
HealthStream offers performance learning management solutions to help develop your healthcare staff into leaders and reduce turnover.
View All ProductsHealthStream works with healthcare organizations to create engaging and high-quality training videos for your staff and management.
View All ProductsImprove care quality and save money by making informed decisions about your healthcare facility and staff with HealthStream's reporting analytics solution.
View All ProductsHealthStream's proven methods for the improvement and overall engagement of your healthcare staff foster a positive workplace and increase retention rates.
View All ProductsThe leadership development program from HealthStream helps mold your high-potential healthcare employees into proven leaders.
View All ProductsFulfill compliance requirements with a variety of programs and courseware designed to address critical regulatory requirements as well as educate staff to recognize and mitigate risks.
View All ProductsBy increasing your healthcare staff's focus on quality and safety with HealthStream, they can help to reduce medical errors and readmission rates.
View All ProductsLearn about what HealthStream's healthcare policy management software and how it can help aid your organization efforts.
View All ProductsHealthStream's education helps address diversity, equity, and inclusion within your organization, as well as promoting health equity in the communities you serve.
View All ProductsDeliver custom or industry designed product training directly to patient and resident care environments to reinforce proper use.
View All ProductsTeach your healthcare staff about the revenue cycle and claim management through targeted training and video tools from HealthStream.
View All ProductsIn all areas of resuscitation, from neonatal to elderly care, clinical deterioration is a risk that can be avoided with the help of HealthStream's training programs.
View All ProductsHealthStream's EMS Program offers a comprehensive, CAPCE accredited EMS course library that meets National Registry annual recertification.
View All ProductsNurture the skills of your nurses and medical staff to help mold them into effective leaders with development training from HealthStream.
View All ProductsMake sure your clinicians have the support they need to provide competent care with clinical competency training and development from HealthStream.
View All ProductsHealthStream’s learning management system and comprehensive suite of competency management tools empower your healthcare workforce to deliver the best patient care.
View All ProductsThe suite of healthcare onboarding solutions available from HealthStream aids in nurse retention and improved patient outcomes.
View All ProductsGive your healthcare staff the decision support and skills training they need with the online products available from HealthStream.
View All ProductsHealthStream leverages medical professional development in healthcare by providing staff training programs
View All ProductsExperience standardized and centralized healthcare credentialing, privileging, and enrollment that is smarter and faster than ever before.
View All ProductsAutomated, web-based provider credentialing and enrollment software for growing medical groups.
View All ProductsNCQA-certified CVO verification services for initial and re-credentialing files in an overflow or full-service capacity for healthcare organizations.
View All ProductsSearch, review, and add providers into the Epic provider master file with our Epic app integration, Provider Validate.
View All ProductsFinally, a comprehensive resource to support collecting, storing, and sharing credentialing data with ease.
View All ProductsHealthcare scheduling software designed to optimize staffing requirements & elevate patient care
View All ProductsPrecisely align staffing and needed resources to enable efficient patient flow and high-quality, cost-effective patient care.
View All ProductsHealthStream’s free nurse schedule app, NurseGrid™, is built to help you care for your staff and engage with their specific needs.
View All ProductsMitigate risk and elevate your quality of care. Improving both clinical and business outcomes starts with a smarter, more integrated approach to regulatory training, continuing education and quality management.
Learn MoreBy Susan Cline, MSN, MBA, RN, NEA-BC, Consultant and Creative Health Care Management
Nursing orientation plays a pivotal role in the competency and retention of newly hired registered nurses. Effective orientation and precepting programs produce nurses who provide competent, quality patient care and are enculturated as productive members of the healthcare team. With the replacement cost of one registered nurse estimated to be as high as $64,000, retention of staff continues to be an important objective for nurse managers and directors. Additionally, collaborative relationships and teamwork have been identified as key indicators of nurse satisfaction.
Effective nursing orientation programs should include these five essential components:
1. Preparation
Successful nursing orientation requires the development of a curriculum and the training and preparation of preceptors. Specialty units should consider implementing a didactic portion of orientation that focuses on common diagnoses and procedures, along with high risk/low incidence competencies. It is important to understand that an expert clinical nurse may not make for an effective preceptor. Preceptors should be selected both for their clinical expertise and for their ability to teach and evaluate new staff members. A preceptor workshop with modules on adult learning and providing feedback can be very helpful in preparing preceptors to orient newly hired registered nurses.
2. Incorporation
New staff members should be welcomed and incorporated into the team as early as possible. Introduce new staff members in morning huddles, staff meetings, and by e-mail communication. Provide a thorough tour of the environment, introducing team members by name and role. Encourage preceptors to take rest periods and lunch breaks with new staff members during the orientation period. Nurse managers should check in with new staff members on a daily basis, even if it is just a quick “Hello” and “Is there anything that you need?” Ensure that new staff nurses have access to all of the electronic systems as early as possible, including computer log-ins, parking garage and door access, and medication dispensing system access. Not having access to the department’s systems is frustrating and alienating, and it creates a barrier to learning.
3. Goal-Directed Precepting
Nurse managers should establish weekly benchmarks to guide precepting activities. Benner’s From Novice to Expert model is an effective approach; new staff nurses start with basic competencies and move toward more complex procedures as the weeks go by. Evaluation forms with the suggested behaviors for each week are an efficient way to track progress and guide patient selection. Preceptors are encouraged to share the new staff member’s learning goals and objectives with the charge nurse and staff nurses on a daily basis so that they can identify patient care and procedural opportunities. Team ownership of onboarding new staff sends a powerful message about collaboration and teamwork.
