Introducing Care of the HCT Patient to New Graduate Nurses Using Problem Based Learning

Topic Significance & Study Purpose/Background/Rationale :Providing nursing care for the HCT patient population is complex. New graduate nurses who begin their nursing career in a large HCT unit often face challenges with the acuity and complexity of the patient population. There are often times where the answer to the question “why would I do that for this patient” is very hard to find. On a 36 bed HCT inpatient unit, there have been many new graduate nurses hired over the past two years. Throughout their orientation process, many are overwhelmed by the complexity of the patient care required and struggle to understand the many complications that arise through the transplant process.

Methods, Intervention, & Analysis: The education department decided to try a new approach for introducing frequently seen clinical situations and complications to a group of new graduate nurses hired for the HCT unit. Patient scenarios were created by the educators starting with a newly diagnosed hematology patient who progresses on to receive a transplant. Each week a new clinical condition was added to the scenario with objectives provided. The new graduate nurses were divided into groups and were expected to return the following week with possible treatment plans or resources that could be utilized for the clinical conditions. Each group was assigned a facilitator, who was a member of the education department. The facilitator’s role was not to provide answers but assist the group with any questions they may have and also guide them to other possibilities they may have missed in their initial response to the clinical situation presented and the objectives.

Findings & Interpretation:The initial weeks of the scenario introductions and clinical problems were challenging as the new graduate nurse had not spent significant time orienting to the clinical unit. As the weeks progressed, they were able to relate the scenario problems to patients they had cared for on the unit and have a better understanding of the treatments and interventions appropriate for the patients. 

Discussion & Implications:Care of the HCT patient is complex. Utilizing problem based learning with scenarios is one method to help new nurses understand the rationale for medications and interventions frequently used.