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https://d1y502jg6fpugt.cloudfront.net/13418/archive/files/bb47978d029e8ce272c5839b360ec759.pdf?Expires=1712793600&Signature=aUem1dQwzuTkgp3bS7eZPfdFrB82WemY2bn8DYJ0JDTmrNwD4BeiQQ%7Eh8ddl2z%7EiXJKCYP5xBXRKs%7E6rF7FABV8PtfiSJ1G0S0Qw2g%7E7eg%7ExA49RPBcMbAi3F8mGc-Wirl1BYN-pwoBKwmj6IUX-AvOaaoqDznMAr5xioSA-UBR1z4opBSCVSM7jkYglddjshUeCYO0cG%7E9CnP0dIVBsbigXi3uXVUUsA59FmCx2T8RtnjtEagwMDfs0a5dKNqq0KwmyeCcF%7EO2RN1wf1nvcsoroYjFo7orV2IyRQfiZEtVA922Pw0xbXTUhTH3l6sdcZ5SjC27U27oiKMwPt6jQbA__&Key-Pair-Id=K6UGZS9ZTDSZM
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The Implementation of the Graduate Nurse Role to Support Nursing Staff during the COVID-19 Pandemic
Cassandra Plamondon, MSN, RN., Kym Peterson, MSN, RN, CNL., Kathy M. Baker, MSN, RN., Jenny Barsamian, DNP, RN., Ann Marie Grillo
Darcy, MSN, RN, ACNS-BC., Lynn Mackinson, MS, RN, ACNS-BS., Andrea Milano, MSN, RN, CCRN, CMC., & Lauren B. Mills, BSN, RN
Introduction/Problem
• Recognized critical staffing needs during the COVID-19 pandemic
• Governor Baker passed an executive order authorizing nursing graduates and senior nursing students
to practice with a limited capacity
• Current process did not support the role of the graduate nurse (GN) practicing in the clinical setting
Aim/Goal
• Increase the nursing workforce by implementing the GN role
• Swiftly create an orientation program that supported the GN amid the COVID-19 pandemic
The Team
Unit-Based Educators, Nurse Specialists, and Nursing Directors from inpatient medical-surgical and
specialty care units
The Interventions
Three phased approach tailored to the individual GN:
Phase 1
Phase 2
Phase 3
• Safety, basic assessments, documentation, prevention of harm, and use of basic equipment
• Advanced assessment skills, medication administration, emergency care, telemetry, and ECG monitoring
• Occurred once GN passed the NCLEX-RN exam and transitioned to the entry-level clinical nurse role
• Continued focus on medication safety, in addition to prioritization of care and evaluation of critical thinking
GNs were surveyed upon completion of orientation and their transition to the entry-level RN role to
assess comfort levels with various professional nursing roles and to identify knowledge gaps and areas
for improvement
The Outcomes
Fifteen of the 16 GNs successfully passed the NCLEX-RN and transitioned to an entry-level RN position with
12 responding to the survey. Six categories for discussion emerged:
Work experience
Communication and
feedback
Support
Clinical confidence
Workload
Transition challenges
• Ten had previous experience as a PCT, eight transitioned to a GN on the unit previously employed as a PCT
• GNs felt comfortable communicating with coworkers, physicians, and patients and their families
• Some reported a lack of communication regarding roles and responsibilities of the GN to other staff
• GNs reported seeking feedback for their performance
• Most felt supported on their units and felt the orientation process was well communicated with them
• Some stated that having several preceptors impacted the progression of their orientation
• Several GNs expressed lack of confidence in performing end of life care
• All felt they had adequate knowledge and experience to perform their job responsibilities
• Most felt comfortable with new situations and procedures
• Most GNs felt the workload was reasonable, feeling they could prioritize and organize patient care in a
timely manner and felt comfortable delegating tasks when necessary
• A lack of confidence and fear were challenges GNs identified during their transition to practice, followed by
perceived workload, role expectations, and how to use available resources
• GNs desired more experience with medication administration, eMAR, medical equipment, emergency
situations, and how to communicate efficiently with physicians
Implications for Future
• Improve communication with nursing staff to
increase the understanding of the roles,
responsibilities, and limitations of those in the
GN role
• Limit number of preceptors orienting a GN to
one or two key preceptors and ensure
communication occurs amongst those sharing
this role
For more information, contact:
Cassandra Plamondon, MSN, RN – cplamond@bidmc.harvard.edu
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Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Silverman Symposium
Description
An account of the resource
Each year the Silverman Symposium poster session offers BIDMC staff and affiliates the opportunity to share experiences and learn about efforts to improve Quality and Safety.
Date
A point or period of time associated with an event in the lifecycle of the resource
2021
Silverman Poster
Primary Contact
If you would like more information about this project, contact this person. Make email address clickable.
Cassandra Plamondon (<a href="mailto:cplamond@bidmc.harvard.edu" target="_blank" rel="noreferrer noopener">cplamond@bidmc.harvard.edu</a>)
Project Team
Cassandra Plamondon
Kym Peterson
Kathy M. Baker
Jenny Barsamian
Ann Marie Grillo Darcy
Lynn Mackinson
Andrea Milano
Lauren B. Mills
BIDMC Location
The BIDMC location where the poster team resides if identified in spreadsheet. If not identified, choose BIDMC.
BIDMC
Department
Any departments listed on the poster or identified in the spreadsheet.
Nursing
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
The Implementation of the Graduate Nurse Role to Support Nursing Staff During the COVID-19 Pandemic
Date
A point or period of time associated with an event in the lifecycle of the resource
2021
Format
The file format, physical medium, or dimensions of the resource
pdf
Effectiveness
Safety