The following article features coverage from the National Association of Clinical Nurse Specialists (NACNS) 2018 Annual Conference in Austin, Texas. Click here to read more of Oncology Nurse Advisor‘s conference coverage. 

Clinical nurse specialist (CNS) involvement in orientation and on-boarding programs in high-risk settings such as the operating room (OR) can improve nurses’ clinical preparation, job satisfaction, and staff retention, according to an oral presentation at the National Association of Clinical Nurse Specialists (NACNS) 2018 Annual Conference.

The increasing number of surgeries performed in the ambulatory setting is creating a comparable need for experienced OR nurses, further exacerbating staff shortages in this specialty. In addition, undergraduate programs provide minimal exposure to this field resulting in limited interest among new graduates for working in perioperative areas.

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Given the unique nature of this high-risk setting, traditional orientation methods may not be suitable for the surgical suite, and improper on-boarding can result in poor nurse retention. Therefore, the OR CNS has a pivotal role in engaging nurses new to the field with innovative education methods.

Nursing professional development specialists and operational nursing leaders collaborated to revise the orientation experience at Memorial Sloan Kettering Cancer Center. The project included additional didactic content and enhanced simulation experiences before introduction to the clinical environment, and an improved preceptor selection process.

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Orientees who participated in the orientation program during the last year (n=28) were surveyed regarding their experiences with the program. A comparative analysis between those on-boarded with the old program and the revised method indicated that the changes improved the orientation experience for new nurses.

As a clinical leader, CNSs serve as advocates for the clinical learner. Their influence and feedback are essential to effective nurse preparation in settings where high turnover can impact patient outcomes. Nurse retention and job satisfaction are improved by strong nurse training methods. These training methods can be adapted to aid in staff training in other high-risk clinical settings, reported Ms Saulan.


Saulan M, Debanich M. The CNS role in revising OR orientation. Oral presentation at: NACNS 2018 Annual Conference; February 28-March 3, 2018; Austin, TX.