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24-SPEC-372-Blog Nurse Onboarding Made Right 02. Blog Image-V2-MD (1)

Nurse Onboarding Made Right: 6 Key Steps for Success

May 2nd, 2024
May 2nd, 2024

Nurses work diligently to deliver care to patients despite staffing shortages. This demand to provide high-quality patient care with fewer and fewer resources, including staff, creates the perfect environment for burnout, especially for new grads. Ill-equipped preceptors can also increase the risk of new nurses leaving their positions. These six key steps to improve the nurse onboarding process will turn the tide on turnover rates.

What Is Driving Nursing Turnover?

In recent years, staffing shortages and burnout have taken the lead in problems facing nursing leadership. Before the COVID-19 pandemic, nurses were in high demand because of aging nurses retiring and limited enrollment into academia due to a lack of nursing faculty. After the pandemic, many nurses retired early or left healthcare altogether. This staff shortage has led to remaining nurses being morally squeezed, many past their breaking points, creating some of the highest rates of burnout the profession has ever seen. A recent study noted that 91% of nurses surveyed reported burnout, specifically due to inadequate staffing and low job satisfaction.

The high turnover rates in nursing create immense performance and operational strain on the healthcare system. The many current job openings beckon new and seasoned nurses into an already stressed healthcare paradigm. Reevaluating the onboarding process for new nurses will develop a supportive environment for career growth and longevity while helping staff create the work-life balance needed to combat burnout. 

6 Key Steps for Successful Nurse Onboarding

Nurse onboarding has historically been a uniform format without individualization. Implementing these six steps can make the process enjoyable and successful, reducing staff turnover.

1. Create Strong Leaders

Preceptors guide and teach newly hired nurses various aspects of the position. Unfortunately, inadequate preceptor training can be a recipe for disaster. A formal plan to educate preceptors is imperative to developing a foundational workforce to train and sustain nursing staff. HealthStream’s Preceptor Development program's interactive modules and online skills/competency checklists equip preceptors with the necessary skills while assessing their ability to communicate and collaborate with preceptees effectively.

2.  Welcome New Hires

Many new hires come to the organization without knowing the system or the staff. Take time to welcome new hires before their first day of work. Nurse leaders emailing new hires with a welcoming message and even a brief statement from the senior nursing leadership can make for a warm and inviting presence. A short meeting or lunch with the intended preceptor before the start date establishes the relationship early and eases first-day anxiety.

3. Communicate Effectively

Communication is essential in all areas of the onboarding process. Effective communication sets clear expectations for both preceptors and new hires. Communicate clearly defined job descriptions, expectations, and responsibilities to preceptors and new hires. Staff can feel overwhelmed and distracted without clearly defined roles, leading to ineffective and inefficient onboarding.  

4. Ask for Feedback

The onboarding process is dynamic and will change over time. Regularly check in and inquire about the process. Getting feedback from preceptors and new nurses can foster new ideas and workflows. This feedback will create a successful onboarding process, reducing turnover rates. HealthStream offers tools like online skills and competency checklists. These competency evaluations will also assist in identifying any barriers to onboarding.

5. Plan for Support

A successful onboarding process creates a supportive environment. Individualized learning plans will help determine the amount of education and support nurses need. After the onboarding process is complete, both new and seasoned nurses require ongoing support. Create a plan early in the onboarding process for identifying mentors as resources or sounding boards for nurses.

6. Prioritize Mental Well-Being

Due to the significant increase in burnout, supporting the preceptor and new nurse's mental well-being should be a top priority for nursing leadership. Establishing an effective and efficient onboarding process can reduce dissatisfaction and frustration. Communicate to preceptors and staff the available peer-support options within the organization. Educate preceptors on signs of burnout to watch for in new hires and intervention strategies. Respect the preceptor and nurse's time away from the organization, as over-scheduling an already strained staff can increase nurse turnover.

Nursing leadership and healthcare systems can utilize these six key steps to transform the nurse onboarding process. Using a validated tool for preceptor development creates confident and well-trained preceptors. Welcoming staff and continual communication with preceptors and nurses can reduce anxiety and frustration. Receiving feedback from both nurses and preceptors allows for evaluation of the onboarding process and opportunities for improvement. Planning for ongoing education after the end of onboarding ensures peer support from seasoned nurses. Honoring staff’s time away from the job will enhance nurses’ mental well-being during onboarding and beyond, creating a more resilient nursing workforce.

Contact Healthstream to learn more about how the Preceptor Development program can improve onboarding and reduce nurse turnover.

 

References

Galanis, P., Moisoglou, I., Katsiroumpa, A., Vraka, I., Siskou, O., Konstantakopoulou, O., Meimeti, E., & Kaitelidou, D. (2023). Increased job burnout and reduced job satisfaction for nurses compared to other healthcare workers after the COVID-19 pandemic. Nursing Reports, 13(3), 1090-1100. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10443294/
Homecare Homebase. (2021, December 17). Nurse retention and onboarding challenges and best practices. https://hchb.com/nurse-retention-onboarding-challenges-best-practices/
Hong, K. J., & Yoon, H. (2021). Effect of nurses’ preceptorship experience in educating new graduate nurses and preceptor training courses on clinical teaching behavior. International Journal of Environmental Research and Public Health, 18(3), 975. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7908293/
Kurnat-Thoma, E., Ganger, M., Peterson, K., & Channell, L. (2017). Reducing annual hospital and registered nurse staff turnover—A 10-element onboarding program intervention. SAGE Open Nursing, 3. https://journals.sagepub.com/doi/full/10.1177/2377960817697712?utm_source=twitter&utm_medium=SAGE_social&utm_content=sagenursing&utm_term=c460af57-63a1-4817-822a-70f7b2be3aa3  
Sanders, S. (2024, February 1). Navigating the 2024 healthcare staffing surge. WSi Healthcare Personnel. https://www.wsijobs.com/blog/2024/1/29/navigating-the-2024-healthcare-staffing-surgenbsp 
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