Cardoivascular E.N.T.E.R. Fellowship Program

Experienced Nurses Transitioning Effectively For Retention

(Program launch in September 2009)

The Cardiovascular E.N.T.E.R Fellowship Program is for experienced nurses (greater than 6 months post graduation) who want to transition into cardiovascular specialties (telemetry or cardiac cath lab).  The program is a year long. The nurse is obligated to the organization one year following completion of the program.

Start Dates for Program

September 2009
February 2010
September 2010
February 2011

A Blended Learning Approach

• 10% Class Room with small group didactic, on-line and clinical simulation training.
• 85% Unit Experience with Clinical Preceptor
• 2.5% Professional Development Experience with small group experiences and clinical simulation
• 2.5% Mentor Experience

The fellows will follow a working schedule similar to the clinical preceptor.  For the first three months, class will be every Monday in the simulation lab.  The fellows will work two eight hours shifts and two 12 hour shifts each week on day shift.  If the fellow rotates to the off-shifts, they will be paired with a learning facilitator for the last one to three months of the program.  The fellow will not rotate to the off-shift until a full patient load is managed.  The cardiac cath lab fellows will take call with the clinical preceptor or a learning facilitator until they have demonstrated specific competencies to take call on their own. 

Program Content

Key nursing skills that will be developed are based on the AACN progressive care core and critical care competencies which include:

• Dysrhythmia monitoring techniques
• Basic and advanced life support
• Basic dysrhythmia interpretation and treatment
• Drug dose calculation
• Continuous medication infusion administration
• Patient monitoring for standard procedures
• Hemodynamic monitoring
• Recognition of signs and symptoms of cardiopulmonary emergencies
• Interventions for stabilization
• Interpretation of ABGs and communication of findings
• Airway management and oxygenation systems
• Assessment and management of ventilated patients
• Assessment and management of enteral and parental nutrition
• Assessment and management of renal therapeutic interventions
• Recognition of and evaluation of the family’s need for enhanced involvement

Essentials of Critical Care Orientation is a national evidenced based on-line program by AACN designed to provide the nurse the theoretical knowledge required to care for the patients cardiovascular specialty areas.  The program consists of modules organized using the body systems approach. Developed to present the standard didactic content of a basic telemetry care course and is integrated with group discussions, case studies and clinical experiences.  The test mechanism is used as a pre-assessment to determine the individual learners’ needs as well as a post assessment to check for concept comprehension.  A skills check list is included to assist in guiding the learners’ clinical activities.  Each module contains a detailed review of anatomy and physiology, physical assessment, diagnostic and laboratory tests and discussion of common disorders for each body system. The modules are:

• Introduction to Care of the Critically Ill is an introduction to AACN, evidence based practice and Synergy Model.
• Cardiovascular Assessment reviews anatomy and physiology, risk factor assessment and diagnostic procedures.
• Basic Hemodynamic Monitoring reviews basic dysrhythmia interpretation and hemodynamics with pharmacological management.
• Cardiovascular Diseases reviews common disorders such as Acute Coronary Syndrome, Heart Failure, Pulmonary Edema, Valve Disease and Cardiomyopathy.  The focus is on clinical presentation, testing and therapeutic goals.
• Cardiovascular Interventions reviews common invasive procedures such as Coronary arteriography, pacemakers and cardiac surgeries. The focus is on indications for procedure, management and complications.
• Pulmonary System reviews anatomy and physiology, ventilation and oxygen delivery, common pulmonary disorders, and thoracic surgery.
• Neuro System reviews anatomy and physiology, common neurological disorders, and intracranial pressure monitoring.
• Renal System reviews anatomy and physiology, fluid and electrolyte disturbances, and acute and chronic renal failure.
• Hematology System reviews anatomy and physiology, and common hematological disorders.
• Endocrine System reviews anatomy and physiology, and common endocrine disorders.
• GI System reviews anatomy and physiology, common disorders and nutritional support.
• Multisystem reviews the stages and types of shock, sepsis, SIRS and MODS.  This section also includes specialty populations such as the geriatric and pediatric populations.

The use of patient simulation manikins for real-life scenario testing is scientifically proven to improve patient care delivery systems and prevent emergent patient codes such as cardiac arrest.  This is critical to the provisions of a safe and efficacious way for nurses to practice skills and improve competency in treatment and clinical decision making, encouraging collaboration and reducing the preventable codes within the hospital (Landry, Oberleitner, Landry, Borazjani, 2006).  The manikins are life-sized simulators that can be programmed to simulate a wide variety of patient symptoms and clinical scenarios. The simulator is used to develop crisis management techniques, critical thinking as well as assessment skills. The simulator has an ECG library of 2500 cardiac rhythm variants, pulses and heart sounds synchronized with ECG as well as cough, vomiting, moaning and other sounds to respond to patient interventions directed by the nurse. The simulation is programmed and uses timed algorithms based on the nurses’ responses. 

For More information, contact a Human Resources professional at 256-5410 or call Organizational Development at (803) 256-5839.