Nurse Onboarding
According to the May 2021 McKinsey survey, 22% of nurses reported the strong likelihood of leaving their current healthcare positions. The same survey revealed that of the 22% of nurses, an unsurprising 60% said it was a result of the pandemic, citing “insufficient staffing, workload and emotional toll” as the primary turnover culprits.
This troubling stat is further compounded by the expected 1 million registered nurse job vacancies the Bureau of Labor Statistics anticipates through 2022. Health care organizations need to do all they can to engage and retain their nurses.
Well-structured, engaging onboarding has been proven to increase retention. It strengthens the decision to join the organization, provides the tools needed to be successful, and establishes the foundation of their connection to the team and patients. SHRM reports that great onboarding leads to 69% of employees being more likely to stay for three years.
We talked to a nurse at a local hospital to better understand her onboarding experience. Jessica, a nurse with years of experience across multiple states, shared that most of the onboarding she has experienced has been disorganized, stressful and made her question her decision to join the organization. Her most recent position was no exception. She explained how some modifications to onboarding and training that could have helped her transition to her new position.
Here are her top 5 nurse onboarding wishes:
1. Communication
Jessica was initially delighted when she was offered her dream nursing job. But her delight was short-lived. Immediately following the exciting news, Jessica was inundated with emails from various HR specialists throughout the organization. In some cases, she even noticed duplicate information being communicated to her. This caused her an unnerving sense of confusion and uneasiness.
To make matters worse, Jessica didn’t hear another word from her future team until two days after her start date. In hindsight, Jessica would have felt considerably more comfortable joining her new team if there had been some communication with her future co-workers and supervisor. This is particularly critical within the healthcare industry where quality training is largely dependent on team relationships and dynamics.
Best practice: Establish a standardized communication protocol for new nurse hires between the offer letter and their first day. Have the hiring manager send a “welcome to the team!” email or ship a welcome gift to their home. This makes the new nurse feel valued and opens the lines of communication in case they have any questions that can’t be answered by non-clinical personnel.
2. Job responsibilities & expectations
Jessica was an experienced nurse prior to taking her new job. While she was confident in her abilities as a nurse, her new job responsibilities were not as clearly defined as she would have liked. As she settled into her new role, the needs of her department were still vague. She would find herself wearing a new hat every day and often learning new skills on the fly. It was as frustrating as it was distracting!
Best practice: Clearly defined job descriptions and role assignments help new nurses understand what they are responsible for and how they fit into the organization. Clearly defined roles and scope of practice reduces unnecessary ambiguity and creates a much more efficient and productive training timeline.
3. A day in the life
Jessica mentioned that prior to her career in nursing, preparing ahead of time didn’t seem as important. But in an environment as chaotic and unscripted as a hospital, being prepared is paramount. She wishes she would have known how this unit differed from others she had encountered in the past. Workload, time management, scope of practice and the patient population were entirely different. Having an understanding of what to expect on a typical day would have significantly reduced the learning curve.
Best practice: Help manage your new nurse’s expectations by sharing what daily life at your healthcare organization is typically like. Coordinating communication with future peers creates a rapport of comfort and trust that would enable nurses to reach their maximum potential as quickly as possible.
4. Centrally organized training
Jessica was never provided a training manual or skills checklist and often received conflicting information from various team members. Having a more structured approach with a standardized procedure would have reduced the confusion created by multiple information sources. She would have loved to know:
- What she would be trained on
- When the training would be
- Who would be the trainer
- Is there any unit/department specific training needed
Best practice: Establish training schedules, manuals and procedural documents that clearly delineate the mentor/mentee relationship with real-time digital assessment tools. Consider pairing your new hires with an onboarding buddy or mentor during the onboarding process.
5. Orientation
Jessica’s first day included an orientation with health insurance, financial directives, compliance paperwork and a general overview. This is often overwhelming in the moment and can lead to rushed and misinformed choices. Having access to this information prior to her orientation day would have allowed more time for thoughtful consideration and more informed decisions.
Best practice: Leverage onboarding technology and securely send your nurses their new hire documents digitally before their first day. Automate this step to simplify the process for HR and reduce orientation time.
6 proven nurse retention strategies
The team at NurseJournal.org shared their 2022 nurse onboarding strategies with us:
- Listen to the concerns of your nursing staff
- Make workplace culture a priority
- Meet the needs of nursezs by adjusting protocol
- Expand diversity and represenation for your nurses
- Actively address the lack of nurse educators
- Support the nurses at the forefront of healthcare innovation
Great nurse onboarding = higher nurse retention
Developing a standardized, structured onboarding process is one of the most effective ways to ensure each new nurse experiences consistently great onboarding. Make sure to include these five important nurse onboarding tips and continuously incorporate feedback from your nurses to improve your onboarding process.
Your nurses deserve more, especially after what they’ve been through during the pandemic. Start retaining them the moment they accept, and never stop. It’s the smartest way to maximize the investment you’re making in your team members throughout their entire journey.
