The pediatric intensive care unit (PICU) at Primary Children’s Medical Center, Salt Lake City, Utah, has developed an orientation and progressive education program to provide both mentorship and clinical guidance for nurses as they move from novice to expert in the critical care environment.

The PICU is a diversified and challenging place to work. Our unit is a state-of-the-art, 26-bed, multidisciplinary unit for children ages newborn to 18 years. These young patients have a wide variety of illness or injury needs, including respiratory distress, multisystem organ failure, multiple trauma, and postoperative cardiovascular care. Nurses are often overwhelmed entering this setting.

Because of the nursing shortage, the unit must now hire new graduates. These eager but inexperienced nurses are placed into a special, progressive education program that begins in a medical-surgery area. During the 6 to 12 months when they...

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