Changing the Culture: Introducing Fledgling Nurses into an Exclusively Experienced Crew

• Published in: Journal of perianesthesia nursing Vol. 36; no. 4; pp. e33 - e34
• Main Authors: Wood, Primary Investigator: Lisa, Bonaccorso, Co-Investigators: Elizabeth, Ferrari, Kathleen, Oddi, Carly, Tran, Cindy
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.08.2021
• ISSN: 1089-9472; 1532-8473
• DOI: 10.1016/j.jopan.2021.06.097

The Post Anesthesia Unit (PACU) has historically hired experienced nurses only. At a time when a demand for nurses far exceeds the supply, our aim was to create a program that enables new graduate nurses to successfully begin a career in this critical care setting while also addressing these shortages. The goal of this trial was to create a program in which new graduates receive an appropriate orientation to PACU while also being able to solidify newly gained nursing skills traditionally acquired through prior medical/surgical or intensive care experience. A 12-month orientation program was implemented. New graduate nurses were carefully selected based on prior experience and clinical competency. In the first phase, graduate nurses were trained exclusively on care for patients that have already met phase I criteria but could be floor, step down, or ICU status. The next phase included a standard PACU orientation to care of immediately post-surgical patients of various needs. Upon successful completion, the graduated nurses then cared for immediately post-surgical or phase I complete patients on their own. During this time, they selected a nurse mentor to meet with monthly to discuss confidentially what was going well, where they needed further assistance, and other concerns during their first months as trained nurses. We found through proper and systematic training, new graduate nurses are able to become competent PACU nurses. This has created an environment for learning that gives the new graduate nurses the confidence to ask questions without fear of judgement for the rest of their career. Training nurses with no prior nursing experience has had a positive effect on experienced nurses, reminding them of where they come from, reaffirming how much they know and creates a culture of continual learning while positively impacting staffing outcomes during a time of hiring shortages. New graduate nurses can be successfully integrated into the PACU and still have a great nursing foundation to build a full and opportune laden career. This residency program prepares new graduate nurses to be successful and excel in the fast paced, critical care environment that is PACU and beyond. Future research can focus on the retention of these individuals.