DEU Stories and Experiences

In the fall of 2008 and spring of 2009, after many months of planning, the University at Buffalo School of Nursing piloted the Dedicated Education Unit (DEU) on three nursing units at the Erie County Medical Center (ECMC) in Western New York (WNY) and one unit at Millard Fillmore (Gates). The ECMC Units were 10 South, 8 North and 12 zone 3, with UB Faculty Dr. Mattie Rhodes and Professor Claire Meyers overseeing the pilot units. 

Four nurses on each unit were designated as DEU Nurses and assigned to work with two senior nursing students each.  The original nurses on 10 South, Amy Toy, Michele Lariviere, Michelle Gulczewski and Amy Thoms are now on 7 zone 3 and 8 zone 2, where they continue in the role of the DEU Nurse.  Patty Kiblin, 10 South Unit Manager during the pilot phase, continues as manager of the 7 zone 3 DEU.

The unit manager of 8N, Peggy Cieri and two of the original DEU nurses, Maureen Moore Healy and Selina Wenke, still remain in the program.  Twelve zone 3 with Unit Manager Sonya Melvin, remains a DEU nurse although the original nurses have completed advanced degrees and have been promoted to other positions in the hospital.

UB recognizes the dedication of these nurses and the outstanding contributions in educating over 250 student nurses on DEUs at ECMC. A number of UB graduates are now employed by ECMC and several are working as DEU nurses. Thanks to this successful clinical partnership, the model has been shown to enhance the student’s clinical learning environment as well as nurse satisfaction. 

One of our newest Dedicated Education Units is located at Catholic Health Systems Sisters Hospital, St. Joseph Campus, on 5 South, a busy 26 bed telemetry unit with many complex patient care needs. The staff nurses are new to working in a the DEU, therefore Dr. Fabry, UB faculty instructor for the DEU, anticipated a transition period while the nurses got acclimated to the unit. However, she was pleasantly surprised at how well the staff and students adapted to the their new positions and how enthusiastic the students were to work side by side with experienced RNs providing patient care. 

One student wrote, "I love the dynamic of the floor! I feel like everyone works as a team.  The manager and charge nurse are hands on, approachable, and just seem to be very well rounded leaders."  Another student wrote, "I felt that in 3 short weeks I have grown leaps and bounds and I couldn’t have asked for a better first clinical experience."  The nursing staff also found this to be a positive experience.  One of the DEU nurses told me "I enjoyed working with the UB students and faculty." They also said that having the students with them, has reignited their passion for practicing nursing. Three of the DEU nurses are planning to continue their education. 

In Fall 2014, a new Dedicated Education Unit (DEU) was established on 3 East.  The DEU has been successfully implemented across the US in an effort to positively impact nursing education (Edgecombe, Wotton, Gonda, & Mason, 1999; Gonda, Wotton, Edgecombe, & Mason, 1999; Moscato et al., 2007; Wotton & Gonda, 2004).  In the DEU model, two nursing students are paired with an expert staff nurse while an academic faculty member guides the instruction of both the staff and students.  Students are socialized into the role of the nurse, and the nursing unit acts as a “village” in the training of the student (Moscato et al., 2007, p. 32). The DEU clinical environment provides students with enriched clinical time that allows for increased mentoring and practice in prioritization, communication, technical, and assessment skills (Ranse & Grealish, 2007).  Students can care for more patients and perform skills because they do not need to wait for one academic instructor (Edgecombe et al., 1999; Miller, 2005; Moscato et al., 2007).

Comments from students in the first couple weeks into clinical have been amazing.  They are as follows:

“My preceptor is always very encouraging.....she shows us and explains thoroughly what she does as a nurse. She is always confident, a quality you need as a professional.”

“The first two days of clinicals exceeded my expectation and then some. I enjoyed every second that I was there and even found myself not wanting to leave. There were so many things I loved about the experience and so many things I have learned already.......I cannot stress enough how comforting and realistic my experience has been being able to follow around the RN I was assigned to.  I was scared to jump right into the process, but being able to follow around someone that first day allowed me to understand the flow of what an actual day is like for a RN.”

“Approaching the first day, I was a little nervous about what would be expected and how the day would go. But when I met with my RN, I immediately felt comfortable and ready to learn.”

