Critical Care Internship Program

Week One
Day 1
Introduction to Internship Program
Overview of Human Systems
Techniques of Physical Examination
Patient Assessment/Vital Signs
Interpretation of Laboratory Values
Clinical Decision Making
History Taking/Communication
Common Problems in the ICU
Psychosocial Aspects of Critical Care
Day 2
Cardiac Didactic
Anatomy Review
Cardiac Assessment
Cardiac Dysrhythmia Review
Hemodynamic Monitoring (Swan, A-line, Vigilance)
Pacemakers
Cardiac Pharmacology
Vasopressor Agents
Drug Calculations
Intravenous Fluid and Electrolytes
Day 3
Cardiac Skills Lab
Cardiac Assessment (heart sounds recognition)
Cardiac Rhythm Recognition (System Trainer)
PA Catheter and A-line Insertion (assisting the physician)
PA Catheter Readings (obtaining accurate numbers)
Transvenous, Transthoracic and External Pacemaker Application
Pharmacology Challenge (case studies with time element)
Day 4
Clinical Day 1 Meet with manager and clinical partner observation of unit and clinical
nursing skills of preceptor, question and answer.
Day 5
Clinical Day 2 Orientation and Observation, assists with patient care

Week Two
Day 1
Cardiac Didactic
Chest Pain
Acute MI
Hypertensive Crisis
Pulmonary Edema
Cardiogenic Shock
Use of Thrombolytic Agents
Cath Lab Procedures
Cardio Vascular Surgery/IABP
Cardiac Arrest/ Defibrillation/Cardioversion
Day 2
Cardiac Skills Lab
Cardiac Assessment (effective evaluation of the cardiac patient)
Case Studies (applied knowledge)
Sheath Removal
IABP (lab module-understanding the basics)
Mock Codes, Defibrillation (Life-pak 9, 10, 12) Cardioversion
Day 3
Respiratory Didactic
Anatomy Review
Pulmonary Assessment
Oxygenation
ABG Interpretation
Pulmonary Function Measurement (SPO2, ETCO2, VT, NIF, FVC)
Airway Management
Modes of Oxygenation
Respiratory Treatments
Suctioning
Day 4
Clinical Day 3 Orientation and Observation; assists with patient care
Day 5
Clinical Day 4 Orientation and Observation; assists with patient care

Week Three
Day 1
Respiratory Skills Lab
Respiratory Assessment (lung sounds recognition)
Airway Management (ACLS review and lab application, airway inspection, use of oral
airways, size determination, positioning, continuous oral suction)
ABG case studies (applied knowledge acidosis, alkalosis - intervention and correction of
abnormalities)
Modes of Oxygenation (clinical application NC, simple mask, non rebreather, partial
nonrebreather, ventimask)
Suctioning (proper technique for oral and NT suction)
Day 2
Respiratory Didactic
Pulmonary Diseases
SIRS/ARDS
Pneumonia
Respiratory Failure
Mechanical Ventilation
Care of the Ventilated Patient
Weaning From Mechanical Ventilation
Ventilator Dependence
Tracheotomy
Day 3
Respiratory Skills Lab
Respiratory Assessment (effective evaluation of the respiratory patient)
Case Studies (applied knowledge)
Mechanical Ventilation (patient assessment, care of the ETT, oral care, open suctioning
technique, in-line suctioning technique, trouble shooting alarms, weaning parameters.
Day 4
With Assistance-(The clinical partner and the nurse intern share the work evenly)
Clinical Day 5 Direct patient care of one critical care patient with assistance
Day 5
With Assistance-(The clinical partner and the nurse intern share the work evenly)
Clinical Day 6 Direct patient care of one critical care patient with assistance

