EMERGENCY DEPARTMENT NEW GRADUATE RN
ORIENTATION 2009 PLAN
WEEK 1: 9/14-9/18
BPO 9/14
PCO 9/15-9/17
First Net Training 9/18 0730-1300-Stephanie and Maggie
LIFT Training 1400-1600-NMH
OBJECTIVES/GOALS:
 Successfully log-in and navigate First Net
o Quick reg.
o Complete RN assessment
o Complete triage form
o Document information in I-VIEW
o Document I&O
o Order a medication
o Document medication on MAR
o Order a diagnostic test
o Order lab tests
o Complete pre-arrival note
o Complete depart process
o Document restraints
o Move pt from triage to bed and/or bed to hall
o Assign/unassign self to patient
o Provider check-in/check-out
o Identify medical staff caring for patient
WEEK 2: 9/21-9/25
9/22 0730-1600 with Stephanie and Maggie
Assign locker
Ensure access to e-mail/ENA online modules/ELM/trauma pyxis
Meet and greet with ED Management team
Management paperwork
Review of EMTALA
ED Hierarchy/chain-of-command
Documentation standards
Find NMH policies on intranet
Bedside waive testing
Glucometer competency
Tour of ED areas
Patient Rounding
BKAT
Basic Arrhythmias on-line course
OBJECTIVES/GOALS:










Complete BS waive/glucometer competency
Log-in to email/NM Connect/ENA
Find and open locker
Meet management and complete paperwork
Verbalize overview and understanding of EMTALA
Verbalize proper RN documentation standards and location of
policy
Be able to locate policies on the intranet
Verbalize key concepts of pt rounding
Complete BKAT
Complete Basic Arrhythmias on-line course
9/23 0730-2000:
Cardiac A&P/CAD/MI/activation of cath lab-lecture by Shana Kusin,
MD
Review and practice with Lifepak 20 (including pacing and defib),
DASH, Marquette, transvenous pacer, rhythms-Stephanie and Maggie
Written case scenarios/role play: What do we do?-Stephanie and
Maggie
o CP
o STEMI/cath lab
o VF/pulseless VT-defib
o SVT
o 3rd degree
Rhythm strips written test-Stephanie and Maggie
Critical Blood Loss protocol-Stephanie and Maggie
Attend Blood Administration class 1330-1430-NMH
OBJECTIVES/GOALS:
 Review structures/functions of the cardiac system
 Review principles of circulation
 Review electrical conduction of the heart
 Describe normal values for P, QRS, ST
 Review NSR, ST, SVT, VF, VT, Junctional rhythms, AV blocks, asystole,
PEA, paced rhythms
 Review the 4 P’s of arterial occlusion
 Review techniques for assessing non-invasive BP/orthostatics/ABI’s
 Review tests for assessing the cardiovascular system
 Review characteristics of cardiac cells-automaticity, excitability,
conductivity, contractility
 Review proper electrode placement for cardiac monitoring
 Review responses to symptomatic arrhythmias
 Be able to ID rhythms on telemetry monitor
 Review components of DASH/Marquette/Lifepak monitors
 Differentiate angina vs MI









Review risk factors associated with CAD
Verbalize management of angina and MI
Demonstrate cardiac assessment
Demonstrate use of transvenous pacer, pacer function on Lifepak, defib
function on Lifepak, cardioversion function on Lifepak
Verbalize indications and procedure for sending patient to cath lab
Attend blood administration class
Verbalize process for ordering/drawing/sending blood bank specimen
Recognize indications to initiate Critical Blood Loss protocol, locate fridge
Review and be able to locate Blood Administration Policy
9/24 0730-2000
Utilize CCI equipment to review, demo and return demo venipuncture, PIV
insertion, collection of blood cultures, insertion of foley and straight cathsStephanie and Maggie
Practice skills above in ED-Stephanie and Maggie
4 hours to complete ENA modules
GOALS/OBJECTIVES:
 Demonstrate proper technique to obtain specimen by venipuncture,
collection of blood cultures, PIV insertion, insertion of foley/straight
cath (using sterile technique)
 Complete assigned ENA modules
9/25
0730-1600 with Stephanie and Maggie
Review of most commonly used meds in ED
Review 7 rights of med administration
Review RN resources for med questions
Practice hanging IV medications, IVFs, administering IVP and PO meds
on unit (include reassessment of efficacy of meds, side effects, monitoring)
Re-cap of the week: any questions???
Discuss journaling expectations
OBJECTIVES/GOALS:
 Check for med order
 Identifiy patient prior to administration
 Verbalize 7 rights: med, dose, route, time, indication, patient,
documentation
 ID high risk meds
 Verify order and document on MAR
 Access resources for med questions
 Demonstrate correct technique for administration of IV
meds/fluids/IVP/PO
 Demonstrate proper monitoring of patient during and after med
administration

