Welcome to Health Care POV | sign in | join
Transition to RN

Orientation: Learning the Culture of an Organization

Published January 14, 2009 12:50 PM by Bridgette Williams

As the word implies, orientation is the process of becoming familiar with the structure of a business entity, such as medical facility. Usually a standard format, orientation introduces an organization to new employees. Orientation tells of the history, goals and mission of a facility. It's also an opportunity for you to observe the culture of the organization.

Organizational culture mirrors the mission of the facility. In terms of the workplace, culture is the common qualities of employees that assist an organization to work as a cohesive unit.

To thrive, employees must be acclimated in that culture. A federal government agency such as the Department of Veterans Affairs (VA) - my employer - has its own organizational culture.

The mission of the VA is based on a quote from President Lincoln: "To care for him who shall have borne the battle, and for his widow, and his orphan." To address this mission, the VA is divided into three sections: Veterans Health Administration (VHA), Veterans Benefits Administration (VBA) and National Cemetery Administration (NCA). As America's largest employer of nurses, the VHA supports the VA mission by providing healthcare to military veterans and families.

I have observed two factors that distinguish the VA from other medical facilities: patient population and technology.

The patient population plays an integral role in learning the culture of the VA. A commonly held belief among is: military veterans sacrificed their own health to preserve the freedom of the United States. In return, they deserve the best healthcare.

Due to exposure to environments from abroad, military veterans are a dynamic health population. Often, veterans have healthcare needs unlike those of other Americans. As veterans return to America from the wars in Iraq and Afghanistan, many have debilitating long-term healthcare needs such as post traumatic stress disorder (PTSD), traumatic brain injury (TBI) or deconditioning. Often, common illnesses such as diabetes mellitus are combined with PTSD and/or TBI.

Technological Factor

The VA has embraced technology. More than half of patient-care tasks in the health administration section are computerized. Bar code medication administration (BCMA) is software that assists in giving medications to patients. Computerized patient record system (CPRS) allows me to chart patient care activities. Medication administration and patient charting are completely computerized.

The VA orientation was divided into three areas: organizational, nursing and unit. It covered the expected topics - benefits, payroll and security - and was straightforward. The lingo, on the other hand, was a completely different animal. The VA uses many acronyms; employees often use acronyms in their conversations. I remember someone asked me if GLTC is a part of VHA. After looking at the person as if she had grown a third eye on her face, I asked her what GLTC meant. When she told me that GLTC is an acronym for geriatrics and long-term care, I understood her question! Learning this lingo, specifically how to talk in acronyms, is significant to assimilating to the VA culture.

The third part, my unit orientation, was a blend of introductions and observations. Unit orientation is a great time to learn the pace of unit activities, the personalities of staff and the duties you're expected to perform as a RN.

Orientation Observations

As a full-time new graduate RN, my 12-week unit orientation is in full swing. I am finishing week 2 of unit orientation. Each day I shadow my preceptor, I learn something new. Most days follow a planned schedule, while other days, the events of the day dictated the schedule. Shadowing my preceptor, I observed the clinical application of the RN as a unit leader. Duties such as assigning patients to staff, delegating clinical tasks and admitting new patients are only a few of the day-to-day RN functions.

Equally valuable, I am learning how to problem-solve concerns with patient's and patient's family. Additionally, I am learning how to communicate effectively and diplomatically with all staff such as CNAs, LPNs, advanced practice nurses, allied health professionals and medical staff.

I look forward to the next weeks of unit orientation. Each day I am scheduled to work is another clinical opportunity to transitioning to an RN.

4 comments

Enjoyed your article. I am delighted to know that after 33 years with the VA they are still providing a good amount of time for orientation. You may find that the VA is ahead of schedule in computerizing patient records, lab reports, BCMA and other forms. The VA like the military uses numbers rather than words to identify their forms. You will soon know what a 10-2633, CA1 and CA2 are - it took me a few weeks to get that straight. Just remember who you are providing care for and you will be a big asset to you unit and the VA.

Joyce Cohen, Mental Health - RN-BC,PsyD, Lyons VA February 17, 2009 4:13 PM
NJ

Dear Ms. Williams,

Thank you for sharing your insight and optimism for our Veterans. I applied in Nov.08 and am still waiting for an interview. The position Home Based Primary Care for Geriatric Patients is an exact match for me. The postion has been put on hold (most likely the economy) but I am using the time to learn  as much as I can about Veterans Affairs.

You sound like you are in the right field and our government is fortunate to have you.

Sincerely, June Sugar RN

June Sugar, Gerontology - RN, BSG January 29, 2009 7:55 PM
Sacramento CA

As a retired USAF nurse, I envy you.  I truly enjoyed taking care of our military heroes.  Though some have never gotten over their military experiences, others are thriving despite health care issues & making their way through life.  Most patients are very appreciative of all the treatment/care especially the nursing staff.  And despite some of the facilities not having all the private hospital trappings or all the latest equipment & supplies, you'll become very flexible & creative in your nursing management & nursing skills that'll serve you well in your nursing career.  In conclusion, your patient population is another culture you'll learn especially their patriotism & their love/support of their fighting brethrens as patients now.

vonda chaney, School Health - RN, AAC, DOH January 28, 2009 7:19 PM
glen Burnie MD

I enjoyed reading your article. I have been working for the VA a couple of years and I see slow but constant improvement. Since I have been at the VA overhead track lifts have been installed in our area which are great at preventing falls and saving nurses backs from injury. We also have a lot of renovation and building going on in Biloxi.

Clifford Williams, Rehabilitation - RN, Biloxi VA January 28, 2009 2:12 PM
Biloxi MS

leave a comment



To prevent comment spam, please type the code you see below into the code field before submitting your comment. If you cannot read the numbers in the image, reload the page to generate a new one.

Captcha
Enter the security code below: