Aurora St. Luke's Medical Center

Presentation Notes

Poster presented at: American Nurses Credentialing Center (ANCC) National Magnet Conference, Orlando FL, October 8-12, 2019.


The ‘Best Fit Orientation’ is a novel approach for onboarding newly licensed registered nurses utilizing standard orientation tools, a realistic job preview, self-reflection, and a sequenced experience on three different med/surg units with "best fit" unit selection. Positive evaluation and limited turnover with additional cost makes this program attractive.

Purpose: To design and implement a novel approach for effectively onboarding newly licensed registered nurses (NLRN) by providing a realistic job preview during a sequenced orientation experience on three different units. The process ends with a “best fit” decision for the NLRN to support nurse retention.

Relevance/Significance: Premature NLRN turnover is a costly problem. Orientation programs support nurses to transition into their first position, but their effectiveness is in question. Creative approaches are needed to expose NLRN to practice realities, develop skills/confidence, and support them to select a “best fit” position based on preferences for population, culture, and peer/manager relationships.

Strategy and Implementation: This project was implemented at a large urban Magnet designated quaternary medical center with NLRN hires that were undecided about their unit/role preference. The “Best Fit Orientation” (BFO) utilized a centralized cost center and existing orientation materials and unit-based preceptors. Hires were provided with a realistic preview opportunity to experience the work environment on three different med/surg units with open positions and a desire to participate. Orientees completed questionnaires designed to support them in self-assessment, reflection, and problem solving. Each hire completed a portion (13 days) of their orientation on each unit, facilitated by the clinical education coordinator. Each unit experience culminated with a transition day with formal evaluation by unit leaders, preceptors, and the newly hired nurse. Input from leaders and participants were used to optimize the program over time. Costs were transferred to the hiring unit.

Evaluation/Outcomes: All orientees (n=29) completed orientation on time and were hired onto their unit of choice with 95% retention at 2 years. NLRNs gave high ratings for clinical knowledge, skills, confidence, and knowing how to access resources. The preview experience supported them to build relationships and find their specialty. Leaders provided high ratings regarding candidate selection, design, execution, and paperwork. The BFO process is cost neutral compared to the standard orientation process.

Implications for Practice: The BFO program allows for NLRN to experience and identify the unit where they best fit through self-reflection and structured evaluations. Participant and leader evaluations were positive with no turnover. Ongoing feedback and employment duration will be monitored for effectiveness over time.


Bilal, S., & Bashir, N. A. (2016). Effects of the realistic job previews on employee job satisfaction and met expectations. International Journal of Business and Management, 11(4). doi:10.5539/ijbm.v11n4p219

Gilmartin, M. J., Aponte, P. C., & Nokes, K. (2013). Time for realistic job previews in nursing as a recruitment and retention tool. Journal for Nurses in Professional Development, 29(5), 220-227. doi:10.1097/01.NND.0000433146.51557.b7

United States Office Personal Management. (2019). Assessment & Selection: Realistic Job Previews. Retrieved from

Document Type





To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.