EBP: Igniting a Spirit of Inquiry

During month six of the program, Nurse Residents begin to be mentored in the evidence-based practice (EBP) process at KRH.  Through attending a five-part EBP series, each new nurse works with their clinical team to:

  1. Identify an idea that they want to know more about on their unit
  2. Translate their inquiry into a PICOT question
  3. Search the literature
  4. Appraise the literature
  5. Present an action plan

Nurses receive 10 continuing nursing credits for attending the EBP series and are mentored through out the process.  At the end of the series, two winners are identified, each receiving a $350 scholarship that can be used toward their professional development.

This year’s winners presented, “How Hand Hygiene Affects Infection Rates in the NICU” and “The Use of Port Disinfection Caps to Impact CLABSI Rates.”

The Nurse Residents presented their ideas to the nursing leadership team on May 17th, giving them great visibility with leaders in the organization.  Congratulations, Cohort 5!

Leaning into Your Fears: The Deteriorating Patient

One of the first classes that kicks off the Residency is, “The Deteriorating Patient – ABCDE Method,” taught by Carla, Critical Care Educator.

This class is all about giving Nurse Residents a simple, easy to remember, and effective tool to approach a patient who appears to be deteriorating. “This is a big fear for any new nurse – we want our staff to know that they have a lot of resources and support when this takes place – that they won’t be on their own,” noted Mandy, Residency Coordinator.

During the class, Carla reviews the ABCDE method – how to asses Airway, Breathing, Circulation,  Disability, and create an Emergency plan.  Participants also learn about the various  response teams of experts at KRH that are available to them at any time.

 “[This was] easy to understand and easy information to retain.  As a nurse, one the fears I have is not recognizing the deteriorating patient. Loved this!”

– Class participant


Clinical Educators: Raising the Bar

It is 1830, and two RN Residents are coming in for their night shift.  Before they get started, they have a chance to meet with Deb, a KRH Clinical Educator, to freshen up on some skills.


Deb delivers a just-in-time training on chest tubes, epidurals, and PCAs

Deb has over 25 years of clinical and leadership experience.  Her role is to support all staff on the acute care units, but has a special place in her heart for new graduates.  Deb provides support to newly licensed nurses in a number of ways.  “My role is to bridge past clinical expertise with healthcare today. I help our new nurses by providing a safe haven for mistakes, mentoring for career planning, coaching toward excellence, and providing everything from formalized lectures to just-in-time training at the point of service.”

Deb also feels passionately about supporting all RNs  and teaching them how to live well. “If I can help them care for themselves, they are less likely to become a ‘curmudgeon’ in 10 years. This career is too valuable to be miserable when you come to work!”

Thank you to all KRH Educators for your compassion, dedication, clinical expertise, and service.

I like gaining a new perspective from our Nurse Residents.  Healthcare changes so fast, and they are on the cutting edge!       

– Deb Goodrum, Acute Care Educator

Earning the Blue Badge

blue-badgeLast month, 13 newly licensed RNs received the coveted “blue badge.”  This was a day to celebrate, as it designated them off of orientation, and ready to practice on their own.

“It’s kind of a silly tradition, but has become quite meaningful – almost like a rite of passage,” shared Mandy, RN Residency Coordinator.  Upon hire, the nurses get a green badge, which helps remind staff that they are on orientation and not working independently yet.  Switching over to the blue badge allows the team to celebrate and acknowledge how far each Resident has come over the past 16 weeks.  It’s even often accompanied by some applause from peers.

After putting in nearly four months of training on the floor with preceptors, our nurses wear their badges proudly as they become “one of us” – they’ve earned it.


Resident Spotlight: Nick

parker-nicholas-7-22-16Tell us a little about yourself

Growing up locally, I spent the first 15 years of my life in Seeley Lake, Montana, playing in the woods daily, and most summer days, barefoot. After graduating from Loyola Sacred Heart High School in Missoula, Montana, I was awarded a full scholarship for football at Montana State University- GO Cats!!  After a number of experiences including working with mentally handicapped adults, volunteering in hospitals, and participating on a medical mission with a team of surgeons in Peru, my decision was clear that healthcare was for me. I recently graduated with my nursing degree from St. Catherine University and am happily enjoying my first job as and RN here at KRH.

Why did you pick KRH?

I picked KRH for several reasons. I always wanted to be back in the Flathead Valley for the unlimited amount of outdoor activities to enjoy such as hiking, skiing, biking, photography etc. I also desired to be near my family again.

In addition, I sincerely felt during my interview that this hospital was going places. I sensed there was a positive sense of urgency, that employees here are relentlessly trying to better their practice and continually improve the overall patient experience at KRH. Our current journey to Magnet status was a major facilitator for my reason to join this hospital. Magnet recognizes nursing excellence, and I want to work alongside motivated nurses and other interdisciplinary personal alike. I’m excited for when we can designate KRH as a Magnet hospital. Furthermore, no other hospital I looked at had a detailed and proven nurse residency program like KRH. As you nurses out there know, there is nothing more intimidating then graduating from nursing school and getting thrown into the fire of the nursing profession, especially in an acute care setting. After discussing the residency position with Mandy (KRH Nurse Residency Coordinator), I knew this was the perfect place for me.

