New grad orientation programs

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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?????

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?????
They make us take PBDS competentcy on the first day without warning :angryfire It is useless. It put unnecessary stress on us and wasted time, which can be used for concentrating on clinicals. I don't recommend you using it.

I think 6 month is too long but it is appropriate for critical care area.
Our hospital, orientation is 1 and a half month for Med-surg.. 5 and a half months for critical care.

I can't give you much information because I just started a few weeks agos.

Hartford,

I am a huge fan of this idea...I actually picked my job based on that (and other factors)...but I start the program in about a week. (and it will be orientation for a surgical floor)

I'm unsure of the standardisation of teaching in your state, but in the province where I went to school...there doesn't seem to be much. I have friends who can start IV's like a pro-star, and I've never done one. Then I can teach a health class while they've never done that.

What I'm hoping my training will be is things like: here's how we chart here (computer, mar, kardex whatever), spend a day with our venipuncture team, here's how our OR works, these are the community resources that you'll need to refer to, this is how our organisational scheme works, this is our pastoral care co-ordinator, these are our wound care products and how to use them...etc.

Much luck with your program!

At Stanford we have a new grad program. It is awsome. It gives you that extra support you need. We spend one 8hr day a week in classroom training. Going over things that we might see on the floors, so were more prepared. It's nice!

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?????

This is great---soliciting nursing input for a process that affects nurses. If only more hospitals would do this. Ahhhh, to dream!

A basic ECG course and a critical thinking skills building course would be nice. But, use BKAT or some more practical type of assessment tool for the testing instead of that silly PBDS.

At Stanford we have a new grad program. It is awsome. It gives you that extra support you need. We spend one 8hr day a week in classroom training. Going over things that we might see on the floors, so were more prepared. It's nice!
Hi MandiBSN,
I'm actually interested in new grad programs at Stanford, Lucille Packard, El Camino, etc. Could you tell me more about the one at Stanford?

1) How long was the program? (4 weeks, 12 weeks, 6 months or more?)
2) When does the program start and how many people started with you?
3) Which unit did you go into? Med/surg?
3) How did you like it? What do you feel could be improved?
4) Were you working 3 ?12?s, 4 ?10?s and did you work evenings, nights or days or did you rotate?
5) What advice would you give to someone on how to choose a new grad program?
6) Any interview tips for Stanford?

I graduate next summer and know that recruiters sometimes come to campus in the fall and spring. Any advice is greatly appreciated. Many thanks!

Smile123

I think an orientation program for new graduates is great. The one the Air Force uses is called the Nurse Transition Program and they have it at a few different bases; more choices for the new recruit on where to live. It is 4 months long and focuses on managing the transition from new grad RN to a functioning member of a peacetime health care unit and a ready member of a deployable unit on call to anywhere in the world with a wartime or humanitarian health care mission. We have two nurses in charge of the program. One is an older nurse experienced at writing and explaining policies, and experienced in the emotional needs of young females being a single mom with teenage daughters at home. The other nurse is younger but the pick of the litter when it comes to basic med surg nursing skills, precepting, and evaluating time management skill of nurses. The nurse managers of the units nominate senior nurses to be preceptors for the new grad program, and these two nurses hold the training. The training is one day, and annual refreshers are mandatory for all preceptors. Only RNs with so much nursing experience can be preceptors to new grads. They also have to be not confrontational but assertive and be good role models. I have seen the program reject potty mouths and meanies from being preceptors of new grads. These 2 nurses which run the program also back us preceptors up then the stress gets to a grad from time to time and the grad tries to send a preceptor down the river like that one American idol contestant tried to do Paula Abdul. They sit down with us and the new grad and listen when there is grievances and make suggestions so the new grad gets a clue and completes the program. We don't want to have to give anyone an article 15 or a dishonorable discharge! If you could research from past incident reports the ten most common types of

made by nurses in your facility and train to their
, you'd have some solid improvements coming to your facility through this new grad program alone, and it'd be specific to your hospital's needs. :Melody:

I work at a very poor hospital in Boyle Heights, CA and they serve a very poor community so I was happy to get what I could when we were given the PBDS. It was very stupid and not one nurse I spoke to passed the first time. It is a bunch of video topics,answer according to priority. Then We didn't have staff to precept. I have had almost no moral support except from my classmates outside of the hospital. Now they are "investing" alot of money to purchase a residency program that is well known and used alot at children's hospitals. My heart broke when I found out that not everyone will participate. I'm pretty sure that I won't be becasue I have already precepted for 8 weeks. The program won't start for a few months. I'm so upset that I gave my heart to this company only to be here at the wrong time. I wonder if I made a mistake by following my heart, instead of choosing a magnet hospital with strong support.

