Orientation of New Graduates

Questions have been raised regarding the hiring and utilization of new graduates from nursing programs by health care facilities prior to the person's licensure. Technically, these individuals are unlicensed assistive personnel since they are not eligible to be classified as registered professional nurse (RN) applicants or licensed practical nurse (LPN) applicants. However, to differentiate them from certified nursing assistants and other unlicensed assistive personnel, it is recommended that these individuals be referred to as new graduates. These new graduates may not refer to themselves as RNs or LPNs and may not practice as RNs or LPNs.

32 MRSA Section 2102 2. H. and Chapter 6 Regulations Relating to Coordination and Oversight of Patient Care Services by Unlicensed Assistive Personnel allow a registered professional nurse to coordinate and oversee certain nursing tasks consistent with the standards set forth in the regulation.

The Board has considered the issue of the orientation of new graduates prior to licensure. Orientation and preparation for the role of a licensed nurse is an important aspect of a new nurse's career. It is recognized that orientation involves both didactic and clinical components. For purposes of orientation prior to licensure, the new graduate must be in a structured setting with a defined educational program for the orientation of new graduates. Conversely, if the employer does not meet this requirement, it is not appropriate to employ the new graduate until he or she is licensed.

The employers of new graduates should utilize the following criteria for orientation of a new graduate prior to licensure.

1. The new graduate shall have submitted an application for examination to NCLEX .

2. The new graduate shall have submitted an application for licensure to the Board and have been declared eligible by the Board to take the examination prior to beginning orientation. Upon declaration of eligibility to test by the Board, the applicant is mailed an Authorization To Test (ATT) letter by the test service. The new graduate should provide a copy of the ATT to the employer to show evidence of having applied to the Board for licensure.

3. A registered professional nurse preceptor must be designated as the responsible individual to provide continuous, on-site supervision for the new graduate. However, a registered professional nurse may designate a licensed practical nurse to participate in the orientation for the graduate of a practical nursing program.

4. The new graduate may not engage in independent nursing responsibilities such as: delegating nursing functions to other nursing personnel, and independently passing medications or administering intravenous therapy. The new graduate should not be part of the facility's staffing pattern, i.e. does not carry a patient assignment.

5. New graduates are required to pass the NCLEX  examination within three months of starting orientation. If the individual is not licensed by the end of a three month orientation period or has failed the first attempt at the NCLEX  examination, the new graduate may function only as an unlicensed assistive personnel(UAP).