Preceptor-based orientation programs: Effective for nurses and organizations?

Nursing orientation for acute or critical care nurses typically occurs in 3 stages: general hospital orientation (1 day), general nursing orientation (3-5 days), and a 6to 12-week (or longer) precepted clinical experience whereby new nurses are paired with experienced nurses to learn directly on the unit of hire. Preceptors assist orientees to acquire basic nursing/unit-specific skills and become familiar with patients, protocols, care providers, and the unit’s culture. By the end of orientation, orientees are expected to demonstrate competence in basic unit-specific skills. Casey et al surveyed a cross-section of new graduate nurses (NGNs) from different hospital areas and found high stress and difficulty transitioning from student to professional roles. Root causes included lack of confidence in skill performance, deficits in critical thinking/clinical knowledge, relationships with peers and preceptors, struggles with dependence on others, frustrations related to the work environment (eg, nurse-to-patient ratios), organization/priority setting, and communication with physicians. As Casey et al acknowledged, preceptors are integral to role modeling of professional behaviors and facilitating nurses’ adjustments to their role. Thus, preceptors have immense responsibilities. This review was conducted to discover what impact preceptored orientation programs have on clinical knowledge and skills of nurse orientees as well as organizational and financial outcomes.