implementing a hospital-based radiology nursing orientation program for new graduate pediatric...

Implementing a Hospital-based Radiology Nursing

Orientation Program for NewGraduate Pediatric Nurses

j Marjean Cefaratti, MSN, RN, CPN, NE-BC; Rachel Benninger, BSN, RN, CPN; andRose Nguyen, BSN, RN, CPN

Marjean CRN, CPNDepartmen

No grant s

CorresponNursing, CNW, Was

1546-0843

Copyright

http://dx.d

170

ABSTRACT: Recruitment and retention in the unique and immensely growing field of radiology nursing is chal-lenging as the nursing role evolves in response to advanced imaging and sedation procedures. At Children’sNational Medical Center, the radiology nursing team was confronted with recruiting enough nurses to respondto the rapid expansion of its radiology department. The department was preparing to open a new magneticresonance imaging suite with three new magnetic resonance imaging scanners and additional anesthesiologistsupport for sedation, which would result in increased patient volumes and a need for more nurses. In 2010,the radiology nursing department chose to develop a program for new graduate nurses to acquire the skill setneeded for radiology nursing while meeting the needs of the expanded services. In this article, we report theprocess and outcomes of structuring a 12-week comprehensive New Graduate Nurse Orientation Program thatmet the professional development needs of novice nurses and the specialty’s need to produce competent radi-ology nurses. Through the curriculum and as documented in self- and preceptor evaluations, the orientationprogram’s success was measured by 100% retention of the new graduates, positive self-assessments andcontinued involvement in the nursing profession. Implementing a quality orientation program for new grad-uate nurses resulted in a positive transition into their first year of practice. This program not only developedfour new nurses in the field of radiology nursing, but it also engaged the experienced clinical nurse in sup-porting and mentoring the novice nurse. (J Radiol Nurs 2013;32:170-179.)

KEYWORDS: Orientation; New graduate nurse; Outcomes; Radiology nursing.

INTRODUCTION

The radiology nursing team at Children’s NationalMedical Center (hereafter Children’s National) sup-ports patient care activities in the radiology modalities.Radiology imaging and procedures are scheduled forinpatients, outpatients, and emergency patients in this303-bed, free-standing pediatric hospital. Radiologynurses are essential to this dynamic environment andmust be competent and knowledgeable regarding the

efaratti, MSN, RN, CPN, NE-BC, Rachel Benninger, BSN,, and Rose Nguyen, BSN, RN, are from Radiologyt, Children’s National Medical Center, in Washington, DC.

upport or other financial assistance was received.

ding author: Marjean Cefaratti, Radiology and Sedationhildren’s National Medical Center, 111 Michigan Avenue,

hington, DC 20010. E-mail: [email protected]

/$36.00

� 2013 by the Association for Radiologic & Imaging Nursing.

oi.org/10.1016/j.jradnu.2013.09.001

www.radiologyn

various imaging and interventional procedures,contrast agents and radioisotopes, and the sedationneeds for the pediatric patient. At the time of thiswriting, however, the organization was expanding itsservices and, thus, needed more registered nurses thanthe 18 initially staffed to the unit. Therefore, the pur-pose of this article is to share the successful new grad-uate orientation program specifically designed forfuture radiology nurses.

The unprecedented advances in imaging capabilitieshave propelled the specialty of radiology into dramaticgrowth and practice change (Sousa, 2011). In response,the role of radiology nurses continues to evolve. In thespring of 2010, the radiology nursing team at Chil-dren’s National anticipated dramatic growth in theirdepartment. The addition of more magnetic resonanceimaging (MRI) scanners and a new positron emissiontomography (PET) scanner soon to follow werepredicted to increase patient volumes, which wouldmerit more radiology nurses. The nursing team

DECEMBER 2013ursing.org

mailto:[email protected]

http://dx.doi.org/10.1016/j.jradnu.2013.09.001

http://www.radiologynursing.org

Table 1. Phases of radiology orientation program

Phase 1:

Team Building

Week 1-3 � Child life specialist

� Anesthesia

� MR physicist

� Radiologist

� Radiology information

technology

� Librarian

Phase 2:

Skill

Development

Week 4-12 � Intravenous line access

� Airway

� Monitor

� Contrast

� Policy and procedures

� Assessment

� Med safety

� Metal safety

� Patient/family education

Phase 3:

Professional

Development

Week 10-end

of first year

� Manager meetings

� Leadership networking

� Magnet committee

attendance

� POCT program

� Nurse sensitive indicator

work

� Library: evidence-base

practice

� Professional organizations

MR Z magnetic resonance; POCT Z point of care testing.

