Best Orientation Practices For Nurses - Term Paper Example

Best orientation practices for nurses Best orientation practices for nurses Over the recent past, the issue of nurse retention has generated much attention as turnover rates for nurses have increased tremendously. Currently, turnover rates for new graduate nurses is estimated to be between 35% and 61% (Guthrie, Tyrna and Giannuzzi, 2013). A huge percentage of finances are directed towards hiring and subsequent training of new nurses instead of being directed towards improvement of care and enhancement of health care delivery systems. To ensure nurse retention therefore, there is need for introduction and implementation of effective orientation programs founded on constructive didactic ideologies as well as relevant premises relating to the nursing profession. This paper examines the best orientation practices for New Registered Nurses. In the nursing profession, one of the problems facing nurses involves the retention of nurses. A methodical investigation cited by Kiel (2012) indicates that approximately thirty percent of newly registered nurses abscond from the nursing profession before the end of the first year at the job. Additional investigations showed that a quarter of newly licensed or registered nurses leave their jobs before the end of two years at the job (Kiel, 2012). This has necessitated the need for the introduction of effective orientation programs geared towards equipping these newly licensed nurses with skills and competency to remain at the job. In other words, the main challenge faced by these nurses during orientation is transitioning from being a student to a nursing professional. An article by Brown and Pillar (2014) brings out the fact that health organizations are faced with difficulties relating to how to successfully orient nurses in a bid to help them be accustomed with the daily running of the organizations. According to Robitaille (2013), "An effective orientation process is crucial to help ensure an individuals competency to perform his or her role and familiarize the orientee with an organizations culture, policies and procedures, and unit-level protocols" (p. C7). In some cases, nurse managers assume the newly employed nurses will orient themselves in the course of their duties. Additionally, some nurse managers fail to ensure orientation of new nurses due to the high costs involved in such orientations. As a result, the newly employed nurses experience lack of support from other experienced nurses and hence find it difficult to evolve or develop. This leads to stress and anxiety and this contributes to the increase of turnover rates of nurses. There is need for nurse leaders or managers to recognize the benefits for orientation of new registered nurses as well as the benefits of offering relevant support plans for newly employed nurses. It is worth pointing out that the availability of an accommodating and caring environment within the nursing profession is of considerable advantage. The application of eminent orientation and support plans and strategies that meet the desires and requirements of new nurses are examples of factors that enhance or improve the delivery of health care services. One of the factors that impact on orientation include financial challenges within health care organizations that translates to inadequate spending on prospects for growth (Kooker and Kamikawa, C. (2010). It is also of significance to elucidate the fact that new nurses are sometimes transferred to other departments or units in which they are not adequately skilled to work without proper orientation (Robitaille, 2013). Based on the data presented, one can note the major concern relating to newly licensed nurses is their retention in the nursing profession. This has been identified through numerous and extensive research aimed at investigating reasons for the high turnover rates. It is clear from the data presented that the problem of nurse shortage and retention is not limited to a single nation or region, but it is a global problem. Beginner nurses experience the same problems all over the world and as presented evidence has shown, these include stress, job dissatisfaction, discontentment, and cynicism with nursing as a profession. Working conditions in the contemporary world have put undue strain within the health care system that necessitates newly employed or registered nurses to be assimilated rapidly into the workplace. This has made it imperative for experienced nurses to act as mentors for new nurses. Orientation is mostly aimed at improving the competency level of new nurses. Methodical investigations conducted in Lee Memorial Health System indicated that orientation helps improve the competency level of new nurses (Guthrie, Tyrna and Giannuzzi, 2013). Competency is evaluated through the use of Performance Based Development Systems (PBDS); statistics from these systems show that only thirty five percent of newly employed nurses attain the minimum competency scores for admission. After orientation, it has been noted that sixty five percent of all newly employed nurses significantly improve their competency level (Guthrie, Tyrna and Giannuzzi, 2013). Cockerham (2012) applies Benners theory in relation to orientation and state that beginner nurses mostly employ the use of checklists given by their instructors or nurse leaders hence affecting their capacity for decision making. This subsequently affects their self-confidence and assurance leading to the provision of poor services to the patients. Available literature from past studies also show considerable