ED Technician Educator: An Innovative Extension of the Nurse Educator Role

ED Technician Educator: An Innovative Extension of the Nurse Educator Role

CLINICAL NURSES FORUM ED TECHNICIAN EDUCATOR: AN INNOVATIVE EXTENSION OF THE NURSE EDUCATOR ROLE Authors: Brandi D. Schimpf, RN, BSN, CEN, Robin A. S...

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CLINICAL NURSES FORUM

ED TECHNICIAN EDUCATOR: AN INNOVATIVE EXTENSION OF THE NURSE EDUCATOR ROLE Authors: Brandi D. Schimpf, RN, BSN, CEN, Robin A. Scott, ND, MS, RN, CNS, CEN, and Kathleen S. Oman, PhD, RN, FAEN, FAAN, Aurora, CO Section Editors: Andrew D. Harding, MS, RN, NEA-BC, FACHE, FAHA, FAEN, and Kathryn C. Whalen, DNP, MSN, RN, FAHA

n the ever-changing world of emergency care, the need for continuous, unit-specific education is pivotal. During an expansion of an inner-city, Level II, academic-focused emergency department, this need became even more pronounced. The department expansion included transitioning to a new location, increasing physical capacity, performing a major process redesign, changing staffing patterns, and updating job roles and responsibilities, all of which created a need to examine our resource utilization. While work was being done to redesign our emergency department’s process flow to be more patient centered, the need to assign the right job to the right person, or “job righting,” was evident. ED team members were doing tasks that took them away from the patient—transporting, stocking, and cleaning rooms—all tasks that did not need to be done by clinical personnel. Roles needed to be more defined. Once responsibilities were clearly defined, job descriptions were then rewritten to match. One major change in the department’s job descriptions was that of the ED technician role. The use of ancillary help in the emergency department is not innovative; however, the level of education and expertise of such personnel have always varied. Before the ED expansion, the ED technician could have had any level of education: certified nursing assistant (CNA), emergency medical technician–basic (EMT-B), or emergency medical technician–paramedic (EMT-P). In an effort to have role consistency, we wanted all ED technicians to have a

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Brandi D. Schimpf, Member, Colorado ENA, is Clinical Nurse Educator, University of Colorado Hospital, Aurora, CO. Robin A. Scott, Member, Colorado ENA, is Clinical Nurse Specialist, University of Colorado Hospital, Aurora, CO. Kathleen S. Oman, Member, Colorado ENA, is Research Nurse Scientist, University of Colorado Hospital, and Associate Professor, University of Colorado Denver, College of Nursing, Aurora, CO. For correspondence, write: Brandi D. Schimpf, RN, BSN, CEN, 190 Roslyn St, Ste 1305, Denver, CO 80230; E-mail: [email protected]. J Emerg Nurs 2015;41:238-9. 0099-1767 Copyright © 2015 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.jen.2015.01.024

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minimum of EMT-B training with intravenous certification. Each ED technician would also have a specific scope of practice that would be the same regardless of the level of emergency medical technician (EMT) training. We constructed the ED technician scope of practice based on the standards set by the state of Colorado. 1 These standards were then reviewed and approved by ED leadership and the EMT physician liaison. The change in the ED technician role provided the department with the ability to provide team-based care, 2 joining emergency nurses and ED technicians, thus becoming a more clinically driven and patient-centered unit. A staffing need became evident quickly. Meeting the needs of a physically larger space; staffing to achieve team care; and dealing with a sudden, sustained patient volume increase were contributing factors. In less than 1 year, the ED clinical staff increased by nearly half—emergency nurses by 14 positions and ED technicians by 38 positions— resulting in a total of 52 newly budgeted positions. With such a dramatic increase in staff, unit education became an increasing challenge. Numerous new-employee orientations, regulatory compliance, and necessary unit education became progressively more difficult to accomplish. After much contemplation of unit educational needs, a suggestion of having an additional ED nurse educator was made. In reflecting on the changes in our department, including the development of a new patient throughput plan and team care concept, as well as the dramatic increase in ED technician positions, unit education needs required more focus on ED technician staff. The proposal was amended to request the creation of a new position, the ED technician educator. This role, although similar to the nurse educator role, would be different. The ED technician educator would address specific scope-of-practice competencies and plan focused ongoing education to further enhance the development of the ED technician role. After this novel and innovative role was presented to hospital and departmental stakeholders, overwhelming approval was received and work began to bring this role to fruition. Two departments shared the construction of this role, the emergency department, in which the technician educator would work, and the professional resources department, the department that manages all hospital educators. The ED technician educator

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job description required EMT certification, paramedic preferred, and included a list of desired characteristics such as hospital experience, previous education participation/involvement, and a college degree. Multiple interviews of both internal and external candidates ensued. Once a candidate was selected, implementation of this new role followed. Because this was a new position, no formal technician educator orientation existed; orientation consisted of daily experiences and interactions. Initially, the ED technician educator shadowed the emergency nurse educator, working closely together regarding staff education development, attending meetings, and most importantly, performing real-time communication and education with ED technician team members. A key component in the development of this new role was introducing the educator, as well as his scope of service, to other people and departments throughout the organization. No other clinical unit had grown its education force by using ancillary staff, and so the concept of technician educator required some amount of education as it was established. As the role developed, so did the responsibility; the technician educator began to develop technician-focused education with review and approval by the nurse educator and managers. Classes and in-service programs were developed and overseen by the nurse educator. Although there was not a formal end date for the orientation to the role, the ED technician educator began progressing independently after achieving a level of comfort with daily objectives (ie, new-hire orientations, skills training, and unit processes). The ED technician educator now seeks out information and develops education while collaborating with a multidisciplinary team and continues to partner with the nurse educator to execute unit education. The ED technician educator’s presence has quickly become acknowledged by all team members and faculty and integrated well within the department. This value-added role continues to be an asset to our department and will remain a permanent feature of the emergency department’s education staff. The ED technician educator now sits on various departmental and interdepartmental committees and is asked to assist in various processimprovement initiatives. This new position has anecdotally

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increased satisfaction among ED technicians because they now have a manager and an educator with specific knowledge of their job responsibilities, scope of practice, and certification requirements. ED technicians have a better avenue for voicing concerns and addressing their specific educational needs. In addition, the technician-specific position allows the nurse educator to focus on nursing orientations, education, and clinical issues. This also affords both educators more time to focus on team needs and the ability to practice direct patient care to maintain knowledge and competency. The development of the ED technician role and, subsequently, the ED technician educator was very successful and can be modeled in other emergency departments. In an effort to continue job righting, it was clear that the largest staff growth was in the ED technician role and therefore an ED technician educator was needed. Stakeholders worked together to develop job requirements and scope of service. The process of gaining stakeholder buy-in, writing a new job description, gaining approval from the human resources department, and hiring into the new position took approximately 6 months. Although the process was lengthy, creating innovative ways to meet the needs of an ever-changing, active emergency department is essential in improving care and moving patient throughput forward. REFERENCES 1. Colorado Department Of Public Health And Environment. Emergency Medical Services; 6 CCR 1015-3. http://www.sos.state.co.us/CCR/ GenerateRulePdf.do?ruleVersionId=5205. Published June 14, 2013. Accessed November 4, 2014. 2. Jones F, Podila P, Powers C. Creating a culture of safety in the emergency department: the value of teamwork training. J Nurs Adm. 2013;43(4):194-200.

Submissions to this column are encouraged and may be sent to Andrew D. Harding, MS, RN, NEA-BC, FACHE, FAHA, FAEN [email protected] or Kathryn C. Whalen, DNP, MSN, RN, FAHA [email protected]

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