critical care internship design

  1. At my hospital we've had a critical care internship for several years. This is not a new concept to any of us. Unfortunately, ours is broken and in need of redesign. I'm not going to detail the failures here...what I'm seeking is your experiences about what program designs seem to work...what in your opinion is the right mix of class vs. clinical time? If you could design your own dream internship...what would it look like? What would you expect these interns to be able to do at the end of the program? What kind of support would they receive after completion of the program. If you know of any resources on the web, please include them for me.
    Thank you all...I consider you the experts
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  2. 4 Comments

  3. by   RNinICU
    We recently revised our critical care orientation, but not to improve it. We cut the class time down to two weeks from four, one week for dysrhythmia from two, and six weeks with a preceptor from eight. All this was done to cut costs. The classes were designed by our clinical education specialist and our Primary Preceptors, with input from staff. The classes are held twice a year, so if someone is hired between those times, they attend the next class, but still work in the unit till then. Each new hire is paired with a preceptor, and follows her schedule for the entire six weeks. There is also a lot of teaching done during this period. Each new staff member attends a two day open heart course and a one day CRRT course one year after hire. We used to have people sign a contract that they would reimburse us for the course if they lsft within a year of taking it, but we don't do that anymore either.
  4. by   fedupnurse
    I'd love some ideas too! Our preceptor/orientation program is a mess! I am staff but can pass along the info to someone who may make the approriate changes.
    Thanks!
  5. by   RNinICU
    Our orientation is six weeks with a primary preceptor, a two week critical care course, and a one week dysrhythmia course. The new hire is in the unit immediately, and scheduled for the classes within six months of hire. Our orientation is structured, with certian goals set for each week of the orientation. Both the orientee and preceptor fill out an evaluation of each other and the process on a weekly basis. We do the PBDS to evaluate new hires before they reach the unit, and try to tailor orientation to their needs. A lot of one on one teaching is done during the orientation. We have four primary preceptors who do all of the orientation and teach the critical care course along with our Clinical Education Specialist. We have an orientation booklet given to each new person, which is designed to go along with each weekly goal. For instance, the first week, the focus is on the respiratory system so that section of the booklet, covers vents and ABGs. We also designed the course ourselves, and did our own textbook. We used to have a course that was designed by the staff development departments of the four hospitals in our county, and we were unhappy with it, so designed our own. We did our own textbook, and focus on the types of patients we usually deal with. After the employee has been there one year, they attend a two day open heart training course, and after two years a two day advanced critical care course, and a one day CRRT course. The entire process was developed by our Education Specialist and the primary preceptors, with input from the staff.
  6. by   RNforLongTime
    I just finished my orientation and "protection" period in my 8 bed ICU. I trasnferred over from the tele unit, so I had already taken the Basic EKG course. I had 9 weeks of orientation--6 weeks on day shift and 3 on nights, which is the shift that I'll be working. I took the 2 day ACLS class and my hospital has an Interactive Video Disk system on Critical Care. Still haven't finished that yet, have one more disc to do. There were four discs in all, one on general critical care orientation, one on cardiac, one on pulmonary and one on neurologic. Each disc takes about 90 to 120 minutes to complete.

    My protection period, which was 4 weeks, prevented me from being "bumped" to the floors or called off. The job that I have, is an ICU/Med-Surg position, which means that I'l be floated out to the floor when I am not needed in ICU. Generally our ICU census is low, 2-4 pt's usually. And as I am the most junior RN, I'll be the first one out. Thankfully on night shift (on the floors), there are RN's who are more junior than I and I can bump them. There is only one unit that I am not looking forward to floating to and that is because one of the night shifter's is extremely lazy with a capital L.

    Only bad thing is that it may be months before I work in ICU again. But with summer and vacations on the horizon plus one night shift ICU RN quit and hasn't been replaced, I should probably get to work the ICU more often than normal.

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critical care internship design