Let's talk orientation...

[Cardiac-RN]

Similar to the threads out there regarding employment offers/ compensation, I thought it might be helpful for students and new providers to see what orientation is like (and how it differs wildly) as food for thought when negotiating/ accepting an offer.

Any one who would like to weigh in regarding what kind of orientation/ training they received as a new NP, I am sure it will be valued.

NP role: outpatient specialty practice with a good percentage of hospital/SNF rounding duties on the group's patients

Orientation time: 3 months essentially side-by-side with another provider or hooked very closely with a provider mentor for all needs and questions, split among various providers in the clinic (MDs, PAs, and NPs) and SNFs ; this includes rounding time in the hospitals and facilities, time spent getting to know people in various important supportive roles, and learning modules (computer based, classroom based, and self-study). At the end of this 3 months, I will be evaluated by my collaborating physician, administrative supervisor (on productivity and time management) and be audited by compliance for my documentation (for billing/ revenue metrics). Additionally, routine check in meetings have been built in with my collaborating doc all throughout my first year of employment.

I was pretty satisfied with this plan going into the position, and now that I am in it feel that I will be ready to spread my wings at the end, especially knowing that support is only a phone call away.

I have heard many stories from NPs I have run into that received essentially very little to no orientation, which is why I wanted to query the group and read about others' experiences.

Cardiac

[traumaRUs, MSN, APRN]

I had four months orientation as that was the time required for credentialing at all the hospitals/clinics. This was in a specialty outpt practice with inpt rounding on call once every 4th weekend.

I took this job right out of school after I passed the certification exam. My orientation was much like yours.

Great thread - thanks for starting it.

[Nursetonp]

Np role- new np outpatient office connected to a chiropractor.

1 day of shadowing 1 day of one-on-one training. Left to the birds.

I will say it did make me a better practitioner in the long run. As frustrating as it was in the beginning months, it pushed me to seek out further training from other sources because I was extra paranoid of doing something wrong or missing something.

I took some heat for being a slow practitioner, but I wanted to make sure I put patient safety and my license first.

I am definitely interested in learning if anyone else had a training like this.

[Nursetonp]

Traumarus-

i noticed you are a volunteer ems, I am interested in doing the same. How does that work with your np license? And how would I get involved in volunteering?

Thank you for any info you have!

[babyNP., APRN]

NP role: Neonatal NP, in-patient (starting next month). Will be working at a large NICU with a delivery room service. I will have a patient load of 6-8 patients (depending on acuity) and will round daily with the neonatologist. DR role is rotated, not sure exactly how often. Besides patient care plans, I'll be responsible for any necessary invasive procedures such as intubations, arterial blood draws (in the NICU, we can only get

Orientation: 3 months, supervised with a preceptor. I'm guessing this will be okay, but have nothing to compare it to, obviously. My orientation as a new grad RN in the NICU was about 6 months in a different facility.

[ghillbert, MSN, NP]

In my acute care specialty area, NPs/PAs get basically the time it takes to get privileges/credentialling done - which works out to be 3-4 months as supernumerary, working with other PAs/NPs in the same role. They rotate between the 2 services we cover, depending on which has the more experienced provider they can shadow. They also complete inhouse training modules etc during that time. We do 1 month and 3 month evals and then 1 and 3 months after they have privileges and start working independently.

It felt a little long to me - until I had privileges I couldn't touch a patient or enter orders, and I don't find it useful to just watch other people do things. There's still a big learning curve once you can actually do stuff yourself.

[babyNP., APRN]

That's an interesting point, ghillbert. The way it worked for me is that I'm not able to even start until I get credentialed (should happen soon!).