Radiology Nursing Orientation Program Cefaratti et alJOURNAL OF RADIOLOGY NURSING

acknowledged their need for increased staffing andconsidered strategies to best attract new radiologynurses.

Historically, the department hired only experienced,critical care, registered nurses for their essential skillsof airway management, critical thinking, and sedationexperience. With the immediate need to attract nursesto this unique setting, the radiology nurses initiated dis-cussions regarding the hiring of new graduate nurses.Voicing their thoughts and concerns during staff meet-ings, the clinical nurses discussed the details of this newapproach. When an expansive literature review wasinitiated but yielded no results on new graduate orien-tation programs in pediatric radiology (Blevins 1994;Clark & McClain 2004), the nursing team collabora-tively developed a comprehensive program tailored tothe novice nurse.

The purpose of this new program was twofold; tomeet the expanded service needs in the department interms of more nursing positions and to offer new gradu-ates a job in a nontraditional nursing environment.Through partnerships with nurse educators, the staffand professional development department, and experi-enced radiology nurses, a radiology orientation programwas designed to parallel and augment the existinghospital-wide Nurse Intern Program (NIP).

Dyess and Sherman (2009) recommend a clear collab-orative partnership with organizational resources asbest practice for orientations. The attendance of thenew graduate nurses (NGNs) in the NIP classes withfellow graduate nurses was a valuable resource toenhance the unit orientation program. The radiologynursing team began the process to identify applicantsfor the new program. They reviewed numerous applica-tions, focusing on a few key points to narrow the search.They agreed the applicant have a Bachelor of Science inNursing, have performed some volunteer or work expe-rience, and should be excited about the opportunity tointerview for a nontraditional job setting, as evidentby enthusiasm in the phone interview and the positivebehaviors during the in-person interview. After a pro-cess of phone contacts, scheduled interviews, and anin-depth review of the interview evaluations by the clin-ical nurses, the manager hired four new graduate nursesto participate in the first Radiology New GraduateNurse Orientation Program.

THE ORIENTATION PROGRAM

The Radiology New Graduate Nurse Orientation Pro-gram was a structured 12-week program composed of apurposefully integrated mix of clinical and didacticcomponents. The focus of the program was to intro-duce four NGNs to the unique work setting of radi-ology nursing. The program was designed to extend

VOLUME 32 ISSUE 4 www.radiologyn

the knowledge and theories attained through theirbaccalaureate education with an in-depth orientationto develop the distinct skills and critical thinkingrequired of a radiology nurse. The program providedthe NGNs with a thorough foundation in sedationnursing by focusing on team building, essential nursingskills, and professional development (Table 1).

The unit’s 12-week orientation was purposefully co-ordinated with the hospital’s NIP. The NIP was de-signed to be a supportive network to novice nursesthrough their transition into the role of a nurse atthis institution. This supportive network was importantbecause it facilitated the transition of the nurse into afast-paced, high-acuity, direct patient care setting byway of adequate resources and support systems(Santucci 2004). NIP provided the four radiology nurseorientees with an additional avenue of support and ed-ucation to further enhance their confidence and compe-tency in safe patient care. For example, the NGNsparticipated in simulation labs, which helped provideclinical experiences in a nonthreatening environmentwith their peers. During peer discussions about clinicalexperiences, the nurses had the opportunity to educatefellow NIP members about the complexity of radiologynursing and how it has emerged into a unique specialty.

