Ideas to streamline Hospital orientation

[bobbysgirl]

Hello,

Along side these posts....I am a new hospital clinical educator. I have decided to streamline orientation. One idea I have is to use e-learning for the didactic areas and then practice skills in a classroom. I am thinking of performing a needs assessment because there are things these nurses get in nursing school over and over. Because the orientation program has not been revised in years, I want to make it a selling proposal. Any suggestions?

Thanks

[HouTx, BSN, MSN, EdD]

Hi - welcome to the education 'tribe'.

I realize that you're gung-ho and want to jump right in, but I would advise some caution in what you promise. I know that some of us like change but it doesn't make sense if there is inadequate return on investment. Leadership is always pushing for shorter orientation - but inadequate orientation is a HUGE dissatisfier for nurses and can be disastrous for new nurses. I would urge you to pay close attention to the words you use to describe your improvements... use words like "more efficient", "more satisfying", etc. Make sure you establish specific metrics for determining whether you have met your goals.

What is your goal with orientation? Why do you want to revise it? Are you trying to replace classroom activities with asynchronous online learning in order to make the process more flexible & consistent? If so, do you already have a Learning Management System in place & online courseware available? If not, this can be a huge expense. If you want to develop your own online courses, this will require specialized skills & knowledge that are not easy to come by.

I am a big supporter of individualizing orientation based upon individual needs. But this is a 2-edged sword. Keep in mind that most of us are not reallly objective about our own skills. You will have problems with over-and under-estimation of competency. It is best to try to use some objective measure of skills.

The most important thing to remember? Orientation (by definition) is not meant to teach new skills - but to ensure that new staff understand how your facility does things. Programs for developing skills should NOT be labeled as orientation. Instead, establish a separate identity for this extra stuff. Call it 'IV Therapy', 'Cardiac arrhythmia interpretation', etc... This will keep you out of the "why is orientation so long?" discussion with your CNE.

Best of luck! If you need help, PM me - I will be glad to respond.

[nurse2033, MSN, RN]

As a victim of poor orientation I applaud your idea. I personally like an orientation that somewhat mirrors the nursing process. First you start with your outcomes. Then assess your learners (no one likes to repeat stuff they are good at), then create a plan to best impart the information. Then implement your plan. Evaluate regularly throughout and at the end. Then reassess (perhaps by QA for a few months). As for your idea of computer versus classroom, I would pick the mode that best achieves the outcomes you seek. That will vary depending on your learners and available resources.

My unit is working on a multilevel orientation process which will both shorten and lengthen it. Nurses will be cleared for lower acuity patients first. This orientation should be relatively short. Once they are comfortable, and doing well by either QA or some other assessment, they go back in for moderate acuity patients and are evaluated there as well. Then they hit all the specialty training and assessments for the highest acuity patients. The advantage to this system is that if they can't handle the first stage, you haven't wasted a lot of time and money training them for things they can't do anyway. Hopefully this type of employee will be few and far between, but not everyone works out. Experienced nurses will be passed through this process quickly based on their abilities. New grads will have the time they need to absorb a lot of new information. Good luck!

[bobbysgirl]

Thank you! The hospital I work at does have Healthstream program. Question: Are there some skills that should be taught with orientation on the specific unit ie: bladder irrigations? We do have unit specific educators but I am unsure of their role at this point. I requested their job description, but have yet to see one.

As educators at my hospital, we do preceptor classes, leadership classes, cpr, new hires, cna orientation,travelers orientation, nursing students orientation, new nurse orientation, etc...It can be overwhelming:uhoh3:, and new to this position, I see many things taught over and over. If you have any knowledge to share or ideas, I am open and ready. Any help is greatly appreciated! Thank you!!!

[bobbysgirl]

Thank you. Question: What are the "main skills" that should be gone over in orientation and which ones are more appropriate to be done with the preceptor on the unit?

[bobbysgirl]

HouTx,

6 months has gone by since I put into a place a streamlined orientation process. It has worked well, but alot of comments I have received on evaluations have been "It was a good review." I don't want it to be a review but, as you state, to ensure new hires know how the facility does things. Should skills such as IV therapy, catheter insertion, etc...be left out of orientation? I have wondered why the hospital have these in orientation when they get this training in school. I appreciated ideas and suggestions. Thank you!