The nursing orientation process becomes a matter of focus in the service quality of the healthcare system because it enhances the integration of new graduate nurses (NGN), faculty nurses, and a culturally and linguistically diverse workforce into the nursing workforce. Purposeful orientation processes help settle transitions by offering employees the skills, knowledge, and support that they need to make a successful beginning. This paper reviews five studies related to the developmental trends of improving nursing orientation management and the prudence of the research-based evidence in creating and conducting orientation programs for the NGNs, nursing faculty, and CLDRNs.
The Problem
This literature review focuses on improving the orientation process of the nursing faculty for new graduate nurses (NGNs) and the hospital setting. It shows the dynamics involved when NGNs change from students to practising nurses and emphasizes how orientation programs should be sufficiently equipped to ensure their successful integration into the workplace. In addition, the review established the use of cultural competency, language ability, and support systems, which aid CLDRN integration into nursing.
Search Strategies
The sources used for this literature review were retrieved online through Google Scholar. A search using search terms, e.g., ‘nursing development,’ ‘the purpose of orientation in nursing,’ ‘the kinds of nursing orientation,’ ‘strategies for nursing orientation improvement,’ ‘the significance of improved nursing orientation, ‘ targeted nursing articles written in 5 years and could solve the issue of developing nursing orientation.
Levels of evidence
These research methods comprise a systematic review, an integrative review, or a quality improvement pilot project. Based on a comprehensive and integrative literature review approach, Kiel (2020) and Rogers et al. (2020) identified the efficient directions for the orientation programs of non-governmental organizations and nursing professors, respectively. By the Groth et al. (2023) survey, a quality improvement pilot project was initiated and facilitated to create and execute a newcomers’ plan for new junior nurse faculty.
Literature Review
The importance of improved nursing orientation
Kiel (2020) researched to discover the significance of competence enhancement programs for graduated nurses on hospital sites. As part of the systematic literature review, published studies from 2008 to 2018 were identified using five databases. Researchers applied the particular criteria for inclusion and exclusion to this pool of studies. The research project aimed to single out the most effective NGN orientation in the hospital framing.
The study results revealed that existing orientation modalities involve preceptorship, classes, and patient care simulations. The most effective orienteers had clearly defined goals and used proven instructional materials (Kiel, 2020). The most efficient orientation program includes learning materials, support systems, and learning methods with well-proven efficacy. In addition, nursing managers must develop measurable goals for the program and NGNs so that regular evaluations are doable in real-time.
The author states that the implementations can be adaptable to the hospital’s allocated Budget and existing technology. Orientation duration should be agreed upon based on orientation needs and activities (Kiel, 2020). The result of the research is related to the nursing orientation improvement issue because considerable evidence-based study underlies the design and management of orientation programs. Nonetheless, the research has some constraints. The study’s limitation is that it focuses on studies published before 2018, which may cause earlier results than recent studies. Moreover, it only included studies published in English, which may also decrease the generalizability of the data.
In like manner, Rogers et al. (2020) conducted research that focused on how vital orientation programs are in nursing faculty. The study was guided by knowing the essential elements of faculty orientation and developing the faculty orientation checklist and mentor-mentee responsibilities index. Rogers et al. (2020) published an integrative review employing the Ganong method, resulting in 48 articles that met the criteria and were critically evaluated and interpreted. The findings unravelled the core parts of faculty orientation in nursing, involving instruction on academic culture, scholarship, and service. The program’s designers also developed a comprehensive orientation program and job specifications based on research.
The research exhibited that orientation in the academic setting supports nursing instructors through the transition process. A detailed checklist is helpful for the mentor and the mentee to track progress. Resolving the needs of a novice instructor could lead to higher faculty satisfaction, better student learning outcomes, and improved faculty retention and productivity (Rogers et al., 2020). The study’s weaknesses include, among others, not stating the sample size nor mentioning the stratified sampling method. Moreover, the study needed to be more comprehensive as it only included the studies published before 2018. This may limit the applicability of the study’s outcomes.
The study relates to the nursing orientation improvement issue, the general introduction of scientific evidence and the organization of the orientation programs for nursing faculty. Nursing managers can use the result of this study to guide the implementation and management of orientation programs that are congruent with evidence-based findings, bearing in mind the available Budget and technology that the hospital owns (Rogers et al., 2020). The results of this study are a reference for future nursing orientation for educators.
Similarly, Groth et al. (2023) have implemented a quality improvement pilot project to see the effects of orientation programs on nursing staff behavior. The research’s principal goal was to design and run an orientation program for the new nursing faculty. Groth et al. (2022) implemented a quality improvement pilot project through a convenience sample of the novice nurse faculty using pre and post-design. The research introduced the pre-orientation program as an essential aspect of cultural awareness, instruction, academic accomplishments, and service. The orientation program index will include a job description for mentors and mentees, an extensive checklist, and an incredible feeling about the learning materials.
The study’s outcome showed that the orientation program increased job satisfaction, productivity, and retention among novice faculty members and improved student yield. This study points out the importance of dealing with the concerns of new faculty during orientation (Groth et al., 2023). One of the study’s limitations is that it is a convenience sample with a pre-post design, which may be the reason for the limited transferability of the findings. Moreover, the study does not have a control group, so the correctness of the results could be in question.
This research is applied to the problem of improving nurses’ orientation because it accentuates the importance of an evidence base in developing and managing orientation programs for nursing faculty. The results of this study can guide nurse managers to create and manage orientation programs with the help of evidence-based research while considering the Budget and other hospital resources such as technology (Groth et al. (2023). In addition, the results of this study can be used to increase understanding and improve nursing orientation for nursing professors in the future exploration of this field.
