Effective use of Nurse Educator position

Specializes in New Critical care NP, Critical care, Med-surg, LTC.

I'm on a committee looking at the most effective use of certain resources within our hospital that support nursing. Specifically I'm looking to develop some ideal aspects of a nurse educator position and would love to hear feedback from anyone based on successful (or not) use of this role. Some of the suggestions I've got so far:

Develop a needs assessment and platform for nurses in the unit to take on an annual basis.

Attend interdisciplinary rounds at least once a week to hear some of the issues that might come up related to education.

Post a calendar at least monthly with anticipated hours on the unit- be sure that 4 (2?) hour increment minimum is scheduled to allow nurses to time to accommodate workflow. Have to have some hours that cover at least a little of all three shifts (not on the same day).

Develop - slide decks by e-mail? poster boards in the huddle space? alternative education formats? Educator trivia game night jeopardy style?

I'm thinking Audreysmagic might have some excellent ideas about what doesn't work- based on the recent lonely educator ballad. We really don't want to waste anyone's time, nurses on the unit say they want more education, but are we setting ourselves up to have one frustrated educator and a bunch of avoidant nurses?

Thanks for any suggestions?

10 Answers

What is the terminal goal?

Looking at your post I am not sure what your terminal goal is. Creating the perfect educator is an impossible task unless you define what actual goal is. I know it seems crazy because we all have the idea of what an “educator” is in our minds but having traveled to hospitals throughout the United States and the world I can say with confidence that the role of educator and their goals vary greatly.

Is the purpose to increase the general clinical performance of the floor nurse? Support hospital or unit goals through education? Increase employee satisfaction by offering them professional development opportunities? All of the above? None of the above? Depending on your goals you may find different interventions to be more appropriate than others. I cannot overstate how critical it is to first determine the goals.

The approach

One of the things that is effective is taking a more holistic approach. What I mean by this is you cannot just have classroom hours, cannot just do unit rounds, cannot just put out posters, you have to do all of it all of the time.

  • Microlearning has been shown to be very effective for adults, and especially busy nurses. Instead of the traditional long periods of lecture think of multiple 5-15 minute long education bursts. If you are educating on the floor 5 minutes is considered about the max. After that, even if they have the time you start losing their interest.
  • Small groups is also really important, especially on the floor. No more than 5, seriously. At 5 you are likely to have 1 heckler which is easily managed but at 6 you start getting 2 hecklers which feed off of each other. Seriously, 5 at a time with 3 being the ideal.
  • Posters are good but only 1 central large poster with detail and many small simple posters everywhere that communicate 1 single aspect of information. If you are discussing CAUTI for example you can have 1 large poster with the policy, best practices etc but then have many small posters with a single statement that the need for Foley’s should be assessed every X amount of time. Then on a regular basis, as in every few days or once a week change that poster to another single fact. These small bursts of hyper-focused and revolving sources of information tend to keep interest and more effectively deliver information.
  • Assign unit champions for any given topic. Select one or two people, preferably not just the charge nurses, to be a topic champion. You can dive deeper into the education with those individuals and allow them to carry your message. Nothing is more effective than lateral pressure.

Accountability

Beyond those goals what role or authority does the educator have in the hospital structure? This is an exceedingly important foundational element to education. I have been to hospitals where certain unit directors or managers will have a personal philosophical difference on education or goals and either undermine or outright challenge the educator on those units which means their educational efforts are lost on deaf ears. Without authority those educators are nearly powerless and their effectiveness is severely diminished. Contrast that to many Canadian educators and they have a nearly clinical manager role where they oversee much of the clinical practice on any given unit, relegating the unit managers to more of a personal leadership role instead of the traditional American clinical practice leadership role.

This might be outside of your committee’s scope but it is a very important consideration. If the educator does not have formal authority they should at least have routine cohort and higher level leadership meetings. Does not have to be frequent but it does have to be regular and quarterly at least. This gives the educator a chance to discuss challenges and goals with the unit directors/managers and then a chance to discuss higher level challenges or goals with senior leadership.

