Orientation Length and Type

Loo17 · Aug 15, 2014

-What length of orientation did you have? 12 weeks

-Were there specific ER classroom time or general nursing classes? How many hours would you estimate? 1 week (36 hrs) general nursing/hospital orientation, 1 week (36 hrs) ED specific classroom training

-What is your experience? (10 years med-surg or new grad) 5 years intermediate care

- How long ago was your orientation period? (like was it 33 years ago or just last year?) 2013

Then here are some questions about your ER:

100 bed level 1 trauma center with separate pedi ED

-What is your current patient to nurse ratio? 1:4-1:6 for main ED, 1:4 pedi, 2 trauma nurses for 4 trauma bays, 3 triage nurses for main, 1 triage nurse for pedi, 1 flow coordinator, 4 charge nurses with no patient assignment, and a shift supervisor for both main and pedi

- What type of ancillary help do you have if any? PCT's 1:12, do EKG's, vitals, patient care; phleb 1:24, draw labs, istats; RT 1:96, hour long nebs, manage cpap and vents, transport pts to ICU with nursing; orderlies, transport of patients and stocking rooms.

- What tasks do they do? See above

- Can you send squads to triage? Yes but they don't like it.

- Do you have protocols? Limited. Facility is teaching hospital. Tylenol, zofran, xrays for broken bones, EKG's.

Uncle Rico · Aug 15, 2014

-What length of orientation did you have?

12 weeks

-Were there specific ER classroom time or general nursing classes? How many hours would you estimate?

Only 2 days of cardiac dysrhythmia class and 1 week of general nursing class (40hrs)

-What is your experience? (10 years med-surg or new grad)

New grad

- How long ago was your orientation period? (like was it 33 years ago or just last year?)

On my 10th week at the moment.

Then here are some questions about your ER:

-What is your current patient to nurse ratio?

4 to 1

- What type of ancillary help do you have if any?

Not much at all. We have roughly 1or 2 techs at night for about 20 bays which means we have to start IV, do ekgs, transport, record vitals etc.

- What tasks do they do?

Transport patients, ekg's, IV's, vitals,

- Can you send squads to triage?

- Do you have protocols?

No

RNCEN · Aug 15, 2014

-What length of orientation did you have?

16 weeks

-Were there specific ER classroom time or general nursing classes? How many hours would you estimate?

Cardiac dysrhythmia class x 2 days, ACLS, PALS

-What is your experience? (10 years med-surg or new grad)

I was a new grad with experience as an ER tech while in nursing school

- How long ago was your orientation period? (like was it 33 years ago or just last year?)

2012

Then here are some questions about your ER:

-What is your current patient to nurse ratio?

1:3 or 1:4 in acute areas, we don't have assignments in minor acute, just pick up...usually 1:5 to 1:8

- What type of ancillary help do you have if any?

ED techs (EKG's, straight sticks-no lines, transport to tests, assist with traumas) and Paramedics (lines, US lines, help with traumas, transport to tele floors)

- What tasks do they do?

See above

- Can you send squads to triage?

No

- Do you have protocols?

We get pt's started without orders, line, labs, EKG's if needed, urine, basic meds-zofran etc.

doubleshotespresso · Aug 15, 2014

-What length of orientation did you have? 6 weeks, they just extended it to 7

-Were there specific ER classroom time or general nursing classes? How many hours would you estimate? 2 days classroom in 4th week

-What is your experience? (10 years med-surg or new grad) new grad, worked here at a tech

- How long ago was your orientation period? (like was it 33 years ago or just last year?) I'm in the 3rd week

Then here are some questions about your ER:

-What is your current patient to nurse ratio? 1:3-4 depending on acuity

- What type of ancillary help do you have if any? Techs, lab

- What tasks do they do? Lab does all draws, techs collect urine, do ekgs, transfer patients, get vitals

- Can you send squads to triage? No

- Do you have protocols? A few official ones for chest pain, stroke, etc. But otherwise we have a lot of autonomy to order obvious meds, X-rays,

OlivetheRN, ADN, BSN, RN · Aug 15, 2014

-What length of orientation did you have?

Almost 6 months

-Were there specific ER classroom time or general nursing classes? How many hours would you estimate?

We had a week of general hospital orientation, a week of hospital wide new grad and a week of ED specific classes. All days were 8-5.

