Staff nurse preceptors: a program they "own"

Application of a change theory model to develop a competency-based orientation (CBO) program managed by staff nurse preceptors resulted in preceptor satisfaction, improved patient outcomes, and a more effective, efficient orientation program. After assessing the group using Hersey and Blanchard's framework, the CNS selected change strategies to implement the CBO, including: (1) helping staff nurses to redefine problems with current orientation procedures; (2) anticipating and overcoming their objections to CBO; (3) bolstering their confidence in a trusting, accepting environment; (4) motivating them as preceptors; and (5) providing direction, models, and explanations. These strategies helped preceptors accept and feel an "ownership" of the new program, resulting in many outcomes in the system. Veteran staff nurses gradually assumed ownership for individual orientees and managing orientation activities in the CBO. Rather than precepting individual orientees, the CNS assumed responsibility for establishing CBO and helping preceptors maximize their potential.