It’s the season for college in my house – admission packets, orientation, decisions about what to study…it’s all vaguely familiar. I think every ECLS program goes through a similar process when deciding about their education process. Who will take care of the ECMO patient? Who will take care of the ECMO pump and circuit? How do you find them and choose them? An application process may not be a bad idea. What qualifications do you think your team should have at a minimum? ELSO has guidelines that will help you determine what those minimum qualities are. Should you have them obtain references? References offer valuable information and lets a leader see what a prospective specialist is thought of by their co-workers. It may be worthwhile to have a screening test and determine what their baseline knowledge is. Should you have an interview process? Leaders learn so much about individuals in an interview. How does this person communicate? How do they present themselves? Interview techniques tease out many variables and may help identify the best possible ECLS team members for your program.
It is true that many ECLS programs have a problem with attrition. It’s not uncommon to lose 50% by end of the first year. Staff resignations may start with the very first day of class: they sit down, ready to learn and then “POW” – it’s overwhelming to them. Extracorporeal Life Support is not an easy concept. It’s not just a matter of a pump and some tubing – hook it up to a patient and go. The typical ECLS class is long and involved. Staff members are required to learn and be tested on physiology related to VV or VA ECMO, systems management, equipment and circuitry troubleshooting and anticoagulation management. Or they finish class, make it through orientation and then sit by themselves at an ECLS patient’s bedside. The reality of how critically ill that patient is, and more importantly, how dependent that patient is on their skills and knowledge is too much to bear, and they quit the team.
Finding out if the team member is going to be able to handle the critical stress that will be a part of every day care is an important part of the selection process. Some ECMO programs have a detailed process for picking team members that isn’t fully complete until they finish orientation. A developed mentorship program can be incredibly beneficial. Most institutions have a mentoring program for new staff – can you modify your existing process for your ECLS team? If a leader maintains the thought that new ECLS staff must be nurtured and encouraged along the way – especially the first year – they will have an increased likelihood of keeping that staff member engaged and happy in their work.
If this is all new to you and your institution, or if you have a unique aspect to your ECLS team selection process – lets chat about it. Leave me a comment!
I am hopeful that we have made the right decisions with our child about college. I am certain he has met their application requirements. Now all that remains is for the college to mentor him through his first year, and for him to complete the process and graduate!