-What is your experience? (10 years med-surg or new grad)

New grad

- How long ago was your orientation period? (like was it 33 years ago or just last year?)

2013

Then here are some questions about your ER:

-What is your current patient to nurse ratio?

1:3 or 1:4 major side, flex can be 1:5-1:8 as we just do pick up. Psych holding you can have up to 10.

- What type of ancillary help do you have if any?

ED techs, if we're lucky we get up to three techs (and/or medics) on major side not assigned specific rooms. They do straight sticks, EKGs, foleys, transport non tele pts. Medics do IVs, EKGs, transport tele patients.

- What tasks do they do?

See above

- Can you send squads to triage?

Yes

- Do you have protocols?

Yes

emtb2rn, BSN, RN, EMT-B · Aug 15, 2014

What length of orientation did you have?

13 weeks

-Were there specific ER classroom time or general nursing classes? How many hours would you estimate?

Both, approx 36 hours.

-What is your experience? (10 years med-surg or new grad)

Was a new grad.

- How long ago was your orientation period? (like was it 33 years ago or just last year?)

'08

Then here are some questions about your ER:

-What is your current patient to nurse ratio?

1:4-1:6 main, 1:6-1:8 fast track, up to 1:8 psych.

- What type of ancillary help do you have if any?

Techs in each area plus 1 in triage, phlebs, RT, transport.

- What tasks do they do?

Techs - EKGs, vitals, patient care, compressions, transport when transport personnel not available.

Phlebs - draw labs as needed.

RT - abgs, set up/manage vent/bipap (although most rns can do this before rt shows up), goes with pt if vent needed for transport.

- Can you send squads to triage?

Oh yeah.

- Do you have protocols?

Yes. Do not include meds though.

applesxoranges, BSN, RN · Aug 18, 2014

Thanks for replying! I am just comparing my orientation to others to find out if it is the norm. It apparently was not.

imanedrn · Aug 19, 2014

-What length of orientation did you have?

3 months

-Were there specific ER classroom time or general nursing classes? How many hours would you estimate?

I had a 2-hr critical care class once every other week or so.

-What is your experience? (10 years med-surg or new grad)

Prior to ER, I'd worked med/surg for 1.5 yrs. Now, I have 6.5 yrs experience total. During my last 5 yrs in the ER, I also did 6 months in PICU.

- How long ago was your orientation period? (like was it 33 years ago or just last year?)

5 yrs ago

-What is your current patient to nurse ratio?

At present, it ranges from 5:1 (in fast track), 4:1 (for level 3's), or 3:1 (for level 1 or 2). At my last hospital, it was all 4:1, regardless of acuity.

- What type of ancillary help do you have if any?

At present, tons! Each pod (10-15 pts) has 1 ED tech. The entire ER has tons of resources too -- social workers, discharge planners, transportation coordinators, phlebotomy in the ER, IV team. I feel spoiled when compared to my last hospital which had almost nothing. We RNs (and a couple LPNs) did almost everything ourselves.

- Can you send squads to triage?

What is this?

- Do you have protocols?

Yes, and I love them! Again, my current hospital (I'm a traveler now) is fantastic. They expect you to put protocol orders in. I love that the doctors don't second-guess you for doing it. There is an expectation and then an appreciation for having done it.

happyinillinois · Aug 27, 2014

-What length of orientation did you have? 12 weeks

-Were there specific ER classroom time or general nursing classes? How many hours would you estimate? Critical care:40 hours, EKG 16 hours, ACLS, PALS

-What is your experience? New grad

- How long ago was your orientation period? 2011

Then here are some questions about your ER:

16 bed ER

-What is your current patient to nurse ratio? 1:4-for main ED, 2 triage nurses , 1 charge nurse with no patient assignment.

- What type of ancillary help do you have if any? 1 tech, lab draws, collect urine, transport. 1 Medic same and could start IV, answer BLS radio calls, transport tele patients on a monitor. 1 EKG tech

- What tasks do they do? See above

- Can you send squads to triage? No.

- Do you have protocols? Limited. Facility is teaching hospital. Tylenol, zofran, xrays for broken bones, EKG's. Always residents around, usually asked resident for what you needed and then gave it.

applesxoranges, BSN, RN · Aug 28, 2014

Apparently our orientation was a "scram and cram" because they were desperately short. The new bunch that they hired are getting the more typical orientation period of 8 to 12 weeks.

It's very interesting to see what people are posting. Thank you!