The orientation systems at Mercy Medical Center in Des Moines are the same for all nurses. The subjects usually attend a four to five-week formal class from where they are expected to learn the skills and competencies required for the job. The new nurses are joined by a preceptor whose main objective is to give practical insights to the discussion. Their readiness for the job will be evaluated through a series of assessment activities. A clinical resource nurse may also be requested to gauge the suitability of new recruits to the positions they will fill in. After the probationary period, the orientation coordinators will make recommendations to the unit director for new staff integration. Nursing orientation continues to be a major concern not only here in the US, but also across the globe. This challenge has various negative implications, and it is paramount for policy makers to engineering decent strategic plans if they aim at addressing it. Nursing shortage, according to Adrenira et al. (2008), denotes a scenario where the demand for nursing professionals exceeds the supply. Nursing orientation has various implications. First, it increases nurses’ workloads (Forsyth & Mackenzie, 2006). In other words, the few nurses available have to double or tipple their work rates in order to meet the healthcare’s expectations. Secondly, there is an increased likelihood for error, and this may compromise patient safety (Forsyth & Mackenzie, 2006). Thirdly, there are high chances of the spread of infections to patients and staffs (Forsyth & Mackenzie, 2006). Fourthly, there is an increased likelihood of occupational injury (Forsyth & Mackenzie, 2006). Fifthly, a nursing shortage hampers the public’s perception of nursing as a profession (Forsyth & Mackenzie, 2006).
The orientations should be longer and more individualized; adequate training of the preceptors and anticipating the compatibility; the role of mentors; educating older nurses about the importance of retention; how to avoid early burnout in new grads; simulation of clinical situations that are specific to certain units; residency program of new grads that would last up to 1 year which could be the solution of all issues related to nursing orientation in a long run-the new grads would be paid during this time as registered nurses but the training would be adequate and it would allow the nurses to gradually adapt to the real world of nursing, become comfortable with their coworkers which can ultimately increase the retention and the job satisfaction.
The main objective of an orientation program is to prepare new nurses to be confident and to provide competent and safe patient care (Park & Jones, 2010). The orientation program is also used to increase the rate of retention, which is essential for addressing nursing shortage in the country. In order to improve the nursing orientation process at Mercy Medical Center, the paper recommends three strategies: 1) simulated learning, 2) mentoring program, and 3) case studies.
Simulated Learning
Barriers to Implementation
The problem-solving strategies discussed in the earlier section of this paper entail the use of technology, time, and money in their implementation. Nevertheless, the availability of resources does no guarantee that the plan can push through without barriers. Orientation coordinators and the rest of the staff are likely to be presented with factors that will complicate the process.
The first barrier is the existence of policies that are not uniform across the system. Mercy Medical Center consists of several departments that may not be coordinated in terms of their standard operating procedures. Waiting to close the gap among them can significantly slow down the implementation of the proposed orientation strategies. In addition, the plan should be applicable to all nursing specialties. Nurses may need to be categorized on the basis of their duties and responsibilities and grouped accordingly so that integration of new nurses can be addressed effectively in the orientation.
The second barrier is the observation that nurses perform a variety of roles. Their obligation is not solely limited to that of a bedside nurse in a hospital setting. The orientation strategy needs to give guidance that will help nurses achieve flexibility at work—for instance, being able to shift from being a direct caregiver to the coordinator of care to supporting team member. Accomplishing this requires knowledge-acquisition activities that hone the capacity of the nurses to adapt easily to the changes as they happen and to maintain focus under pressure.
On the other hand, successful implementation of proposed plan necessitates more than just procedures that tell the nurses how to apply their knowledge and skills. The lack of motivation in the staff can also act as a detriment to the plan. Managers should, therefore, be able to influence the staff into believing that the proposed changes are for their benefit and that of the people they serve.
References
Adeniran, K., et al., (2008). Transitioning Internationally Educated Nurses for Success: A Model Program."The Online Journal of Issues in Nursing, pp. 1- 10.
American Association of Colleges of Nursing (AACN) (2014).Nursing Shortage. Retrieved on July 26, 2014 http://www.aacn.nche.edu/media- relations/fact-sheets/nursing- shortage.
Drury, V., Francis, K., & Chambers, Y. (2009). Where have all the young ones gone: implications for the nursing workforce," Online Journal of Issues in Nursing, 14 (1), 1- 10.
Forsyth, S. & McKenzie, H. (2006).A comparative analysis of contemporary nurses' discontents.Journal of Advanced Nursing, 56(2), 209-216.
Honor Society of Nursing (HSN) (2014).Facts on the Nursing Shortage in North America. Retrieved on July 26, 2014 http://www.nursingsociety.org/Media/Pages/shortage.aspx
Dutra, D.K. (2013). Implementation of case studies in undergraduate didactic nursing courses: a qualitative study. International Journal for Equity in Health. Doi: 10.1186/1472-6955-12-15.
Forsyth, S. & McKenzie, H. (2006). A comparative analysis of contemporary nurses' discontents. Journal of Advanced Nursing, 56(2), 209-216.
Goodridge, J.M. (2003). Orientation programs for registered nurses: best practice guidelines. Association of Registered Nurses of Newfoundland and Labrador. Retrieved from http://www.arnnl.ca/documents/publications/Orientation_Guidelines.pdf.
Honor Society of Nursing (HSN) (2014). Facts on the Nursing Shortage in North America. Retrieved on July 26, 2014 http://www.nursingsociety.org/Media/Pages/shortage.aspx.
Kidd, M. & Rook, G. (2012). Tripping over the welcome mat: Why new nurses don’t stay and what the evidence says we can do about it. American Nurse Today 7 (6). Retrieved from http://www.americannursetoday.com/tripping- over-the-welcome- mat-why-new-nurses-dont-stay-and-what-the-evidence- says-we-can-do-about-it/