Week Four
Day 1
Gastrointestinal Didactic
Anatomy Review
GI Assessment
Acute GI Bleed
NG/G/J Tubes
Pancreatitis
Hepatic Failure
Abdominal Injury/Trauma
Ostomies
Bowel Regimes
Day 2
Neurological Didactic
Anatomy Review
Neurological Assessment
Delirium, Depression, Dementia
SAH/Intercerebral Bleed
Seizures
Cerebral Embolic Events
Traumatic Brain Injury
Spinal Cord Injury
DI in Head Injury
ICP Monitoring/Ventriculostomy
Day 3
GI/Neurological Skills Lab
GI Assessment (effective evaluation of the GI patient)
Case Studies (applied knowledge)
NGT Insertion (Levine, Anderson, Salem Dobhoff)
Troubleshooting NGT problems
Ostomy/Rectal Bags (use/application)
Neuro Assessment (effective evaluation of the neuro patient)
Case Studies (applied knowledge)
Halo, Philadelphia Collar, ICP monitor, Ventriculostomy
Day 4
With Assistance-(The clinical partner and the nurse intern share the work evenly)
Clinical Day 7 Direct patient care of one critical care patient with assistance
Day 5
With Assistance-(The clinical partner and the nurse intern share the work evenly)
Clinical Day 8 Direct patient care of one critical care patient with assistance

Week 5
Day 1
Surgical Didactic
Care of the Post-op Patient
Post-op Complications
Pericardial Procedures
AAA Repair
Vascular Surgery
Abdominal Surgery
Thoracic Surgery
ENT procedures
Orthopedic Procedures
Day 2
Endocrine/Hematology Didactic
DKA
SIADH
Hyperosmolar States
Thrombocytopenia
Coagulopathies
DIC
Anemia
Leukopenia
Leukocytosis
Day 3
Endocrine/Hematology/Surgical Skills Lab
Endocrine and Hematological Assessment (effective evaluation of the Endocrine or
Hematological patient)
Case Studies (applied knowledge)
Insulin, Sandostatin drips
Blood product administration/Blood warmer
Surgical Assessment (effective evaluation of the Post-operative patient)
Case Studies (applied knowledge)
Fluid Resuscitation
Wound Care
Wound Drains
Traction Application
Day 4
With Assistance-(The clinical partner and the nurse intern share the work evenly)
Clinical Day 9 Direct patient care of one critical care patient with assistance
Day 5
With Assistance-(The clinical partner and the nurse intern share the work evenly)
Clinical Day 10 Direct patient care of one critical care patient with assistance

Week 6
Day 1
Renal Didactic
Anatomy Review
Renal Assessment
Renal Failure (Acute Chronic)
Hemodialysis
Plasma Exchange
Maintaining Electrolyte Balance
Life Threatening Electrolyte Imbalance
Day 2
Peripheral vascular Didactic
Assessment
Arterial Insufficiency
Venous Insufficiency
Critical Care Emergencies
Sepsis/Septic Shock
Toxic Ingestions (Drug Overdose Acute ETOH Intoxication)
Day 3
Renal/Vascular/Critical Emergencies Skills Lab
Renal Assessment (effective evaluation of the renal patient) Case Studies (applied
knowledge)
Hemodialysis lab (observation)
Vascular Assessment (effective evaluation of the vascular patient) Case Studies (applied
knowledge)
Sepsis Assessment (effective evaluation of the septic patient) Case Studies (applied
knowledge)
Overdose Assessment (effective evaluation of the Overdose patient) Case Studies
(applied knowledge)
Day 4
Under Direct Supervision-(The clinical partner is used as a resource but has no other
duties. The nurse intern is responsible for the full assignment)
Clinical Day 11 Direct patient care of one critical care patient under direct supervision
Day 5
Under Direct Supervision-(The clinical partner is used as a resource but has no other
duties. The nurse intern is responsible for the full assignment)
Clinical Day 12 Direct patient care of one critical care patient under direct supervision

