New Grad 3 weeks into orientation. How independent should I be by now?

[greyL]

This is my 3rd week of orientation in ICU. I'm actually supposed to be on PCU, but for some reason they orient you on ICU first.

Anyway, the first 2 weeks were good, but today was awful. My preceptor somehow ended up with 2 orientees, and I was responsible for 2 patients, and I had never had patients as acute as these before, and it was just a mess. =(

One was a new admission with a bipap and kept desatting down to the 70s and the other had a bowel movement 4 times today and was disoriented, lethargic, and uncooperative and over 200 lbs. =(

I just dont' know if I'm expected to handle this stuff by 3 weeks, or if I just kind of got dumped into a situation that should be way beyond my abilities. I didn't get to sit down until 2 o'clock and then I looked at my orders (which my preceptor never taught me how to do ugh, so I feel a bit lost when it comes to orders) and saw that there was stuff that needed to be done, that I hadn't done yet. All my meds were given an hour late. It was just awful, and I wanted to cry.

And I don't know if I'm just a baby and I should be doing all these things by myself by now.

[mursinary]

You shouldn't be independent at all right now. No offense, but you're just a little Nursling. I understand that things in the unit can be hectic and your preceptor somehow ended up with two orientees, but that's still no excuse for leaving you alone to manage two critically ill patients.

At three weeks into my orientation I probably shouldn't have been trusted to do anything by myself but maybe turn and wipe patients.

If you feel comfortable at all discussing the situation with either the Manager or Educator, I'd urge you to do so. This isn't just a matter of your comfort, but most of all a matter of patient safety.

Hang in there and I hope they start to teach you like they should be.

[JeanOfAllTraits]

I am so sorry! I wish I was there right now just to sit with you and tell you that you're not the only one who's been there. I was fortunate to start out with a whole bunch of friends who were new nurses at the same hospital as me who all started at the same time. We've all said again and again that we never would have made it through our first year transition without one another.

1) No, you should NOT have been put into that situation. I had a bit of experience before I started ICU and I've oriented for a couple of months and I'm still not totally on my own yet. Three weeks as a new grad is no where near enough time for you to be independent in the ICU, especially not a new admit. Your preceptor should have been constantly checking in with you.

2) I would talk with your educator or whoever is in charge of your orientation. He or she needs to be aware of this and take steps to make sure that it doesn't happen again. It's not good for you, your long term career, patient care or the hospital.

If you want to talk or just let it all out with someone who is relatively close to being a new grad, feel free to PM me. :)

[greyL]

No offense taken, mursinary. I just get really worried that maybe I'm not progressing. I can do all the tasks required for my patients, but when it comes to the more critical thinking stuff, and looking up new orders, and really just the whole bigger picture, I start to get lost.

My preceptor talked to the charge nurse and told her to never do that to her again, so I don't think they'll stick her with 2 orientees again.

[jacobyme]

GreyL, it's not just about them doing that to her sweetie... It's also about you. Make sure you get the help you need. You have to aka the questions you have and make sure they are aware that you are not comfortable with that. You are not ready to solo and should not be expected to.

[Biffbradford]

There is NO way you should be covering 2 patients at this point. Knowing what staffing is like , worst case scenario would be the preceptor would take the sickest patient(s) and orientees take the least sick. Even then, the preceptor should be looking over your shoulder every moment.