BCEN's 2020 Distinguished CEN Award winner Jude Lark discusses how certified nurses have innovated during the pandemic and how hospital and nurse leaders can help them succeed.
The COVID-19 pandemic has challenged healthcare workers these past months like no other time in recent history but certified emergency nurses (CENs) rose to the occasion, according to Jude Lark, BSN, RN, CEN, CCRN, emergency services clinical nurse educator at Atlantic Health System’s Overlook Medical Center in Summit, New Jersey.
"I believe our certified nurses came through strong. They utilized their knowledge of best practices and skills to help us facilitate and drive new, innovative ways to care for our COVID patients and each other," says Lark, who was recently named the Board of Certification for Emergency Nursing's (BCEN) 2020 Distinguished CEN Award winner.
Due to their nature, CENs have a higher level of competency and knowledge, Lark says, and they have been providing the emergency department with the expertise and the ability to adapt and drive necessary changes for the patients, staff, and the community to deliver quality and safe care during a challenging time.
CENs as Innovators
A challenge faced by emergency departments during the pandemic is safely triaging a high volume of patients who may be infected. "Right from the get-go, we had heard that we needed to become prepared. And then the patients came in one by one and then one by 100, so we had to learn as we went and teach as we went," Lark says.
In responses, Overlook Medical Center changed its triaging process, with a screener and a nurse stationed outside to screen patients for COVID-19 symptoms then appropriately place them in the department, she says. Next came figuring out how to handle the high volume and acuity of the COVID-19 patients, which necessitated setting up tents.
Staff would also need to be trained on using powered air purifying respirators (PAPRs), which no one in the department had used before, Lark says. "So, we created a video. I used physicians that came in on a Saturday and filmed the process of donning and doffing the PAPRs so that you could properly protect yourself when you're intubating or doing any aerosolization-type of process. You need to protect yourself and the rest of the community by wearing the PAPRs."
How nurses responded to codes also had to be redesigned to avoid possibly contaminating crash carts, Lark says. To avoid bringing the crash cart into a patient's room, grab-and-go bags were made so a staff member could remain outside the room and quickly hand them to someone inside. To communicate with colleagues outside the patient's room, staff members inside the room used dry erase markers to write on the windows to minimize opening and closing the door.
Help CENs Succeed
Even before the pandemic, Lark says CENs were stepping up and taking an active role as leaders due to a strong focus on shared governance at Overlook Medical Center and Atlantic Health System. CENs serve on system governance committees as well as site-specific committees that address quality, practice, professional development, and research.
Leveraging the knowledge and expertise of CENs, the health system, including the emergency department educators, developed its first emergency residency program for nurses over the past year. According to Lark, the first group of 10 emergency department nurses are set to graduate next month. "We're very excited about this type of a program that will lead to improved learning, education, critical thinking, retention, and certification."
Lark credits Overlook Medical Center with creating an environment in which CENs are encouraged to succeed and thrive through promotion of professional development and certification. "Whether you are a hospital leader or a nurse leader, promotion of [professional development] goes a long way," Lark says. For example, Overlook has provided annual certification review courses for the staff. Nurses from other health systems in the tri-state area are invited to join the review courses.
In June, Overlook held a two-day certification course with Jeff Solheim. Since then, five nurses have become certified and seven more are scheduled to sit for the exam before the end of the year, Lark says.
"It takes a leadership group to stay on track, to drive and maintain positive encouragement toward certification. The hospital must say it stands behind you and will reimburse you for everything that you're going through to become certified," she adds.
The Future of CENs
Lark predicts younger nurses and new graduates from residency nursing programs will seek out certification earlier in their careers and, as a result, their clinical abilities at the bedside will improve as the years go by.
While the pandemic has been a trying time for all healthcare workers, Lark says now is the time to regroup and reenergize nurses' passion and drive toward certification.
"I think [certification] does excite the team. It excites the newer nurses and I see more advancement in certified nurses—a higher percentage, certainly—across the country," Lark says. "I see more residency programs across the country because we're finding that this is a better way to educate that new graduate coming out of school. I believe that's part of our future."
Certified nurses are using their knowledge and expertise to innovate patient care during the pandemic.
Promote professional development to encourage nurses to seek certification and take a more active role in leadership.