Week 7
Day 1
Complications of IV Therapy
Hazards of Immobility
Pressure Ulcers
Nutrition
Laboratory Interpretation
Pain Management
Maintaining Normothermia
End of Life Care
Critical Care Nursing (Tying It All Together)
Course Review
Day 2
Cardiac Enhancement
Chapter Review
Clinical Scenarios
Critical Thinking and Knowledge Application
Question and Answer
Competency Check offs
(Pacemaker, Defibrillator, Swan: set-up, waveform acquisition and interpretation, A-line:
set-up, waveform acquisition and interpretation Vigilance, Sheath Removal )
Mock Code
Defibrillation and Cardioversion
Day 3
Respiratory Enhancement
Chapter Review
Clinical Scenarios
Critical Thinking and Knowledge Application
Question and Answer
Competency Check offs
(Oximetry, ETCO2, Modes of Oxygenation, BiPap, Mechanical Ventilation, ABG
Interpretation, Suctioning, Trach Care)
Day 4
Under Direct Supervision-(The clinical partner is used as a resource but has no other
duties. The nurse intern is responsible for the full assignment)
Clinical Day 13 Direct patient care of one critical care patient under direct supervision
Day 5
Under Direct Supervision-(The clinical partner is used as a resource but has no other
duties. The nurse intern is responsible for the full assignment)
Clinical Day 14 Direct patient care of one critical care patient under direct supervision

Week 8
Day 1
Surgical Enhancement
Chapter Review
Clinical Scenarios
Critical Thinking and Knowledge Application
Question and Answer
Competency Check offs
(JP Drain, Hemovac, Wound Care, Traction Application, Doppler, Chest Tubes)
Day 2
Potpourri Enhancement
(Endocrine, Hematology, Renal, Gastrointestinal, Neurological)
Chapter Reviews
Clinical Scenarios
Critical Thinking and Knowledge Application
Question and Answer
Competency Check offs
(Lab Value Interpretation, NGT Placement, Ostomy/Rectal Bag Application
Ventriculostomy, ICP Monitoring)
Day 3
Final Exam
The Final Exam consists of a total of 100 questions.
There will be 10 separate sections consisting of 10 questions each.
2.5 hours have been allotted for completion of this exam.
One 15-minute break will be allowed after the first 60 minutes.
No materials are allowed in the testing area. The exam will be proctored. Pencils and
calculators will be provided.
Tests will be graded at the completion of the exam while the students are at lunch. The
test will then be reviewed.
Testing Subsections
Cardiac
Hemodynamics
Respiratory
Renal
Neurological
Surgical
Endocrine/Hematology
Gastrointestinal
Laboratory
Mechanical Ventilation
A passing grade of 84% must be obtained to retain employment within the
Intensive Care Unit
Grades of 75 to 83 are eligible to retest within one week.
Individuals with grades less than 75% will be placed in a less demanding area within
the hospital or be released from employment.
Day 4
With Assistance-(The clinical partner and the nurse intern share the work evenly)
Clinical Day 15 Direct patient care of two critical care patients with assistance
Day 5
With Assistance-(The clinical partner and the nurse intern share the work evenly)
Clinical Day 16 Direct patient care of two critical care patients with assistance

