Orientation of New Graduate Nurses to Acute and Critical Care: Reimagining the Preceptor Role

Hospitals and health systems experienced unprecedented levels of nurse turnover during the COVID-19 pandemic, increasing the need for new graduate nurses in the postpandemic workforce.

With a growing shortage of qualified preceptors, a redesign of the preceptor role was proposed. Clustering new graduate nurses into small groups of 2 to 5 allows for increasing the number of new graduate nurses onboarded with a limited number of preceptors.

A group-orientation model was used to assign a preceptor dedicated to orientation and unburdened with patient assignment to a small group of new graduate nurses. New graduate nurses stayed within the group for the first phase of onboarding, from 4 to 8 weeks, then transitioned to 1:1 supervision with a preceptor for the last phase of orientation.

Preceptor and new graduate nurse satisfaction increased. New graduate nurse retention also increased by 3 percentage points compared with new graduate nurses oriented with the traditional model over the same period. The cost of preceptor salaries in the first 15 months of the group-orientation program was approximately $10 000 per new graduate nurse.

The group-orientation model appears to be financially viable, with favorable impact on new graduate nurse retention.

A group-orientation model for onboarding new graduate nurses may be a useful approach to accelerate onboarding, enhance satisfaction, and decrease turnover. The cost of providing group orientation may be offset by cost savings seen when new graduate nurse retention increases.