Implementation of a Clinical Nurse Manager Orientation at a Community Clinic

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. This variation in practice is secondary to the lack of a formal orientation program. 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. A nurse manager orientation that lacks clear objectives can lead to feelings of incompetence, disempowerment, and job dissatisfaction for the nurse managers and their staff members. The American Organization for Nursing Leadership (AONL) nurse manager competencies ensure that nurse managers acquire knowledge and enable them to be effective leaders. Nurse managers efficiently manage the unit’s operations, patient outcomes, and staff. The American Organization for Nursing Leadership’s (AONL) nurse manager competencies have been implemented as the clinical nurse manager orientation. The nurse manager competencies are based on the nurse manager learning domain framework and capture the skills, knowledge, and abilities that guide nurse leaders' practice. The American Organization of Nurse Leadership (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 includes 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 are measured weekly after weekly curriculum, content outline, and resource materials have been reviewed and applied to clinical practice. Weekly evaluations are completed to ensure the clinical nurse manager has met the objectives. The project lead provides education and support to the preceptor throughout the orientation. A weekly meeting between the orientee, preceptor, and project lead occurs to provide feedback on the progress of the orientee in meeting the weekly objectives, orientation expectations, goals, and competencies. Preliminary results show the clinical nurse manager orientee has progressed from novice to competent or proficient in many of the required competencies in the role of a clinical nurse manager. The CNM has rated 18% of the competencies as advanced beginner, 50% of the competencies as competent, 27% of the competencies as proficient, and 4.5% as expert. Preliminary conclusions 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.