How to improve the operating skills of junior nurses quickly and effectively

The emergency ability of nurses refers to the ability of nurses to observe the changes of patients' condition keenly, analyze and judge them, and calmly and decisively cooperate with rescue and nursing with skilled skills. In the increasing number of medical disputes, the problems of nursing safety management are increasingly prominent, especially the problems involving nurses' emergency ability in clinical emergencies account for a large proportion. Nurses who have worked for less than 5 years are defined as junior nurses because of their short working hours and relatively insufficient work experience. Junior nurses are the most prone to nursing defects. According to literature reports, the nursing defects of junior qualified nurses who have worked for less than 6 years account for 54% of all nurses, and the nursing defects caused by insufficient first aid ability account for a considerable proportion.

In recent years, due to the opening of a new ward building in a hospital, the increase of inpatient beds and the expansion of ward scale, junior nurses have become an indispensable force among hospital nurses. However, nursing first aid skills are less trained in schools and internships. Therefore, the hospital nursing department regards improving the emergency ability of junior nurses as one of the important contents in nursing management, and has carried out systematic emergency ability training for junior nurses, which has improved their ability to deal with emergencies and achieved good results. The report is as follows.

1 problems of junior nurses

1. 1 Lack of clinical experience and limited comprehensive emergency response capability. Because junior nurses do not have a solid grasp of theoretical knowledge, especially the relative lack of professional theoretical knowledge, lack of clinical work experience, limited nursing observation ability and professional ability, poor psychological quality, insufficient attention to ward emergencies, and weak sense of crisis, it is easy to cause nursing error risks and medical disputes.

1.2 There is a general lack of emergency knowledge and ability in wards. Through years of clinical observation, it is found that junior nurses generally lack the first aid knowledge of ward emergencies, and they are often helpless in the face of emergencies and emergency nursing problems, and they do not know how to deal with them, which may easily lead to nursing safety hazards.

1.3 Poor self-discipline, weak sense of responsibility, lax work attitude, muddling along at work and coping with things. Junior nurses lack a sense of responsibility for their work. They can observe the patient's condition at a glance, and have poor judgment on the progress, outcome and prognosis of the disease, so they are lucky. Seldom actively learn emergency knowledge and skills, but only passively learn and respond when things happen.

2 training methods

2. 1 Implement graded training

The standardized training plan is formulated by the nursing department and distributed to all subjects together with the standardized training manual. Implement the three-level training mode of nursing department-intensive care professional group-department training. The nursing department is in charge of standardized training for junior nurses, and is responsible for formulating training plans and training evaluation standards; At the same time, the case analysis of medical accidents and medical disputes is strengthened in teaching, so that junior nurses can consciously regulate their words and deeds with laws and regulations, enhance their legal awareness, strengthen their study of legal knowledge, and strengthen their legal awareness and service awareness. The professional study group consists of 3-5 senior head nurses in critical illness and corresponding specialized nurses, and is responsible for the training of first aid knowledge in clinical nursing, first aid theoretical knowledge in general wards, communication skills and common first aid instruments.

Training on the operation procedures, dosage forms, pharmacological effects, precautions, incompatibility and adverse reactions of commonly used rescue drugs; The department training group consists of 2-3 technical backbones with the title of nurse or above, with the head nurse as the team leader, focusing on cultivating the ability to observe the condition (active patrol, patient listening, grasping the main points of observation, correct observation methods, accurate assessment of the condition, asking for instructions in time when problems are found, and timely and accurate recording) and the ability to cooperate with rescue (complete preparation of first-aid articles, rapid operation specifications, accurate dosage and usage of first-aid drugs, emotional stability, calm response, rescue procedures, etc.). At the same time, he is responsible for the first aid process, theoretical knowledge training and nursing technology operation training of common critical diseases in various specialties.

2.2 training form

2.2. 1 adopt centralized teaching and step-by-step training to combine scenario demonstration, simulation training and clinical practice. In the nursing demonstration classroom, let every junior nurse play the leading role in the drill, conduct group scene demonstration and simulation training on the emergency process (procedure) of ward emergencies, experience every link of the rescue process personally, deepen the impression, deepen the perceptual knowledge and enhance the sense of responsibility, so as to improve the ability to deal with nursing emergencies, handle emergencies and protect themselves.

2.2.2 Enter the emergency room and ICU in stages for rotation to improve the skills of analysis, judgment and rescue. Emergency room and ICU are places where acute, dangerous and serious patients are concentrated. The patient's condition is complex and changes rapidly, and all kinds of rescue instruments and equipment are complete. Let junior nurses enter the emergency room or ICU in batches for rotation, so that junior nurses have more opportunities to participate in the rescue of various critically ill patients, master the rescue procedures of diseases, and master the use of various instruments and equipment. After each rescue, they are required to review the details, find out the shortcomings, analyze the reasons, sum up the experience and lessons, and the teacher will explain the key steps and precautions. At the same time, organize critical cases and case discussions. Through the participation and reflection of rescue, we will constantly accumulate experience. Before the end of the rotation, the head nurse and the teaching teacher will organize the examination, and the students can leave the department only after reaching the standard. Through the rotation of emergency room and ICU, the ability of junior nurses to find, analyze and solve problems is gradually improved.

2.3 Evaluation method

2.3. 1 formulate unified standards and detailed rules. The nursing department and the professional study group adopt scenario simulation assessment, and draw lots to decide the assessment scenario, mainly to assess the adaptability, mastery of the process, first aid coordination ability and intensive care record writing ability of nurses. Combining theory with practice, the assessment score of more than 90 points is qualified. If the assessment is not up to standard, the emergency training team of the department will strengthen training and make-up exams, requiring everyone to pass the exam.

2.3.2 The head nurses of all departments review and consolidate the first-aid knowledge by asking questions in the morning meeting, and master the first-aid knowledge skillfully. At the same time, organize junior nurses to carry out bedside nursing rounds and put forward enlightening questions, so that they can master the key points and comprehensive observation ability. Effectively improve the on-site emergency response capability.

3 Conclusion

The emergency ability of nurses is one of the important indexes to measure the quality of nursing connotation. Preventing nursing risks and nurse-patient disputes is an important content of hospital nursing management, and controlling or reducing disputes is also an important standard to reflect the level and quality of nursing management. Wang et al. investigated the training content needs of 288 junior nurses. The results showed that the training of nursing first aid skills was most recognized by junior nurses, accounting for 83.7%. It can be seen that junior nurses themselves have a considerable desire for first aid training. By adopting effective training methods, the hospital nursing department strengthens the training of junior nurses' emergency ability, helps them to analyze the shortcomings in emergency coordination, enhances their legal awareness and self-protection awareness, urges them to constantly learn new nursing knowledge and skills, improves their own technical level and ability to observe and solve problems, and improves their analysis, judgment and decisive decision-making ability in emergency environment, which is recognized by junior nurses and clinicians, ensures the safety of clinical nursing work and improves the nursing level.