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Facilitating a Major Staffing Transition in a State Psychiatric Hospital With Changes to Nursing Orientation

BACKGROUND: A large state psychiatric hospital experienced a state-mandated Reduction in Force that resulted in the abrupt loss and rapid turnover of more than 40% of its nursing and paraprofessional staff. The change exemplified current national trends toward downsizing and facility closure. OBJECTIVE: This article describes revisions to the nursing orientation program that supported cost containment and fidelity to mission and clinical practices during the transition. DESIGN: An existing nursing orientation program was reconfigured in alignment with principles of rational instructional design and a core-competencies model of curriculum development, evidence-based practices that provided tactical clarity and commonality of purpose during a complex and emotionally charged transition period. RESULTS: Program redesign enabled efficiencies that facilitated the transition, with no evidence of associated negative effects. CONCLUSION: The process described here offers an example for hospitals facing similar workforce reorganization in an era of public sector downsizing.