In contrast to literature that states every new nurseneeds a single designated preceptor (Zwerneman &Flanders 2006), the experienced radiology clinical

171ursing.org


Cefaratti et al Radiology Nursing Orientation ProgramJOURNAL OF RADIOLOGY NURSING

nurses felt that the unique patient flow in radiologymade the rotation of multiple preceptors more condu-cive to the learning needs of the novice nurses. There-fore, the manager and the clinical nurses designed arotation process in which each of the four NGNs expe-rienced a rotation of core preceptors each week; thepreceptors were carefully selected for their specializedskill sets and unique personalities. According toBaxter (2010), the need for effective preceptors cannotbe understated because their role requires them toorient new staff to clinical settings, facilitate socializ-ation, teach technical skills, and to challenge and pro-mote critical thinking. The intended outcome of themultiple preceptor experience was for the NGNs tocomplete the orientation program with a broadenedperspective of nursing practice that they could incor-porate into their own care practices as they transi-tioned from novice to advance beginner nurses.

The first week of the orientation program was estab-lished as a “shadow week,” where the NGNs followedtheir assigned preceptor to become familiarized withthe department, sedation and hospital policies, andkey members of the interprofessional team in radi-ology. During the course of the next 4 weeks, 4- to 8-hr blocks of time were scheduled for the NGNs tospend with various radiology team members. Thenurses spent a 4-hr session with the magnetic resonance(MR) physicist learning about (1) his role, (2) best prac-tices for the unique MRI environment, and (3) theindispensable value of MR safety. The radiology infor-mation technology team provided the NGNs with edu-cation on the radiology information system, which wasthe primary electronic documentation and schedulingtool used in the department. This software programaugmented the hospital’s information system; both pro-grams are necessary for radiology nurses to coordinatecare for their patients.

The child life specialists embraced the NGNs byscheduling each to an 8-hr shadow day. The dayfocused on (1) how to communicate with the pediatricpopulation, (2) how to engage parents to participatein the care of their child, and (3) how to collaboratewith the child life specialists to achieve a quality exam-ination and positive experience. Professional develop-ment included being in the hospital library workingwith a librarian on basic research tactics, evidence-based practice literature, and other computer programsavailable to nurses. Finally, the anesthesiologist sup-ported the NGNs with a hands-on experience duringan 8-hr session in the MRI sedation bay to learn (1)airway assessments, (2) airway management, (3) emer-gent care, and (4) the tools and equipment requiredto manage the pediatric sedated patient. By spendingtime and establishing a relationship with members of

172 www.radiologyn

the interprofessional team, the NGNs had the opportu-nity to create a solid base for a safe and trusting envi-ronment; a most important phase for a successfultransition into the workplace (Santucci 2004).

During weeks 4 through 12, the NGNs were orientedto several roles within the MRI setting, including pre-examination/work-up, sedation/patient monitoring,and recovery/postsedation. Four weeks in the sedation/patient monitoring role ensured the NGNs were compe-tent in the monitoring of a sedated patient. Duringthis time preceptors focused on the critical care skillsof interpreting changes in patient status and respondingappropriately. As a sedation/patient monitoring nurse,the NGNs worked alongside the anesthesiologists tosafely induce, sedate, and monitor patients throughoutthe duration of the examination. Here, NGNs focusedon intravenous line skills, airway management, elementsof sedation, and ensured a metal-free environment forthe safety of the patients, the staff, and the equipment.

As the pre-examination/work-up nurse, the precep-tors introduced the NGNs to the admission, education,and preparation process for MRI patients and theirfamilies. NGNs were provided opportunities to honeparticular nursing assessment skills of obtaining ahealth history and completing physical examinations.Under direction of their preceptors, the NGNs becameproficient with the hand-off report to the interprofes-sional members involved in the patient’s care. Desig-nating 2 weeks of the orientation program to this roleresulted in the NGNs’ ability to obtain pertinent infor-mation to ensure there was a seamless safe sedatedexamination.

Preceptors focused on many facets of postsedationcare during the 2-week orientation to the recovery nurserole to include both outpatient and inpatient care. Post-sedation patient management, home discharge teaching,and 24-hr follow-up phone calls to families were allessential components to the care of the outpatient popu-lation. The preceptors also focused on the hand-off andsafe transfer of the acute and critical care patients back totheir units after sedated examinations. Rotating throughthese three roles, pre-examination/work-up, sedation/patient monitoring, and recovery/postsedation, theNGNs attained the essential skills to be confident andcompetent radiology sedation nurses.