Re-assess effectiveness/SE of med given
WEEK 3: 9/28-10/2
9/28 0730-2000
Pulmonary A&P/CHF/Pulmonary edema/PE/pleural effusion lectureJeremy Branzetti MD
Asthma/status asthmaticus/ARDS lecture-Katrina Leone MD
Review of airway equipment/oxygen devices-Stephanie and Maggie
4 hours ENA online modules
OBJECTIVES/GOALS:
 Review CHF/Pulmonary edema/PE/pleural effusion/ Asthma/status
asthmaticus/ARDS/pulm A&P
 Locate intubation supplies, difficult airway cart
 Discuss indications for intubation
 Review documentation during intubation
 Identify and apply different oxygen delivery systems
 Perform a pulmonary physical assessment
 Complete assigned ENA online modules
9/29 0730-2000
Shadow RT for 4 hours
COSMO 1230-1530
Craig Leonard RT-o2 devices/scenario
Linda Morris APN-trach scenario
Debriefing-Stephanie and Maggie
Case studies: ACLS rhythms
OBJECTIVES/GOALS:
 ***NEED TO REVIEW SCENARIOS WITH LINDA AND CRAIG***
9/30 0730-1600
8 hours on unit with preceptor
OBJECTIVES/GOALS:
 Refer to Skills Matrix
10/1 0730-1600
Vents/trachs/ABGs/capnography lecture-Linda Morris APN
Utilize CCI/HFE equipment to demo and return demo of pulm assessment,
care of pt with a chest tube- Stephanie and Maggie
RSI lecture- Stephanie and Maggie
Go to CTICU/11W to assess pts with CT’s-Stephanie and Maggie
Debriefing/journal review/discussion-Stephanie and Maggie
OBJECTIVES/GOALS:









Review eval of blood gas results
Demonstrate capnography
Purpose of commonly used vent modes
Review RN management of pt on a vent
Review components of chest drainage system
Locate equipment needed for CT insertion
Locate RSI boxes
Verbalize meds/doses for RSI
Verbalize indications/exclusions for RSI
WEEK 4: 10/5-10/9
10/5 0730-2000
Sepsis lecture-Matt Pirotte MD
Hemodynamics lecture-Stephanie and Maggie
Utilize CCI/HFE equipment to review CVP/art line/ports/PICCs- Stephanie
and Maggie
4 hours ENA online modules
OBJECTIVES/GOALS:
 Complete assigned ENA online modules
 Review sepsis-RN treatment
 Demonstrate proper equipment set-up for CVP/art line
 Demonstrate proper technique for accessing a
portacath/administering medication
 Demonstrate proper technique for blood draw from a
PICC/administering medication
10/6 0730-1600
Stoke/induced hypothermia lecture-Deb Bergman APN
Spinal Cord/seizure lecture-TBA
Indications/application of Ccollar-Stephanie and Maggie
NICU 0730-1030 to assess neuro patients-Janet Palamone SE/Matt Groth
SE
OBJECTIVES/GOALS:
 Review stroke/induced hypothermia
 Complete neuro assessment on a patient in NICU
 Verbalize determining level of consciousness and how to document
 Review types of intracranial bleeds
 Review factors that increase ICP
 Review initial responses to stroke and seizure
 Review meds to treat stroke and seizure
 Verbalize indications for placing a Ccollar


