©2015 American Association of Critical-Care Nurses doi: http://dx.doi.org/10.4037/ccn2015368 Tele-ICU The end of the formal unit orientation program is a stressful time of adjustment for nurses hired into crit- ical care without previous critical care experience. Although most units offer reassurance that experienced colleagues will provide the needed guidance, consistent support may not be available for many reasons. Development of a structured postorientation program designed to provide support and ongoing feedback to bedside nurses who have completed orientation is one strategy to assist nurses through this period of adjustment. The experience and expertise of the tele–intensive care unit nurse are excellent resources that can be called on to provide the needed support. (Critical Care Nurse. 2015;35[4]:e8-e16) Theresa Brindise, RN, BSN, MS Manisa Phophairat Baker, MSN, APN, CCRN, CCNS Pat Juarez, MS, APN, CCRN, CCNS Development of a Tele-ICU Postorientation Support Program for Bedside Nurses A lthough telemedicine dates back to the 1970s, when hospital caregivers reached out to off- site experts for consultation, 1 it has only recently become a subspecialty of critical care prac- tice (the tele–intensive care unit, or tele-ICU). Today, the tele-ICU operates with the goal of providing a “safety net” of additional surveillance and support to hospital-based critical care staff and to ultimately enhance outcomes for critically ill patients. 2 Advocate Health Care, a 12-hospital Midwestern health care system with 15 critical care units, has had a functioning tele-ICU for more than 10 years. The tele-ICU staff includes 45 tele-ICU nurses (eRNs); is typically staffed with 7 eRNs, 2 physicians, and 2 clerical assistants; and routinely monitors up to 250 patients on each shift. Over the years, the focus of the tele-ICU has evolved from the management of and intervention in crises to the implementation of standardized evidence-based practices and the monitoring of key result areas. The bedside nursing staff and the eRNs have developed a collaborative relationship and the bedside nurses appreciate the addi- tional expertise and support provided by the eRNs. In this article, we describe a postorientation program that was developed to meet the needs of novice nurses who have successfully completed their critical care unit orientation with a preceptor but who lack confidence in their performance and feel a need for addi- tional support. We discuss not only how the need for this program arose, but also strategies for designing and implementing the program and the lessons learned from its operation. e8 CriticalCareNurse Vol 35, No. 4, AUGUST 2015 www.ccnonline.org Downloaded from http://aacnjournals.org/ccnonline/article-pdf/35/4/e8/120772/e8.pdf by guest on 28 May 2020