Orientation Timeline

[mitchsmom]

I am wondering what most units are using for their orientation timeline?

Also, do you set a goal for an actual number of checkoffs (certain minimum number of deliveries, baby catches, c/s, mag, etc.)?

I am updating ours and so I'm just curious and looking for ideas. Our have 6 months and we have always done postpartum, L&D, then baby catching toward the end.

Does anyone do L&D first? I know that postpartum is kind of an easier intro, but I'm wondering if maybe it would be better to start with L&D, when new grads are "fresh" and motivated, and wind things down with postpartum. (Don't know if we could even if I wanted to, because doing pp first also gives us staff to pull to PP during high census needs...but that would really be an advantage to the orientees because they always get ripped off by being pulled to pp when they are supposed to be in L&D training)

Like I said, just looking for ideas and benchmarking what works for others.

We are an LDRP unit with about 65 deliveries a month and we do it all: LDRP, OR circulating, OR catching, PACU, sick baby stabilization for transfer to NICU, lowish risk antepartum, etc.

[ashleyisawesome, BSN, RN]

Ours varies based on the nurses experience, how fast they learn and the unit needs. Generally we train to PP first, since it can be done quicker, then they work in a PP for a few months to get used to it and are trained in labor later. For each area (PP, Nursery, labor, OR/PACU, antepartum, triage, Resus/aka baby catcher) we have a checklist that your preceptor has to sign saying you are competent in those skills. There isn't a certain number of times you have to do a skill to get checked off, but in general it's a see one, do one with assistance, then do one independently and you get checked off (at least when I precept).

PP orientation is about 4 weeks for nurses with prior experience in med/surg or another similar area, longer for a new grad.

For labor training we spend anywhere from 12-16 weeks, sometimes more with a preceptor with labor patients. Once you are signed off and deemed ready to be on your own in labor, we get about 4 weeks of C-section training (including OR and PACU). We have them come in for day shift scheduled sections. Not everyone is trained to catch babies and it just kind of happens after you've been a labor nurse for a while (I think we should have more structured training in that department). We allow people to train to triage after 1 year of labor experience, but I've seen people just get thrown into it with no additional training (myself included). Some of the skills on the check list don't get done because you can't guarantee someone will get a hemorrhage, dystocia, etc, during orientation. In that case the preceptor goes over the policy with the preceptee and signs them off with a note that says "policy reviewed".

We have trained some nurses to labor before postpartum. I don't really know how my manager decides who to train to what area first. We have the same issues with orientees getting pulled to postpartum due to high census when they should be training to labor.