Emergency nurses work together to standardize emergency department nurse orientation in Central Zone

Jami Gillis and Haley Avery, clinical nurse educators
Jami Gillis (left), clinical nurse educator for Cobequid and Hants emergency departments and Haley Avery (right), clinical nurse educator for the QEII's Halifax Infirmary emergency department, were two of the four team members involved in revamping the orientation program for emergency department nurses in Nova Scotia Health's Central Zone

A group of nurse educators noticed a flaw in the system to orient new emergency department nurses and put in the work to fix it.

Heather Peddle-Bolivar, Jami Gillis, Haley Avery, and Suzanne MacDonald got together to figure out a more efficient way for emergency department nurses to transition into the job. This is for people who are either a new hire in Nova Scotia Health’s Central Zone (Halifax area, Eastern Shore or West Hants) or are working between different sites.

As emergency department staff do, once they noticed the problem in February 2019 they got started right away, preparing the research and work to create a new orientation process.

After two months of compiling a literature review and preparing the research needed, they were able to start putting changes in place by April 2019. They have continued to make new changes along the way.

“We recognized each department in Central Zone was doing orientation in a mostly similar way; we appreciated it was taking a lot of time, but we felt it wasn’t giving the new hires everything they needed,” said Peddle-Bolivar, speaking about what initiated the change. “We worked together with Central Zone leadership, professional practice and our leadership team to figure out a way we could do it so that orientation was meaningful for everyone.”

Before they got started, they asked nurses in any emergency department what they had in common with other emergency departments in the Central Zone. Jami Gillis explained, “We felt we used the same policies, care directives, medical functions. We actually had more in common than differences.”

Their research confirmed that this feeling was correct.

The new program is focused on knowledge translation to support staff working in the emergency department to be prepared in a different way.

The new program consists of four days of class and one day of e-learning modules. While it is longer than the previous orientation, which was one eight-hour day, it has proven to be more efficient.

“We have heard from preceptors that new nurses are coming better prepared with more understanding. They’re familiar with the tools we use and the language we speak. There is an introduction to those things that put them at an advantage,” said Gillis. “I’ve even seen through this change, new staff coming more prepared and aware of the processes, forms and care directives. They are informing the practice and, in some cases, informing senior staff and collaborating with them to enhance awareness among the entire team.”

The new orientation also provides nurses with an easier transition between departments in Central Zone.

It creates a more straightforward process for nurses who transition between sites or work in multiple sites. “For example, if they had orientation at Cobequid Community Health Centre, then move to Dartmouth General Hospital, they don’t have to start from scratch. We can get them started faster as they already have a solid foundation,” said Peddle-Bolivar.

As for the future of this project, team members all agree that it will continuously evolve.

They hope to soon have an online format so people can participate from home rather than in a classroom setting. It will also accommodate those living away. Along with the online format, they would like the online version of the orientation to exist as a reference place and resource for emergency department staff.