4. Direct and Timely Two-way Feedback
Nurse managers should meet with new staff nurses and their preceptors weekly or bi-weekly. Both the preceptor and the new staff nurse should provide feedback on their progress. Ask new staff nurses to be open and honest about their confidence and comfort level. It is frustrating for everyone to discover that the new staff nurse is behind in achieving orientation benchmarks. Feedback should be honest but encouraging, with concrete suggestions for improvement. Preceptors are encouraged to provide feedback as close as possible to patient care events or procedures. Timely and effective feedback will enhance the learning experience and increase the new nurse’s confidence. It is important to note that there will be new team nurses that will required an extended orientation but will continue on to success. Plan ahead for this as you evaluate completion of weekly benchmarks.
5. Ongoing Support
At the conclusion of the nursing orientation period, the nurse manager should make plans for the future support of the new staff nurse. The assignment of a mentor or “buddy” provides a resource and a sounding board for clinical questions and debriefing. Any routine documentation audits should be explained throughout orientation so that expectations are clear. The annual evaluation process, along with any forms or documents, should be reviewed. Involvement in shared governance councils and unit projects will support retention and longevity of new staff nurses. Participation in unit activities and continuous learning are key to engagement and prevention of burnout.
Incorporation of these elements as part of nursing orientation provides structure for the initial onboarding, precepting, evaluation, and ongoing support of new staff nurses. These practices are a worthwhile investment in teamwork, nurse satisfaction, and high quality patient care.
Contact HealthStream to speak to a solutions expert learn more about our courses relatd to The Importance Of Effective Communication In Nursing.
Susan’s experiences as a Magnet® Program Director and front line manager have re-ignited her passion for her profession. As a consultant at Creative Health Care Management, her greatest joy is mentoring individuals, teams, and hospitals to develop their gifts in pursuit of a culture of excellence. Susan’s professional interests include mission and vision development, project management, and transformational leadership through effective communication in addition to the development of structures and processes to support a Magnet® journey. Susan can be contacted at scline@chcm.com.
HealthStream’s learning management system and comprehensive suite of competency management tools empower your healthcare workforce to deliver the best patient care.
View All Learning & PerformanceHealthStream offers performance learning management solutions to help develop your healthcare staff into leaders and reduce turnover.
View All ProductsHealthStream works with healthcare organizations to create engaging and high-quality training videos for your staff and management.
View All ProductsImprove care quality and save money by making informed decisions about your healthcare facility and staff with HealthStream's reporting analytics solution.
View All ProductsHealthStream's proven methods for the improvement and overall engagement of your healthcare staff foster a positive workplace and increase retention rates.
View All ProductsThe leadership development program from HealthStream helps mold your high-potential healthcare employees into proven leaders.
View All ProductsWhen you enact HealthStream's quality compliance solutions, you can do so with the confidence your healthcare organization will meet all standards of care.
View All Quality & ComplianceFulfill compliance requirements with a variety of programs and courseware designed to address critical regulatory requirements as well as educate staff to recognize and mitigate risks.
View All ProductsBy increasing your healthcare staff's focus on quality and safety with HealthStream, they can help to reduce medical errors and readmission rates.
View All ProductsLearn about what HealthStream's healthcare policy management software and how it can help aid your organization efforts.
View All ProductsHealthStream's education helps address diversity, equity, and inclusion within your organization, as well as promoting health equity in the communities you serve.
View All ProductsHealthStream offers professional training and education on how to best optimize your reimbursement process within your healthcare organization.
View All ReimbursementTeach your healthcare staff about the revenue cycle and claim management through targeted training and video tools from HealthStream.
View All ProductsLearn about our advanced resuscitation training solutions. Our solutions are designed to help improve patient outcomes.
View All ResuscitationIn all areas of resuscitation, from neonatal to elderly care, clinical deterioration is a risk that can be avoided with the help of HealthStream's training programs.
View All ProductsHealthStream's EMS Program offers a comprehensive, CAPCE accredited EMS course library that meets National Registry annual recertification.
View All ProductsNurture the skills of your nurses and medical staff to help mold them into effective leaders with development training from HealthStream.
View All ProductsExpand the decision-making skills and effectiveness of your healthcare workforce with HealthStream's clinical development programs and services.
View All Clinical DevelopmentMake sure your clinicians have the support they need to provide competent care with clinical competency training and development from HealthStream.
View All ProductsHealthStream’s learning management system and comprehensive suite of competency management tools empower your healthcare workforce to deliver the best patient care.
View All ProductsThe suite of healthcare onboarding solutions available from HealthStream aids in nurse retention and improved patient outcomes.
View All ProductsGive your healthcare staff the decision support and skills training they need with the online products available from HealthStream.
View All ProductsHealthStream leverages medical professional development in healthcare by providing staff training programs
View All ProductsLearn more about HealthStream's Provider Credentialing, privileging, & enrollment solutions.
View All CredentialingExperience standardized and centralized healthcare credentialing, privileging, and enrollment that is smarter and faster than ever before.
View All ProductsAutomated, web-based provider credentialing and enrollment software for growing medical groups.
View All ProductsNCQA-certified CVO verification services for initial and re-credentialing files in an overflow or full-service capacity for healthcare organizations.
View All ProductsSearch, review, and add providers into the Epic provider master file with our Epic app integration, Provider Validate.
View All ProductsMake sure your healthcare staff can schedule out appointments and work schedules with ease using HealthStream's line of software solutions.
View All SchedulingHealthcare scheduling software designed to optimize staffing requirements & elevate patient care
View All ProductsPrecisely align staffing and needed resources to enable efficient patient flow and high-quality, cost-effective patient care.
View All ProductsHealthStream’s free nurse schedule app, NurseGrid™, is built to help you care for your staff and engage with their specific needs.
View All Products