Healthcare organizations continue to face intense workforce pressure, particularly among nurses. While burnout and turnover were already challenges before 2020, the pandemic sharply accelerated them and many of those effects remain today.
For HR leaders, the question is no longer whether retention is a priority, but where intervention can have the greatest impact.
Increasingly, the evidence points to onboarding.
Keep reading to see what a nurse told us of her experience … and what HR in healthcare should focus on to improve.
Related: Click Boarding is trusted by leading healthcare companies for onboarding and offboarding
A Nurse’s View
We talked to a nurse at a local hospital to better understand her onboarding experience. Jessica, a nurse with years of experience across multiple states, shared that most of the onboarding she has experienced has been disorganized, stressful and made her question her decision to join the organization. Her most recent position was no exception.
She explained how some modifications to onboarding and training that could have helped her transition to her new position.
Here are her top 5 nurse onboarding wishes:
Communication
Jessica was initially delighted when she was offered her dream nursing job. But her delight was short-lived. Immediately following the exciting news, Jessica was inundated with emails from various HR specialists throughout the organization. In some cases, she even noticed duplicate information being communicated to her. This caused her an unnerving sense of confusion and uneasiness.
To make matters worse, Jessica didn’t hear another word from her future team until two days after her start date. In hindsight, Jessica would have felt considerably more comfortable joining her new team if there had been some communication with her future co-workers and supervisor. This is particularly critical within the healthcare industry where quality training is largely dependent on team relationships and dynamics.
Best practice: Establish a standardized communication protocol for new nurse hires between the offer letter and their first day. Have the hiring manager send a “welcome to the team!” email or ship a welcome gift to their home. This makes the new nurse feel valued and opens the lines of communication in case they have any questions that can’t be answered by non-clinical personnel.
Job responsibilities & expectations
Jessica was an experienced nurse prior to taking her new job. While she was confident in her abilities as a nurse, her new job responsibilities were not as clearly defined as she would have liked. As she settled into her new role, the needs of her department were still vague. She would find herself wearing a new hat every day and often learning new skills on the fly. It was as frustrating as it was distracting!
Best practice: Clearly defined job descriptions and role assignments help new nurses understand what they are responsible for and how they fit into the organization. Clearly defined roles and scope of practice reduces unnecessary ambiguity and creates a much more efficient and productive training timeline.
A day in the life
Jessica mentioned that prior to her career in nursing, preparing ahead of time didn’t seem as important. But in an environment as chaotic and unscripted as a hospital, being prepared is paramount. She wishes she would have known how this unit differed from others she had encountered in the past. Workload, time management, scope of practice and the patient population were entirely different. Having an understanding of what to expect on a typical day would have significantly reduced the learning curve.
Best practice: Help manage your new nurse’s expectations by sharing what daily life at your healthcare organization is typically like. Coordinating communication with future peers creates a rapport of comfort and trust that would enable nurses to reach their maximum potential as quickly as possible.
Centrally organized training
Jessica was never provided a training manual or skills checklist and often received conflicting information from various team members. Having a more structured approach with a standardized procedure would have reduced the confusion created by multiple information sources. She would have loved to know:
- What she would be trained on
- When the training would be
- Who would be the trainer
- Is there any unit/department specific training needed
Best practice: Establish training schedules, manuals and procedural documents that clearly delineate the mentor/mentee relationship with real-time digital assessment tools. Consider pairing your new hires with an onboarding buddy or mentor during their first days and throughout the process.
Orientation
Jessica’s first day included an orientation with health insurance, financial directives, compliance paperwork and a general overview. This is often overwhelming in the moment and can lead to rushed and misinformed choices. Having access to this information prior to her orientation day would have allowed more time for thoughtful consideration and more informed decisions.
Best practice: Leverage onboarding technology and securely send your nurses their new hire documents digitally before their first day. Automate this step to simplify the process for HR and reduce orientation time.
Graduate & Travel Nurses Need More, Too
Focusing on these two groups can significantly improve retention in what are traditionally high-turnover groups.
Special Considerations for New Graduate Nurses
Early-career nurses face a steep learning curve, with stats showing early attrition among new graduate nurses remains meaningfully higher than among more experienced peers – often due to stress, lack of confidence, and insufficient support (source).
Onboarding programs for new graduates are most effective when they emphasize:
Gradual ramp-up of responsibilities.
Strong social integration to reduce isolation.
Ongoing education and development pathways.
Clear escalation and support mechanisms.
Automation and mobile access matter here, not as technology features, but as ways to reduce friction during an already demanding transition.
Onboarding Travel Nurses Requires a Different Lens
Travel nurses introduce additional complexity with their unique challenges. Contracts are short, nurses often arrive from out of state, and organizations rely heavily on trust and preparedness before day one – especially as they lean into this area more.
Effective travel nurse onboarding typically spans three phases:
Before day one
Provide housing guidance, facility maps, onboarding schedules, and unit-specific policies to reduce uncertainty before arrival.
With a linear onboarding process, you can make sure nurses see and acknowledge every piece of information they’ll need before their start date. That’s a real confidence boost … and ensures they’re likely to show up when promised.
Day one
Prioritize human connection, system access, and orientation to equipment and workflows. Many healthcare systems do this well already with their support, but since they’re away making sure they feel connected with and cared for is vital.
First 30 days
Maintain open communication, gather feedback, and update onboarding materials based on recurring questions.
While travel nurses may be temporary, their onboarding experience directly affects patient care continuity and team morale … and any future hires you may need, as well!
How HR Can Improve Nurse Onboarding Experiences
Across permanent nurses, new graduates, and travel staff, the pattern is clear:
Onboarding is not paperwork.
It is risk mitigation, productivity enablement, and retention strategy rolled into one opportunity.
For healthcare HR leaders, modern onboarding means:
- Starting engagement at offer acceptance, not day one.
- Reducing administrative lift through automation.
- Supporting compliance without overwhelming new hires.
- Adapting onboarding experiences by role, unit, and employment type.
- Extending support beyond orientation into the first several months.
Higher Retention Is Real ROI
Nurses have carried an extraordinary burden over the past several years, and retaining them requires more than appreciation.
It requires a culture that respects their time, reduce uncertainty, and support their success from the moment they say yes. And your onboarding is the first impression on if you provide that culture nurses are looking for.
Organizations that treat onboarding as foundational infrastructure, rather than a checklist, are better positioned to stabilize their workforce and protect patient care.
If this is something you’re looking for, explore the Click Boarding platform further.
