The document describes several nursing orientation programs across different specialties. A general orientation program involved an 8-week preceptorship with 9 new graduates, which resulted in a 47% increase in retention. A second program included general, unit-based, and nurse residency components, leading to a current 13% turnover rate. An ICU orientation was 16 weeks with a structured schedule and resulted in a 40% reduction in orientation time and 95% 1-year retention. A PCU program was 10 weeks with teams of 3 nurses and preceptors and increasing patient loads, intended to ease the transition to the unit. Overall the programs aimed to smoothly transition new nurses and improve retention rates.

1. Nursing Orientation
By: Robert Derrett

2. General (NO Specialty)
• 8-week orientation using preceptors and multiple adult teaching/learning
methods, such as group discussions, case studies, and self-learning
computer modules.
• 9 new graduates participated in the program over 9 month period.
• Sample of 21 registered nurses completed preceptor program; head nurses
and preceptors participated and new graduates were evaluated prior to and
after participation in the program. 1
– Data analysis showed strong support for preceptor program from all categories of
nurses.
– Result: Retention rate for participating new graduates increased 47% after
program implementation.

4. General Cont…
• Nurse(s) are entered into 3 programs.
• First program is general orientation (hospital policies and procedures,
review of clinical skills common to all acute care units, and familiar clinical
problems).
• Second program is a unit based orientation consisting of classes that
provide specialized knowledge and clinical time with a preceptor.
• Time spent directly in unit based orientation varies from 6 weeks to as much
as 6 months depending on the adjustment/transition of new graduate.
Simultaneously baccalaureate nurse is entered into a nurse residency
program. 2
– Result: Current turnover rate is 13% with this program as of July 2005

5. General Cont….
12 Week Orientation Schedule. 3

6. General Cont…
• Gnosis program (accredited provider of continuing nursing education): 11-
week program of classes, planned clinical experiences, and feedback
sessions. All nurses participate in care of their preceptor’s patients. Upon
completion of GNOSIS nurses begin their unit-specific orientation, which
varies from 8-35 weeks.
– Result: Nurses for North Carolina’s High Point Regional Health System retention
rate is 88%, up from 44%. 4

7. ICU Orientation
• 16-week orientation plan. Intermediate level and stable ICU-level patients
with a higher planned acuity to be done 9 to 12 months after hire (Schedule
on following slide).5
– Result: 40% reduction in orientation time for new graduate nurse and high 1 year
retention rates (95%)
• Orientation ranged from 8-12 weeks depending on the nurse’s number of
years in nursing and level of experience. 6
• All new nurses required to attend classes offered every 2 months or test out
via written examination.

8. ICU Schedule

10. PCU
• 10 week orientation. NG divided into 2 teams of 3 nurses. Each team paired
with 1 preceptor. NG worked two 8-hour shifts (provided by hospital nursing
education department) and two 12-hour (worked on unit in teams) shifts
second week of orientation.
• Each team responsible for the care of 3 patients. Each NG was assigned to
1 patient and was responsible for their care with assistance from preceptor.
• As weeks progressed, NG patient load increased hire.7

11. Final Remarks

12. Citations
1. Butler, K. M., & Hardin-Pierce, M. (2015, Spring). Leadership Strategies to
Enhance the Transition from Nursing Student Role to Professional Nurse.
Nursing Leadership Forum, 9(3), 113-114.
2. Return on investment: Benefits and challenges of a baccalaureate nurse
residency program. Nursing Economic$, 21(5), 13-18, 39.)
3. Beeman, K. L., Jernigan, A. C., & Hensley, P. D. (1999). Employing new
grads: A plan for success. Nursing Economics, 17(2), 91.
4. Craven, C. (2002). GNOSIS program pays off. Nursing management,
33(8), 15-16
5. Chesnutt, B. (2012, April). Meeting the Needs of Graduate Nurses in
Critical Care Orientation. CriticalCareNurse, 32(2), E51-E52.
6. Morris LL, Pfeifer PB, Catalano R, et al. Designing a comprehensive
model for critical care orientation. Crit Care Nurse 2007; 27: 37–60.
7. CriticalCareNurse, 29(2), E26-27.