Provide one example, with supporting evidence, of how the organization facilitates effective transition of new graduate nurses into the nurse practice environment. Describe how the transition process is evaluated for its effectiveness.
OR
Provide one example, with supporting evidence, of how the organization facilitates effective transition of newly hired experienced nurses into the nurse practice environment. Describe how the transition process is evaluated for its effectiveness.
Provide one example, with supporting evidence, of how the organization facilitates effective transition of nurses transitioning within the organization from one specialty care area to a different specialty care area. Describe how the transition process is evaluated for its effectiveness. Pete Leboo
Provide one example, with supporting evidence, of how the organization facilitates effective transition of advanced practice registered nurses into the organization. Describe how the transition process is evaluated for its effectiveness.
Example One
Beginning in the spring of each year the Nursing Directors and representatives from Associate Services meet to discuss the number of new graduate nurses each area can support. Once candidates are identified a group of associates interview the new graduates and utilize the new graduate decision matrix. Based on the candidates’ long-term interests, prior experience, and open positions, the top candidates are placed in a primary site for orientation. At FF Thompson Hospital the sites would be obstetrics, medical/surgical, or critical care nursing. Prior to beginning their orientation the new graduate must successfully pass the NCLEX state licensure exam. Additionally, if a new graduate nurse does not have their BSN they agree to complete this in 5 years. When a new graduate nurses are on boarded they are placed into the Nursing Float Pool as Nurse Residents. Orientation runs 3-12 months depending on the specialty area. During their residency they are oriented on one of the nursing units but also spend short periods of time in other areas of the hospital, such as Diagnostic Imaging, Pharmacy, Surgical Care, and the rehabilitation areas. This gives them a "world view" of the organization and the many departments that are required to support the day-to-day operations of the units. After orientation they are placed in an available position and this typically occurs on the primary unit they oriented on. Each nursing unit has a unit-specific competency assessment which guides the orientation process. Alice Brocklebank was hired as a new graduate BSN in Obstetrics. Her orientation was segmented into three departmental areas of practice: Antepartum/Postpartum, Nursery, and Labor & Delivery. The department utilizes an orientation checklist for each area. For specific tasks, the checklist refers the orientee to the department policy or a nursing textbook for additional information. The checklist is designed so the preceptor demonstrates the skill to the orientee, observes a return demonstration, and adds notes to evaluate the performance of the skill and whether additional practice is needed (Exhibit SE7.1).
Exhibit SE7.1
Exhibit SE7.1 Antepartum and Postpartum Orientation
The new nurse is paired with one preceptor for each clinical area, Nursery (Exhibit SE7.2) and Labor and Delivery (Exhibit SE7.3) so they receive continuity of education and assessment of their knowledge and progress. The orientee and the preceptor each meet periodically with the Director to provide feedback on the process, the learning progression and their satisfaction with their roles.
Exhibit SE7.2
Exhibit SE7.2 Nursery Orientation1
Exhibit SE7.3
Exhibit SE7.3 Labor and delivery orientation1
As the orientation process comes to a close the orientee, in this case Alice, performs an assignment independently with their preceptor available as back-up. Throughout the entire process the preceptor does not have an additional assignment so they can be 100% devoted to the orientation process. Having the preceptor available for questions and to help should the orientee become overwhelmed ensures a smooth transition to being independent on the unit.
Provide one example, with supporting evidence, of how the organization facilitates effective transition of nurses transitioning within the organization from one specialty care area to a different specialty care area. Describe how the transition process is evaluated for its effectiveness.
Example Two
Pete Leboo, RN, was hired as a clinical nurse for the Emergency Department (ED) in June of 2013. His background as an Registered Nurse was primarily working in Long Term Care. Orientation in the ED was conducted by two primary preceptors and follow-up was conducted regularly with Director. In September of 2013 a leadership change occurred in the ED. The new director of critical care nursing, Joshua Kulp, BSN, RN recognized that Pete was not on-boarding to the ED as quickly as expected after discussing his progress with the preceptor nurse and reviewing the ED Checklist (Exhibit SE7.4). After several weeks of structured support and mentorship it became apparent that Peter would not be successful in making the transition to the ED. Pete met with Joshua and the CNO (Hazel Robertshaw, PhD, RN, CENP) to discuss options. Pete was committed to remaining at FF Thompson. A decision was made by Pete, Joshua and Hazel to identify an alternative clinical nurse position within the hospital. Hazel discussed with Elizabeth Alexander, MS, RN, CN-E, Director of Medical Surgical Nursing the availability of a position. Based on this discussion and with Pete's consent it was determined that Pete would transfer to 3 East (3E) a Medical/Surgical unit primarily caring for the orthopedic patient population. The goal was to orient and become a successful member of a tight-knit group of health care professionals and complete the required checklist (Exhibit SE7.5). Pete was oriented by Tammy Giamei, RN a primary preceptor on 3E. Tammy and Pete spent four weeks together through the on-boarding process. They utilized the Job Specific Checklist and weekly met with the Elizabeth to review progress. Pete transitioned to 3 East in November of 2013 and began to take independent assignments in January of 2014 (see exhibit SE7.6).
Exhibit SE7.4
Exhibit SE7.4 ED RN
Exhibit SE7.5
Exhibit SE7.5 Clinical Job specific skills checklist 7 for 3E RN
Exhibit SE7.6 Exhibit SE7.6 Pete Checklist.pdf