Partnership

Don't forget to leverage others who are trying to educate in your facility. Manufactures spend millions on education and are looking for opportunities to educate. Ask companies for CE education, posters, people to come educate, etc. They do not always just educate on products but many times discuss diseases, standards and guidelines, etc.

Beyond helping the floor, ask the manufacturers to come and and educate the educators and leadership! This is a very common practice outside of the United States.

Leverage the resources you already have at hand.

Specializes in Nursing Professional Development.

How do you currently evaluate your educational activities? Use your course evaluations to feed into your planning for future activities. Ask what additional topics they would like. Ask them about what formats they prefer. Ask what time of day ... etc.

Be sure to use a variety of formats because no one format (or time of day) works best for everyone. Some people are visual learners and would prefer a poster or handout. Others don't remember what they read and learn much better in a lecture or discussion format ... etc.

Also use your quality improvement data to feed into your education. That data often shows what the staff does well and what they don't do well. That data will also provide evidence of whether or not your education was effective at improving practice. Showing that you are improving practice can get you a lot of administrative support, more money, etc.

Make sure you understand the difference between education "needs" and educational "wants."

Those of just a few thoughts off the top of my head.

This is an excellent post and replies.

Random thoughts from a staff-member:

I agree with the perspectives already posted.

I have wondered if people sometimes struggle in the educator role based on a mismatch between the company's goals for the role, and the needs as perceived by staff. For example, QI data may indicate a need for improvement in some particular area, but the underlying difficulty may not be lack of education but some other limitation. Conversely, there are many topics that staff would like to hear more about to improve personal performance/confidence during particular patient scenarios, but these may not translate into improved metrics associated with X [latest hot topic area-to-be-improved].

6 hours ago, Subdermal said:

[...]Contrast that to many Canadian educators and they have a nearly clinical manager role where they oversee much of the clinical practice on any given unit, relegating the unit managers to more of a personal leadership role instead of the traditional American clinical practice leadership role.

This is interesting. The staff educator I have felt was most helpful did function as a clinical support and unit educator combined - a huge role, which, although it isn't what I'm advocating, was very well-received and appreciated due to the intimate knowledge of specific patient care issues that nurses in that area wanted and needed to be educated about, as well as unit-/department-specific issues/QI stuff/etc.

Simple example: The clinical support/educator has firsthand knowledge that alarms are often not addressed in a timely manner on the unit/in the department. Alarm fatigue has become an issue. This is a safety issue and to some extent a patient- and staff-satisfaction issue. The educator pours through the details of the equipment manuals knowing that, for each piece of equipment, staff likely received a relatively brief inservice and henceforth have not learned the equipment functionality much beyond what can be found in the quick-start guide (and who knows where that is, now, anyway!). Education can now be presented to increase staff knowledge and use of additional relevant functionalities of the equipment, with the goal of reducing alarm overload/fatigue and increasing patient safety. After the education sessions, the presentation is saved in a way that promotes quick future access.

Speaking of that: Side topic. A limitation r/t the utilization/staff uptake of education topics is the issue of difficulty accessing the information once it has been presented. Sure, we don't want a bunch of binders piled up and fliers tacked everywhere, but in the meantime we often haven't done a great job indexing items in a format that is quickly accessible in real time for future use after the presentation. I felt this was worth mentioning with regard to the OP topic because if information can't be re-located after the fact, people "learn" that (future) educational topics aren't going to be of much long-term use. My theory is that this increases the 'in-one-ear-and-out-the-other' phenomenon. I'd love it if educational presentations were summarized and indexed into a format that can be accessed as quickly as EMR-integrated drug references are, for example. (I realize this is as much a tech issue as an education issue specifically). I believe (but don't know for sure) that if staff get the message, "Here is some more good information useful for your practice and here is this quick and organized way for you to reference it in the future..." they would see additional value in the educational presentations. If that makes sense. ?

Specializes in school nurse.

