Have you ever hired nursing assistants and, after HR paperwork and a quick tour of your facility or agency, sent them off to a full day's work? Does orientation seem like a waste of time with CNAs? After all, many of them don't stick around long, so why bother? Well, here's a tale from my past that spells out the problem with that theory:



When I started my first job as a new nursing graduate, it was on a busy hematology/oncology unit at a big teaching hospital. I was green, intimidated and in need of a good orientation. Did I receive it? Nope...instead I was thrown into a full patient assignment. (There was a preceptor assigned to me, but she was busy with her own caseload.) When I expressed my concerns to my preceptor, she said to me, "Look, we know an orientation would be nice. But, you're a warm body to fill a spot on this shift. Just do the best you can because none of us have time to help you."

What happened? Well, thankfully, I avoided causing any harm to my patients! But, my stress level went sky high; I felt alienated from my co-workers; and I spent my days off worrying about work. Before long, I developed strep throat and walking pneumonia. After a month, I transferred to another oncology unit where the staff was willing to orient me.

So, guess what? Once again, the heme/onc unit was short staffed! Their neglect of my learning needs was shortsighted and cost them another "warm body". And, as time went on, I found out that the cycle continued; very few nurses wanted to work on that unit. Their attitude about orientation harmed everyone: the supervisor, the staff and the patients!

It's the same with nursing assistants. If they are not oriented properly to their role within your workplace, they are likely to become stressed, overwhelmed and anxious to move on to another job. This vicious cycle is part of why CNA turnover is so high across the United States.

There is good news. Studies have shown that, on average, when an organization institutes a high quality orientation, their turnover rate decreases by 50% within two years! A good orientation program should include information on professionalism, communication, teamwork, patient rights, infection control, time management, stress management, personal wellness, customer service, cultural diversity, quality improvement, documentation and lots of practical client care tips.

And, your nursing assistant want to be oriented to their jobs! Here's what just a few CNAs had to say on this subject:

“Orientation is so important. It doesn't matter if you've been a CNA for years; when you start a new job, you should be oriented to that workplace. Orientation gives you insight into what is expected of you, your duties.” Barbara H.

“I think it is very important to always have an orientation process. A new CNA needs the opportunity to get used to the other employees without pressure to perform right away. It's also important for them to be able to observe the other CNAs and how they interact with each client. Then when new CNAs are finished with the orientation process, they will feel more comfortable and be better equipped to help each patient in a more individualized manner.” Lori B.

“I believe that in order to give proper care to clients you need a proper orientation. If the facility does not orient you properly, it is doing a disservice to both the clients and the other workers there. At my current workplace, I feel that my orientation was insufficient; I had a 3 hour information session with one of the supervisors and was put on the floor the next working day. I was not even told where to find items such as incontinent products or basic hygiene items. In some cases, this lack of orientation could have put residents in danger (but thank God it didn't).” Janet P.

So, as Nike says, just do it! Orient your nursing assistants and you'll improve your aide retention rates and provide the tools and support that CNAs need when they begin a new job.