The Science Journal of the American Association for Respiratory Care

2003 OPEN FORUM Abstracts

THE DEVELOPMENT AND PRELIMINARY OUTCOME OF AN NICU PRECEPTORSHIP PROGRAM FOR NEW RESPIRATORY THERAPY GRADUATES.

Melissa K. Brown RRT-NPS, Sharp Mary Birch Hospital for Women, San Diego, California. Grossmont Community College, El Cajon. Ca.

 
Background:
Sharp Mary Birch Hospital for Women is a large free standing women's center with a 60 bed level III NICU and over 8,000 births a year. There is an acute shortage of neonatal respiratory therapists in the San Diego area. Due to the high cost of living in the San Diego area recruitment of experienced respiratory therapists from other locations is difficult. Other area hospitals that have neonatal/pediatric specific departments also offer superior pay and receive the bulk of qualified clinicians in the area. Respiratory services for the Mary Birch NICU are contracted through a neighboring sister adult acute care hospital. The primary method of obtaining new NICU respiratory therapists was to train respiratory therapists currently practicing in the adult ICU of our sister facility. This practice led to a non-stop orientation cycle as well as the constant draining of the most highly skilled adult practitioners to the NICU. Another problem was the local community college that provided the majority of respiratory therapists for local hospitals currently had no neonatal clinical rotation in their curriculum.

Program Development and Design:
Contact was made with the local respiratory therapy program and all second year respiratory therapy students were scheduled for an 8 week rotation through the Mary Birch NICU. The college already offered an excellent semester long didactic course in neonatal pediatric respiratory care, but it was not offered until the second year of study. Very limited neonatal equipment was taught or available in the student's laboratory on campus. These circumstances would put students in the NICU clinical environment without proper preparation. The community college moved the timing of the neonatal pediatric course from the second to the first year of instruction. And the most widely used neonatal ventilator was purchased for the student's equipment laboratory. To assure students were prepared to begin the hands-5on portion of their neonatal rotation, 20 hours didactic instruction was provided on site, by the hospital's NICU clinical specialist and the colleges clinical instructor, during the first two weeks of the rotation. At the end of the year, two new graduate respiratory therapists, who excelled during their NICU rotation, were hired for full-time employment at Mary Birch NICU. They were placed on day shift for six months with an assigned, single preceptor whose schedule they mirrored, with the agreement; they were to successfully complete all entry- level competencies by the time of their 30- day evaluation. They were provided a 30- day orientation, containing both didactic and patient care assignments and the presence of a preceptor resource in the unit with them at all times.

Program Outcome:
The two new graduates successfully completely their 30, 60 and 90 days evaluations and subsequently completed training in advanced skills such as high frequency ventilation and Nitric Oxide administration. After 6 months they were released from their preceptors and joined an assigned shift. The two new graduate RT's have successfully completed their first year at Mary Birch as valued contributing members of the NICU respiratory therapy staff.

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