Meeting challenges when building and implementing a successful orientation program

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Meeting challenges when building and implementing a successful orientation program 

After reading this article, you will be able to:

  • Identify three challenges when implementing a successful orientation program
  • Discuss at least three strategies for meeting some of the challenges to effectively orient new hires

Author’s note: My name is Diana Swihart, PhD, DMin, MSN, CS, RN-BC. I am the director for the ANCC Magnet Recognition Program for Bay Pines (FL) VA Healthcare System and a commissioner with the ANCC’s Accreditation Program.

What is a successful orientation? 

A successful new hire orientation requires planning, execution, and follow-up of learning experiences with the new employee from the first contact. I am a strong advocate for the use of interactive, staff-centered, relationship-based new hire orientations that build on best practices.

When implementing a new hire orientation, it’s best to build structures and processes on best practices identified in the literature (Avillion 2006; Lawson 2002), evaluations from past and present new employees, and outcomes from focus groups. People are an organization’s most critical asset. Yet, in the first few months of beginning a new job they were once eager to embrace, new hires report feeling discouraged, disillusioned, and overwhelmed. This is frequently the result of how they were introduced, transitioned, and integrated into the new organization and/or service.

Orientations are meant to welcome new hires; to introduce employees to the organization and work environments, coworkers, and leadership; to remove the mystery of their new roles, assignments, and responsibilities; and to provide positive attitudes and skills for successful transition and integration into another adjunct in their careers. 

We know that frequently does not happen. So what does happen? Typically, new hires experience a parade of boring, speaker-centered, lecture-driven presentations or computer-assisted training with little or no opportunity for genuine discussion or interaction. Even when colorful materials are provided and interesting PowerPoint® slides are used to visually enhance the training, the sheer abundance of information can exhaust the most enthusiastic new hire. 

Then the clinical orientation begins. New knowledge, skills, attitudes, and competencies must be processed in varied amounts of time. Some organizations require a new hire to pass a medication administration exam, adding test anxiety to an already demanding schedule of experiences and learning activities.

Years of new employee feedback and evaluations of new hire and clinical orientations delineate a number of challenges with traditional orientations, as well as opportunities to improve them.

A Development Dimensions International and Monster Intelligence 2006 global study of more than 3,700 job seekers and 1,250 hiring managers (Kaiser Associates) demonstrated that 32% of employees who had been in their current jobs less than six months were already job searching. 

Job dissatisfaction scores have been reported during or immediately after the new hire orientation and extending to nearly 18 months post-hire. What are some of the shortfalls that prevent organizations from being competitive, driving up turnover and decreasing productivity and the job satisfaction of employees? 

Building and implementing successful new hire orientations will always carry challenges that invite creative strategies to meet them uncommonly well. Several such challenges include those discussed in the following examples.

Challenge: Orientation facilitators do not address the traditional short-term focus of orientations, which is giving too little or too much information too quickly to sufficiently encourage the retention of new hires.

Solution strategies:

  • Provide an operating context for new hires for knowledge transfer and application to practice.
  • Expand support and include a services focus. Begin this prior to hire and extend support through preceptorships and mentors for 12–18 months to ensure a smooth transition from the orientation to the organization to full integration into the culture of the new service, department, and/or unit.
  • Give new hires current contact lists and job aids to help decrease initial information overload. Continue to add new knowledge (e.g., policies, procedures, cultural norms, patient population–specific skills, formal and informal rules, available resources, equipment) throughout the orientation. 
  • Provide opportunities throughout the orientation for new hires to share their knowledge and skills during presentations, preceptorships, learning activities, and team assignments. Owning their learning can help new staff members build confidence and collegiality.

Challenge: Failure to transition and integrate new hires into the workforce (e.g., providing inadequate orientation to the organization, performance metrics, and assigned accountabilities). 