The new nurses continued to strengthen their criticalthinking and nursing skills by becoming certified in Pe-diatric Emergency Assessment, Recognition, and Stabi-lization (PEARS) and Pediatric Advance Life Support(PALS). Through the American Heart Association,both courses are designed to help health care providersimprove quality of care to seriously ill or injured in-fants and children. The focus of the PEARS certifica-tion course is pediatric assessment, specifically early




recognition and stabilization of children at risk for car-diopulmonary distress. The emphasis on early recogni-tion and intervention is well documented in theliterature (Famolare & Romano, 2013), and this courseprovided the NGNs an opportunity to enhance theirpediatric assessment skills for use in all areas in whichthey were newly hired. Sedation nurses, to include theradiology nursing team, also were expected to be certi-fied in PALS. Through the PALS course, the nurses un-derwent simulated pediatric emergencies to emphasizethe important concepts of a methodical approach topediatric assessment, basic life support, treatment algo-rithms, effective resuscitation and team dynamics.These courses helped the new nurses become equippedand competent at recognizing and responding to emer-gency situations and heart rhythm interpretation;essential skills they would need as radiology sedationnurses.

TOOLS/INSTRUMENTS

The transition of the NGNs from an educational pro-gram into the professional practice setting has beenwidely recognized as period of stress, role adjustment,and reality shock (Fink, Krugman, Casey & Goode,2008). To ensure the NGNs experienced a quality andthorough training program, three components of theunit orientation included specific tools to assess theirprogress. The first component used unit-specific compe-tency tools required in the role of the radiology nurse tocare for sedated patients in the MRI setting. The sec-ond component was consistent weekly meetings withthe new graduates, the manager, and the preceptor todiscuss experiences, progress, challenges, and futuregoals. The third component was the self-assessmenttool whereby each NGN completed a Self-Assessmentof Knowledge/Skills tool at three intervals of the orien-tation; the beginning of the orientation, after the12-week unit orientation, and at the completion ofthe first year of employment. All three componentswere designed to continuously validate the quality ofperformance while supporting the NGNs throughoutthe first year in their professional practice.

Unit-Specific Competency Tools

Unit-Specific Competency Tools were developed toenhance the skill set required of the radiology nurse tocare for the sedated patient undergoing an MRI.Because the MRI environment is unique and requiresnonferromagnetic equipment, the NGNs had to be pro-ficient on the proper use and able to identify trouble-shooting tactics of this specific equipment. The nursemust be competent with MRI specific cardiorespiratorymonitor and the medication infusion pumps in additionto the cardiorespiratory monitors and medication


pumps used throughout the hospital. The nurses hadto become competent in central-line access and careand intravenous access skills and knowledge. Arterialline knowledge andmonitoring in theMRI environmentwas an essential skill to master because many criticalcare patients require continuous invasive blood pressuremonitoring. Knowledge of the administration ofcontrast media and care of possible extravasationswere also included in the competency tool packet. Seda-tion medications and the airway assessment and man-agement competencies were obtained through the“Day in the Bay,” working side by side with the anesthe-siologist in the sedation bay. The tools were completedby each new graduate during the course of the 12-weekorientation program. A total of eight competency check-lists (Table 2) were included in the orientation packet:MRI cardiorespiratory monitor, MRI infusion pump,the cardiorespiratory monitor used throughout the hos-pital, Central line/Porta-a-cath access, intravenous ac-cess, administration of contrast media and care ofpossible extravasations, airway management, and seda-tion medications. While developing the competencypacket for the orientation program, the experiencedclinical nurses agreed these tools were useful in acquiringclinical competence in both novice and experiencednurses; they are now implemented as the annual unitbased competencies for radiology nursing.

Weekly Meetings

Through weekly evaluations and meetings with theNGNs, the manager and preceptors provided the novicenurse with constructive feedback and began to build re-lationships. Fink et al. (2008) reported that many newgraduates wanted more feedback, a sense of belonging-ness, and a connection to their manager. Preceptorsprovided feedback bymeans of immediate verbal assess-ments during patient care activities and again duringweekly evaluations. It is essential that nursing leadershipstay connected with new graduate nurses and promote asense of belongingness to help guide them (Sherman2012). The weekly meetings with the manager led toopen conversations in which the NGNs felt comfortableexpressing their progress, concerns, and goals. The timespent together was an opportunity to foster an opentrusting relationship among new employees and theirsupervisor.

