OR Manager April 2022 - 9
Human Resources
Orientation
Continued from page 1
1 discusses the value of orientation and
programs for nurses new to the OR. Part
2 focuses on orientation of experienced
and per diem OR nurses, along with social
onboarding and program evaluation.
Value of orientation
Employees who receive insufficient onboarding
are more likely to leave an
organization, which is particularly detrimental
in the OR. According to a 2021
report from NSI Nursing Solutions Inc,
OR nurses are the most difficult specialty
to recruit, taking an average of
111 days to fill a position, similar to the
115 days cited in the company's 2020
report (sidebar, Value of orientation by
the numbers).
Despite its importance, orientation
programs for OR nurses in the United
States lack consistency and have little
oversight, according to Jim Stobinski,
PhD, RN, CSSM(E), CNOR, CNAMB,
who is CEO of the Competency and Credentialing
Institute (CCI) in Englewood,
Colorado. In addition, many have not
been rigorously studied to determine
effectiveness. Stobinski points out
that for accreditation, The Joint Commission
and DNV verify that staff have
completed orientation, but there is no
mechanism to assess the quality of that
education, and no state or national requirements
specific to the perioperative
nurse title exist. " The employer defines
who is a perioperative nurse, " he says.
Adding to the orientation challenge
for OR leaders is the fact that most
schools of nursing offer students only
minimal exposure to the OR. " It's up to
the healthcare facility to provide new OR
nurses with what almost amounts to a
college course, " Vortman says.
Employers,
therefore, have to develop
the best programs possible to
meet the orientation needs for four
groups: new graduate nurses, practicing
nurses without OR experience,
www.ormanager.com
Value of orientation by the numbers
A few statistics illustrate the importance of orientation as a retention tool and for an effective
workforce.
➤ 15.3%: Average turnover for RNs working in surgical services
➤ 23.9%: Percentage of new RNs who leave within 1 year
➤ 97 to 126 days: Time it takes to recruit OR nurse (average 111 days)
➤ 22%: Percentage of nurses who may leave their jobs within the next year
➤ $40,038 to $61,000: Turnover cost for bedside nurse (likely much higher for the OR)
➤ $120,000: Approximate cost of training an OR nurse
➤ $270,800/year: Amount an organization can save by reducing RN turnover by 1%
Sources
NSI Nursing Solutions. NSI national health care retention & RN staffing report. 2021.
McKinsey & Company. Nursing in 2021: Retaining the healthcare workforce when we
need it most. May 11, 2021.
Thew J. Want to keep nurses at the bedside? Here's how. Health Leaders. March 27,
2019.
Vortman R, McPherson S. The state of the perioperative nursing specialty workforce: A
concern for executive nurse leaders. Nurse Leader. 2021;19(3):281-288.
nurses with OR experience, and per
diem nurses. Each group has its special
needs, but commonalities also exist.
The basics
Vortman says an effective orientation
program includes didactic presentations,
practice in a simulation or skills
lab, and clinical experience (circulating
and scrubbing) with a preceptor. Clinical
experience usually includes rotating
through multiple specialty service lines.
A syllabus provides an outline that
educators and orientees can use to ensure
essential information is covered
(sidebar, Syllabus excerpt, schedule
sample). The syllabus includes topics,
objectives, and evaluation parameters.
Information is based on AORN's 2018
position statement on the orientation of
RNs and surgical technologists, which
outlines content in the following areas:
safety, physiological responses, infection
prevention and control, behavioral
responses, and health systems.
While many topics are obvious (for
example, fire safety), the list can help
identify those that an organization might
not
think to include, such as ethics.
Most facilities also incorporate two classic
perioperative texts:
* Berry and Kohn's Operating room
technique, 14th edition
* Alexander's Care of the patient in
Surgery, 16th edition.
Organizations may use commercial
resources such as AORN's Periop 101:
A Core Curriculum or Nurse in Surgery
Essentials (NISE™) to standardize orientation,
ensuring that nurses receive
what they need to provide optimal care
to patients (sidebar, Overview of Nurse
in Surgery Essentials).
Vortman notes that these programs
save educators' time by reducing the
need to frequently update didactic materials
when information changes. " When
you invest in these programs, you know
you are getting up-to-date information, "
she says.
Standardized programs may also
help improve retention. For instance,
when Vortman implemented Periop 101
in the 500-bed medical center where
she worked, 1-year retention rates improved
from 59% to 87% and 2-year
rates improved from 37% to 70%. (Learn
Continued on page 10
OR Manager | April 2022
9
https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/nursing-in-2021-retaining-the-healthcare-workforce-when-we-need-it-most
https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/nursing-in-2021-retaining-the-healthcare-workforce-when-we-need-it-most
https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/nursing-in-2021-retaining-the-healthcare-workforce-when-we-need-it-most
https://www.healthleadersmedia.com/nursing/want-keep-nurses-bedside-heres-how
https://www.healthleadersmedia.com/nursing/want-keep-nurses-bedside-heres-how
https://www.healthleadersmedia.com/nursing/want-keep-nurses-bedside-heres-how
http://www.ormanager.com
OR Manager April 2022
Table of Contents for the Digital Edition of OR Manager April 2022
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