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Orienting and Onboarding Clinical Nurse Specialists: A Process Improvement Project

Garcia, Mayra G. MSN, RN, PCNS-BC; Watt, Jennifer L. MSN, RN, CNS; Falder-Saeed, Karie MSN, RN, PCNS-BC; Lewis, Brennan MSN, RN, PCNS-BC, PNP-BC; Patton, Lindsey MSN, RN, PCNS-BC

doi: 10.1097/NUR.0000000000000294
Feature Article

Purpose: Clinical nurse specialists (CNSs) have a unique advanced practice role. This article describes a process useful in establishing a comprehensive orientation and onboarding program for a newly hired CNS.

Description: The project team used the National Association of Clinical Nurse Specialists core competencies as a guide to construct a process for effectively onboarding and orienting newly hired CNSs. Standardized documents were created for the orientation process including a competency checklist, needs assessment template, and professional evaluation goals. In addition, other documents were revised to streamline the orientation process.

Outcome: Standardizing the onboarding and orientation process has demonstrated favorable results. As of 2016, 3 CNSs have successfully been oriented and onboarded using the new process.

Conclusion: Unique healthcare roles require special focus when onboarding and orienting into a healthcare system. The use of the National Association of Clinical Nurse Specialists core competencies guided the project in establishing a successful orientation and onboarding process for newly hired CNSs.

Author Affiliations: Pediatric Clinical Nurse Specialists, Children’s Health Children’s Medical Center, Dallas, Texas.

The authors report no conflicts of interest.

Correspondence: Jennifer L. Watt, MSN, RN, CNS, 8713 Briarcrest Dr, Rowlett, TX 75089 (

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