What are other facilities doing for clinical orientation?

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Specializes in NICU, adult med-tele.

Hi! I am working on my practicum for my Master's in the staff development department. A large chunk of my practicum is focused on clinical orientation for new employees. My preceptor and I are interested in finding out what other facilities are doing for orientation. I have reviewed the literature but I am interested in the reality. There are a few topics I am especially interested in, such as IVs and patient safety.

I would love to know how your facility handles things like IV competencies in clinical orientation. Do your new hires hit the floor with a completed competency for IVs? If so how do you complete that during orientation? Do you use a patient simulator of some sort? Something else I haven't thought of? Do you leave it up to the units to complete those competencies as the employee progresses through orientation?

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Specializes in Hospital Education Coordinator.

I have found it near impossible for me to train new hires during the new nurse orientation period, when I have them from various departments. We have new employee orientation for all new hires on Monday and Tuesday. Then Wed is nurse computer training and Thur/Fri is nurse orientation. Then they go to floor and get checked off on all equipment, skills, etc. That way the NICU nurses do not have to endure a lecture about adult patient care.

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Specializes in LTC, Education, Management, QAPI.

Do some research on the "onboarding" process also. It has been around a while, but more facilities are starting to adopt it. The purpose of onboarding is to get staff to buy in to the company mission and be a part of the community of staff. It enhances confidence and loyalty and helps with orientation and outcomes

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Specializes in Critical Care, Education.

Nice to see this thread bumped - it's a perpetual issue.

Labor budgets are under tremendous pressure - so orientation has taken a huge hit. We have even more to accomplish - especially since computer training eats up ~ 12 - 18 hours now - but have to do it in a much shorter period of time. Our NEO has basically 3 goals: 1) provide information about organization/facility specific processes, rules & regulations; 2) socialization - ensure that the newbie feels comfortable in their new job, knows what resources are available, etc; and 3) identification of any skill/competency 'gaps' that need addressed in order to meet fulfill job responsibilities.

Given today's economic constraints, the clinical skill gaps have to be addressed at the department/service line level. We use a hybrid approach - providing didactic instruction via online learning and some regularly scheduled traditional classes & psychomotor instruction & skills validation at the department/service line level. We have found that asynchronous online learning is a much more learner-centric way to deliver didactic material.

We measure outcomes: Level II upon completion of orientation; Level III at 90 days.

There is NOTHING we can do in NEO to engender loyalty... that has to come from the manager. People don't leave jobs, they leave managers. My organization scrutinizes turnover. Retention is a manager responsibility that is hardwired into their performance evaluations.

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Specializes in Hospital Education Coordinator.

As usual, HouTx hit the nail on the head!

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Specializes in LTC, Education, Management, QAPI.

I agree that in orientation we cannot engender loyalty, but the actions of the company and the amount of time spent with a new employee up front sets the tone from what the employee can expect. For example, my boyfriend left a company that had little orientation and ultimately was not well structured. Moving to a well structured company with on-boarding gave him a better feeling of security and professionalism from that new job. It really did help him feel part of the company and set the tone for his time there (he is still there). I saw a difference in how he perceived the company. That is a huge factor in loyalty, of course- depending on the size of the company and whether or not they are truly involved in activities of the business in which they own.

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Specializes in LTC, Education, Management, QAPI.

And P.S. HouTx - I agree with majority of your post, but I am leaving my current company because of the company, not my manager. My team is great, but my company is not able or willing to provide some of the things we need to provide the care for which they are asking us to provide.

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I actually left my last position because of the manager (crazy) although I really wanted to like her, and the company (cheap, cared nothing about patient care, and dangerous), oh and the administrator was a pathological liar, very scary.

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Specializes in Hospital Education Coordinator.

Another tip: I use the Joint Commission National Patient Safety Goals as an outline for nurse orientation. On our last surveyor was pleased to see that we had these on the agenda (they are my topics). Of course , I also have facility-specific info to cover as well, but I make sure policies related to those topics are discussed.

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Specializes in Tele, Stepdown, Med/Surg, education.

Wow, I agree with so many of the above comments. I'm about to leave my job because of the limited onboarding and lack of structure within the organization. This left me feeling lost and unfulfilled. I have an interview for nurse education manager position next week.

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Specializes in LTC, Education, Management, QAPI.

yeah. The on-boarding process is not just NEO- it is an ongoing process that extends a long period of time after the initial NEO, and for companies that use it, there is a higher retention rate and better recruitment rates because the reputation of those facilities is elevated versus those that have TBF (Trial By Fire) as we have all experienced!

When a company says, "Hey, I picked you to do this job and I'm going to spend a LOT of money and time on making sure that you do well and succeed," you actually do begin the process of buy-in. This is not only backed by evidence, but it is personal experience. You are ABSOLUTELY correct that buy-in to company processes will not manifest if the management team does not perpetuate it as well, as I also recently experience vicariously through by significant other. NEO and on-boarding matter, but they only start the processes, the environment has to continue it.

I know I keep bumping this thread a long time late but I really want it to keep going!!! ;-)

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