Implementation of a Clinical Nurse Manager Orientation at a Community Clinic

Abstract

Problem: Nonprofit community health centers in the mid-Atlantic region provide healthcare services and resources to a vulnerable patient population with many chronic conditions and limited to no health insurance. The community clinics have seen a variation in patient care and nursing practice by the clinical nurse managers (CNM). This variation in practice is secondary to the lack of a formal orientation program. Purpose: This quality improvement initiative aims to implement an orientation program that actively engages the experienced nurse to enhance the application and retention of critical onboarding information. The overall project goal of the CNM orientation program is for the CNM preceptee to rate all American Organization for Nursing Leadership’s (AONL) Nurse Manager competencies at a level of competent, proficient, or expert. Methods: The AONL competency orientation program was implemented over 12 weeks. A 12-week lesson plan was implemented with one new clinical nurse manager. The lesson plan included weekly objectives and resources to ensure the clinical nurse manager is competent to lead and oversee the daily operations of the community clinic. A pre-assessment of the CNM’s knowledge and understanding of the AONL nurse manager competencies was completed before the implementation of the CNM orientation program. The AONL nurse manager competencies were measured weekly after weekly curriculum, content outline, and resource materials were reviewed and applied to clinical practice. Weekly evaluations were completed to ensure the CNM met the weekly objectives. The project lead provided education and support to the preceptor throughout the orientation. A weekly meeting between the preceptee, preceptor, and project lead occurred to provide feedback on the progress of the preceptee in meeting the weekly objectives, orientation expectations, goals, and competencies. Results: The CNM preceptee progressed from novice, advanced beginner, or competent to proficient and expert post the implementation of the AONL Nurse Manager Orientation program. The CNM preceptee rated 48% of the competencies as proficient and 52% of the competencies as an expert. Conclusions: The post assessment results suggest that the clinical nurse manager orientation effectively prepares new clinical nurse managers in a community clinic setting to enhance the application and retention of critical onboarding information.