Updated: Apr 7
Intensive Care Unit (ICU) orientation is the cornerstone of success for nurses working in the ICU. As nurses move into new positions, there are many choices and aspects to consider before saying yes to the job. Mary Watts, BSN, RN and Maureen Bishop, MSN, CNS discussed ICU orientation and how to be a successful ICU nurse. They met at the 2018 NTI Conference in Boston, Massachusetts. They talked about the changing face of nursing employment.
Maureen cited, "Because of the market and availability of people to go wherever they want to go in this day and age and I think with this generation, they are more mobile."
A recent study found that millennials will change jobs an average of four times in their first decade out of college, compared to about two job changes by Gen Xers their first ten years out of college. Ms. Bishop explained that the expectation of employment at her institution is two years.
Ms. Bishop has been hiring new grads into the ICU for the past 10 years. "Mostly we look for passion. We do what is called a blended orientation concept. They do online modules, classroom time where they learn basic critical thinking skills and they take an 8-week arrhythmia course." In addition, they are required to take and pass ACLS and "of course the most important part is to spend time bedside." Ms. Bishop attributes her facility's orientation success to utilizing AACN's ICU Essentials of Critical Care Orientation (ECCO). According to the AACN, "ECCO's up-to-date, interactive evidence-based education easily blends into your existing orientation plans. AACN's 24/7 customer support, comprehensive reports, and progress tracking tools make implementation straightforward." The ECCO program has earned accolades for its content: "American Association of Critical-Care Nurses (AACN), a leader in providing standard-setting education and expertise that nurses and healthcare organizations can trust, recently won two prestigious Brandon Hall Group silver awards for excellence in the Best Learning Team and Best Advance in Custom Content categories."
Even after the 4-6 month official orientation, there is a mentorship program too; where new grads and seasoned have added support for an extended period of time. They also have follow up with Ms. Bishop as well as the unit manager. Mary asked about whether orientation is customized for the experienced nurse and Ms. Bishop assured her that the orientation must be flexible in order to meet the needs of everyone. Customized orientation is also important to AACN and their ECCO program. Ms. Bishop also emphasized that they welcome nurses who apply from out of state, both new grads and experienced nurses.
Evaluating the end product of orientation is extremely important. Ms. Bishop states that the criteria she uses to evaluate orientees consists of their ability to grasp the concepts of ECCO and put them into practice. She also emphasizes the need to utilize solid critical thinking skills when confronting complex patient care. Other important aspects of a successful new ICU nurse are that they are able to coordinate all the aspects of care including physical assessment into a solid plan of care. This includes understanding lab results, medications and how they affect the overall care of the patient. She concludes, "so for me, it's really how they are doing on the job. Are they putting that knowledge into practice?"
Nurses want to be successful in their chosen career. There are many barriers to a successful orientation but using a known product to facilitate this process will increase the odds of retaining ICU nurses.
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