After all the work that goes into attracting and selecting the right person for the job, making sure that things go well when they start work is essential if the effort is not to be wasted. The first few days are vital to the success of your recruitment process--and it is often in these first few days that your perfect new hire hands in their notice or just doesn't turn up for work. Hopefully your improved selection process has resulted in matched expectations of the job from both sides, so an early departure should be unlikely.

Preparing for the First Day

A usual, good planning is key for success. Everything must be ready--name badge, locker, keys, desk or personal space, uniform, staff manual or other information. The team must be briefed (buddy appointed, practice tour arranged, introductions etc), and your induction programme must be set out ahead of time. Make sure your new employee knows where to park, which door to come in and where to go first. A friendly welcome makes all the difference and a coordinated approach, early tour and introductions, and company at lunch time will help your new employee feel at ease with everyone. Clear name badges make life easier on both sides

Setting up a Structured Induction Scheme and Getting Staff Support

The aim of any induction scheme is to ensure the new employee:

 Feels welcome and involved from day 1

 Is taught the skills and knowledge necessary to do the job over a pre-defined period (the induction period)

 Becomes competent to perform the job required

 Integrates satisfactorily into the team or hierarchical structure

 Buys into the practice's values and overall aims

 Reached a point where self-development is possible within the job role

 If successful, wishes to continue working and develop the role

Having written support materials is essential for a good structured induction programme in anything but the smallest organisation. Checklists and 'How to do It' manuals are very helpful, not only for planning and training, but also for the new employee to self-direct their own training and induction, and allow them to look things up when they need to. Ideally, an overlap period with the departing employee is helpful if the job roles are similar, but frequently this is impossible because of the length of time of the recruitment process. It may also be that you wish to start afresh with the new employee and encourage the team to carry out the induction to build and strengthen relationships. Either way, a checklist of things to learn is helpful for focusing effort and ensuring that everyone has the knowledge and skills they need (and often are assumed to have) to do the job.

The danger is drowning in a sea of paperwork and giving the idea that the new person is not trusted to work independently. For a scheme to work, both the supervisor(s) and the employee must have ownership of it. At Mill House, we started with an area- and activity-based induction programme, covering each area of the job (e.g., wards, theatre, reception for nurses) in turn. We listed all the things a new employee needed to know, including use and care of equipment, clinical protocols, health and safety issues, and all the activities carried on in that area. Against each item is a check box for the trainer to sign, and another for the employee to sign when they are confident. A good place to start is the job description, which can be broken down into tasks and required knowledge.

As the practice has grown, this induction programme, particularly for our nurses has become unwieldy and we have converted it to a time-based programme, mapping the activities to a time plan, and further prioritising them. For the first four weeks this is set out day to day, so that the new starter knows what they will be doing on day 1, 2 , 3 and so on. A mix of administrative items (payroll issues, staff discounts, general policies etc), and technical training (general ward work for nurses) helps to keep the employee's attention, and avoids overwhelming them with information, whilst allowing them to perform some useful and enjoyable nursing tasks on the first day. It also means that different trainers interact with the employee from day 1 which aids integration, gives variety to the new person and helps the trainers carry on with their own day to day tasks during induction.

Early on in the process, it is vital for the practice decision makers to share their perspective and mission, and clarify exactly how the new employee can contribute to this day to day.

Involving all the team in designing the induction programme is very useful for giving them ownership of the process and encouraging them to be involved, and this will be discussed further in a later paper.

It is useful to reassure new employees that they can ask to be shown something as many times as they need, and some quality control of training by observing performance and questioning will help to asses how the employee (and the supervising staff) are doing. By following a checklist, it is straightforward for anyone to see how the new person is progressing, and also to help fill gaps or assist in areas where confidence needs support.

Quick learners and those with experience can jump ahead if necessary, and check off items they are confident about. Inexperienced or less confident new employees can take more time and revisit areas if necessary. Although the time plan seems rigid, it can be as flexible as required as it is always easy to see where someone has got to. Familiarity with the structure of the induction is essential if other staff are to pick up the training part way through the process. Keeping things simple is essential.

Problems can occur with experienced staff if supervisors do not double check competencies, as poor practice and inadequate skill levels in certain areas can be missed. When they are picked up much later, this can be very demotivating and often difficult to handle.

