Journal Article

ADDRESSING THE AMBULATORY ONCOLOGY NURSING SHORTAGE BY ADAPTING A STANDARDIZED ORIENTATION TO EACH INDIVIDUAL

Wong, Agnes, Le, Sandy, Jansen, Catherine

2023

Overview

Since February 2020, it's been estimated that 20% of healthcare workers have left their positions, and approximately 24% of nurses will leave their position within a year (NSI, 2022). In our ambulatory infusion center, we had approximately 60% turnover in staff between 2020-2021 due to retirements, transfers, or transitions into other positions within the organization. Concurrently we created more 24 and 32-hour positions for staff satisfaction and retention. Due to the ongoing nursing shortage and challenges recruiting experienced oncology nurses, we recognized there was an opportunity to adapt our orientation process, based on our current staff (who had limited experience in mentoring new nurses), and each new hire's level of oncology nursing experience. The objectives for this project were to 1) review and critique our past orientation process; 2) create a standardized, yet individualized, process for onboarding of staff based on experience; and 3) provide tools for mentors. Intervention: While the oncology CNS took the lead in this project, feedback was solicited from various stakeholders (e.g., director, manager, charge nurses) as well as staff that were hired just prior to this process. Components that were developed included a competency self-evaluation tool, orientation checklist, revised RN job specific initial skills competency assessment for Oncology/Infusion, milestone map, mentoring responsibilities, and a binder to include pertinent general information (e.g., policies and procedures, oncology practice care, and workflows) with additional training materials for nurses new to oncology. This process allowed us to clarify pertinent training needs, and to set expectations for continuous learning ~ with specific milestones for the initial three months. Information gained from training nurses with limited or no oncology experience, then soliciting their feedback involving additional strategies for supporting novice nurses ~ was invaluable. Engaging our staff in building basic expectations, sharing new documents, and apportioning mentoring responsibilities has had many positive outcomes. Creating ideal assignments for learning in ever-changing schedules was challenging but has enhanced communication amongst staff. Less-experienced nurses in the department also joined in the process by identifying opportunities for specific learning experiences. As a result, the commitment to new employees' success and enhanced teambuilding has been strengthened. Summary: While a standardized approach to onboarding in the ambulatory oncology setting is crucial, it is still imperative to adapt the orientation to each individual's experience level and needs.

• Publisher: Oncology Nursing Society
• Subject: Nurses / Nursing / Oncology / Orientations