We appreciate the comments by the reader. Our development of the orientation model has evolved from just such feedback from graduate nurses. Our redesign goals were consistent with the issues identified above, including new graduates feeling overwhelmed in a constantly changing environment with a steady flow of new information.

Selecting unit preceptors who are willing to work with graduate nurses in contrast to a mandated assignment, always provides a more positive experience for both parties involved. The idea of consistent preceptors remains an ongoing struggle to balance given scheduled class times, patient acuity, and the staffing needs of the unit. The improved quality of our orientation program has helped bridge the gap to acceptance of graduate nurses in the critical care unit by other staff members and members of the health care team.

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