https://www.infirmiere-canadienne.com/blogs/ic-contenu/2025/10/14/service-durgence-lalberta-ameliorer-maintien-poste
Clinical nurse educators took unit-focused approach to improve practice and support workplace culture
By Erin Acorn & Lyndsay Russell
October 14, 2025
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With the current expectations, demands, and organizational issues placed on nursing, staff retention is a key priority for emergency departments nationwide. Ongoing professional education enhances knowledge, improves nursing practices, and leads to better patient outcomes.
For our emergency department (ED), which is located in Alberta, 2023-2024 presented a year of growing pains. Like many emergency departments nationwide, the ED experienced a large exodus of senior staff. Factors such as heavy patient loads, poor work-life balance, hospital overcrowding, increased patient acuity, and lack of experienced nurses further contributed to nursing burnout and moral distress, which threatened staff retention rates.
Over 100 new nurses with varied backgrounds and work experience were orientated to the ED at this time. While the new staff were a welcomed and needed addition, these new hires represented a significant expense to the unit in terms of the direct cost of recruitment, hiring, and orientation — as well as indirect costs such as decreased group morale and the loss of organizational knowledge and productivity.
Newly hired nurses were tasked with heavy patient workloads and minimal at-the-elbow support from experienced staff. The deficit of experienced nurses available to support the new hires affected patient safety and the confidence levels of new nurses.
During this time, the clinical nurse educators (CNEs) were heavily focused on preparing and providing education for the new hires, leaving senior staff feeling overlooked and forgotten. A cultural shift began to occur, as a division between “old” and “new” staff emerged, further threatening staff retention levels and team dynamics.
In response, the CNEs updated their educational priorities for 2024, taking a unit-focused approach. They sought to boost staff morale, advance knowledge, improve nursing practices, support unit culture, and influence staff retention rates through the use of flexible scheduling, relevant topics, and engaging learning opportunities.
Flexibility
Flexibility in scheduling proved to be a vital component of increasing staff participation. It supported professional educational opportunities, which was a means of valuing and retaining staff.
With ED management support, shift adjustments were made (when possible) to increase staff availability, and additional sessions were offered outside the CNEs’ regular working hours. Staff voiced an appreciation of the flexibility in scheduling and the ability to attend sessions in the evenings.
Relevant topics
Relevant educational topics for the year were influenced by multiple factors, including requests from senior leadership, quality improvement initiatives, accreditation standards, operational changes, and concerns raised through the hospital’s reporting and learning system. In keeping with the educational goals for the year, the CNEs strove to respond to staff needs and implemented self-evaluation tools.
Education in most emergency departments includes a laddering process; as staff develop their skills and experience, they advance within the department to patient care areas with higher acuity.
Self-evaluation tools were introduced in 2024 to help staff personally assess their skills, formulate individualized learning goals, and gauge mental preparedness. Encouraging collaboration with the CNEs, this tool supported staff as they progressed within the department, ensuring that they were neither overlooked nor pressured to take on roles for which they did not feel qualified. It also allowed the CNEs to identify trends that could be pulled into engaging learning opportunities for the entire department.
Staff engagement
Four novel educational opportunities for ED staff were implemented throughout the year, using multiple adult learning principles. The CNEs were able to foster staff engagement through unit education days, staff updates, independent learning stations, and a micro-learning initiative.
Unit education days
The goal of unit education days was to provide engaging educational opportunities to all ED staff. Each day consisted of multiple drop-in sessions hosted by the unit CNEs, which allowed a mix of new and old staff to attend. The CNEs focused on being creative and intentional in how they presented content by utilizing multiple adult learning principles.
The first unit education day focused on changes to the organization’s mass hemorrhage protocol. This session included a lecture highlighting the key principles relevant to nursing practice, a matching game to reinforce key content, and a hands-on-skill station, which allowed staff to practise preparing blood components and using the rapid infuser.
Lastly, a communication game generated conversation about distractions, effective communication, and the mental load within the trauma room. Subsequent session topics included diabetic ketoacidosis, trauma skills, and a focused, hands-on charting practice session with specialty narrators.
Staff update days
Staff update days took place in the fall of 2024. The first session was open to all ED nurses, which fostered a team approach by mixing staffing levels and experience in the classroom.
The second session was tailored for triage-trained nurses. The content for these updates stemmed from the need to standardize nursing practices, recertify skills such as IV pumps and the defibrillator, and ensure that accreditation standards were being met. It also addressed concerns identified from the reporting and learning system.
Both sessions took a practical and goal-oriented approach to maintain staff engagement. Each session used a variety of teaching modalities, such as interactive games, group work, and videos.
Additionally, to further support and acknowledge the contributions that staff make to the ED, time was allotted during each update to discuss proposed and implemented changes and address staff concerns. These concerns were taken back to management, quality improvement, and leadership teams to be addressed.
Presenting these learning opportunities in a practical and goal-oriented approach encouraged collaboration among staff and gave the team a safe place to share and support one another on issues and topics that were relevant to the unit.
Independent learning stations
Shift work makes it difficult for the educational team to connect with and support staff 24 hours a day. Yet, as adult learners, nurses are problem-focused and want educational opportunities to assist them in their daily practice environment. The use of independent learning stations offered another opportunity to engage with staff by meeting educational needs in a less traditional setting.
Independent learning stations were set up in the unit education room, allowing staff access 24 hours a day. The original station focused on arterial lines, while subsequent stations focused on transvenous pacing and chest tubes. In each of these stations, CNEs utilized a combination of hands-on activities and poster presentations to provide an engaging, self-directed learning opportunity. Poster presentations highlighted key content, including safety, patient monitoring, and nursing considerations. Actual equipment was available in conjunction with the written content to promote psychomotor skill development.
Again, the CNEs received positive feedback for these stations, as staff were able to self-identify their learning needs and seek out more experienced co-workers to have their questions answered, encouraging a collaborative and supportive environment.
Microlearning
The microlearning initiative is a unique way to engage staff by offering access to educational content when they want or need it, keeping with the notion that adult learners want access to education to assist them in their day-to-day practice.
Using a QR code linked to a Google document and embedded with written content, videos, and reflective questions, each session takes less than 10 minutes to complete, allowing for relevant, succinct, and accessible educational opportunities.
In an effort to increase engagement, CNEs have utilized the ED staff nurses to present content in the short videos. As a result, the topics become more relatable, and discussion encourages peer-to-peer learning between old and new staff.
Topics included transvenous pacing, frostbite protocol, and invasive procedure set-up tips, as well as a showcase of services provided by other specialty areas, such as the Central Alberta Sexual Assault Response Team. The QR codes are available on the unit educational bulletin board, and some topics have been linked to independent learning stations to allow people to reference them when needed.
Looking ahead
With the current expectations, demands, and organizational issues placed on nursing, staff retention is a key priority for emergency departments nationwide. Ongoing professional education enhances knowledge, improves nursing practices, and leads to better patient outcomes. In their review, the CNEs found that offering flexible, relevant, and engaging educational opportunities had a profound impact on the unit.
By taking a unit-focused approach, we saw a shift in our unit’s culture, including more peer-to-peer collaboration and higher staff retention rates than in previous years. Moving forward with educational and leadership support, we plan to continue our unit-focused educational initiatives that support staff and foster a cohesive culture that will benefit our staff and patients in the years to come.
Erin Acorn, RN, BScN, M.Ed., and Lyndsay Russell, CNE, RN, BN, work in the emergency department of Red Deer Regional Hospital in Red Deer, Alberta.
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