ANPD believes no matter your role in the practice of NPD, you belong in our community. That’s why our Specialty Spotlight series is highlighting members furthering NPD goals in unique and invaluable ways. Today, the spotlight is on the Central Division manager of onboarding, orientation, and regulatory education—a unique role held by Kristina Pickering, DNP, RN, CNL, NPD-BC.

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Can you describe your career journey, and how you ended up in your current role?      

My career began as a night shift nurse on a med-surg unit. In that environment, I developed a deep appreciation for the preceptors, superusers (unit leaders who support practice changes and product and process implementation), and nurse educators who played such a pivotal role in supporting the clinical competence, quality outcomes, and professional development of all nurses. 

After several years of serving as a preceptor and unit superuser, I was presented with the opportunity to formally enter into a nursing professional development (NPD) role. I joined a wonderful team of NPDs that truly embraced the NPD Practice Model as the means of approaching nursing education and competency validation.

Through a series of interprofessional workgroups that spanned multiple hospitals and levels of the organization (regional and system), I was able to network with NPDs and leaders who shared the common goal of ensuring that professional development met learner needs in a meaningful and reasonable manner. Participating in these interdisciplinary groups provided me with the opportunity to build new skills, learn more about the organization, and network with both formal and informal leaders.   

In 2022, through the process of a system-wide reorganization, the role of the Central Division manager of onboarding, orientation, and regulatory education was implemented. In this role, I support leaders, NPDs, and clinical nurses with regulatory education and orientation through a process of standardization, consultation, and oversight. My role helps promote transparency, best practices, and innovative approaches to education across the 23 acute care facilities in the five states that make up the Central Division.

How was this role developed, and how are you measuring its effectiveness?

This role was new to the division structure implemented in 2022. The intent was to increase efficiency by aligning content and standardizing practice related to orientation and required education. In addition, this role would provide consultation to clinical partners on questions and concerns regarding regulatory education, orientation, and onboarding. 

Early on, we recognized the critically important need for this role to balance standardization of education content and delivery with the justified need for autonomy and at times individualization at the hospital level. The goal for this position is to have leaders and NPDs see this role as someone who is focused on collaboration and partnership as opposed to micromanagement. 

The process of alignment and standardization has provided the added benefit of alleviating some of the workload for local teams, enabling them to focus on continuing development of staff with offerings such as in person classes and training or at the elbow coaching. 

Our measurement for improvement in 2023 was the ability to align on shared regulatory modules and the development of minimum specifications for orientation across all 23 acute care facilities.  We have also been able to share feedback from survey findings across our facilities to better target education. 

What does an average day in your position look like?

The cadence of my day varies, but common activities include:

1. Participation in nursing and interprofessional workgroups at the division and system level, representing the perspective of nursing as well as the 23 hospitals in the Central Division. I serve as a conduit to ensure that information and feedback is transferred between the Providence St. Joseph Health (PSJH) System Level and the Central Division nursing education leaders.
2. Development of education content. As an NPD I am involved in the development of education resources to meet regulatory and practice needs for both the Central Division and PSJH System (51 hospitals in seven states). 
3. Consultation on individual facility strategies to meet regulatory education and competency requirements. In my role I consult on strategies to meet regulatory requirements. I also connect subject matter experts across the 23 facilities in our division to explore how individual facilities meet the regulatory requirements and opportunities to share a best practice and subsequently standardize an approach. 
4. Meeting with individual NPD teams to understand their current state of education and competency practices. Through this process we have been able to improve transparency across the 23 acute care hospitals in our division and have conversations on best practices and opportunities for standardization.

What is a professional achievement you are proud of?

In 2023, through a process of current state assessment and collaboration with local facilities across the division, we were able to reach consensus on orientation minimum specifications using Maslow’s Hierarchy as the foundation of our approach (see image below). The implementation of Maslow’s Hierarchy in the context of nursing practice has provided a much-needed opportunity to positively impact the human experience of our new caregivers.  

I am also proud of the collaboration and partnerships with interprofessional leaders and teams across the 51 facilities in our health system. An example of this is pulling together an interprofessional group of nurses, pharmacists, and informaticists to build a multi-modal pain management module to improve practice in alignment with regulatory requirements. 

 

As a division, we have been able to cultivate this role into one that has proven beneficial to the facilities we serve by providing resources, consultation, and representation. This role has been developed with the intent to serve as a voice for nursing and to meet a need for support with regulatory education, onboarding, and orientation across a variety of acute care and critical access hospitals throughout the five states in our division.

Are there any special considerations to navigate in this position?

Something to be mindful of when supporting facilities in multiple states is the variation in state regulatory requirements that can impact education and competency assessment. This variation can be challenging when looking at standardization. That being said, this variation and the way each individual facility operationally meets these requirements has been a robust opportunity to identify best practices and look at new ways of meeting orientation and regulatory education requirements.

What advice do you have for NPD professionals looking to find a similar career path?

Early on in my NPD career, one of my mentors advised me that listening with the intent to understand as opposed to respond is an invaluable skill as an NPD. This has proven true, and my most successful work has been the result of truly understanding the learners, the problem, and the environment in which all of these elements exist. 

The NPD Practice Model is a great tool that honors the role that the learner, the practice issue, and the environment play in education and professional development. It also supports the growth and development of the NPD practitioner.      The model aligns with the skills necessary to be successful in this role: an understanding of the need and the learner, collaborative relationships that focus on a common goal, and ultimately interventions that support excellence in clinical practice and patient outcomes.