We don’t eat our young! The Royal North Shore Hospital Second Year Transitions to Emergency Department Program

Ms Jessica Willetts1, Mr Martin Ward1

1Royal North Shore Hospital, St leonards, Australia

The creation of the innovative Second Year Transitions to Emergency Program was designed and implemented following the need to change practice around the development of our novice nurses. Our ED, had in the past, accepted first rotation TRN’s directly into the ED. Feedback from the TRN’s was that it was too early to be rotated to ED. Incidentally very few of the 38 nurses completing the TRN program over a 5 year period remained in the Emergency department with many citing professional fatigue at year three, hence the development of the Second Year Program.  This inaugural program is designed to facilitate the participant’s development of foundational knowledge and clinical skills necessary to practice safely and effectively in a Level 6 Tertiary Referral Hospital Emergency Department setting.

The objective of the program is to develop and fully support Year 2 RN’s to ready them to effectively function in the resuscitation rooms within 12 months of working in the Emergency department.

The program structure consists of a development plan to suit the needs of each participant with specific targeted training days and courses.

The key concept of the program is the invention of an ED specific Moodle page equipped with educational resources such as podcasts and ‘You Tube’ videos enabling the participants to gain a better understanding of the critical care nursing skills and how to utilise key equipment prior being exposed to the area.

Participants have been surveyed about their previous nursing experience, future intentions, current capabilities and expectations of the outcomes of the program.

The outcomes of this program are to develop and consolidate clinical emergency nursing skills within a tertiary department setting; competency in critical thinking and clinical decision making within a time pressured environment; and to commence the development of clinical leadership skills in a critical care setting.


Jess Willetts has worked at the Royal North Shore Emergency Department since 2004. Jess was appointed Clinical Nurse Specialist in 2014 and has been a Clinical nurse educator in the emergency department since 2015.  Jess has a passion for emergency nursing and a vested interest in the implementation of educational tools and simulation techniques to assist the development of nurses into proficient nursing clinicians.