Having completed the first four to six weeks on a day by day basis, the next few weeks can be covered on a weekly basis or by months. Our own induction programme covers one year, with year 2 and 3 competencies for student nurses undertaking Veterinary Nurse training.

Manuals

To complement the induction checklists, written manuals, standard operating procedures or 'How to do It' sheets are extremely useful, and avoid the 'Chinese Whisper' problems which are so common in larger teams or organisations. Regular observation and quality control also help pick up where these problems are occurring, and they are commonly a result of the cascading of information from one person to another without checks being made along the way. Of course, written materials are useless if they are kept on the shelf, are boring to read, seem irrelevant and are not regularly updated. Manuals need to be working documents, used regularly and purged and updated frequently. All pages should be marked with date and filename and path if produced on computer, so they can be easily reviewed and updated. Developing the habit of getting the manual out whilst training is an excellent way of getting staff used to using the manuals, and of keeping them current and interesting, as well as discouraging bad habits in experienced staff, who often forget the agreed protocol and train the new employee in a different way. Manuals can include instructions and plans for work, equipment servicing schedules and parts ordering details, health and safety guidelines, supplementary references and notes for future improvements of replacement of equipment. Frequently referred-to items can be posted on the wall or inside cupboards.

A Staff Manual, given to all staff can include employment and pay policies, training and development policies, who's who and organisational chart, any practice rules e.g., dress, behaviour, internet and email use, health and safety policies and commonly used clinical and payment policies.

A selection of comprehensive client handouts (or FAQ's) can be very helpful for new staff. Covering areas such as neutering, parasite control, vaccination, useful telephone numbers and common presenting diseases, they can be referred to easily in reception or during phone conversations so the correct information is to hand and does not have to be memorised all at once. If the client can take the information away, or the practice can send it out, so much the better--it's good marketing too. Good induction systems are thus an integrated part of any practice's overall marketing and customer service strategy, and can save a lot of time in the long run!

Giving Feedback

As well as keeping an informal eye on progress, it is essential to give regular feedback to any employee, particularly a new one. Their own view of your induction process is helpful for refinement of the process and quality control of your own supervisory activity. I would suggest that feedback should follow the induction schedule--at the start, it should be provided every day--by communication before leaving and summing up the day's activities. Finishing the day on a high note really can make a difference to a new employee's self esteem and enjoyment of the job. It also helps make it clear that the day has ended--it can be very disconcerting if everyone just leaves with out saying goodbye! This end of day chat can include planning for the following day and signing off completed tasks.

Later, a monthly more formal mini-appraisal is helpful with a short agenda to include:

 Progress and achievements

 Training completed

 Aims not met, difficulties encountered

 Action plan for the next period

 Any other comments

Notes can be made by hand and the action plan publicised to the team so that support is available. Each month, the action plan can be checked and the previous notes reviewed to ensure any issues have been dealt with.

Harnessing Enthusiasm

A more formal 3 month appraisal is used in our practice with the supervisor and a partner to assess the effectiveness of the induction process so far and to plan further ahead. This meeting often brings good ideas for improving our induction and the timescales and organisation involved. It is also at this point that the employee can start to see further than their own induction and can show where their interests, enthusiasm and curiosity lie. This is a good time, for able and progressing people, to introduce some responsibility and encourage discussion around improving services or processes. For new staff with experience in other industries, this can be very useful as they have an opportunity to share their own experience and see how they can make a difference. Where the new employee is a member of a larger team e.g., a receptionist, nurse or vet, it is at this point we usually allocate an area of responsibility either as second in command or directly. Ensuring this area is one they feel passionate about and interested in will make a huge difference to their personal growth within the practice, and further induction can be planned to include this area in more depth. Investing your trust in a new staff member early on can be a very powerful way of ensuring they feel part of the team, but it is important to choose your timing and the type of responsibility given carefully, considering the individual and their progress so far.

After induction is completed, ongoing training and development are vital for the new employee, and the rest of the staff. This will only happen if each individual really wants to develop and can see where they can contribute to the success of the team or the practice. Once the enthusiasm is there, harness it in the right direction to move the practice forward and free yourself from some day to day supervision.