Self-Assessment Tool

The self-assessment tool (Table 3) was a valuable in-strument for the novice nurse to evaluate personalcompetence and confidence through three phases ofthe orientation program. The tool provided a compre-hensive list of skills and knowledge to which theNGNs could rate self-achievements. The tool was not

173ursing.org


Table 2. Competency tools


174 DECEMBER 2013www.radiologynursing.org


Table 2. Continued


VOLUME 32 ISSUE 4 175www.radiologynursing.org


Table 2. Continued

Nursing Orientation Self-Assessment of Knowledge/Skills Tool was shared by Donna M. Roe, DNP, APRN, BC, CEN, St. Joseph Hospital,

Nashua, NH.


graded but instead was used to address the individualstrengths and weaknesses assessed by the NGNs them-selves. Dyess and Sherman (2009) report that new grad-uates express concerns about the ability to provide safepatient care and meet the performance expectations ofthe organizations that employ them, therefore it wasimportant to strengthen the competencies of the newnurses throughout the orientation program. The self-assessment tool provided the individual nurses the op-portunity to score their confidence level in meetingthe unit expectations and expressed confidence in theirown abilities secondary to the other support systems inplace.

176 www.radiologyn

OUTCOMES

The measurement of quality outcomes of the RadiologyNew Graduate Nurse Orientation Program was evidentthrough 100% retention after the first year, the develop-ment of four new radiology nurses, and their engage-ment in the professional practice. Each of the threephases in the program (team building, skill sets, and pro-fessional development) resulted in a positive outcome.

The first phase of the orientation focused on teambuilding and provided a sense of belongingness for theNGNs. The positive outcome in this phase was 100%retention of the new nurses at the end of their first



Table 3. Self-assessment of knowledge/skills


year. The support from leadership and their nursing col-leagues, the variety of preceptor styles, and abundanceof experiences provided the new nurses with a sense ofbelongingness to the radiology team. In addition, thenew nurses were given opportunities to observe nurseleaders networking, attend management meetings withtheir manager, and participate in organization-wideMagnet Recognition Program� activities, leading themto feel a sense of professional engagement. The fourNGNs expressed these positive experiences helped shapethem to be well-rounded radiology nurses as reported inthe evaluations and weekly meetings, thus resulting in100% retention.

The second phase of the orientation concentrated onskill development. The positive outcome resulting fromthis phase was the development of four new graduate


professionals entering the work force of a unique pa-tient care setting. The four NGNs stated the detailedorientation program had given them the tools neededto safely sedate, monitor, and recover pediatric pa-tients. Through the weekly meetings and evaluations,it was noted the nurses were adapting quickly to thework environment with confidence. They masteredthe skill sets required for the radiology nurse to carefor the sedated pediatric patient and exemplified thecompetence to work autonomously. Assessment skillsimproved with their background in PEARS andPALS certification along with the constant reassurancefrom their colleagues. Through daily placement ofintravenous catheters in several sedated patients, theNGNs became proficient in the skill of intravenousinsertion.

177ursing.org



The variety of pediatric patient types and diagnosesexperienced by the NGNs continued to groom thenovice nurses to be competent radiology nurses. Theoriginal timeline designed for the program was a 12-week orientation to pediatric sedation nursing. It wasplanned for the nurses to work a full year in the MRIsetting because this environment has a multitude ofnursing resources. This setting was designed with nineregistered nurses in the suite at all times. The new nursesalways had a colleague nearby to answer a question,confirm an assessment, or facilitate with the patientcare process. However, after 6 months, adjustmentswere made to introduce them to the other modalitiesin the radiology department. This decision was basedon the clinical skills attained by the NGNs and theirgrowth in competence and confidence throughout theprogram. In addition, it was noted that the sedation,monitoring, and recovery of several patient types, diag-noses, and varied ages had been experienced by theNGNs during the 6 months. Preceptors were identified,and a new 4-week orientation was designed to orient theNGNs to the unique examinations, work flows, sedationmedications, and patient care activities in the othermodalities of the department. They were introduced tothe areas of fluoroscopy, computed tomography, andpositron emission tomography, and interventional radi-ology, where they learned a new set of skills and devel-oped relationships with interprofessionals outside ofthe MRI suite.