How has your experience been in the Nurse Residency Program so far?

The nurse residency program has been a fantastic experience so far. I have had three amazing preceptors who have allowed me to work through the challenges of day-to–day nursing responsibilities, but staying near to catch me if I fall. In addition, I have made lasting relationships with the other nurse residents. There is nothing better than to have support from people going through the same experience who can relate both positives and negatives to daily nursing tasks. Staff at KRH want me to succeed – not just my preceptors, but other nurses, managers, doctors, pharmacists, case managers and more. They buy into and understand that for an organization to succeed, everyone must perform well at their job, and that takes support for one another and respecting them no matter that their job title or years of experience. People at this organization “get it”, and I feel privileged to be here.

Welcome to the KRH family, Nick!

We are so glad to have your expertise and great attitude on our team.

Lab Draw 101

How do you correctly apply the tourniquet?  How do you choose the correct collection device? What’s the right angle of insertion? These are just a few of the questions our Residents asked when learning to draw labs –  a skill that can be a bit intimidating to tackle during year one.

From learning to label a tube correctly to ensuring that the integrity of the specimen is protected, Nurse Residents learned the ropes from Laboratory expert and Phlebotomist, Kelly L. last week.

After learning correct methods in the classroom, the Residents will each have an opportunity to fine-tune their skills during morning lab draws with Kelly by their side.

“It was really helpful to learn how important it is to assess [the veins] thoroughly and think about how you can get the cleanest sample possible without compromising the vessel… It was helpful to get to play with and practice with all the different needles. So often during school you don’t get hands on experience especially with multiple devices.”           

Leaving No Nurse Behind

On July 25th, KRH welcomed its newest group of Nurse Residents to KRH.  The group is made up of 13 engaged and excited nurses, ready to integrate and socialize into the profession. We enjoyed a hike up to the top of Lone Pine State Park for a view of the beautiful Flathead Valley, where these nurses will now call home.  Some are locals, and some have come from as far as New York and Louisiana.  Welcome to the KRH family, Cohort 5!  FullSizeRender

Resident Spotlight: Shannon

Howard, Shannon 3.18.15What has been one of the most valuable parts of this program for you?

 Having the opportunity to succeed and fail with grace under the observation of a more experienced nurse. The chance to grow comfortably without the pressure of being expected  to care for a team without help has been a tremendous confidence booster. 

 What have you enjoyed about your preceptors?

Having the opportunity to create close friendships with my peers which has allowed induction into the tight-nit team on the nursing unit much easier.

  What has been the best class you attended and why?

The class titled, “when to call the doctor” was one of the most beneficial classes. It helped to break down the wall of fear that gives me pause when I need to call the doctor. Dr. Short is a very personable provider and he does a great job taking every opportunity to explain information to nurses that allows for better care delivery. 

 A graduate of Southern Nevada college, outside of the hospital, Shannon’s time is dedicated to her pursuit of a Masters in Nursing Education, rock climbing, and being the best daughter, significant other, auntie, dog-mom and friend she can be. Go Shannon!



When the Heart Stops

During the final Residency Friday before nurses began to work independently, they had a chance to learn the ins and outs of how to care for a dying patient and family. There are some things that just aren’t taught in school and are downright scary for a new nurse.  What do I say to the family? How does it feel to push that last pain medication? What do I need to do once the patient has passed?  What support do I have as a nurse if it has been an emotional experience for me?


The team also learned how to face one of the most commonly voiced concerns about being new – “What do I do if my patient stops breathing?” In order to ease fear, the residents took time in a simulation lab to learn the ropes of a code.

“Those first couple of minutes until help arrives are crucial.  It’s easy to get overwhelmed and freeze. The goal of the Code Blue Simulation is to help RNs learn their role during a code and when to call for help. The first time they tried it, it was a little chaotic. Then it got easier.  This is why we practice!” shared Mandy Pokorny, Residency Coordinator.

This was one of the most helpful ways I have experienced playing out code blue situation. I feel like my confidence increased quite a bit! If nothing else I can at least put on the oxygen. Making the scenarios as real life as possible and utilizing a “real” code team was helpful. I also love getting in there and doing it!

– Spring 2016 Resident

Resident Spotlight: Barb

EKG Training

Residents and seasoned RNs reviewing strips at Skills Lab


What about the Program made you want to apply?

I applied to the residency program because I felt that the reorganized EBP program met my needs as a new nurse. I wanted to be supported in my new role but  also have some autonomy. I wanted to have consistency in my preceptors and receive regular feedback from them. I felt that the Residency program offered that opportunity.

What are you looking forward to most as you move through this first year?

I am looking forward to a time where all the knowledge I am learning in this first year will become second nature.  Putting knowledge into practice can be overwhelming and difficult.  It can be discouraging at times when you think you’ve “got it” but you don’t.  You just have to trust the process.

What is one thing you enjoy about working at KRH?

I really enjoy the atmosphere of my work place.  I feel very supported and welcomed by my co-workers.

McConnell, Barb croppedA recent graduate of Montana State University, Barb has been working on the Intermediate Care Unit for past 10 weeks. Welcome to the team, Barb!