Enhanced Orientation for Nurses New to Long-Term Care

Manitoba

Pressure on the long-term care (LTC) sector is growing as people are living longer and the needs of individuals entering LTC are becoming more complex. What is more, it is often more difficult to retain and recruit nurses in this area.

Recognizing these issues, the Winnipeg Regional Health Authority (WRHA), Manitoba Health and the Manitoba Nurses Union collaborated to pilot a project entitled Enhanced Orientation for Nurses New to Long-Term Care. The project involved the introduction of a mentorship program and a series of six clinical workshops designed to provide nurses in LTC with the foundation and support needed to excel in their work. When nurses develop greater leadership capacity, are better equipped to serve their residents’ needs, and are more satisfied with their work, LTC becomes a more desirable workplace.

Project Objectives: 
  • Increase retention rates by providing better orientation programs for nurses new to LTC
  • Enhance the profile of LTC as a desired area of practice
  • Develop greater capacity for nursing leadership, training and support within LTC facilities
  • Develop an interprofessional component to the LTC orientation program
  • Enhance the knowledge of geriatrics and specialized skills of health care providers new to LTC
  • Bring consistency to geriatric orientation programs
Project Implementation: 

The 18-month project was implemented at three of the 38 personal care homes in the WRHA. Twenty-three nurses took part in the pilot, including 12 protégés (4 RNs and 8 LPNs) and 11 mentors (9 RNs and 2 LPNs). Nine of the protégés were new graduates and three were nurses that had worked in other settings but were new to LTC.

The protégés were matched with experienced nurse mentors who provided support and guidance. The mentors attended a one-day workshop that focused on building and enhancing their mentoring skills. A week later, the protégés and mentors were paired during a one-day orientation workshop. This allowed the partners to meet, to talk about their expectations, and to review tools available throughout the mentoring relationship.

The project also offered a series of six clinical workshops based on topics clinically relevant to LTC. The workshop content was developed and delivered by content experts in the various subject areas with an eye to an interprofessional perspective. Interactive sessions complete with  PowerPoint presentations and activities/case studies were developed for each topic along with a corresponding participant’s handbook which was printed and distributed to workshop attendees. In addition to the protégés and mentors participating in the pilot, the clinical workshops were open to any professional staff member working within an LTC facility in Winnipeg. A total of 390 staff attended the six workshops. The majority of attendees were nurses but also included registered dietitians, social workers, occupational therapists, speech-language pathologists, a chaplain and a patient safety officer.

Program guides containing all of the educational materials required to reproduce the enhanced orientation program were distributed to stakeholders to promote sustainability and transferability to other jurisdictions in Manitoba and nationally.

Project Outcomes: 
  • The responses to both the enhanced orientation program and the clinical workshops were extremely positive
  • Attendance at the clinical workshop series exceeded expectations
  • Protégés said that the enhanced orientation program had a positive effect on their transition into the workplace and their level of confidence
  • Mentors expressed appreciation for the opportunity to build their mentoring skills and share their experiences and knowledge with the new nurses
  • Mentors expressed a desire to support and ‘protect’ their protégés
  • Many staff from disciplines other than nursing attended the clinical workshops and their evaluations of the content were positive
  • A program guide for the enhanced orientation program was developed and 50 copies distributed to stakeholders to promote the sustainability and transferability of the project
  • WRHA plans to implement the enhanced orientation program for new nurses and staff within all 38 of Winnipeg’s personal care homes
  • WRHA is interested in expanding the mentorship program and education component of the project to other sites within the WRHA
  • Parkland RHA in Western Manitoba has adopted the education materials to their mentorship program and has begun using them to train nurse managers, mentors and new recruits
  • Central RHA in South-Central Manitoba has expressed interest in adapting the educational materials to their mentorship program
  • The Department of Health and Wellness in Prince Edward Island is planning to implement the Enhanced Orientation Program in all of the public and private LTC facilities in PEI
  • An LTC facility near Denver, Colorado, has also expressed interest in the program
Additional Materials: