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competency, critical care, nurse leader, orientation, preceptor



  1. Elmers, Coleen R. MSN, RN


In the past, only experienced nurses were hired to work in critical care areas. With the prolonged nursing shortage, more and more facilities are hiring recent nursing graduates to work in these fast paced critical care units. How does this impact the orientation process in critical care? What competencies and skills are necessary in a nurse that will be working in a critical care setting? Are there specific competencies all critical care nurses must possess, even those with little or no previous experience? How do you help new registered nurses develop critical-thinking skills during orientation? These are very important questions that need to be addressed in order to get the outcome we want by the end of orientation: a competent critical care registered nurse. This article will explore significant factors that have the capacity to negatively or positively influence the success of an orientation program. During my years of nursing practice, I have found 4 factors that are especially crucial to the success of a critical care orientation program. These factors include:


1. strong leadership support throughout the comprehensive orientation process.


2. appropriate preceptor selection.


3. focus on developing critical-thinking skills.


4. use of a competency-based orientation plan.