Open Forum

Good morning,

I am wondering if anyone has a specific onboarding process or program for RNs transitioning from inpatient positions to ambulatory care? Many of the nurses that I hire into my clinic come from the inpatient arena and the transition has been quite difficult for them, especially when it comes to telephone triage and childhood immunizations. I am hoping to develop a toolkit of sorts that could be used during the orientation process to help RNs become more comfortable in the ambulatory environment. 

Thank you,

Amy

Hello!  I am the ACC educator for VA Palo Alto. We also have a PACT educator. I am newer to this area and learning the complexities of PACT.  Ambulatory in my area also covers specialty clinics which adds more skills to nurses. In my experience so far the biggest struggle is learning how to manage the daily schedule to meet all the requests and the metrics. There is a lot to think about: prioritize and close out correctly.

I treat this area the same as any other specialty. Nurses transitioning in their practice to new specialties must be given the time to develop the KSA for the role. New Grads have a residency and established nurses transitioning should go through a Fellowship. Although we don't (yet) refer to our program as a Fellowship - it is. The orientation for PACT nurses is upwards of 12-16 weeks. We are still working out the right formula. the Ambulatory areas have a Competency Based Orientation that maps out the weeks - we are working to standardize (to the extent possible) for all the Ambulatory areas.

VA Southern Nevada has a PACT Hub of Excellence: PACT Hub of Excellence - Home (sharepoint.com).  They have a separate orientation  - i want to model this. 

Another great resource: Patrick Turpin from VA San Diego. He has much more knowledge of the role and onboarding new nurses.

I didn't give you a lot of answers but hopefully guided you in the right direction.  We are all in this together!  Cynthia

Good morning,

I am wondering if anyone has a specific onboarding process or program for RNs transitioning from inpatient positions to ambulatory care? Many of the nurses that I hire into my clinic come from the inpatient arena and the transition has been quite difficult for them, especially when it comes to telephone triage and childhood immunizations. I am hoping to develop a toolkit of sorts that could be used during the orientation process to help RNs become more comfortable in the ambulatory environment. 

Thank you,

Amy

Good morning,

I am wondering if anyone has a specific onboarding process or program for RNs transitioning from inpatient positions to ambulatory care? Many of the nurses that I hire into my clinic come from the inpatient arena and the transition has been quite difficult for them, especially when it comes to telephone triage and childhood immunizations. I am hoping to develop a toolkit of sorts that could be used during the orientation process to help RNs become more comfortable in the ambulatory environment. 

Thank you,

Amy

We also have been revamping our orientation checklists with a special focus on Ambulatory care.  One thing that we have found helpful is Simulation based modules from our University of Washington School of Nursing to review scenarios in a safe environment.  And like you said, use of telephone triage decision support tools and guidelines for what is urgent (call back within 1 hour), emergent (call back within 4 hours), and routine (call back with 24 hours). 

Good morning,

I am wondering if anyone has a specific onboarding process or program for RNs transitioning from inpatient positions to ambulatory care? Many of the nurses that I hire into my clinic come from the inpatient arena and the transition has been quite difficult for them, especially when it comes to telephone triage and childhood immunizations. I am hoping to develop a toolkit of sorts that could be used during the orientation process to help RNs become more comfortable in the ambulatory environment. 

Thank you,

Amy

We also have been revamping our orientation checklists with a special focus on Ambulatory care.  One thing that we have found helpful is Simulation based modules from our University of Washington School of Nursing to review scenarios in a safe environment.  And like you said, use of telephone triage decision support tools and guidelines for what is urgent (call back within 1 hour), emergent (call back within 4 hours), and routine (call back with 24 hours). 

Good morning,

I am wondering if anyone has a specific onboarding process or program for RNs transitioning from inpatient positions to ambulatory care? Many of the nurses that I hire into my clinic come from the inpatient arena and the transition has been quite difficult for them, especially when it comes to telephone triage and childhood immunizations. I am hoping to develop a toolkit of sorts that could be used during the orientation process to help RNs become more comfortable in the ambulatory environment. 

Thank you,

Amy

Good morning,

I am wondering if anyone has a specific onboarding process or program for RNs transitioning from inpatient positions to ambulatory care? Many of the nurses that I hire into my clinic come from the inpatient arena and the transition has been quite difficult for them, especially when it comes to telephone triage and childhood immunizations. I am hoping to develop a toolkit of sorts that could be used during the orientation process to help RNs become more comfortable in the ambulatory environment. 

Thank you,

Amy