Implementation of an Individualized Onboarding and Training for Nurse Managers
BACKGROUND: The onboarding and training of nurse managers varies drastically in healthcare institutions across the US, even within the same organization. Though evidence-based studies have demonstrated that the onboarding and training process are related to employee engagement, retention, and to the achievement of positive departmental and institutional goals and outcomes, most healthcare organizations do not invest in providing an effective onboarding and training based on evidence models and frameworks. This project was conducted at a 345-bed tertiary teaching medical center in the Boston area to determine the need for instituting an effective evidence-based onboarding and training process for nurse managers.
METHODS: A pre- and post-intervention survey was conducted among 14 clinical nurse managers hired in the last 3.5 years for various ambulatory clinics and inpatient wards to explore their onboarding and training experience at the medical center in their first 90 days. Multiple platforms were utilized as bases for the creation and implementation of the three interventions presented in this project, including the Johns’ Hopkins Nursing Evidence-Based Practice Model (JHNEBPM), the American Organization for Nursing Leadership (AONL), the American Association of Critical Care Nursing (AACN), the Frontline Nurse Leader Conceptual Framework (FNLF), along with the “Novice to Expert” theoretical framework by Nursing Theorist Patricia Benner.
INTERVENTIONS: The 14 nurse managers were asked to complete a pre-interventions quantitative survey related to their onboarding and training process at the medical center (MC), and to their experience level as a NM. Each participant was then asked to attend a one-hour presentation and was introduced to three proposed interventions for the implementation of an individualized onboarding and training process for nurse managers. The interventions presented included the utilization of the AONL’s Nurse Manager Competency Questionnaire (NMCQ) with mentorship, the utilization of the AACN’s Fundamental Skills of Nursing Management (FSNM) online modules, and the creation of an onboarding and training checklist based on the AONL’s Nurse Manager Leadership Development Framework (NMLDF). Participants were also asked complete a qualitative survey about their perceived effectiveness of the three interventions on the onboarding and training of new nurse managers after their attendance to the presentation.
RESULTS: The quantitative and qualitative survey responses from participants revealed that their experience level as a NM and as registered nurse did not make the onboarding and training process easier for those who were more experienced, whether they came from another institution or were promoted from within. Participants expressed that having a formal evidence-based training platform, including an individualized and structured mentorship process, would have facilitated in accelerating their onboarding and training, as well as the achievement of departmental and organizational goals.
CONCLUSION: Instituting a formal and individualized onboarding and training process with mentorship for newly hired clinical nurse managers will assist in advancing their knowledge about the organization, and in the provision of necessary skills to complete tasks more efficiently. Having such a process will subsequently promote faster achievement of departmental and organizational goals, including staff engagement, employee retention, increased patient satisfaction and outcomes, as well as promote strategic alignment with the mission and vision of the medical center.