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Lutheran General Hospital

Presentation Notes

Professional Development poster presented at Transforming Practice: The Intersection of Technology and Nursing Excellence; Advocate Health Nursing Research and Professional Development Conference 2025; November 12, 2025; Virtual.

Abstract

Background/Introduction:

Post pandemic, experienced nursing preceptors are in short supply straining their ability to provide adequate support and training. An inpatient unit, recently doubled in size, faced significant challenges when quickly hiring large volumes of nurses, 68% being newly licensed nurses (NLNs). Despite meeting hospital first-year turnover benchmarks, there were concerns using inexperienced preceptors could lengthen orientations and negatively impact turnover rates. Unit needed to reimagine orientation. Literature suggested success with a two orientee to one preceptor (2:1) model in non-nursing healthcare disciplines, though limited literature was available for nursing.

Purpose or Objective:

Project aimed to utilize preceptors more efficiently without lengthening orientation, diminishing experiences, or impacting first-year turnover rates.

Method or Evaluation:

Implemented a 2:1 pilot on a 38-bed medical-surgical telemetry unit. Day shift preceptors selected based on clinical and precepting expertise, willingness to participate and were offered a one-time monetary stipend. NLN orientees chosen from interview, personality, and prior experience. An orientation toolkit was modified to structure a gradual progression in patient assignment and learning expectations. Leadership regularly met with participants evaluating progress and pilot success leading to modifications and individualized learner accommodations. Participants ranked the pilot via a Likert scale and provided qualitative responses, collected through surveys, from which themes emerged.

Results or Findings:

Early benefits included NLN knowledge sharing, increased well-being support, and teamwork. Combined participant rating of 3.68 (4.0). Challenges included limited individual attention and uneven skill development. Orientation length remained unchanged, saving $19,194. First-year turnover rate decreased by 49.75% and was 0% for NLNs in this pilot, resulting in a 100% return on investment and a benefit-cost ratio of 2.00.

Conclusions/Implications for Practice:

Social support, teamwork, and peer-to-peer learning in a 2:1 model enhances the orientee's experience while efficiently using available preceptors, maintaining orientation length and reducing first-year turnover. With a solid structure and clear communication, this model is a useful approach for units with preceptor limitations.

Document Type

Poster

Publication Date

11-12-2025


 

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Nov 12th, 12:00 AM

Less is More! Exploring a Two-to-One Preceptorship Model

Background/Introduction:

Post pandemic, experienced nursing preceptors are in short supply straining their ability to provide adequate support and training. An inpatient unit, recently doubled in size, faced significant challenges when quickly hiring large volumes of nurses, 68% being newly licensed nurses (NLNs). Despite meeting hospital first-year turnover benchmarks, there were concerns using inexperienced preceptors could lengthen orientations and negatively impact turnover rates. Unit needed to reimagine orientation. Literature suggested success with a two orientee to one preceptor (2:1) model in non-nursing healthcare disciplines, though limited literature was available for nursing.

Purpose or Objective:

Project aimed to utilize preceptors more efficiently without lengthening orientation, diminishing experiences, or impacting first-year turnover rates.

Method or Evaluation:

Implemented a 2:1 pilot on a 38-bed medical-surgical telemetry unit. Day shift preceptors selected based on clinical and precepting expertise, willingness to participate and were offered a one-time monetary stipend. NLN orientees chosen from interview, personality, and prior experience. An orientation toolkit was modified to structure a gradual progression in patient assignment and learning expectations. Leadership regularly met with participants evaluating progress and pilot success leading to modifications and individualized learner accommodations. Participants ranked the pilot via a Likert scale and provided qualitative responses, collected through surveys, from which themes emerged.

Results or Findings:

Early benefits included NLN knowledge sharing, increased well-being support, and teamwork. Combined participant rating of 3.68 (4.0). Challenges included limited individual attention and uneven skill development. Orientation length remained unchanged, saving $19,194. First-year turnover rate decreased by 49.75% and was 0% for NLNs in this pilot, resulting in a 100% return on investment and a benefit-cost ratio of 2.00.

Conclusions/Implications for Practice:

Social support, teamwork, and peer-to-peer learning in a 2:1 model enhances the orientee's experience while efficiently using available preceptors, maintaining orientation length and reducing first-year turnover. With a solid structure and clear communication, this model is a useful approach for units with preceptor limitations.

 

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