Every newly hired nurse at Legacy undergoes the six-day General Nursing Orientation (GNO) to give them a solid understanding of Legacy philosophies, policies and protocols. The program includes a competency assessment class, electronic medical record class, three clinical didactic classes and an orientation skills day with equipment competencies, simulation training and an open computer lab. Staff nurses and clinical experts from a variety of disciplines within Legacy present the topics.
New nurses at Legacy are assigned to a nurse preceptor to help them transition into their role at Legacy. This one-to-one relationship provides the new hire with a uniquely tailored educational experience that meets the new hire's clinical practice learning needs and also provides a role model, mentoring, and a resource he/she can call on, often long after the preceptorship ends. As Kim Harris, R.N., says, "I drive an hour every day to work at Legacy. I could have worked at a hospital much closer, but I really liked the preceptor program — I wanted to be a safe and conscientious nurse. I want to do a good job."
Legacy has taken a leading role in simulation training with the construction of the Simulation Lab at the Carl Peterson Clinical Education Center at Legacy Emanuel Medical Center. Simulation training is part of general nursing orientation for all new hires. The lab includes three SimMan electronic dummies, a birthing simulator and a child simulator. Simulation training offers a variety of clinical environments and the simulation dummies come with a dizzying array of scenarios for testing and training purposes. The simulation training provides a safe atmosphere for new hires to learn and review skills that would otherwise require live patients. The result is improved competency, confidence and team collaboration for employees and improved safety and clinical care for patients.
Rapid Response Teams
Every Legacy hospital has a Rapid Response Team (RRT) available 24 hours a day to assist any staff nurse who determines an patient's condition is deteriorating. When called, the RRT rushes to the patient and works side-by-side with the nurse and physician to provide whatever treatment is necessary.
An RRT is a group of critical care specialists who are available to rush to the bedside of any patient whose condition seems to be becoming worse. The Rapid Response Team is not intended to supplant the patient’s doctor or to take over for the nurse, but rather to work side-by-side with these caregivers. The growing use of RRTs is based on research that shows it is best to treat patients early in their decline, before a crisis occurs. Hospitals using RRTs report reductions in cardiac arrests, unplanned transfers to the ICU and overall mortality rates.
Legacy’s Rapid Response Teams include an ICU nurse, respiratory therapist and resident. Primary tasks of the RRT are responding to requests for RRT intervention; consulting with each patient’s primary nurse and physician; assessing patients with the primary nurse; providing treatments and interventions using established protocols; assisting with the treatment plan for the patient; and completing documentation.
Typical examples are a post-transplant patient whose blood pressure drops, an ED patient with shallow breathing and low blood pressure, or a surgical patient with breathing problems.
Staff comments include: "We could have lost him had it not been for the RRT. . . . After each event, we reviewed what we did as a team. I've learned so much from them." and "I'm glad the RRT was there to help. I want to give my patients the very best care possible. . . . It makes me less stressed that I have someone to call if a patient's condition is going downhill."