proof that student newly registered nurses experience a lot of stress as they move from being a student to being integrated into nursing profession. This stress is as a result of absence of self-confidence, experience, as well as inconsistencies within the nursing profession that fails to mirror the anticipations and hope of the newly registered and employed nurses (Kooker and Kamikawa, 2010). Therefore, the benefits of an orientation program can never be understated. New nurse often feel satisfied with nursing as a profession when the working conditions and environment makes them feel secure, worthy, and cherished. To achieve this, there ought to be the introduction and implementation of effective and encouraging practices that will help the new nurses be integrated and retained in the nursing field. One of the strategies that can be used to solve the issue of orientation includes the use of an internship program in health organizations (Kooker and Kamikawa, 2010). Such an internship program should include instructive sessions as well as practical sessions form a specific number of months in order to help the new nurses understand the daily running of health institutions and the services offered in every department. Internships have been proved to improve the competency level of new nurses. For instance, an internship program introduced in Lee Memorial Health System in 2006 that encouraged critical-thinking improved the competency level of the interns from thirty eight percent to fifty five percent (Guthrie, Tyrna, and Giannuzzi, 2013). As mentioned earlier, the encouraging experienced nurses to act as mentors for the newly registered nurses is of significance. Mentoring programs helps decrease anxiety and stress among the new nurses since they have someone to talk to and ask for guidance. Subsequently, mentorship programs heartens the growth constructive and mutually respectful relationships among nurses, and also ensures new nurses receive necessary support from experienced nurses (Kooker and Kamikawa, 2010). Other than internship and mentorship programs, preceptors also play an important role in the orientation programs for new nurses. By definition, a preceptor is an skilled and qualified care giver or nurse who assists new nurses in the learning process within health care organizations. Robitaille (2013) posits that "Because preceptors help orientee acquire basic nursing and unit-specific skills and become familiar with patients, protocols, providers, and the facilitys culture, preceptors assume a great responsibility as they model professional behaviors and facilitate nurses adjustments to their role" (p. C7). Therefore, preceptors play a vital role in orientation of newly registered or employed nurses. For example, an orientation program in Centra Health that trained experienced nurses to act as both preceptors and mentors increased orientation satisfaction among new nurse from forty percent to a hundred percent in each and every department (Brown and Pillar, 2014). Residency programs have also been used in the many parts of the world particularly the United States to combat the challenges associated with orientation. Dyess and Parker (2011) asserts that pragmatic investigations have shown that official residency programs significantly "improves retention rates and increases clinical skill or competency" (p. 616). In conclusion, the field of nursing has been faced by the problem of nursing shortage as many nurses leave their jobs after a few years at the job. This has been the reason for the introduction of constructive orientation programs aimed at improving job satisfaction and subsequently improve the retention of nurses. There are many courses of action that are employed by nurse leaders to ensure the nurses are retained. Subsequently, newly licensed nurses are oriented through a number of ways. For instance, nurse residency programs has been proved effective in helping beginner nurses transition from being a student and a working professional in nursing. Preceptors are also used in many health care organizations to guide the beginner nurses in their learning. Other orientation strategies include internships and mentorship programs. Experienced nurses are appointed and trained on how to offer guidance to the new nurses in a bid to make them feel comfortable and satisfied with the nursing profession. These orientation practices have been proved successful through research. References Brown, K., & Pillar, M. (2014). Education Day Poster Presentations: Customizing Orientation to Improve RN Satisfaction. Retrieved from www.learnmore.duke.edu Cockerham, J., Figueroa-Altmann, A., Eyster, B., Ross, C., & Salamy, J. (2011). Supporting Newly Hired Nurses: A Program to Increase Knowledge and Confidence while Fostering Relationship Among the Team. Nursing Forum, 46(4), 231-239. Dyess, S., & Parker, C. G. (2012). Transition support for the newly licensed nurse: A programme that made a difference. Journal of Nursing Management, 20, 615-623. Guthrie, K., Tyrna, J., & Giannuzzi, D. (2013). Transitional Orientation: A Cost-Effective Alternative to Traditional RN Residency Programs. Nursing Economics, 31(4), 172- 183. Kiel, J. M. (2012). An Analysis of Restructuring Orientation to Enhance Nurse Retention. The Health Care Manager, 31(4), 302-307. Kooker, B. M., & Kamikawa, C. (2010). Successful strategies to improve RN retention and patient outcomes in a large medical centre in Hawaii. Journal of Clinical Nursing, 20, 34-39. Robitaille, P. (2013). Preceptor-based orientation programs for new nurse graduates. AORN Inc, 98(5), C7-C8. Read More