1. Ramsey, Rance BSN, RN

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As the chief nursing officer of a rural critical access hospital in West Texas for more than seven years, I've successfully recruited and retained numerous newly licensed RNs (NLRNs) from area community colleges ("Hearing the Voices of Newly Licensed RNs," November 2013). Although I agree with the need for a strong preceptor relationship to better enhance the learning and transitional needs of NLRNs, the recommendation to implement a more extensive and lengthy orientation program is unrealistic for our small rural hospital, which has very few resources.


We've found that the key to success is teamwork. In settings with such limited resources, a multidisciplinary approach that includes nurses, certified nursing assistants, pharmacy technicians, respiratory and physical therapists, radiology technicians, physicians, and mid-level providers can lead to a better sense of community and cohesiveness among all providers and is especially effective in helping NLRNs to transition from being novice to advanced-beginner nurses.


With the support of a preceptor and the experience of being a member of the multidisciplinary team, NLRNs gain experience and obtain feedback and support from providers in various disciplines, helping them to strengthen their confidence in their practice. According to Yonge and colleagues,1 this teamwork approach is particularly helpful in preparing new RNs for a successful transition to working in rural areas.


Rance Ramsey, BSN, RN


Stanton, TX




1. Yonge OJ, et al. "You have to rely on everyone and they on you": interdependence and the team-based rural nursing preceptorship Online J Rural Nurs Health Care. 2013;13(1):4-25