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Critical Care Course for Senior Level BSN Nurses

Elizabeth Greger

Grand Canyon University

Nur-647E Nursing Education Seminar 1

Dr. Lyn Cain

August 17, 2021

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Critical Care Course for Senior Level BSN Nurses

Introduction

Many graduate nurses are entering the job force in specialized units, such as the intensive

care unit, but lack knowledge that is needed for the care of critical patients. Universities are

limited in the amount of time needed to educate students on more specialized care, so hospitals

are met with the responsibility to continue graduate nurses’ education with classroom and hands

on skill instruction. In an effort to prepare senior level nursing students for their job in specific

patient care, university professors are beginning to offer additional courses for those who want to

specialize in an area of their choice. This paper will discuss a course offered at Grand Canyon

University in basic intensive care (critical thinking, pulmonary conditions, cardiac care, and

critical neurological assessment skills) for senior level baccalaureate nurses using both lecture

instruction and clinical instruction in an effort to prepare them for their first job in an intensive

care unit.

Course Description

Basic critical care knowledge used in the care of all critical patients includes signs and

symptoms in pulmonary, cardiac, and neurological body systems, as well as critical care thinking

used to quickly recognize, diagnose, and treat a deteriorating patient. This course will be divided

into four hour-long sessions that would begin with a power point lecture that covers highlights of

a body system before the students are divided into smaller groups for role play and learning

activities. The power point lecture notes would include take-home diagrams and detailed

instructions on how to apply different monitors and equipment used in the intensive care unit.

Individual hands-on instruction would give each student an opportunity to apply the new

knowledge so they would be prepared to use it at the bedside. Studies have shown that most
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people are visual or kinesthetic learners and would respond well to this type of instruction

(Chetty, Handayani, Sahabudin, Ali, Hamzah, Rahman, & Kasim, 2019). Using the equipment

would improve information retention so nurses would be ready for independent patient care.

Grand Canyon University

Grand Canyon University incorporates their Christian worldview into every degree

curriculum so their graduates will gain the skills, knowledge, and values-based foundation to

conduct GCU's mission of preparing learners to become global citizens, critical thinkers,

effective communicators, and responsible leaders (Grand Canyon University, 2021). Their

values-oriented learning experiences help students develop into empowered graduates who are

prepared to lead and serve in the local and global community (Grand Canyon University, 2021).

Nurses who have an influential level of Christian values and knowledge will seek ways to share

meaningful and effective care at the bedside to improve patient outcomes. This course will

include the values used at Grand Canyon University so nursing students can gain new knowledge

of patient illnesses and care and apply it in their career, thereby spreading the Christian

worldview.

Needs Assessment

Transitioning into critical care areas for new graduate nurses may be more difficult

than transitioning into other areas due to the degree of specialized knowledge needed (Innes

& Callja 2018). Research indicated that a theory-practice gap is evident in role-related

knowledge, skills and clinical thinking, and that reality shock occurs as new graduates enter the

nursing workplace (Innes & Calleja, 2018). Aspects that would improve novice nurses’

competence and confidence included having a designated resource person, knowledge and

skill instruction, and orientation to unit routine (Innes & Callja, 2018). Research also
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demonstrated a theory-practice gap and patient safety risk, which means there is an

imperative need to provide support to graduates during the first year of practice to build

relationships that increase their patient care capacity, confidence, competence, job

satisfaction, and retention rates (Innes & Callja, 2018). Beginning critical care instruction

(such as this course) during the last year of baccalaureate degree plans would provide a

foundation for further on-the-job instruction and hopefully improve all of these aspects.

Course Description

Nursing students need both practical disease knowledge and clinical skills to provide

competent patient care. This course, provided through Grand Canyon University, would

provide both levels of advanced knowledge in cardiac, pulmonary, neurological, and critical

thinking. Each session will teach a different topic – cardiac monitoring and emergencies

(CPR, heart rhythms, and low or high blood pressure issues), pulmonary monitoring and

emergencies (lung sounds, blood gas levels, and oxygen delivery equipment), neurological

assessment (stroke assessment scales, and seizure treatment), and critical thinking (detecting

subtle changes in patient condition and analyzing interventions to prevent further

deterioration). Each session will begin with a power point that explains critical patient

emergencies and how to treat them. Then the students will participate in clinical type stations

that have the equipment used for that system. The cardiac session will have a cardiac monitor

with ECG strips to identify and different lethal arrhythmias that need emergent defibrillation

and medication. The students would practice applying ECG leads and using the defibrillator.

