Nurse Onboarding: Making First Impressions Count

Guest Contributorby Dr. Renee Thompson | Posted | Culture

Nurse Onboarding: Making First Impressions Count

Welcoming a new nurse to your organization or facility is an important process that sets the tone for a positive relationship. Filled with promise and potential, that relationship can ultimately lead to many fruitful and productive years of employment. So the onboarding process is the perfect place to begin on the right foot.

From the first exposure during the application process to the first day of work, you, as an organization, are making an impression. And those first impressions have a far-reaching impact on an employee’s intent to stay.

Organizations that put as much effort into welcoming new employees as they do in retaining them are much more likely to engender organizational engagement and loyalty.

The cost of new hire turnover in nursing

The cost of turnover for a nurse is generally agreed to be somewhere between $22,000 and $64,000 USD, depending on the facility, specialty, and other factors. Of that amount, the lion’s share of those costs are related to onboarding.

When you take onboarding seriously, you can minimize new hire turnover and increase employee satisfaction.

With an approximate average RN (registered nurse) turnover rate of 13% and the average RN vacancy rate in the 8 to 10% range, we can see that retention of qualified, loyal nurse employees is crucial for the smooth operation of any healthcare facility.

Action plan for onboarding

Successful onboarding requires an astute understanding of the key principles of making a good first impression during the most critical time of a new employee's exposure to an organization.

To create a successful onboarding process make sure you pay close attention to:

1. Strong partnerships between HR and the nursing recruitment/hiring team

If you think about it, onboarding actually starts with your recruiting process.

All too often there is a disconnect between Human Resources and the nursing recruitment team during the initial application and interviewing process.

Many desirable candidates slip through the cracks at this time because of a lack of coordination and communication between HR (generally the first contact with the potential employee) and the hiring manager or nurse recruiter.

Once a candidate applies, there needs to be ongoing and immediate communication between HR, the nurse recruiter and the hiring manager, including weekly status updates regarding the candidate’s progress through application and hiring procedures.

The goal is to make the process as seamless and transparent for the candidate as possible – and to make a good first impression.

2. New employee touch-points

Throughout the onboarding process, there are key “touch-points” that can have a big impact on the new hire.

If you're savvy, you'll recognize these touch-points and actively seek to engage with the new hire at these critical times. This helps to reassure the new hire by validating their desire for employment with you while assuaging their fears and concerns.

Key touch-points include:

  1. the application and interview process
  2. clear communication regarding hiring details
  3. the first day of orientation
  4. the first week of orientation
  5. the first day on the clinical unit

So for each of these touch-points, make sure key stakeholders are well trained and equipped to fulfill their roles. Design efficient processes that give the new employee all the support, information and training they need. Look to communicate your organizational mission, vision, values and culture as well as your organization's high level goals.

3. New employees’ fears and anxieties

Every new employee has anxieties and fears about their new job, especially if that new employee is a novice nurse.

Common fears and anxieties may include:

  • not knowing where to go
  • not knowing what to wear
  • not knowing who their preceptor will be
  • not understanding organizational expectations
  • not knowing how to navigating the organizational culture

So be proactive and forward-thinking. Design an onboarding process that welcomes new employees and assuages their fears. And introduce them to all the supports you have available to help them succeed in their role and progress in their careers.

Nurse onboarding requires thoughtful consideration

Onboarding new nurses deserves thoughtful consideration, and savvy, system-wide strategies.

By addressing the frequent disconnect between HR and the nursing recruitment/hiring team you can streamline the onboarding process. Welcoming new employees is everyone’s responsibility, thus an “all-hands-on-deck” approach to onboarding requires buy-in from the key organizational players that can certainly make (or break) the onboarding process.

Check in with the new hire at identified touch-points, making sure you address the understandable fears and concerns that arise as the new nurse navigates both a new clinical position and the organizational culture of a new workplace.

If you do all this, you'll be able to attract, onboard, train and retain loyal, skilled and satisfied employees.

Your Turn: What elements or activities do you see as critical for successfully onboarding new nurses?

This post was written in collaboration with Keith Carlson who is the Chief Nursing Officer for a home health agency and the blogger behind the award-winning nursing blog, Digital Doorway. Connect with Keith on Twitter.

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How great organizations welcome new employees

In this eBook, explore the best practices that every organization should follow to build strong and lasting working relationships with new employees.


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