Two books are reviewed. Staff Educator's Guide to Clinical Orientation: Onboarding Solutions for Nurses by Alvin D. Jeffery and Robin L. Jarvis and Everyday Bias: Identifying and Navigating Unconscious Judgements in Our Daily Lives by Howard J. Ross. I highly recommend the Jeffery and Jarvis book and recommend the Ross book. They address quite different topics, but the Appendix in the Ross book addresses talent management, which is a component that impacts the degree of organizational onboarding and orientation required.
Staff Educator's Guide to Clinical Orientation: Onboarding Solutions for Nurses by Alvin D. Jeffery and Robin L. Jarvis, 2014. Indianapolis, IN: Sigma Theta Tau International. 201 pages and costs $34.95.
Onboarding staff remains a constant and chronic issue if the number of Doctor of Nursing Practice projects is any indicator. In one sense, it isn't a surprise that this process is under scrutiny for ways to improve and shorten the process. A good onboarding and orientation sets an employee up for success, and a poorly run onboarding makes the employee wonder what he or she has gotten into. The orientation not only serves to get the employee working but is also the first step the organization takes to ensure patient quality and safety. So it is an important part of bringing on staff and not just something to endure.
There are two ways to revise an onboarding program, tweak it around the edges or start over. In either case, Jeffery and Jarvis provide a framework that helps identify the components of a good clinical orientation. The authors call this book a just-in-time field guide for quick reference. The book begins with a chapter-by-chapter description of the content or focus of each chapter, thus enabling the readers to turn to the information they need at the time. Although the authors hope the entire book will be read, they realize that nurses are busy and sometime just need the information now.
Chapter 1 is "Important Considerations for Onboarding and Orientation." They offer stories of two different onboarding situations and their outcomes, thus setting the stage for why a planned and thoughtful orientation is needed. The ADDIE model for instructional design is described. Each of the components (Analyze, Design, Develop, Implement, and Evaluate) is discussed. The authors intersperse illustrative stories and examples throughout the book's chapters. Principles and Principals of Onboarding are discussed and examples given. Suggestions and sources are provided. After the chapter conclusion, questions for reflection or discussion are provided. Key takeaways and references end each chapter.
Chapter 2 is "Analyzing and Designing an Orientation Program." This chapter has excellent practical ways to gather data from the principals. The various methods (interviews, surveys, focus groups) are described and explained. Table 2.3: Common Errors to Avoid in Onboarding Programs is comprehensive and very useful. Ways to understand your learners and their characteristics are suggested. The impact of program structure is discussed. A template design worksheet is provided.
Chapter 3 is "Developing and Implementing an Orientation Program." Centralized and decentralized programs are discussed, and different ways to approach the programs are presented. A section discusses preceptors and how to find them and use them effectively. Chapter 4 presents how to "Evaluate an Individual's Competency." The differences between time-based and competency-based orientations are discussed. Competency and confidence are differentiated. Critical thinking skills and various approaches to help with this process are presented. The role of the principals or stakeholders in this process is discussed. The chapter, as all do, ends with questions to help the readers reflect on their use of the content.
Chapter 5 is "Working With Orientees." How to work with both new graduates and experienced nurses as orientees is discussed. Various situations, both positive and less positive, that will occur are discussed, with suggestions and examples given. I have encountered more than once each situation described, and the authors do an excellent job presenting well-thought-out ideas for the reader to consider. Chapter 6 is "Evaluating an Orientation Program." Real-world examples of program evaluations are presented and how the evaluation could be improved. Levels and types of evaluation are presented with examples. There are useful worksheets to organize the orientation evaluation at several levels. The final worksheet in this chapter is very helpful, as it combines features of several models discussed.
Chapter 7 is "Regulatory Considerations" including laws that are pertinent to employment. It is very comprehensive and offers excellent tips. The last chapter is "Practical Tips for Staying Organized." It suggests ways to organize files, maintain your calendar, and how to use a learning management system. The Appendix is chocked full of "Essential Orientation Materials for Your Office": Books, websites, and a 1-minute literature review of pertinent articles. The book concludes with an index for even easier access to information than the chapter-by-chapter content that begins the book.
I highly recommend this book for anyone who is involved in orientation regardless of the level of involvement you may have in the process. It is useful for the nurse in charge of the entire orientation and the nurse who serves as a preceptor for the newly hired staff. It truly is a field guide and is worth the cost and time spent reading it.
Everyday Bias: Identifying and Navigating Unconscious Judgements in Our Daily Lives by Howard J. Ross, 2014. Lanham, MD: Rowman & Littlefield. 183 pages and costs $36.00.
I received this book as part of a work-related unconscious bias training for all employees. I attended the workshop and found it to be eye-opening. I learned about unconscious bias and the numerous ways we are biased without our realization of the fact. I began to read the book and realized it is a mix of anecdotes and the exercises I experienced in the workshop. I believe the book offers good content for your consideration, although it is very densely worded and makes and remakes the same points. Despite this writing style, it is a worthwhile book.
The book begins with acknowledgments and an introduction, titled "Blinded by the Light of Our Bias." The author lays out examples and studies that demonstrate implicit bias. This lays the foundation for the remaining chapters that address aspects of bias. The first chapter is titled "If You Are Human, You Are Biased." Bias is defined as a particular tendency or inclination that prevents unprejudiced consideration of a question, someone, or a situation. The chapter discusses how and biases form. In Chapter 2, "Thinking About Thinking," the author leads the readers to consider how their thoughts are formed and what has influenced them. The idea that we can do something about our thoughts is introduced.
Chapter 3 presents "The Many Faces of Bias." A few examples of not seeing what is in front of us are given and how the suggestion of one thing may prevent the person from seeing another thing. Pattern recognition is discussed as one way we make decisions and how this influences stereotypes. The influence of patterns on our bias is discussed and how they influence our thinking. Chapter 4 begins with the Trayvon Martin story and the biases that resulted in the tragedy. This leads to the next chapter where the sense of power and privilege, or lack thereof, influences how person operate in life. In Chapter 5, "Who Has the Power," power in its various forms is discussed. The distinctions of power among people are presented with examples that can be seen in everyday life. One example of a wealthy Black family in Florida who were invited by the White store owner to shop after-hours is powerful.
Chapter 6 presents the "Networks of Bias in Everyday Life." The systems discussed are the legal system, politics, and, as we as nurses know, the healthcare system. In Chapter 7, the author presents how to learn to disengage from bias. The author believes there are six major areas of focus that can help people work on their individual patterns of bias. Each of these is discussed in detail, and actions that influence these areas are presented.
The author addresses how to make organizations more conscious of bias in Chapter 8. He titles the chapter "Incubators of Consciousness." He offers examples of organizations that have made conscious decisions to reduce bias and biased decisions. He also gives eight questions to ask when making groups decisions. He states these are great questions, and I have to agree with him. In the conclusion to the book, the author discusses how changes in bias result in improvements both to the individuals who actively works to reduce their unconscious bias and to those around them impacted by these changes. Part of the reason I reviewed this book in conjunction with the onboarding book is the Appendix. In the appendix, a list of 10 ways to identify and navigate bias in talent management is presented. This goes directly to the issue of successful onboarding and orientation. The book ends with a bibliography and chapter notes.
I recommend this book with the caveat that it provides a lot of material but could have been shorter. The material it presents is important, and the ways to address unconscious bias are presented.
I recommend both books. I highly recommend Staff Educator's Guide to Clinical Orientation: Onboarding Solutions for Nurses and recommend Everyday Bias. Each book serves a different purpose, but both offer information and approaches necessary for successful work environments.