I don't have any specific suggestions except for one:

Don't increase paperwork for floor nurses, whether it's surveys or the like; it will not be good for rapport, i.e. it'll just be one more d***ed piece of paper to fill out.

Thank you for coming at this from a supportive angle!

Specializes in New Critical care NP, Critical care, Med-surg, LTC.
5 hours ago, Subdermal said:

What is the terminal goal?

Looking at your post I am not sure what your terminal goal is. Creating the perfect educator is an impossible task unless you define what actual goal is. I know it seems crazy because we all have the idea of what an “educator” is in our minds but having traveled to hospitals throughout the United States and the world I can say with confidence that the role of educator and their goals vary greatly.

Is the purpose to increase the general clinical performance of the floor nurse? Support hospital or unit goals through education? Increase employee satisfaction by offering them professional development opportunities? All of the above? None of the above? Depending on your goals you may find different interventions to be more appropriate than others. I cannot overstate how critical it is to first determine the goals.

The approach

One of the things that is effective is taking a more holistic approach. What I mean by this is you cannot just have classroom hours, cannot just do unit rounds, cannot just put out posters, you have to do all of it all of the time.

  • Microlearning has been shown to be very effective for adults, and especially busy nurses. Instead of the traditional long periods of lecture think of multiple 5-15 minute long education bursts. If you are educating on the floor 5 minutes is considered about the max. After that, even if they have the time you start losing their interest.
  • Small groups is also really important, especially on the floor. No more than 5, seriously. At 5 you are likely to have 1 heckler which is easily managed but at 6 you start getting 2 hecklers which feed off of each other. Seriously, 5 at a time with 3 being the ideal.
  • Posters are good but only 1 central large poster with detail and many small simple posters everywhere that communicate 1 single aspect of information. If you are discussing CAUTI for example you can have 1 large poster with the policy, best practices etc but then have many small posters with a single statement that the need for Foley’s should be assessed every X amount of time. Then on a regular basis, as in every few days or once a week change that poster to another single fact. These small bursts of hyper-focused and revolving sources of information tend to keep interest and more effectively deliver information.
  • Assign unit champions for any given topic. Select one or two people, preferably not just the charge nurses, to be a topic champion. You can dive deeper into the education with those individuals and allow them to carry your message. Nothing is more effective than lateral pressure.

Accountability

Beyond those goals what role or authority does the educator have in the hospital structure? This is an exceedingly important foundational element to education. I have been to hospitals where certain unit directors or managers will have a personal philosophical difference on education or goals and either undermine or outright challenge the educator on those units which means their educational efforts are lost on deaf ears. Without authority those educators are nearly powerless and their effectiveness is severely diminished. Contrast that to many Canadian educators and they have a nearly clinical manager role where they oversee much of the clinical practice on any given unit, relegating the unit managers to more of a personal leadership role instead of the traditional American clinical practice leadership role.

This might be outside of your committee’s scope but it is a very important consideration. If the educator does not have formal authority they should at least have routine cohort and higher level leadership meetings. Does not have to be frequent but it does have to be regular and quarterly at least. This gives the educator a chance to discuss challenges and goals with the unit directors/managers and then a chance to discuss higher level challenges or goals with senior leadership.

Partnership

Don't forget to leverage others who are trying to educate in your facility. Manufactures spend millions on education and are looking for opportunities to educate. Ask companies for CE education, posters, people to come educate, etc. They do not always just educate on products but many times discuss diseases, standards and guidelines, etc.

Beyond helping the floor, ask the manufacturers to come and and educate the educators and leadership! This is a very common practice outside of the United States.

Leverage the resources you already have at hand.

If we could meet, I would totally buy you lunch for your efforts in this response, thank you!! We're really starting from scratch trying to improve the overall performance, morale and retention in our unit that has seen massive turnover in the past year. At a recent meeting, many people cited "education" as a key need for the unit, but there were no specific needs or wants identified- so trying to figure out what will meet the goals of the people in the unit is a challenge. I will take your post points back to my co-chair and this is a GREAT start for us. Again, I appreciate your response and time!