“In fact, my favorite part of clinical was seeing a patient’s reaction to the RN's therapeutic communication…  Before the RN left, the woman said, “I was really feeling bad for myself until you came in. This is the best day I’ve had in a long time. I appreciate you being so kind it truly makes me feel better.” Her gratitude was touching. Seeing how simple it is to make a difference exemplifies why I want to be a nurse.”

“All of the nurses/staff were great and I am looking forward to going back this week.”

Advances in medical science in the past 50 years have increased the amount of knowledge the student nurse needs to acquire (Giddens et al., 2008; Lindeman, 2000). Not only do nursing students need to learn in an overloaded curriculum, they must also learn to practice in a highly technical system populated, predominantly, by high-acuity patients. Given that students and faculty believe students are not adequately prepared for their first nursing job, experience-based learning, or hands-on clinical practice, is vital to the transition of the student into a professional nurse (Benner, 2010; Benner, Sutphen, Leonard and Day, 2010; Benner, Tanner, & Chesla, 2009).  Furthermore, nurses on the units are often re-energized in their passion for nursing when working with DEU students.  DEU nurses across the nation have returned to school to advance their degree (Moscato, 2007).  Partnerships between academic and practice institutions are critical to ensure that the profession of nursing is a leader in improving quality and safe patient care.

References:

Benner, P. E. (2010). Educating nurses: A call for radical transformation (1st ed.). San Francisco, CA: Jossey-Bass.

Benner, P., Sutphen, M., Leonard, V., & Day, L. (2010). Educating nurses: A call for radical transformation. San Francisco, CA: Jossey-Bass.

Benner, P. E., Tanner, C. A., & Chesla, C. A. (2009). Expertise in nursing practice: Caring, clinical judgment & ethics (2nd ed.). New York, NY: Springer Pub.

Edgecombe, K., Wotton, K., Gonda, J., & Mason, P. (1999). Dedicated education units: 1 A new concept for clinical teaching and learning. Contemporary Nurse, 8(4), 166-171. doi: 10.5172/conu.1999.8.4.166

Giddens, J., Brady, D., Brown, P., Wright, M., Smith, D., & Harris, J. (2008). A new curriculum for a new era of nursing education. Nursing Education Perspectives, 29(4), 200-204.

Gonda, J., Wotton, K., Edgecombe, K., & Mason, P. (1999). Dedicated education units: 2 An evaluation. Contemporary Nurse, 8(4), 172-176. doi: 10.5172/conu.1999.8.4.172

Lindeman, C. A. (2000). Pressures on nursing education. Creative Nursing, 6(4), 10.

Miller, T. W. (2005). The dedicated education unit: A practice and education partnership. Nurse Leadership Forum, 9(4), 169-173.

Moscato, S. R., Miller, J., Logsdon, K., Weinberg, S., & Chorpenning, L. (2007). Dedicated education unit: An innovative clinical partner education model. Nursing Outlook, 55(1), 31-37. doi: S0029-6554(06)00311-3 [pii]10.1016/j.outlook.2006.11.001

Ranse, K., & Grealish, L. (2007). Nursing students' perceptions of learning in the clinical setting of the Dedicated Education Unit. Journal of Advanced Nursing, 58(2), 171-179. doi: JAN4220 [pii]10.1111/j.1365-2648.2007.04220.x

Wotton, K., & Gonda, J. (2004). Clinician and student evaluation of a collaborative clinical teaching model. Nurse Education Practice, 4(2), 120-127. doi: S1471-5953(03)00033-7 [pii]10.1016/S1471-5953(03)00033-7

From the Visiting Nursing Association of Western New York website:

This year, the Visiting Nursing Association, in collaboration with the UB School of Nursing, instituted the first home health Dedicated Education Unit (DEU) in the area! 

Robin Brown, BSN, RN, manager of clinical outreach and practice transitions, embraced the idea of a home health DEU. Her goal has been to broaden the exposure of nursing students to home health nursing and to use the DEU model as well as the capstone experience as a means to identify students who would be a good fit for our new graduate nurse residency program. 

These students pair with a preceptor two times a week, for five weeks in an effort to use and build their skills as they learn how dynamic and rewarding a career in home care can be.

So far (October 2019), 14 RNs have completed specialized training that allows them to function as a clinical instructor in the VNA DEU.