Advocate Lutheran General Hospital

Presentation Notes

Presented at: Southeastern Wisconsin Building Bridges Nursing Research Conference; April 19, 2024; Milwaukee, WI.


Background/Significance: In a post pandemic state of nursing, experienced preceptors are in limited supply, and those that remain are at risk for burnout. A newly expanded unit hiring large volumes of new graduate nurses (NGNs) needed to redesign orientation to accommodate NGNs with resources available.

Purpose of Project or Study: Project aimed to utilize preceptors more efficiently without lengthening orientation, diminishing orientation experiences, or postponing hiring. Implemented a two orientee to one preceptor (2:1) pilot for two NGN cohorts.

Lit Review: Limited literature is available evaluating nursing preceptorships outside of traditional one-to-one approaches. Other healthcare disciplines demonstrated benefits utilizing a 2:1 approach.

Sample/Population and Setting: Two cohorts piloted, on a 38-bed acute medical-surgical telemetry unit, each with two NGNs and one preceptor. Day shift preceptors selected based on clinical and precepting expertise, willingness to participate and were offered a one-time monetary stipend. NGNs chosen from interview, personality, and prior experience. An orientation toolkit was modified to structure a gradual progression in patient assignment and learning expectations.

Results/Outcomes: Qualitative responses and ratings collected, via surveys and touchpoints, and themes categorized. Benefits identified NGN knowledge sharing, increased well-being support and teamwork, and decreased workload of the preceptor. Combined satisfaction rating of 3.68 (4.0). Barriers included inadequate one-on-one time, imbalance in progression of skills, increased administrative workload, and self-doubt in preceptors. Length of orientation remained unchanged.

Conclusion: Many benefits occurred early in the orientation period, while challenges presented in the later half as patient assignment ratios increased. In response, near the end of orientation, cohorts shifted to one-to-one preceptorships to foster critical thinking and time management. Social support, teamwork, and peer-to-peer knowledge sharing enhanced the orientee's experience while efficiently using available preceptors and maintaining orientation length. With a solid structure and clear communication, this model is a useful approach for units with preceptor limitations. Further data to be collected regarding NGN retention and turnover.

Document Type

Oral/Podium Presentation




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