There have been multiple research studies that prove the benefits of healthcare simulation.  The NCSBN (National Council of State Boards of Nursing) did a study that provided substantial evidence that up to 50% of high-quality simulation (scenarios involving Standardized Patients) can be effectively substituted for traditional clinical experience in all pre-licensure core nursing courses (Hayden, Smiley, Alexander, Kardong-Edgren, & Jefferies, 2014). 

Healthcare simulation allows learners to practice clinical skills (physical assessment, prioritization of care and critical thinking) & to refine their interpersonal and communication skills (interview and history taking, patient education) in a safe, non-threatening environment.

References

Hayden, J.K., Smiley, R.A., Alexander, M., Kardong-Edgren, S. & Jeffries, P.R. (2014).  The NCSBN national simulation study: A longitudinal, randomized controlled study replacing clinical hours with simulation in prelicensure nursing education. Journal of Nursing Regulation, 5(2) Suppl., S1- S64.

Jeffries, P. R. (2015). Reflections on Clinical Simulation: The Past, Present, and Future. Nursing Education Perspectives (National League for Nursing), 36(5), 278–279. https://doi-org.ju.idm.oclc.org/10.1097/00024776-201509000-00002

Lindell, D., Poindexter, K., & Hagler, D. (2016). Consider a career as a healthcare simulation educator. American Nurse Today, 11(5), 58–59. Retrieved from https://search-ebscohost-com.ju.idm.oclc.org/login.aspx?direct=true&db=ccm&AN=115590210&site=ehost-live 

 

This article suggest that moral distress plays a key role as the new graduate nurse transitions from the learning setting to the professional clinical setting.  The author further suggests several unit-based interventions to reduce levels of moral distress in order to assist and make the transition more smoothly for the new graduate and the preceptor.

 

It is imperative that new graduates start with a firm foundation.  Otherwise, without prompting they can crumble under the pressures of learning a new unit, learning new systems and becoming a well-rounded nurse.  Not only are turnover and moral distress harmful to patients, but they are also harmful to hospitals and the healthcare system at large; nurse turnover costs can range from $90,000 to $145,000 per nurse depending on the localized salaries and specialty (Bong, 2019).  This study boost about the importance of new graduate nurses requiring support to effectively develop competency and promote retention.   

Dedicated preceptors and appropriate patient assignments were associated with increased comfort, confidence and retention.  Having a standardized practice allows both the preceptor and the new grad to know what’s expected of them.  The pressure of the preceptor being responsible for content and the pressure of the new grad trying to prove themselves is lifted.  Now they have a week by week model made available to them to ensure that they are on the same track.  This practice allowed for two measures of success.  The first measure of success focused on retention with a target of 2% improvement.  The second measure of success focused on patient satisfaction with a target of 0.5% increase.

This program is continually evolving, future research studies and evidence-based projects would be beneficial in the continuation of the program.  As the program is refined and fine-tuned it can be dispersed to other departments within different organizations in the hopes of increasing retention and patient satisfaction.

The goals of nursing orientation programs have been to successfully transition nurses into their new roles and retain professionals in the nursing field.  Nursing orientation can be a time of culture shock, and if nurses experience a negative orientation experience, they many leave the field completely (Powers, Herron, & Pagel, 2019).

Since the late 1990s into the early 2000s, research has provided evidence that structured orientation programs with individualized attention provided by mentoring relationships with preceptors have increased retention of professional nurses and facilitated in increasing patient safety (Cooney, 1992; Klein, 2009; Riegel, 2013). 

 

Nurse preceptor programs are continually evolving to reach new nurses, ensure nurses are supported in gaining skills, and work closely with qualified preceptors who offer direction and support needed to facilitate transitioning successfully into their new roles.  New graduate nursing orientation programs have transitioned from long “death by PowerPoint” presentations to hands-on interactive residency programs that fulfill the gap between nursing school and novice nurse.  

 

References

 

Baldwin, K. M. , Black, D. L. , Normand, L. K. , Bonds, P. & Townley, M. (2016). Integrating Retired Registered Nurses Into a New Graduate Orientation Program. Clinical Nurse Specialist, 30(5), 277–283. doi: 10.1097/NUR.0000000000000235.

 

Ballard, J. , Mead, C. , Richardson, D. & Lotz, A. (2012). Impact of Disease-Specific Orientation on New Graduate Nurse Satisfaction and Knowledge Retention. Journal of Neuroscience Nursing, 44(3), 168–174. doi: 10.1097/JNN.0b013e3182527465.

 

Cooney, A.T. (1992). An orientation program for new graduate nurses: The basis of staff development and retention. The Journal of Continuing Education in Nursing, 23(5), 216-219. Retrieved from https://ju.idm.oclc.org/login?url=https://search-proquest-com.ju.idm.oclc.org/docview/915651966?accountid=28468

 

Klein, G. S. (2009). Beyond orientation. Nursing Management (Springhouse), 40(1), 10–13. doi: 10.1097/01.NUMA.0000343975.14096.75.

 

Powers, K., Herron, E. K., & Pagel, J. (2019). Nurse preceptor role in new graduate nursesʼ transition to practice. Dimensions of Critical Care Nursing, 38(3), 131–136. doi: 10.1097/dcc.0000000000000354

 

Riegel, E. M. (2013). Orienting a new generation of nurses: Expectations of the millennial new graduate. Open Journal of Nursing, 03(07), 461–466. doi: 10.4236/ojn.2013.37062