Ann Russell RN, MSN, CCRNAnn Russell RN, MSN, CCRN
Nurse Educator, Nursing Education & Research  

Ann is the coordinator for the critical care nursing orientation. She received her MSN in 1999 at the University of Hartford with a Nursing Education focus. Ann has 20 years of experience in surgical nursing including vascular, trauma and burns, and surgical ICU. Ann has been a faculty member of the Hartford Hospital Simulation Center since 2004 and has revised the ICU Core program to incorporate simulation into its curriculum. Ann has presented on the use of simulation at various conferences in CT. 
A Critical Care Nurse Educator Explains a "Full Circle" Experience.
by Ann Russell, RN, MSN, CCRN

“V tach, Room 4!” was the first announcement I heard. I was in Room 3 and it was my first day in Bliss 7I. Turned out, it was a false alarm, but I learned right away, that in critical care you’ve always got to hope for the best but plan for the worst, as one of my co-workers would often say.

Critically ill patients

“Planning for the worst”, or anticipating complications is imperative for critical care nurses to learn. Patients requiring critical care usually have life-threatening injury or illness: hemodynamic instability, compromised airway, severe head injury, or organ failure. Patients may require close monitoring after a procedure or recovery from anesthesia. These patients require such vigilant nursing care, that nursing assignments are usually 1-3 patients.

Learning how to be a critical care nurse is, at the very least, challenging. Nursing students may have some exposure in school, but it is far from enough preparation. A solid orientation to this specialty usually builds upon previous experience in acute care. Some hospitals offer critical care courses to prepare nurses for their orientation to the intensive care unit (ICU).

Critical Care Core

Hartford Hospital provides a course for nurses preparing to work in an ICU or step-down. Offered every other month, the “Critical Care Core” is based on the Core Curriculum recommended by the American Association of Critical Care Nurses (AACN). The course runs a little over 3 weeks and combines several methods of learning: web-based, lecture, case studies, simulation, and clinical. In addition to myself, classes and simulations are led by a variety of experts: unit-based critical care educators, respiratory therapists, staff nurses, and others.

Participants in Critical Care Core often describe the course as intense and at times overwhelming. It is not a good time to be making other life changes, such as relocating or going to school. Critical Care Core requires a lot of focus, yet at the same time, participants feel intellectually stimulated and very prepared to begin a precepted orientation. One nurse recalls “My most valuable lesson was talking out loud and learning to communicate with my peers”. This is a common response to working in simulated scenarios with others.

Clinical Orientation

Clinical orientation is completed with staff nurse preceptors from your unit. Your unit-based educator will assist you and your preceptor(s) in developing an individualized orientation, selecting patient assignments, and assessing your progress (by competency and goal completion).

Troubleshooting technology and applying hemodynamic concepts aren’t the only types of lessons to be learned. How do you help a family to say good-bye to their loved one who will not survive? The psychosocial demands may be unexpected. Your preceptor, educator, manager and others such as social workers and chaplains will help you to learn to help support families in crisis.

Continuing Education

Critical care nurses are always learning. Evolving technologies and advanced procedures keep us on our toes! Hartford Hospital’s critical care educators offer regularly scheduled courses for critical care nurses such as Advanced ICU Core (advanced hemodynamic concepts), Continuous Renal Replacement Therapy, Intra-Aortic Balloon Pump therapy. Hyperbaric Oxygen therapy.  All courses have contact hours and are free to Hartford Hospital employees.

All critical care staff are invited to “Ethics Forums”, which allow staff to discuss ethical issues related to patient care, using actual cases. Representatives from the Ethics Committee are available to comment and answer questions.

Critical care nurses can also get involved in the Transformation of the ICU project (TICU). Its’ vision is: to transform our ICU services by identifying and exceeding the expectations of its patients, families and staff by establishing a culture that promotes safety and quality in a patient and family centered environment.

Recently the critical care educators offered a CCRN Review course. CCRN is the critical care certification offered by AACN. Nurses are eligible to sit for the exam after 2 years of experience. AACN provides much education on their website and through annual conventions. Membership does have its privileges, including journals and scholarships. Northern CT. chapter (NCC), the local AACN chapter, has several representatives from the hospital.

Full Circle

I was not sure what to do that first day when I heard “V tach!” announced. Now, I teach others what to do. It takes time to get comfortable with certain skills, and I found great resources around me.

I am proud of the orientation we provide critical care nurses. But even more so, I am proud of each of the participants I’ve had in class. Their thirst for knowledge motivates me. Often, when I run into them now, I am amazed at their talent and progress, and it always makes me smile!