from their preceptors. The nurses will complete the residency program in August 2005, and it is anticipated that a new group of nurses will begin the program thereafter.
Recommendations
Organizations seeking to initiate a successful residency program for new graduates in nursing should: (1) develop a detailed written education plan and evaluation tool and obtain appropriate approvals; (2) develop inclusion criteria and a thorough interview process for prospective participants; (3) train preceptors and emphasize the importance of their continued involvement in the program; (4) foster collaboration among nursing management, nursing educators, and hospital administration throughout development and implementation of the program; and (5) establish effective communication channels to encourage active participation in the program by all health care staff.
Good Samaritan Hospital Medical Center, 1000 Montauk Highway, West Islip, NY 11795
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