At the end of last year, my terrific former boss, Regina Phelps, invited me to meet and teach a new group in New York at the United Health Services Hospitals. One of those creative educators, Bernadette (Bernie) Fabrizio, MEd, RN ([email protected]), cardiology educator, performance improvement coordinator, shares an idea and its inspiration below. Thanks, Bernie!

Keep it short and simple-don't you wish everyone would?

In 20 years of bedside patient care, many times I went home tired, but I had no idea that the role of nursing educator would test my stamina and endurance. Staff development and continuing education require a mastery of complex and multifaceted skills. Until I began to study for American Nurses Credentialing Center (ANCC) Board Certification in Professional Nursing Development, I did not really understand what a complex feat of mental gymnastics my practice had become.

The American Nurses Association (ANA) (2000) identified a number of roles necessary to meet professional nursing development standards: change agent, consultant, educator, facilitator, leader, and researcher. I realize now that educators are expected to wear many hats each and every day! These hats are now firmly integrated into my practice. When planning a project, I look at the task from the perspective of each "hat" and try to "keep it short and simple."

Cardiopulmonary resuscitation (CPR) is a basic competency performed by professionals and lay rescuers across the country. Recently, a need to improve documentation about these emergency events was identified. The change agent, consultant, educator, facilitator, leader, and researcher met on the night shift during a late-winter snowstorm. Historically, this team does its best work during the wee hours of the morning. The "consultant" vocally and vigorously expressed the need for accurate, complete, and legible documentation to protect staff and the organization should questions arise about the resuscitation. The "leader" clearly identified that CPR skills and response times were not the issue; however, documentation of the efforts to resuscitate the patient needed improvement. Timepiece accuracy was already being addressed by the engineering department. Completeness of documentation was the main concern, and this responsibility fell to nursing.

The "researcher" got to work on a literature search to identify best practice for documentation. In addition, a review of adult learning theories was inherent since when a solution was created it needed to be integrating into the daily practice of nurses. Rescuers needed to understand that incomplete documentation affects their practice. The "change agent" and "facilitator" agreed that what was needed was a simple "in-your-face" prompt. CPR documentation was the topic, not the task of compressions and ventilations. The "educator" stretched saying, "It's time for me to do my part." The "educator" knew that rescuers work tirelessly to resuscitate patients. Suddenly, the idea emerged: CPR is cardiopulmonary resuscitation. There it was staring me straight in the face. Use what the staff already knew and place the behavior to be changed in a positive light.

Permanent markers, poster board, construction paper, and glue stick in hand, the educator went to work. After what felt like hours, the "leader" looked at what the "educator" had created and enthusiastically said this is simple, positive, and easy to remember. "We have done it; let's get a cup of coffee to celebrate."

As you have probably already guessed, there was only one person working that snowy night-me. As I walked back into the office with a fresh cup of coffee, I had to admit that approaching the problem wearing all my different hats had indeed created a viable solution. There on the table stood a colorful poster board illustrating documentation on the CPR record, with a mnemonic that has spread through the organization, ultimately improving documentation. It's even short and simple:

CPR-Charting Protects the Rescuers

C-Charting

P-Protects the

R-Rescuers

REFERENCE