During the third phase, professional growth anddevelopment, the NGNs self-reported through evalua-tions and weekly meetings that they felt valued andsupported by their nursing colleagues. The final posi-tive outcome was the NGNs’ confidence to move pastwhat was expected and lead the way to shape the dy-namic workplace environment. They felt empoweredto implement changes on their unit and participatedin hospital-wide activities. Leading educational projectsto improve patient care in the department was aninvaluable experience for the NGNs. In radiology,they initiated a new process for pregnancy Point ofCare Testing and validated the competency of eachnurse with this new program. They were engaged inthe nurse sensitive indicator work on the unit andquickly became the leaders by collecting data,analyzing results, and preparing and presenting theoutcomes in hospital committees. The nurses joinedtheir professional organization, attended local chaptermeetings, and assisted with planning a Nursing GrandRound presentation at the hospital. The NGNscontinue to be involved in nursing initiatives on theunit and in the hospital and have become valued andimportant members of the interprofessional healthcare team.

178 www.radiologyn

Future Program Revisions

Outcomes are dynamic and define areas requiring addi-tional effort to achieve improvement. The radiologynursing team at Children’s National found that tomake an orientation program successful and make im-provements for the future, it is essential that there isopen communication between new nurses, their peers,and the management team. Evaluating the new orienta-tion program through continual open communicationand using evaluation tools was an opportunity toimprove this first time endeavor. In the Journal ofContinued Education in Nursing, Dyess and Sherman(2009) wrote that feedback from new nurses about theirexperiences and transitions is an important part of anyproject’s success and development. The orientationevaluation information obtained revealed three signifi-cant improvements for future new graduate nursingorientation programs.

The first improvement will be to increase the numberof days in the sedation bay with the anesthesiologist.The new graduate nurses rated the “Day in the Bay”as an excellent experience and found it to be very help-ful with airway management; however, they agreed1 day earlier in the orientation and 1 day later afterclinical experiences would have been more beneficial.The second improvement will be more time dedicatedto intravenous access because it is an essential part ofthe skill set associated with being a radiology sedationnurse. The NGN evaluations revealed a day solelydevoted to intravenous access of both nonsedated andsedated patients would have resulted in earlier compe-tence and confidence with a variety of ages. Workingwith the organizations intravenous team would be anopportunity to improve their experience with a varietyof pediatric patients requiring intravenous access. Thethird significant improvement will be using the evalua-tion tools consistently among the preceptors. The rota-tion between core preceptors during the 12 weeks was apositive experience for the NGNs, but they expressedthe preceptors were inconsistent with the “rating sys-tem.” It would be beneficial to have the preceptorsdiscuss the rating system together for future orientationprograms. Implementing these three improvements willhelp strengthen the future Radiology New GraduateNurse Orientation Program.

In contrast to the new graduates’ assessments forimprovement, each preceptor documented areas ofimprovement in their weekly evaluations. A commontheme emerged in two areas; a need to improve confi-dence in intravenous access and airway management.It was noted the new graduates were knowledgeablein the skill to place an intravenous line, however, theycontinued to express a sense of disappointment when




unable to achieve access on the first attempt. Addition-ally, the new graduates understood airway anatomy,assessment, and equipment but were hesitant identi-fying appropriate interventions in response to airwaycompromise. Throughout the weeks of orientation,the NGNs developed confidence in these two areaswith the support of positive preceptor coaching andcontinued experiences with all patient types.

DISCUSSION

The recruitment and retention of new graduate nursesis a primary focus for many nursing organizationswith estimated turnover rates ranging from 35% to60% during their first year (Jones 2005). It can be costlyand time consuming to hire and train new graduatenurses; Messmer et al. (2011) writes that it can cost hos-pitals upwards of $300,000 yearly in nurse turnovers. Itis essential for institutions to implement timely andcost-effective training programs for new graduatenurses and a welcoming and supportive environmentduring the first year in the work force.