Integrating nurses through orientation
Kamau et al. (2023) researched the Culturally and Linguistically Diverse Registered Nurses (CLDRNs) as they were integrated into the nursing workforce in Finland. A qualitative descriptive design was applied to investigate the integration process and the barriers and facilitators of the CLDRNs. The study used a qualitative descriptive approach with data analysis from 24 CLDRNs in Finland (Kamau et al., 2021). Through content analysis, the study identified five key categories that encapsulated the experiences of CLDRNs: before immigration, in-country job skills and language requirements, sense of competence, and positive and negative integration factors.
It turned out to be the most essential part of the research, where I could define the main issues CLDRNs face while integrating into the local healthcare system, which are caused by culture, language, and ethnic gaps. The research findings underscored the relevance of cultural sensitivity, language proficiency, and a professional network that comprised colleagues and other organizations in integrating the CLDRNs into the nursing profession in Finland (Kamau et al.,2023). Nevertheless, the shortcomings of the research should be highlighted to ensure the results are reliable. Generalizing the effect of the research by using the convenience sample, however, might restrict the study’s effectiveness for the entire CLDRN community. Moreover, the experimental study’s deprivation of a control group may affect the reliability of its findings.
This study has significant implications on the culture of nursing tasks because the findings emphasize one of the essential factors of proper incorporation of immigrant nurses into the nursing workforce: cultural knowledge and language skills. This data can comprise the basis for a specialized or individualized orientation course that would deal with the most relevant aspects of immigrants, thereby boosting their retention and career progression rates (Kamau et al., 2023). Moreover, it diversifies the topic, allowing researchers to improve CLDNRs onboarding procedures.
Transitioning of nurses through orientation
Hamilton et al. (2020) found orientation to be a key element of the transition from a newly graduated registered nurse to a full-fledged qualified nurse through a research study they conducted. The mixed-methods research that we are undertaking is aimed at determining the experiences of the newest registered nurses during the first practical period and assessing the issues raised by the qualitative approaches.
Through a meticulous examination of thirteen articles meeting the review criteria, the study identified seven key themes that emerged from the collective experiences of novice nurses: social, professional, emotional, transitional difficulties, reflections, transitioning shock, and feeling (Hampton et al., 2020). These topics partially shaped young nurses’ bright and exclusive experiences as they passed through this critical stage of professional, personal, and emotional development.
The study recognizes transition-to-practice programs with specific components such as orientations, preceptorships, and residencies for new nurses. The report showed that these programs help new staff cope with the learning curve and achieve success in the nursing environment. According to this, these programs should be designed to make it easy for veteran and novice nurses- to get good results (Hampton et al., 2020). The analysis is highlighted by the complexities and the subtleties of transitioning, highlighting the urgency for creating individual plans for support and assistance and the issues first faced by novice nurses.
Within nursing education and practice, this integrative review contributes significantly to the teachers of nurses and healthcare organizations. Stakeholders in this field can become aware of the concerns of novice nurses during their transition and design initiatives and programs to improve the transition experience for novice nurses (Hampton et al., 2020). The review advises a systematic method for transition-to-practice programs, emphasizing the necessity of socialization, professional advancement, and adequate application of support to deal with transition difficulties at the appropriate level.
Solutions
The study revealed that the most effective orientations had well-defined objectives when applied to the established learning materials. Critical elements of an effective orientation program include resources, materials, support, and proven learning methods. Nursing managers should formulate clear targets for the project, and NGNs should have development assessments immediately.
Conclusion
This literature review exposes the dynamics of well-tailored nursing orientation programs for new graduate nurses (NGNs), faculty in nursing, and culturally and linguistically diverse registered nurses (CLDRNs). The orientations would be well-planned, the learning material would be well-designed, and the support systems and goals would be measurable. Practical approaches for a unique orientation to meet the needs of the CLDRNs and successful integration of the cohort into the nursing workforce should include specific cultural competencies and language fluency. They delivered quality health services and tailored organizational orientation strategies that resulted in increased satisfaction, the productivity of nurses, and retention.
References
Kiel, J. M. (2020). An analysis of restructuring orientation to enhance nurse retention. The health care manager, 39(4), 162–167. https://DOI: 10.1097/HCM.0000000000000303
Rogers, J., Ludwig-Beymer, P., & Baker, M. (2020). Nurse faculty orientation: An integrative review. Nurse Educator, 45(6), 343-346. https://DOI: 10.1097/NNE.0000000000000802
Groth, S. M., Duncan, R., Lassiter, J., & Madler, B. J. (2023). Onboarding orientation for novice nurse faculty: A quality improvement pilot project. Teaching and Learning in Nursing, 18(1), 212-218. https://doi.org/10.1016/j.teln.2022.07.010
Kamau, S., Koskenranta, M., Isakov, T. M., Kuivila, H., Oikarainen, A., Tomietto, M., & Mikkonen, K. (2023). Culturally and linguistically diverse registered nurses’ experiences of integration into nursing workforce–A qualitative descriptive study. Nurse Education Today, 121, 105700. https://doi.org/10.1016/j.nedt.2022.105700
Hampton, K. B., Smeltzer, S. C., & Ross, J. G. (2020). Evaluating the transition from nursing student to practicing nurse: An integrative review. Journal of Professional Nursing, 36(6), 551-559. https://doi.org/10.1016/j.profnurs.2020.08.002
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