Several organizations found it advantageous to use classroom teaching as a framework for the orientation program; derived from this were several benefits. The Methodist Hospital of Houston, TX used this time to familiarize new nurses with the policies and procedures of the overall organization (Pine & Tart, 2007). Children’s Hospital of Boston found it beneficial to begin all new nurse graduates as a cohort in the orientation classes creating a peer group capable of offering support to one another (Shermont & Krepcio, 2006). Children’s Memorial Hospital in Chicago used classroom time to expand on knowledge of clinical competencies gained previously (Halfer, 2007).

  ROLE OF THE PRECEPTOR

  Different approaches were taken when implementing the role of a preceptor into the orientation program. The most common approach taken was the preceptor program model-new nurse graduate focus, which were designed for each new graduate nurse to have a preceptor-guided clinical experience in a one-on-one manner (Salt, Cummings, & Profetto-McGrath, 2008, Pine & Tart, 2007, Orsini, 2005, Shermont & Krepcio, 2006). One program implemented a phased preceptor approach where different individuals lead different aspects of orientation (Halfer, 2007). The research identified many roles and responsibilities of the preceptor that facilitated the transition of the new graduate nurse. These included: serving as a role model, integrating the new graduate nurse into the unit culture, advocating for the new nurse graduate, encouraging and evaluating performance, debriefing after critical situations, offering support and helping adjust to the profession, fostering the development of relationships on the unit, serving as a resource, and teaching clinical skills (Salt, Cummings, & Profetto-McGrath, 2008, Pine & Tart, 2007, Orsini, 2005, Shermont & Krepcio, 2006, Halfer, 2007).

  To ensure the success of the preceptor-new graduate nurse relationship a few organizations ensured that the needs of the preceptor were addressed. Expanding the pool of preceptors was necessary to prevent preceptor burn-out and narrow the generation gap between new nurse graduates and their preceptors within one organization (Shermont & Krepcio, 2006). Preceptors in another program were not counted in productivity for the 12-week duration of the orienatation program in order to focus on the needs of the new graduate nurse (Orsini, 2005). The California Nurse Mentor Project outlined the training of preceptors as a key to success in their program (Mills & Mullins, 2008). The research presented here did not identify competencies required of the preceptor, which could drive future research.

  TANGIBLE BENEFITS 

  It is undeniable, the significant monetary investment required on the part of organizations when transitioning the new nurse graduate to a professional nurse. However, research demonstrated that when an orientation program that increases retention rates is implemented, this initial investment will lead to cost savings later on. At Children’s Hospital in Chicago the turnover rate prior to the implementation of their orientation program was 29.5% within the first year of employment, which decreased to 12.3%. The associated cost per new graduate was $41, 624 and has resulted in a savings to the organization of $707, 608. (Halfer, 2007). Retention was at an all time low in 2003 at the Methodist Hospital of Houston, where 50% of new graduate nurses left their positions. The rate of turnover after implementation of their program was 13% as of July 2005. The organization calculated their return on investment for implementation as 884.75% (Pine & Tart, 2007). The California Nurse Mentor Program was initiated to address the major shortage of RN’s in the Bay Area, where in 2005 60% of RNs left within their first year of employment. Results showed that those participating in the program had an 8% attrition rate; those not participating had a 23% attrition rate. Estimated savings from a monetary standpoint over three years were estimated to be between $1.4 and $5.8 million (Mills & Mullins, 2008).

  INTANGIBLE BENEFITS

  In addition to capturing data related to cost savings associated with new graduate orientation programs, several organizations also captured non-tangible benefits. Many of these are similar across different organizations and included: improved morale, increased nursing and health team satisfaction, increased personal confidence, and improved quality of care (Halfer, 2007; Mills & Mullins, 2008; Orsini, 2005). These benefits were seen not only in the new nurse graduate, but also the nurse preceptor and the unit as a whole. These intangible benefits could have and indirect impact the nursing retention rate of all nurses.

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