Demonstrate proper application of a Ccollar
Review types of SCI
10/7, 10/8 10/9: 2 days: 1x12 and 1x8 on unit with preceptor
OBJECTIVES/GOALS:
 Refer to Skills Matrix
WEEK 5: 10/12-10/16
10/12 0800-1630
DKA/insulin therapy-Kori Sauser MD
GI A&P/GIB/SBO/Diverticulitis/Ischemic bowel/Appe lecture-Cynthia
Galvan MD
GI assessment-Stephanie and Maggie
CT prep-Stephanie and Maggie
NGT placement/lavage-Stephanie and Maggie
1430-1530 COSMO ACLS scenarios-Stephanie and Maggie
Debriefing of COSMO-Stephanie and Maggie
OBJECTIVES/GOALS:
 Review DKA and treatment
 Review types of insulin
 Review RN treatment of SBO/GIB/diverticulitis/appe/ischemic
bowel
 Demonstrate GI assessment
 Demonstrate proper placement of NGT, concepts of NG lavage
10/13 0800-1630
Renal A&P/kidney stones/types of dialysis lecture-Eunice Park MD
Multi-system Jeopardy-Stephanie and Maggie
1430-1530 COSMO ACLS scenarios-Stephanie and Maggie
Rhythm strip test-Stephanie and Maggie
Debriefing of COSMO-Stephanie and Maggie
OBJECTIVES/GOALS:
 Review structure and functions of the kidney
 Review differences between filtration, reabsorption, secretion,
excretion
 Review etiologies/patho of renal failure
 Review impact of RF on other body systems
 Review S&S leading to abnormal levels of K/Ca/Mg
 Complete rhythm strip test
 Review RN management of the kidney stone pt

Participate in Jeopardy
10/14 0800-1000 sickle cell lecture-Paula Tanabe, PhD, MPH
10/14, 10/15, 10/16: 2 days: 2x12s (including 4 hours off unit to complete ENA
online modules) on unit with preceptor
OBJECTIVES/GOALS:
 Refer to Skills Matrix
 Complete assigned ENA online modules
 Be able to locate sickle cell flowsheet
 Review of sickle cell protocol
WEEK 6: 10/19-10/23
10/19 0730-1600
SA/psych/disaster/team 4/ob/eent lectures-Stephanie and Maggie
OBJECTIVES/GOALS:
 Verbalize location of SA supplies
 Review evidence collection/handoff/dc
 Review criteria for security standby
 Review components of medical clearance
 Review disaster/hazmat/bioterrorism response
 Locate decon supplies
 Locate ED disaster preparedness plan (binder or online)
 Locate OB Doppler
 Demonstrate obtaining FHTs
 Locate OB equipment in trauma room
 Verbalize notification of neonatal resusc. team
 Demonstrate application of splint, sling, knee immobilizer, aircast,
cane/crutch teaching
 Verbalize where to find Td and documentation/indication
 Locate dental box, pH paper, tetracaine, cautery, morgan lens
 Review application of morgan lens
10/20, 10/21, 10/22, 10/23: 2 days: 1x8 and 2x12 (including 4 hours off unit time
to complete ENA online modules)
GOALS/OBJECTIVES:
 Refer to Skills Matrix
 Complete assigned ENA online modules
WEEK 7: 10/26-10/30
10/26 0730-1600
Pediatrics lecture-Stephanie and Maggie
Trauma lecture/equipment-Stephanie and Maggie/Jeff Pastoral RN
OBJECTIVES/GOALS:
 Locate Broselow cart
 Locate PEDS cart
 Locate LET
 Review pediatric assessment
 Review FACES/FLACC
 Locate and verbalize level 1 vs level 2 trauma criteria
 Review trauma documentation
 Verbalize RN care of the trauma patient
10/27, 10/28, 10/29, 10/30: 2 days: 1x8 and 2x12 (including 4 hours off unit time
to complete ENA online modules) on unit with preceptor
OBJECTIVES/GOALS:
 Refer to Skills Matrix
 Complete assigned ENA online modules
WEEKS: 8-16 11/2-12/25
HAZMAT week of 11/2-dates/times TBA-Deb Bergander
2X8 and 2x12 each week on unit with assigned preceptor (including 4 hours off
unit time each week to complete ENA online modules-until all are complete)
Debriefing e.o. week (weeks 8,10,12,14,16) for 1 hour
GOALS/OBJECTIVES:
 Refer to Skills Matrix
 Complete assigned ENA online modules