Heart-pounding, sweat-inducing, dry-mouth stress. There's no substitute for the first time a new nurse hits the emergency room running - without the safety net of a nursing instructor or a simulated patient model.
While it's not always a make-or-break moment, things could be a lot easier. Even with a four-year degree - and often an externship - under their belts, new nurses still must navigate extreme patient incidents while figuring out how their new place of employment works. The result often is high stress - and a high attrition rate.
Enter the nurse residency program at DeKalb Medical Center.
"We realized that with the nursing shortage, we were having trouble finding qualified nurses in emergency and med/surg. We saw how important it was to grow them," said Debra Honer, RN, BSN, CEN, the clinical nurse specialist with the program.
Similar programs have been implemented in Oregon and Washington state, she said.
Nurse residents are new hires and graduates of accredited nursing programs - or transfers from other departments who want to be trained as emergency or med/surg nurses.
Under the tutelage of Melanie Kinder, a veteran emergency nurse and the program's primary preceptor, the nurses get a closer look at the emergency room through both hands-on and classroom instruction, before taking patients by themselves.
Experienced nurses coming to the emergency room from other departments have a shorter program, but also get group training with their peers. The group progresses in a step-by-step fashion followed by two preceptors - one who does the majority of classroom teaching, the other the majority of orientation.
"As a group, they are learning and growing together, going through ACLS [advanced cardiac life support training] together, so that they have some peers; don't feel like they're out there all alone," Kinder said.
In the classroom once a week, instructors discuss different systems in the body, alerting the ER staff on the curriculum that week.
"If it's GI, then those are the patients we focus on in the emergency room," said Kinder.
Helping new nurses ease into the action is key to the program's success.
"When you come to the emergency room it is so overwhelming. This process is to try to make it a gradual and easy process, where the nurses are eased in," Kinder said. "The time to build skills is not in the middle of a hurricane."