Week Nine
With Assistance-(The clinical partner and the nurse intern share the work evenly)
Day 17 Direct patient care of two critical care patients with assistance
Day18 - Direct patient care of two critical care patients with assistance
Day 19 - Direct patient care of two critical care patients with assistance
Week Ten
Under Direct Supervision-(The clinical partner is used as a resource but has no other
duties. The nurse intern is responsible for the full assignment)
Day 20 Direct patient care of two critical care patients under direct supervision
Day 21 - Direct patient care of two critical care patients under direct supervision
Day 22 - Direct patient care of two critical care patients under direct supervision
Week Eleven (Shift/HospitalOrientation)
Under Direct Supervision-(The clinical partner is used as a resource but has no other
duties. The nurse intern is responsible for the full assignment)
Day 23 Direct patient care of two critical care patients under direct supervision
Day 24 - Direct patient care of two critical care patients under direct supervision
Day 25 - Direct patient care of two critical care patients under direct supervision
Week Twelve
Under Direct Supervision-(The clinical partner is used as a resource but has no other
duties. The nurse intern is responsible for the full assignment)
Day 26 Direct patient care of two critical care patients under direct supervision
Day 27 - Direct patient care of two critical care patients under direct supervision
Day 28 - Direct patient care of two critical care patients under direct supervision
Week Thirteen
Under Minimal Supervision-(The clinical partner is assigned one half of a regular
workload and acts as a resource person for the nurse intern)
Day 29 Direct patient care of two critical care patients under minimal supervision
Day 30 - Direct patient care of two critical care patients under minimal supervision
Day 31 - Direct patient care of two critical care patients under minimal supervision
Week Fourteen
Under Minimal Supervision-(The clinical partner is assigned one half of a regular
workload and acts as a resource person for the nurse intern)
Day 32 Direct patient care of two critical care patients under minimal supervision
Day 33 - Direct patient care of two critical care patients under minimal supervision
Day 34 - Direct patient care of two critical care patients under minimal supervision
Week Fifteen
Under Minimal Supervision-(The clinical partner is assigned one half of a regular
workload and acts as a resource person for the nurse intern)
Day 35 Direct patient care of two critical care patients under minimal supervision
Day 36 - Direct patient care of two critical care patients under minimal supervision
Day 37 - Direct patient care of two critical care patients under minimal supervision
Week Sixteen
Under Minimal Supervision-(The clinical partner is assigned one half of a regular
workload and acts as a resource person for the nurse intern)
Day 38 Direct patient care of two critical care patients under minimal supervision
Day 39 - Direct patient care of two critical care patients under minimal supervision
Day 40 - Direct patient care of two critical care patients under minimal supervision

Week Seventeen
Under Observation Only-(The clinical partner is assigned a regular workload and acts
as a resource person for the nurse intern)
Day 41 Direct patient care of two critical care patients under observation only
Day 42 - Direct patient care of two critical care patients under observation only
Day 43 - Direct patient care of two critical care patients under observation only
Week Eighteen
Under Observation Only-(The clinical partner is assigned a regular workload and acts
as a resource person for the nurse intern)
Day 44 Direct patient care of two critical care patients under observation only
Day 45 - Direct patient care of two critical care patients under observation only
Day 46 - Direct patient care of two critical care patients under observation only
Week Nineteen
Under Observation Only-(The clinical partner is assigned a regular workload and acts
as a resource person for the nurse intern)
Day 47 Direct patient care of two critical care patients under observation only
Day 48 - Direct patient care of two critical care patients under observation only
Day 49 - Direct patient care of two critical care patients under observation only
Week Twenty
Under Observation Only-(The clinical partner is assigned a regular workload and acts
as a resource person for the nurse intern)
Day 50 Direct patient care of two critical care patients under observation only
Day 51 - Direct patient care of two critical care patients under observation only
Day 52 - Direct patient care of two critical care patients under observation only
Completion on Transition Program!
Progression through the Critical Care Transition Program will be based on satisfactory
performance as evaluated by the clinical partner for each participant. Acceleration through
the clinical portion of the program will be on recommendation of the clinical partner and
after careful consideration following consultation with the critical care manager, critical care
educator, clinical partner and intern.
Satisfactory evaluation by the Clinical Partner and Critical Care Manager are required for
continued employment within the critical care unit. Individuals in need of extension of
clinical progression will be evaluated at this time. Nurses who are unable to fulfill the role of
critical care nurse will be placed in a less demanding area within the hospital or be released
from employment.
The critical care educator will meet weekly with the clinical partner and intern to assess
assimilation into the critical care environment and determine additional educational needs
that might be warranted as recommended by the critical care manager and clinical partner.