​Nurses Level Up

Cross-training strategy increases nursing competency

PULSE Issue 38 | January 2022

Significantly increased demand for general anaesthesia involvement in electrophysiology (EP) procedures in recent years is attributed to the increased complexity of procedures and patient co-morbidity. At the National University Heart Centre, Singapore (NUHCS), the global trend was similarly experienced which consequently saw a sharp demand for general anaesthesia (GA) nursing support that could not be immediately filled. For a nurse to qualify as an anaesthetic nurse, it typically takes specialised training as well as sufficient practical experience to manage responsibilities which include assisting the anaesthetist in the administration of anesthetic drugs during surgery, assisting ventilation and respiratory support throughout and after surgery, closely monitoring the patient’s condition and their ongoing parameters to prevent any potential complications which are critical in patient care. 

With the background and familiarity of cardiology interventional procedures as well as comprehension of critical parameters affecting cardiac patients, the invasive cardiac laboratory (ICL) nursing team was approached to take on the challenge of cross-training to render anaesthesia nursing support for patients going through EP procedures. In kind, interventional EP trained nurses took on GA duties so they could cross-over to provide GA nursing support when needed. 

The cross-training of EP nurses and ICL nurses began in August 2020 in small batches to avoid straining manpower resources which were already strained by the on-going COVID-19 pandemic. Their training included job shadowing, practical training in the operating theatres as well as in the ICL. The nurses were also rotated on attachments and their training completed after achieving competency tests scrutinised by the department head. By the end of 2021, the cross-training was complete. Now, NUHCS boasts an expanded network of competent nurses ready to better support a bigger spectrum of EP patients. This will relieve the manpower strain within the anaesthetic department, resolves the immediate shortfall of specialised trained anaesthetic nurses, and concurrently enhancing the skills and competency of ICL nurses.