Solution strategies:

  • Ensure that the orientee is not left alone to find his or her own way in the new organization. Preceptors should engage the new hire starting from day one (e.g., by having lunch together to facilitate less formal introductions and an opportunity to help the orientee feel comfortable and welcomed by a new coworker). Preceptors then coach and mentor the orientee’s transition into his or her new role and responsibilities.
  • Team building begins during the hiring interview. As the recruiter and supervisor or manager consider the qualities and abilities needed in a new hire to ensure successful integration into the assigned practice setting, they weave this information into the interview and orientation. When managers select the right new hire before giving him or her the job, the orientee usually becomes more comfortable in the new work environment much more readily.
  • Introduce the orientee to metrics used in performance improvement, evidence-based practice, and research conducted at point of care. When collecting and using data, show the new hire how to set realistic and measurable goals, meet performance measures, and make changes in practice based on outcomes.
  • Explore best practices and systematic processes with the orientee that will help him or her to be more effective and confident in providing care and applying knowledge and skills, and building competency, proficiency, and professional accountability. 

Challenge: Lack of functional management buy-in and participation (e.g., over-management: leads to employee dissatisfaction and resignations more rapidly than many other factors discussed in the literature and reported in exit interviews). 

Solution strategies:

  • Engage a broad cross-section of functional leadership (i.e., preceptors, charge nurses, clinical nurse educators, supervisors, and nurse managers) to help transition and integrate orientees into their new roles and teams.
  • Create participative partnerships with all levels of management to facilitate employee empowerment, enablement, engagement, broader spans of individual control, shared decision-making, and shared leadership. Orientees have fewer complaints and tend to remain with managers who create work environments that facilitate autonomous professional practice, critical thinking, and application of clinical judgment.
  • Distribute appropriate workloads at each stage of orientation.
  • Participate in two-way communication when providing performance feedback, competency assessments, and team assignments. Demonstrate respect. Actively listen to orientees’ ideas and fold them into their assignments and learning activities whenever possible. Praise good efforts and outcomes at each opportunity. Use crucial conversations throughout the orientation to help them succeed.

Challenge: Disparities in early career support encourage orientees to seek new positions when they are ready to advance their careers. 

Solution strategies:

  • Build confidence from first contact. Explore each orientee’s personal and professional goals for career development and advancement. 
  • Help provide clarity and empowerment for career development. Partner the new hire with a clinical educator (e.g., allow time and encouragement for the orientee to investigate continuing education, certification, and/or academic advancement to enhance his or her career goals).
  • Offer cross-training and career progression, challenging assignments, and increasingly more complex responsibilities, authority, and accountabilities.
  • Recognize and celebrate every success, no matter how small, as goals are achieved and new ones set.
  • Revisit the new hire’s roles and responsibilities periodically in the first 12 to 18 months to evaluate progress and determine how to continue to support the orientee’s career development during further integration into the organization.

When building a successful new employee orientation, it is critical to consider the whole person and both personal and professional determinants for enculturation into a new organization and service. Incorporate tools and resources to provide orientations that promote retention and loyalty. Engage orientees through discussion, humor, and interactivity. Help them become comfortable quickly, confident of new knowledge, skills, and relationships. 

Most new hires come into an organization excited about new possibilities. Truly successful orientations help them realize those new possibilities, integrate them into high-functioning teams with participative management, and support their career progression. Meeting orientation challenges with creative strategies facilitates a more positive experience that translates into job satisfaction and greater possibility of protracted retention.


Avillion, A.E. (2006). Designing Nursing Orientation: Evidence-Based Strategies for Effective Programs. Marblehead, MA: HCPro. Inc.

Lawson, K. (2002). New Employee Orientation Training. Alexandria, VA: ASTD Press.

Kaiser Associates. (n.d.) “Onboarding Programs from World-Class Corporations.” Accessed online December 6, 2009, at


Adapted from Briefings on Evidence-Based Staff Development (formerly The Staff Educator), February 1, 2010.