The nursing profession continues to be an everchanging and rapidly developing field with manydifferent job opportunities for new graduates. As theneed for more properly trained nurses continues togrow, institutions continue to offer new graduate nurseorientation programs. Institutions want to mold andproduce nurses that embody the ideals and necessaryskills set-forth by their organization. The radiologynursing team at Children’s National implemented forthe first time a new graduate nurse training program.The team wanted to produce nurses with the necessaryunique skills that are specific to a pediatric radiologysedation nurse and offer NGNs an opportunity towork in a nontraditional environment for their first job.

SUMMARY

Radiology nursing is a unique field in the nursing profes-sion and requires an in-depth orientation even for nurseswith many years of experience. At Children’s National,it was essential to the nurse manager and the nursingteam to develop a program that would recruit and retainradiology nurses. Hospitals across the nation face thechallenge of finding nurses who encompass the distinctskill sets of radiology nurses. Sousa (2011) questionswhere to find nurses with the broad skill base and abilityto pull together all the essential pieces to be a successfulradiology nurse. The radiology nursing team at Chil-


dren’s National responded and hired new graduatenurses and groomed their own. In comparison withthe 3-week MRI orientation for experienced nurses,the development of a 12-week orientation program fornew graduate nurses resulted in the recruitment andretention of four exceptional pediatric radiology seda-tion nurses. Implementing a Hospital-based RadiologyNursing Orientation Program for New Graduate Pedi-atric Nurses was a successful endeavor for both thenew graduates and the experienced clinical nurses atChildren’s National.

AcknowledgmentsWe thank Donna M. Roe, DNP, APRN, BC, CEN, St. Joseph

Hospital, Nashua,NH, for her kindness in sharing theNursingOrientation Self-Assessment of Knowledge/Skills Tool.

ReferencesBaxter, E.P. (2010). Providing orientation programs to new grad-

uate nurses. Journal for Nurses in Staff Development, 20(4),12-17.

Blevins, S.J. (1994). The role of a radiology nurse. RadiologyManagement, 16(4), 46-48.

Clark, P.L., & McClain, I.B. (2004). Interventional radiologynursing. Journal of Radiology Nursing, 23(2), 51.

Dyess, S.M., & Sherman, R.O. (2009). The first year of practice:new graduate nurses’ transition and learning needs. The Jour-nal of Continuing Education in Nursing, 40(9), 403-410.

Famolare, N., & Romano, J.C. (2013). The implementation ofPEARS training: Supporting nurses in non-critical care set-tings to improve patient outcomes. Journal of PediatricNursing, 28(3), 267-274.

Fink, R., Krugman,M., Casey, K., &Goode, C. (2008). The grad-uate nurse experience. Qualitative residency program out-comes. Journal of Nursing Administration, 38(7e8), 341-348.

Jones, C.B. (2005). The costs of nursing turnover, part 2: Appli-cation of the Nursing Turnover Cost Calculation Methodol-ogy. Journal of Nursing Administration, 35(1), 41-49.

Messmer, P.R., Bragg, J., & Williams, P.D. (2011). Support pro-grams for new graduates in pediatric nursing. The Journal ofContinuing Education in Nursing, 42(4), 182-192.

Santucci, J. (2004). Facilitating the transition into nursing prac-tice: Concepts and strategies for mentoring new graduates.Journal for Nurses in Staff Development, 20(6), 274-284.

Sherman,R.O. (2012). Evidence-based effective nursing leadership.Retrieved from http://ce.nurse.com/course/ce620/evidence-based-effective-nursing-leadership/, October 29, 2013.

Sousa, M.F. (2011). Management and leadership: Educating andorienting the radiology nurse of the future. Journal of Radi-ology Nursing, 30, 135-136.

Zwernemen, K., & Flanders, S. (2006). Practice matters: Do youwant to be a preceptor?American Nurse Today, 1(2). Retrievedfrom, http://www.americannursetoday.com/article.aspx?idZ5164&fidZ5120. October 29, 2013.

179ursing.org

http://ce.nurse.com/course/ce620/evidence-based-effective-nursing-leadership/

http://ce.nurse.com/course/ce620/evidence-based-effective-nursing-leadership/

http://www.americannursetoday.com/article.aspx?id=5164%26fid=5120

http://www.americannursetoday.com/article.aspx?id=5164%26fid=5120


implementing a hospital-based radiology nursing orientation program for new graduate pediatric...

Documents