#4 Transitioning Form

TURNOVER MANAGEMENT JOURNAL

Transitioning

General Information

This management journal is designed as an intensive approach for skilled nursing facilities with recruitment, retention, education, employee satisfaction and any other areas deemed appropriate to utilize NAHCA's menu of services and expertise.

Facility Name *

Orientation Start Date *

Preceptor's Name *

Preceptor's Email *

Orientee's Name: *

Shift Hired For *

Choose Shift

Day Shift
Night Shift
Overnight Shift
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How Long Is the Orientation & Training Period? *

Transition Date *

Had orientee been with other employees prior to Preceptor?

Yes

Describe The Transitioning

What do you feel made your preceptor relationship set the orientee up for success? *

What obstacles or barriers did you overcome in precepting this new nursing assistant? *

Is there anything you will do differently next time you precept a new nursing assistant? *

What was the most important thing you learned from this experience? *

Additional transitioning comments: *

How do you evaluate the overall performance of the orientee? *

Excellent

Good

Satisfactory

Poor

Is the orientee ready for transition? *

Yes, They Are Ready!

No, They Need Support!

What is the orientee's weakness, if any?

What is the orientee's greatest strengths?

Any recommendations?

*Information gathered during this form submission are confidential and will not be shared or distributed outside the facility or company. The sole purpose of the journal is to gather information and tailor an action plan for mutual work and to achieve the goals and objectives of the partnership. No other use is intended.