Monday, October 22, 2018
by Kathryn Holleman • firstname.lastname@example.org
BJC | The need for intensive care nurses is steadily increasing across the country. And ICUs, with their fast pace and challenging patients, are exactly where many new graduate nurses want to work.
But the time it takes to orient an inexperienced graduate nurse to a demanding, specialized environment is simply more than many ICU staffs can spare. The result? Graduate nurses often aren’t considered for ICU positions they want, and ICUs must pass on a pool of eager job candidates.
BJC’s new ICU nurse internship solves this problem by rotating new graduate nurses through a variety of critical care settings across the organization, while teaching them some of the critical thinking and specialized care skills they’ll need. At the end of the 12-week program, the nurse interns will have chosen the BJC ICU they want to work in and will be prepared to start working.
The first cohort to go through the program completed their internships in August. The nurse interns and the instructors who hosted them gave the internship high marks and suggested that the model might work for other areas of nursing.
Collaboration at its best
The idea to start an ICU nurse internship grew out of the chief nurse officers’ council (CNOC) meeting held in April. At the meeting, BJC talent acquisition manager Shawn Ray presented job application data, including the number of open ICU nursing positions and the number of new-graduate applicants for those positions who were turned away.
As a solution, CNOC participants thought onboarding new graduate hires as an ICU cohort could be both efficient and effective, making sure the new hires received thorough, systematic training while taking pressure off the ICU staff. They immediately began to pull in partners across BJC to develop a program — hoping to have it ready in time to hire May nursing graduates.
Partners in the project included the BJC Institute for Learning and Development, Goldfarb School of Nursing at Barnes-Jewish College, and nursing and ICU leadership and staff members from ICUs at Barnes-Jewish, Barnes-Jewish St. Peters, Christian and Progress West hospitals and Missouri Baptist Medical Center.
Despite the tight schedule, the group was able to deliver an internship program, says Jill Skyles, BJC Center for Clinical Excellence senior strategy consultant.
The effort embodied collaboration among BJC departments and hospitals at its best, she says. “We crashed through barriers, with no tug-of-war between departments or HSOs.”
The group worked together to structure rotations through the participating ICUs and develop non-hospital curriculum including ICU simulation scenarios at the Goldfarb simulation lab.
The resulting internship was designed to teach the students how to apply critical thinking skills and nursing expertise in caring for the sickest patients, while giving them enough hands-on experience to fit in comfortably in settings ranging from a community hospital ICU to a specialized neuro unit in an academic hospital.
The first cohort of six graduates hired (the internship is approved to hire up to eight graduates) came from several schools, including Goldfarb, St. Charles Community College, Southern Illinois University Edwardsville and even one from North Carolina. They began the 12-week program in June and ended in August with a luncheon celebration at the BJC Learning Institute.
Beautiful to watch
From its inception, the program made use of the talent available and cooperative partnerships that are possible across BJC, said Jeanne Zack, PhD, BJC quality patient care consultant and lead faculty coordinator of the project, at the luncheon.
“We were thinking like a system. The succinct teamwork was beautiful to watch,” she said.
Nurse educators from several hospitals echoed her sentiments.
“We learned from the other hospitals,” said CH nurse educator Cheryle Phillips. “We all liked and benefited from the info-sharing.”
The program was also effective in preparing the interns to step into their jobs in their respective ICUs, said several of the nurse educators at the luncheon.
For instance, interns rotating through the MBMC ICU participated in the unit’s annual catheter competency. “And now they’ll know the right way to do it from the beginning,” said Matt Meadows, MBMC ICU nurse educator.
Seeing the different settings allows interns “to make an informed decision when they choose where they’ll work,” said CH adult and critical care nurse manager Annette McCauley.
A stint in the Goldfarb simulation lab demonstrated exactly how well-prepared the interns were, said Zack. The interns worked together to respond to various critical care scenarios run on the simulation mannequins. The group displayed the kind of teamwork and critical thinking skills they’d need on the job.
“The sim lab experience was incredibly fabulous,” she said.
Carmella Clark-Gray, PhD, Goldfarb simulation lead, concurred. Typically, nursing students are in the sim lab to learn critical thinking and skills. To watch nurses applying what they’ve already learned and testing them to their limits was exciting, she said.
“We even ‘revved up’ the scenarios a little. The interns exceeded our expectations. It was mind-blowing to watch them respond,” she said.
Members of the first ICU nurse internship cohort have begun working in ICUs across BJC: two at MBMC, two at Barnes-Jewish, one at BJSPH and one at CH.
In the meantime, those who developed the internship are using learnings from the first cohort to make the program even better by the time the next cohort starts in January 2019, says Skyles.
The chief nursing officers have approved extending the critical care internship for another round in January to support the December graduates, along with the addition of an emergency department cohort.
The design process beginning this fall in preparation for the two January cohorts will involve all BJC hospitals. The previously developed new employee orientation designed to serve the four hosting hospitals for the pilot will be reviewed and revised as appropriate to serve all BJC hospitals. Similarly, nursing, critical care and ED design teams will be established to serve all hospitals.
Also, BJH, SLCH, Memorial Hospital Belleville and Memorial Hospital East nursing leaders are eager to host January cohorts.
“This is really exciting, rewarding work,” says Skyles. “Within the two weeks of the new internships being posted, more than 30 applications had been received for the January cohorts.”
Number of views (1780)/Comments (4)
10/23/2018 8:32 AM
This is a great trend of "training our own," both here and with BJH's iPCT program. It demonstrates the internal expertise we have available and enhances our workforce. The manager of one or our ICUs hired one of the first graduates and had rave reviews for the program.
10/26/2018 6:34 AM
Great idea and congrats to the new BJC team members. How does one apply for the program?
10/26/2018 9:05 AM
Thanks for asking! You can email Shawn Ray, email@example.com, or Jeanne Zack, firstname.lastname@example.org, for more information about applying for the internship.
10/30/2018 12:07 PM
Outstanding work by the BJC team and educators from around the system. It was great working with all of you!