New grad orientation programs

[hartford1042]

Our hospital is in the process of planning and developing an orientation program for new graduates. It will be a 6 month Residency RN program. Anyone have experience starting a program like this? And all the new grads out there......ideas as to how the program should be run, what was helpful/not in your orientation, what do all new grads need to know?????

[Daytonite, BSN, RN]

I was part of a committee in a hospital that ran a 10-week new grad orientation program. The way we were set up was that the grads worked Monday through Thursday on their units with preceptors. Occassionally, there were inservice programs set up specifically for them to attend. Every Friday was a classroom day. The grads were in nursing education and had group discussion about how their week had gone. We encouraged them to bring up questions and concerns and discussed them. We also brought in nurses from the various units and people from other hospital departments to talk with them. We reinterated various hospital policies that they needed to know because people will forget that stuff if they don't use it. We provided a lunch for the grads and each week we got take out from different restaurants around the area. This was budgeted in to our program.

I think our grads had a very nice easing into their jobs. One of the biggest problems with grads is helping them get over the realization that they aren't going to have an instructor by their side continuously and they must start making some judgments on their own. The other, of course, is time managment and prioritization. You need to keep in contact with the preceptors of the new grads all the time to make sure all is progressing as it should. Our preceptors were put through an 8 hour seminar on how to precept. The preceptors were required to sit down with their orientee once a week and do an evaluation of what had been accomplished, what needed to be done still, and discuss goals. This generated a written report that went to the person running the orientation program. This continual feedback for new grads is essential! They are a fragile, emotional group. Most want to please their employer and beat themselves up if they feel they are not making the grade. You need to get out and observe the preceptors doing their job just like any other employee to make sure they are doing it correctly.

Be very watchful of the new grads and protect them from being bullied by other more experienced or less-patient nurses. This has to include a period of time after their formal orientation as well, so have a plan for follow-up evaluations. Have flexibility with your program to account for the grads who are a little slower catching on. Encourage other staff to give the grads continual feedback as to how they are performing and to always say good things as well as the not so good. Bullies and impatient staff nurses will undermine all the good you've done for new grads and are the biggest cause of new grads leaving a workplace, so keep an eye out for this happening and give the new grads a way to deal with this, even if it is on how and who to report that behavior to. Some review of assertiveness may be OK. The most important thing is to help establish "life lines" for these grads, so that when they are off orientation they know exactly who they can go to for advice or just a shoulder to lean on. It is very important that they never feel alone or abandoned. You need to look for preceptors who are willing to give this kind of nurturing. Orientation, as you are probably becoming aware, is a very expensive endeavor for a facility, so you want to make it as efficient, pleasant, and successful as possible. Final line is retention. That's what it's all about.