Supporting Our Graduate Nurses: Getting Oriented Together

New nurses fresh out of school face more challenges than ever before. The Designated Orientation Unit (DOU) launched this past summer on R3 is ensuring recent graduates get their bearings, as they receive the tools, support and confidence needed for a successful beginning to their careers here.

"It was such a positive learning experience for me, to actually feel like they cared about me as a new nurse." - Willa McKinley, RN / Graduate Nurse

When Willa McKinley, a Progressive Care nurse on R4, walked into the main lobby en route to her first shift last September, she knew that there was still plenty of learning ahead of her. Over the next four weeks, Willa spent her days, and some nights, in the DOU getting up to speed on everything from the code to get into the medicine room to our protocol for things like IV piggybacks.

“A lot of different nursing skills that you do a few times in nursing school, suddenly you’re doing them every day,” Willa recalled. “[The DOU} was a really big learning environment. That was probably the biggest advantage for me, just getting to ask all the questions I could.”

Katelyn Southwick, RN started here last August after graduating from Clinton Community College. Starting her career in the DOU had her feeling more prepared.

“The [DOU] has been really good about support, and as a nurse, that is huge, knowing you have somebody to ask questions to or just somebody to lean on during a tough day or just in general,” Katelyn added.

The Designated Orientation Unit is based on R3. Every Graduate Nurse spends their first 4 weeks on the floor, and each is paired with a preceptor who has volunteered to be on the unit. While Progressive Care is home to many of the preceptors, some come from different floors and care settings, like Ethan Stansbury, RN who works on R7.

“It takes something to step off your unit that you’re used to. It definitely takes the right type of person that wants to step out of that comfort zone,” stated Ethan, a 7-year veteran of the hospital getting ready for his fifth year of being a Preceptor. “I like to teach. And in this kind of setting, where everyone wants to be there and help grow these new nurses, it’s just a positive environment all around.”

“Everyone who was a nurse on the floor orienting us had opted in to do this, and so they were inclined to be teaching. And there was a wide variety of experience. [Some of the preceptors] have been nurses for 20 years, and others graduated in the class or two ahead of me. There were definite benefits to both. One, the breadth of knowledge of a more senior nurse, but also the [newer] preceptors who were just in nursing school and knew exactly how I was feeling.”

Anna Upton, an RN on R3 who has been with the organization for two years now, was thrilled to be able to provide her new colleagues like Willa and Katelyn with support and education, just like she received in her first year here.

“I am new enough out of school that I remember what it’s like to be a graduate nurse, and I am very glad to work alongside and help them get the experience they need or just give them the space to learn. I find that rewarding, and it’s important to me because there were nurses who did that for me,” Anna said.

One major point of success that all four nurses pointed to is the team learning environment that was created with the DOU. Anna pointed out, “It’s easier to take advantage of learning opportunities,” explaining that if one patient on the floor has a chest tube, all the graduate nurses working can come in and see how to care for a patient with a chest tube and learn how to troubleshoot problems that can arise.

“I find that it builds a team-based atmosphere. Not just with the preceptors working together, but the graduate nurses getting to be with their peers and experience everything together. If everybody is doing something the same way, there’s less inconsistency. So teaching everybody to do things the same way helps strengthen our organization,” Ethan added.

Connections and camaraderie were additional benefits all four nurses spoke about. Graduate Nurses who were going to remain in Progressive Care after completing the DOU had plenty of familiar faces around among the first-year RNs and the Preceptors. Building a rapport with each other meant they were quicker and more comfortable with leaning on each other for questions and support as they came up day-to-day, shift-by-shift.

In addition, the graduate nurses were able to build relationships with those who moved on to other floors or into other care settings once their time on the DOU was over. And those connections grew stronger throughout the year as part of their work together in the New Nurse Residency, which continued offering education and support.

“The DOU just really connects everyone and I think that is really special. There’s a lot of people who I went to school with who I got closer with because of that, but also people who came from different hospitals, different schools, we all got really close because of that experience,” Willa said.

“It was really beneficial to have the preceptor right there with you the whole time at first if I had questions or concerns. It was also nice because now I see the people who were in the DOU that aren’t just on my floor, and I know them and am familiar with them,” Katelyn offered.

With the DOU being housed on R3, the graduate nurses also experienced a diverse patient population, seeing long-term care patients and those with higher acuity. Additionally, they worked the opposite of what their eventual planned shift was going to be, meaning anyone who would be working days also had several night shifts scheduled during the DOU to get familiar with what other nurses experienced.

At the end of the day, though, it all came back to teamwork, a lot of learning, and plenty of enthusiasm for the nurses involved.

“The new nurses just bring a breath of fresh air and excitement. They cause me to question things and look up protocols as I’m trying to teach them, and that means our patients will benefit in the long run because we’re providing even better care,” Anna said. “It’s fun to see how they grow over those 12 weeks we’re initially working together, getting more confident.”

“It gave us just really a team feeling of, look, we’re all in this together, and if we have a question or if we’re struggling, there’s tons of people on this floor who want to be here to help answer questions,” Willa reflected. “It was such a positive learning experience for me, to actually feel like they cared about me as a new nurse.”