An orientation program for new graduate nurses: the basis of staff development and retention.

The nursing shortage and an increased demand for obstetric nurses led a Central Texas hospital to hire new graduates for the Level Three obstetric unit. This change in hiring policy necessitated a reevaluation of the orientation program resulting in a new approach in staff development. A three-phase program was developed beginning with orientation and socialization of the new staff member, continuing with the development of advanced skills, and leading to assignments of complex cases after completing appropriate educational programs. The program has fostered autonomy in the experienced staff nurse and increased job satisfaction as measured by advancement in the career ladder and retention rate. The program is regularly monitored by chart and peer review audits, as well as by the orientees' six-week and six-month evaluations.