St. Joseph’s Health Centre is opening the ICU doors to new nursing graduates interested in a unit that has traditionally been designated for the more seasoned and experienced nurse. With support from the Ministry’s New Graduate Guarantee program, Silvana Biscaro, Director for St. Joseph’s Emergency, Critical Care and Access Services portfolio is excited with the opportunity to provide new nursing grads with the training, orientation and support needed to transition into the critical care setting.
“This new generation of nurses is looking for challenges and variety in their practice and they are attracted to the critical care environment. By offering them the right level of support, we are confident that they will become successful team members in the ICU,” says Biscaro.
St. Joe’s recently participated in a research study with 15 acute care hospitals across the province that looked at the impacts of a bridging program for 4th year baccalaureate nursing students interested in entry-level employment in critical care. Conducted by the University of Western Ontario and the University of Ontario Institute of Technology, nursing students were split into two different groups to complete their 430-hour practicum. The intervention group participants were enrolled in Durham College’s Critical Care Certificate program and were partnered with a preceptor trained in critical care mentoring for their practicum. Students in the control group were paired with a preceptor who had completed a basic hospital-sponsored preceptor program for their placements. While the final and conclusive study results are still being complied, outcome measures did reveal that the students showed a significant rise in their comfort, confidence, and competence levels at the completion of the study compared to when they initially began their ICU placements. Students were also able to secure jobs in organizations of their choice. Results of the study may also inform policy, funding, and curriculum planning decisions with respect to specialty education in undergraduate nursing programs.
Molly Magee, a new grad nursing student who participated in the study was hired in St. Joe’s ICU. “I’ve always known that I wanted a nursing career in the ICU,” says Magee. “I think that it would have been more difficult for me to get a placement in the ICU if I didn’t participate in the (research) study, since it’s really hard for a new grad to do their placement in critical care,” she adds. The New Graduate Guarantee program also helped to secure her employment in the ICU and ensured that her introduction into the critical care setting was done with the guidance and support of her preceptor. Magee was also sent on the RN Exam Review course to assist her in preparing for her final nursing certification exam.
Due to effective capacity planning, St. Joseph’s has been very successful in bridging 96 per cent of our new grads into full-time permanent positions throughout our five clinical program areas. To ensure their success, the Health Centre has a number of internal initiatives to help support new grads as they enter their practice starting with Interprofessional orientation – an approach that is unique to St. Joe’s.
Through five core competencies (trust and respect, knowledge of roles, appreciating differences and conflict resolution, sharing power and shared-decision making) new grads familiarize themselves with the other key health-care providers they will be working with on a daily basis such as social workers, respiratory therapists, occupational therapists, and pharmacists.
“It takes us out of silos and sets the tone for a culture of collaboration, which is important,” says Elizabeth McLaney, Interprofessional Education Manager at St. Joseph’s. “The process brings diverse groups of people together in order for them to learn with, from and about each other, fostering teamwork that we ultimately hope will translate into the work at the bedside.”
More specifically for new grads like Molly who are entering critical care areas, the ICU and emergency department have developed a two-step integration program. Through innovative planning using the Nursing Resource Team (the hospital’s centralized staffing pool) new grads begin their learning and mentorship in a number of medical and surgical inpatient units across the Health Centre. Sandra Lenarduzzi, Manager of St. Joe’s Nursing Resource Team says their focus is to develop critical thinking, organizational and clinical skills as well as learn hospital-specific processes and policies. “This in turn gives them a solid foundation on which their critical care skills will be built,” Lenarduzzi adds.
Although the ICU is traditionally seen as an environment for more seasoned and experienced nurses, Magee feels, based on her experience, new grads can learn the necessary skills and tricks of the trade to be successful in critical care. “It really depends on the person – you need to be really motivated and ready for a challenge to work in the ICU.”
Magee says St. Joe’s has provided her with the support while the ICU team has really involved her in opportunities where she can observe and learn. She also credits her preceptor with helping to ease her transition into the ICU. “I enjoy working so closely with the interprofessional team members here (in the ICU) and there is a really good approach to collaborative care – the staff here is great and I never feel alone. I feel prepared to be in the ICU.”