A classic novel is the premise of a 2-day orientation to the BMT unit

“How do you know I'm mad? You must be. Or you wouldn't have come here.”

This direct quote and others, from the novel, Alice's Adventure in Wonderland, were used to add humor to a detailed and stressful 2-day orientation—or “adventure”—for graduate nurses in the blood and marrow transplantation (BMT) unit at a hospital in West Seneca, New York.

Acknowledging the challenges that must be overcome during the orientation—which are compounded by multiple medications, blood products, infusion pump types, patient acuity, and the pace that must be maintained—similarities were made between the novel and the BMT unit. The program, outlined by Lisa Privitere, RN, BSN, OCN®, BMT, RPCI, and colleagues, in a presentation at the Oncology Nursing Society 36th Annual Congress, follows the story of a young girl (the orientee) on an adventure attempting to make sense of her new world, growing up and forever being changed to the White Rabbit (the preceptor) carrying a watch, always in a hurry.

The program was developed to help graduate nurses assimilate the details of the patient population, including a superior understanding of patient care, disease type, and BMT program regulations. Held off the BMT unit, which was considered a less valuable learning environment, the 2-day adventure used a checklist which included a unit tour, hospital tour meetings, precautions, observe procedures, equipment, nutrition, accreditation agencies BMT Web site, and professional nurse organizations. According to Privitere, the numerous BMT policies and standard operating procedures were better taught and understood without competing concerns. Erin Kobel, RN, BSN, BMT, RPCI, completed the program approximately one month after starting on the unit. She reported that the program was valuable to her understanding patients experience and needs.

Included in the program were pretransplant and posttransplant topics along with numerous BMT meetings. The adventure was reviewed and changes instituted. Compared with past orientees, the knowledge base of the graduate nurses was considered advanced, and their confidence was acknowledged by each of the participants and the entire BMT team. Privitere concluded that the adventure provided the “awakening” needed for the BMT unit to become a place where reality made sense. Veteran nurses expresssed an interest in participating in the program as well. As a result, future plans include developing a 1-day version for veteran nurses.
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