The pulmonary session would have different oxygen equipment, monitors used to assess

oxygen levels, and stethoscopes to listen to different simulated lungs sounds. The

neurological session would have interactive e-learning that provides stroke assessment skills
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and stations to practice those assessments on each other. The course will conclude with

critical thinking because it is used in every aspect of intensive nursing care. Critical thinking

is a learned skill. Even though health care is considered a scientific discipline with set

processes covering almost every step of patient care, there are still instances that require

nurses to formulate new plans derived from critical thinking (Luna, 2021). Novice nurses

need practice and tips on how to use critical thinking so this session would have different

stations with scenarios that require the students to identify things that need critical thinking

and treatment.

Target Audience

The target audience for this course will be baccalaureate nursing students in their last

year of study. Not all students would be required to participate, but the course would be one

of a group of courses offered to students who want to specialize after graduation. This course

would give students an opportunity to experience specific patient care in an effort to help

them decide where they would want to work after graduation.

Learner Resources

Resources used in this course would include the power point notes, diagrams and

instructions on how to use the different equipment, and links to different e-learning used in

the sessions. During the hands-on learning stations, critical care nurse from local hospitals

would instruct the students at each station and be available for any questions the students

may have. Interacting with an experienced nurse would help the students recognize similar

characteristics in themselves, which would help them decide if critical patient care would be

something they want to pursue.

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Program Outcomes and Their Justification

The intended outcome of any education course is to increase the students’ knowledge of

disease treatment and patient care, which improves the patient’s outcome. The cognitive learning

domain is used in this instruction as the student learns new knowledge, applies it to hands-on

clinical skills, and evaluates the effectiveness of the learning (Ruhl, 2021). This course will help

achieve this by providing advanced knowledge in critical patient care and skills through various

strategies including simulation, repetition of skills, and competency-based learning. Research has

shown that these strategies have a positive influence on competence, confidence, and transition;

and structured orientation programs are beneficial to transition, despite diverse delivery methods

and time periods (Innes & Calleja, 2018). During formal education, teachers should use every

opportunity to help nursing students reach their full potential so they are effective nurses in every

situation.

Conclusion

Nursing students learn so much information during their years of baccalaureate

education, but their learning should not end after graduation. This beginning critical care course

would be an important first step in recognizing the needs of critically ill patients, even though it

does not provide very much information. It will also provide a small insight into the knowledge

used in critical patient care. Offering this before graduation would provide the student an

understanding of what would be necessary to become a critical care nurse before they accept

their first job.

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References

Chetty, N. D. S., Handayani, L., Sahabudin, N. A., Ali, Z., Hamzah, N., Rahman, N. S. A., &

Kasim, S. (2019). Learning styles and teaching styles determine students’ academic

performances. International Journal of Evaluation and Research in Education, 8(4),

610–615. https://files.eric.ed.gov/fulltext/EJ1238274.pdf

Grand Canyon University, (2021), Christian Identity and Mission, Grand Canyon University,

https://www.gcu.edu/why-gcu/christian-identity-and-mission

Innes, T., & Calleja, P. (2018). Transition support for new graduate and novice nurses in critical

care settings: An integrative review of the literature. Nurse Education in Practice, 30,

62–72. https://doi.org/10.1016/j.nepr.2018.03.001

Luna, A., (2021). 7 Reason critical thinking in nursing is important. Onward Healthcare.

https://www.onwardhealthcare.com/nursing-resources/seven-reasons-critical-thinking-in-

nursing-is-important/

Ruhl, C., (2021). Bloom’s taxonomy of learning. Simply Psychology,

https://www.simplypsychology.org/blooms-taxonomy.html