Maybe u can check with someone from Florida hospital in Orlando. They do this type of thing. here is a link to descriptions
http://www.linktoyourfuture.com/

Im a new LPN getting my RN thru Excelsior and I plan to go to FL hospital when I get close to the end and try to get into an internship or residency program to help me clinically since EC doesnt do real clinicals. It would also be great for any experienced LPN who gets their RN but doesnt have hospital experience (since its very different than other settings like Drs Offices, clinics, LTC, home health). I really like the idea and all hospitals should offer it. That way new grads wont feel thrown to the wolves and Ill bet turnover would drop considerably simply from being able to ease into the role rather than being thrown into it where u have to either swim or sink!

I'm a new grad RN and I recently finished my 12 weeks of orientation on my med/surg unit. One important suggestion I can make to you: please, please do not give preceptees more than a couple different preceptors. I had nearly every single RN on my unit (to be exact, I had 15 of them!!!!) & even some float pool RNs acting as my "preceptor of the day." It got very confusing trying to do things the way my preceptor of the day wanted them done, since I had so many of them! I feel like I'm a competent new nurse now, but I didn't like being passed around like that. Not very organized-it basically showed how uninvolved my nurse manager is. I never sat down with her to discuss how I was doing during or after orientation-again, sad. I feel like there is no point now, since I'm very good at asking questions if i need help. And I work with very supportive nurses. It's just the nurse manager who basically follows a "laissez faire" nursing management model-not recommended!!!

I'm a new grad RN and I recently finished my 12 weeks of orientation on my med/surg unit. One important suggestion I can make to you: please, please do not give preceptees more than a couple different preceptors. I had nearly every single RN on my unit (to be exact, I had 15 of them!!!!) & even some float pool RNs acting as my "preceptor of the day." It got very confusing trying to do things the way my preceptor of the day wanted them done, since I had so many of them! I feel like I'm a competent new nurse now, but I didn't like being passed around like that. Not very organized-it basically showed how uninvolved my nurse manager is. I never sat down with her to discuss how I was doing during or after orientation-again, sad. I feel like there is no point now, since I'm very good at asking questions if i need help. And I work with very supportive nurses. It's just the nurse manager who basically follows a "laissez faire" nursing management model-not recommended!!!
I totally agree with this poster! I also had at least 10 or more preceptors, including some who did not want to precept. Some were great, and some were unbelievable micromanagers. I would learn how to do something for one preceptor, and then get ripped by the next one. So, I would suggest one or two preceptors, give the orientee some SPACE, create a safe atmosphere where the orientee can ask questions without hearing answers like, "I don't know what they teach you new nurses in school anymore". Catch your orientee doing some things right, not just wrong. It might help to train the preceptors, and only hire as many nurses as you have decent preceptors for.

Oldiebutgoodie

More thoughts on orientation:

1. Use the nursing process as a basis for orientation. Assess the skills and experience of the new nurse, find out what kind of learner he/she is. Plan out how you will work together, and get together to evaluate how it is working for both of you.
2. Don't say, "Good job!" Say, "Good job doing xyz..." If you criticize, it's always easier to hear it along with something the new nurse has done right. Orientation should build a new nurse's confidence, not tear it down.
3. Have "skills days", where you spend time learning things like IVs, phlebotomy, etc. Don't be so tied to the schedule of the day that the new person doesn't have the opportunity to try out new things (wound-vac, EKG machine, etc...)
4. I felt that it would have been helpful to have "emergency training". For example, quiz your new orientee: "You find patient xyz in bed with these symptoms, ... what should you do?" Yes, I know we should know this stuff, but real life scenarios from the unit would be helpful.
5. Have patience. New people can be slow. Telling them, "Faster! Faster!" does not necessarily make them faster, it only makes them crazy. Speed comes with time. However, time-saving tricks are very helpful.
6. If new person has just started nights, it is probably not productive to expect them to be functioning at top level right away, unless the orientee is a night person, in which case, orientee may not be functioning well during days. See point #1, on assessment.
7. If there must be multiple preceptors, try to standardize, so that the orientees are not totally confused.

Oldiebutgoodie

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.

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