Remember back to the first time you walked into your center. That first day was nerve wracking, wasn't it? Before your coffee cooled there were new faces to recognize, new names to learn and new surgeons to understand. That's a lot to process before lunch. And which clique would you eat with then? Now think about how your new hires feel when they arrive for work on their first day. Are your hardened veterans ready to accept new blood? Is your orientation program up to snuff? First impressions are lasting. If they're positive, your new employees will likely thrive in their new roles. If not, their road to success may be a bumpy one.

First things first
Give your veterans advanced notice of the new hire's starting date. Surgery centers are built on routines and your current employees need to be aware that their day-to-day may be interrupted. They need to know that, no matter how busy the day, a wide smile instead of a "who's this?" frown will go a long way in welcoming the new hire.

Explain simple things like where to park, how to punch in, the location of the locker room and which locker is hers. Have a nametag ready for when she arrives. This little effort shows that you were anticipating her arrival and is usually a welcome surprise.

Take the new hire on a tour of the facility. Seeing staff in action will give the newbie a feel for the flow of the surgical schedule and the role of each employee. Reinforce those roles by introducing the hire to each employee you encounter. Ask everyone, from the receptionist's desk to the sterile corridor, to wear nametags. A visual aid is a big help in having the names stick when a person's being introduced to countless new faces and contacts.

The facility tour is also a good opportunity for you to extol the virtues of your current staff in front of the new hire. As you introduce each employee, explain their responsibilities, the length of their tenure, some of their strengths and perhaps a few personal interests. This will give the new hire insights into the people she'll be working with - perhaps who to go to with specific questions about the center or even about what's fun to do on the weekend - and will also make your current staff feel good for having their positive attributes highlighted.

Suggest that your staff offer to take a break or eat lunch with the new hire. Cliques are a reality of the workplace, but they are exclusionary and guarantee that the newbie will feel left out. An invite from the frontline gang will make the new hire feel accepted immediately. During these initial social settings, instruct staff to avoid gossiping about others, including the surgeons. This is never appropriate, but at lunch on the first day or during the initial weeks on a job gossiping can jade a new person's opinion of the center, the surgeons and her co-workers - including you.

Above all, be positive. No workplace is perfect, but if all the new person hears is how bad the supervisor is, or how awful the work environment is, do you think she'll stay?

Getting orientated
Assign someone who really likes to teach, mentor or precept to the new person. If the trainer doesn't like to teach, the new person won't learn. One of my best OR nurses scrubbed for orthopedic cases all the time, but was one of my worst trainers. She liked to do it all herself, and because she was so good she didn't want a new employee to slow her down. In this same OR, my best preceptor was a nurse many described as a klutz. She wasn't very organized and when she scrubbed or circulated, things got done but not very smoothly. Ironically, all new employees loved to have her as their preceptor because she would tell them why we did things the way that we did. She was a great teacher and her trainees always did well.

Be consistent. Use a detailed orientation checklist and make sure the new person gets trained in every aspect. This is only fair to the employee, as she'll be evaluated based on the job description, and it should include a lot of what she's taught during orientation.

Resist the urge to put the new staffer to work immediately. I have been a new employee in places where I was assigned to an OR on day two without even a tour of the facility. When a doctor asked for something, I didn't know where to go to find it. Was I a happy employee? No, and I didn't last long.

Policy and procedures are important and the new employee should be given every opportunity to review them. Assign mandatory training videos, have her read policies, go over forms and review the employee handbooks. But vary time spent on reviewing policies with other tasks. Don't put her in a room for 8 hours to study. That's a recipe for boredom - and disaster.

Perception is important
Keep the welcome wagon rolling. Give the new employee a copy of the orientation checklist and review it with her daily to ensure that everything is covered. Set a timeframe for completion and explain that it's up to her to tell the preceptor or supervisor if there's something on the list that she hasn't gone over.

Constantly measure the new hire's progress and comfort level. Interview her at the end of the orientation period. When the newbie offers a suggestion, listen. Replying with "We've always done it this way" will make new hires hesitate to offer future ideas or comments. Make the suggested changes if they're possible and practical. That will really show your fresh hires that you respect their opinion and they're part of the team.