Implementing New Hire/New RN Orientation for L&D Unit

[OBRN91]

I have worked in my L&D unit for some time now. When I was hired as a new RN there was not much of an orientation process. Seeing more and more new hires/new RN's coming to the unit, I struggle with their transition period because the department still has no formal orientation process, we sort of just throw them in and hope they swim. I have reached out to hospitals of all sizes for input and help with a process but all seem to withhold their information. So I am seeking input or ideas from fellow OB nurses as to their orientation experience or processes. I am not in management/leadership position, I am a fellow OB RN who is seeking to make the transition for new hires to our OB unit smoother for those of us training them and the new nurses themselves.

[LAJJmom, ADN, ASN, CNA, RN]

I just started on a LDRP unit and I am getting 12 weeks of orientation. Ten weeks on dayshift and 2 weeks on night shift. I was hired for nights.

[SoldierNurse22, BSN, RN]

My hospital has a whole 16-week system they put us through that involves textbook reading and goal planning for each week. We completed AWHONN's basic course, STABLE, NRP and our computer charting orientation during this time. We had 2 weeks of OR training. More experienced nurses may not need as much time, but we've found a lot of the new nurses we hire in need the full 16 weeks to feel comfortable before starting on their own.

[RunBabyRN]

Our unit/hospital is linked with a new grad program through a university. For those of us experienced nurses coming from other specialties, they have us attending weekly classes for 6 weeks to learn about c-sections, managing PIH and pre-eclampsia, etc. with the students in the new grad program. We are doing 12 weeks of orientation, give-or-take based on performance.

[Alikatz08]

My hospital has a whole 16-week system they put us through that involves textbook reading and goal planning for each week. We completed AWHONN's basic course, STABLE, NRP and our computer charting orientation during this time. We had 2 weeks of OR training. More experienced nurses may not need as much time, but we've found a lot of the new nurses we hire in need the full 16 weeks to feel comfortable before starting on their own.

My hospital does it like this as well. Basic fetal monitoring, computer charting, NRP, OR for about 2 weeks (more if really needed), reading articles, and it's about 3-4 months long. Like others mentioned, if the nurse is experienced it is usually less, but the new nurses usually utilize the full amount of orientation time. I have a colleague who is helping revamp our units orientation program. There is also a hospital wide run program for all new grad nurses.

[OBRN91]

My hospital has a whole 16-week system they put us through that involves textbook reading and goal planning for each week. We completed AWHONN's basic course, STABLE, NRP and our computer charting orientation during this time. We had 2 weeks of OR training. More experienced nurses may not need as much time, but we've found a lot of the new nurses we hire in need the full 16 weeks to feel comfortable before starting on their own.

May I ask how big your facility/unit is?

[OBRN91]

Our unit/hospital is linked with a new grad program through a university. For those of us experienced nurses coming from other specialties, they have us attending weekly classes for 6 weeks to learn about c-sections, managing PIH and pre-eclampsia, etc. with the students in the new grad program. We are doing 12 weeks of orientation, give-or-take based on performance.

May I ask how big your facility/unit is?

[ashleyisawesome, BSN, RN]

I work in a LDRP. New nurses usually orient to postpartum first, for anywhere from 2-6 weeks depending on their experience and how fast they learn. They work in PP for a while to get comfortable, then they get put in labor orientation. Labor orientation is usually about 16 weeks, including 2-4 weeks of OR/PACU training and fetal monitoring classes. We have a checklist of skills they must perform in front of preceptor and be signed off on before they can be done with orientation. There are a few items on the checklist we will let them slide on and instead just review policy with them because they are rare (we won't hold someone on orientation just because they haven't had the opportunity to witness a cord prolapse, but we will go over what to do in that situation). Once they are done orienting, we usually have them with a "back up" nurse for the first few deliveries, who mostly stays hands off but watches from afar to make sure they don't need any help.

[SoldierNurse22, BSN, RN]

May I ask how big your facility/unit is?

I don't want to be too specific, so I'll tell you what I can. We have under 20 labor beds. We have a separate PP unit with less than 30 beds. We see about 250 births per month.

[klone, MSN, RN]

Ours is similar to SoldierNurse - AWHONN's Basic, then Advanced EFM courses, STABLE and NRP, OR orientation. Typically 4-6 months before they're totally off orientation.

Mine's a smaller facility - fewer than 800 births/year.

[MC RNC]

our facility has an orientation checklist, including policy review, scavenger hunt on the unit and a skills checklist. Because we are a smaller critical access hospital, we have a contract with a larger hospital to send our inexperienced nurses to go to for education such as fetal monitoring classes, specific OB courses such as STABLE, NRP etc and more hands on clinical skills for labor management for a few weeks. Then they return to us to finish out their orientation checklist.

[jennylee321]

I agree that a skills checklist would be great in an L&D environment. My orientation had 2 days in class with 2 days on the floor which I liked instead of having weeks where you are only in the classroom.