2021 Annual Conference

Other

Significance & Background

To ensure newly hired Clinical Nurse Specialists (CNSs) successfully transition into— and remain in— their roles, they must participate in a comprehensive orientation program. Across numerous industries, robust orientation programs have been shown to improve retention, engagement, and job performance. At our organization, an increase in CNS turnover prompted an assessment and redesign of our CNS orientation program. This presentation describes the standardized program created to support newly hired Clinical Nurse Specialists (CNSs) and the resulting impact on CNS turnover.

Evaluation Methods

In 2018, an evaluation of CNS turnover rates, exit interview data, and hiring practices over the previous 3 years revealed that attrition within 2 years of hire was a key contributor to high turnover rates (2015:18.5%, 2016:10.3%, 2017: 16.7%).

Outcomes

In response, we implemented a multi-tiered interview process, developed a standardized onboarding guide, and bolstered orientation to include frequent performance feedback, peer mentoring, deliberate networking, and focused leadership development, framed by the three spheres of influence. Since implementation, CNS turnover has declined to 9.4% in FY18 and 19. Notably in both years, CNSs who turned over did so voluntarily, leaving for family reasons or to pursue a new opportunity within the organization.

Implications

CNSs have a unique and complex role, which requires a standardized and comprehensive orientation. Leveraging the NACNS core competencies to construct a process for effectively orienting newly hired CNSs helps to define role expectations and promote integration into the team for novice and expert CNSs, alike, leading to reduced turnover.