Learning Concepts	Adaptations
Life experiences	Incorporate personal experience into learning experience
Learning new material	Make information relevant to learner
Physical comfort	Minimize physical distractions
Anxiety	Acknowledge and provide support to reduce learner’s anxiety and fear
Problem-centered	Assist learner to recognize problem and find solutions
Information recall	Use short words and sentences, incorporate repetition, give goal-related suggestions, provide concrete and specific statements

II. PROFESSIONAL EDUCATION

A. Emergency Nursing Knowledge Base

1. Multifactorial aspects

a. Essential clinical nursing knowledge

1) Composite of medical specialties, population groups, and flow of patient care (Table 41-2)

2) Integration of episodic outpatient and inpatient care

b. Public relation requirements

1) Proficiency in public relations and customer service techniques

2) Effective interfacing with prehospital care providers (e.g., emergency medical technicians [EMTs], paramedics, firefighters, and law enforcement officers)

3) Skill in activation and implementation of hospital and community disaster management

2. Work environment conditions

a. High-stress area

b. Unexpected workload increases/decreases

c. Teamwork approach

d. Ability to transition rapidly between primary and team nursing

e. Requires mastery of emergency technology and equipment use

f. Patients represent a microcosm of general population at large, including existence of violent situations

g. Incorporates utilization of telecommunication skills

Table 41-2 EMERGENCY NURSING KNOWLEDGE COMPOSITE

Specialty Knowledge	Population Groups	Flow of Patient Care
Cardiology Disaster preparedness and response Hazardous materials Infectious diseases Internal medicine Legal and regulatory requirements Obstetrics Oncology Orthopedics Psychiatry Trauma Wellness, safety, and prevention	Newborns, neonates Infants, toddlers School-aged children Adolescents Adults Older adults Generational: 1. Traditionalist 2. Baby Boomer 3. Generation X 4. Millennial Culture and ethnicity Special needs	Initial patient triage Initiation of lifesaving interventions Diagnostic testing Continual interventions and patient evaluation Patient discharge and teaching Patient admission/transfer

B. Learning Facilitator Roles

1. Clinical nurse specialist

a. Educator

1) Serves as resource to staff, nursing students, and other health care personnel in the acquisition of knowledge and skills related to nursing practice

b. Consultant

1) Collaborates with clinical nurses and other members of the health care team to resolve complex clinical situations for specialty needs of emergency patients

c. Researcher

1) Critically analyzes current nursing research and disseminates relevant findings to improve patient care and patient outcomes

2) Facilitates and/or conducts nursing research

3) Teaches personnel how to evaluate nursing research

4) Implements evidence-based practice model in the emergency department

d. Clinical expert

1) Models excellence in emergency nursing practice through use of assessment, planning, implementation, and evaluation

2) Assists and provides direction to nursing personnel with clinical decision-making, priority setting, stabilization, and resuscitation

2. Nurse educator

a. Organizes and implements orientation and competency-based educational programs

b. Assesses educational needs of personnel

c. Develops, executes, and evaluates educational programs for nursing personnel

d. Serves as clinical resource

3. Nurse preceptor

a. Experienced nurse with training in orientation and precepting new personnel

b. Assignment usually for a fixed or limited time

c. Focuses on unit-specific orientation to policies, procedures, and protocols

d. Facilitates socialization into department

e. Acts as role model and clinical resource

4. Nurse administrator/manager

a. Develops and nurtures ongoing learning culture and environment within the department

b. Supports and encourages involvement of personnel in education process within the department

c. Organizes committees and projects that support education

d. Holds personnel accountable for complying with educational requirements of department

e. Provides appropriate resources for departmental education programs

C. Department Orientation

1. Purpose

a. Introduce new employee to emergency care environment

b. Evaluate new employee’s knowledge and skill level

c. Determine new employee’s educational needs in order to attain role competence

2. Overall requirements

a. Review of specific institutional policies and procedures

b. Review of department’s standards of care

c. Assessment of skill proficiencies with return demonstration

3. Program types

a. Preceptor-sponsored: a preceptor is a specially trained nurse who serves as a role model and resource person for new employees

b. Modularized education: self-instructional orientation program

c. Competency assessment program (CAP) (Table 41-3 and Fig. 41-1)

1) Available through ENA

2) Copies of all competencies should be available within department for use as reference and review

3) Competencies should complement and correlate with department’s ongoing quality improvement program

4) May utilize individual, self-learning modules

Table 41-3 COMPETENCY ASSESSMENT PROGRAM

FIGURE 41-1 Performance criteria. Orthostatic vital signs.

(From Emergency Nurses Association. [2000]. Orientation to emergency nursing: Concepts, competencies, and critical thinking [2nd ed.]. Des Plaines, IL: Emergency Nurses Association.)