Specializes in New Critical care NP, Critical care, Med-surg, LTC.
6 hours ago, Jedrnurse said:

I don't have any specific suggestions except for one:

Don't increase paperwork for floor nurses, whether it's surveys or the like; it will not be good for rapport, i.e. it'll just be one more d***ed piece of paper to fill out.

Thank you for coming at this from a supportive angle!

I agree the last thing we want is to create more work, or busywork, for nurses that are already plenty busy. We were thinking a quick survey monkey through e-mail- less than five minutes for those that want to reply. Knowing that most will not reply, but at least everyone should have a chance to give their input.

Specializes in New Critical care NP, Critical care, Med-surg, LTC.
5 hours ago, llg said:

How do you currently evaluate your educational activities? Use your course evaluations to feed into your planning for future activities. Ask what additional topics they would like. Ask them about what formats they prefer. Ask what time of day ... etc.

Be sure to use a variety of formats because no one format (or time of day) works best for everyone. Some people are visual learners and would prefer a poster or handout. Others don't remember what they read and learn much better in a lecture or discussion format ... etc.

Also use your quality improvement data to feed into your education. That data often shows what the staff does well and what they don't do well. That data will also provide evidence of whether or not your education was effective at improving practice. Showing that you are improving practice can get you a lot of administrative support, more money, etc.

Make sure you understand the difference between education "needs" and educational "wants."

Those of just a few thoughts off the top of my head.

Thank you for your thoughts. We are trying to cover a variety of formats in order to accommodate the different learning styles and needs of nurses at many different experience levels. You've given me good feedback on starting points and evaluation plans. I appreciate your time.

On 1/31/2019 at 4:32 PM, JBMmom said:

If we could meet, I would totally buy you lunch for your efforts in this response, thank you!! We're really starting from scratch trying to improve the overall performance, morale and retention in our unit that has seen massive turnover in the past year. At a recent meeting, many people cited "education" as a key need for the unit, but there were no specific needs or wants identified- so trying to figure out what will meet the goals of the people in the unit is a challenge. I will take your post points back to my co-chair and this is a GREAT start for us. Again, I appreciate your response and time!

May I ask what your turnover rate was and how it compared to the local market?

Any insights from the exit interviews?

Education is always a good thing but the thing I would be curious to understand is if it is education the staff is lacking or opportunities for career advancement? Sometimes those two things are confused for each other, especially by floor nurses.

Specializes in New Critical care NP, Critical care, Med-surg, LTC.
On 2/4/2019 at 9:46 AM, Subdermal said:

May I ask what your turnover rate was and how it compared to the local market?

Any insights from the exit interviews?

Education is always a good thing but the thing I would be curious to understand is if it is education the staff is lacking or opportunities for career advancement? Sometimes those two things are confused for each other, especially by floor nurses.

As far as turnover, nearly 50% of the unit has turned over in the past 18 months, after many years of stability. I'm a relatively new hire to the unit, coming up on a year. They don't do exit interviews, a couple people said they asked for them but were told there wouldn't be one. We're trying to undertake many changes and address some frustrations. Unfortunately, the overall "education" blanket has been thrown around a bit and managers have really latched onto that as if it's the key. So we're trying to do what we can to bring education to the forefront, but it does not really address some other issues. Unfortunately, even among those that left or are still there and unhappy, it's difficult to pinpoint a specific reason for the dissatisfaction. Most responses are something like- it's different than it used to be. So for those of us that are really invested in making changes that will benefit everyone, there's not a lot to go on. Thanks for all your feedback.

Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.

I can't believe I am saying this, did I drink some Koolaid? But look into the Donna Wright competency model. It changed the way we did education where I last worked, and I think the staff really enjoyed it. It gives them a say in what they think they need to learn across various domains of knowledge in the unit. If you have a unit practice council or a clinical ladder, it's easier to get participation in education or learning events, too.

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