Hospitals SUCK at orientation!!

Nurses New Nurse

Published

I'm sorry, but this needs to be said. I hope there are some nursng management types reading this:

I graduated from nursing school last August. I went to one job and the experience was so horrible I found another position on a more med surg type floor in one of the so-called "Top 50" hospitals in the nation. Now, granted, this position seemed to come with a better orientation process and they at least try to orient us in some ways with special classes and pull outs, but it still SUCKS.

Hospitals, administrators -- you are failing at orienting us. Just look at the unhappy posts here by dozens of new grads. The typical experience seems to be: You walk on the unit your first day, no one is expecting you, none of the other nurses bother to introduce themselves or welcome you (they usually think you're a travelor or a float nurse), you are given an "official" preceptor, but then in the following weeks, you may never see this official preceptor again. You then follow ten different nurses who do things ten different ways, and in total, have about 30 different personalities between them all. :uhoh3:

You are left to flounder around for hours on the floor, and if you attempt to ask your Preceptor of the Day a question, you get the look and that attitude that you are just plain stupid and how dare you even ask such a question because, well, "you should know that by now," or some other such comment. Many times you are treated with outright hostility when you are just an honest person trying to do an honest job, and busting your butt in the process.

Come on, hospitals - take a look at corporate America or some other large institution, and try to figure out a better way to train the BACKBONE of your business!!! I mean, I can't figure out why it isn't any better than this?? Do you EVER wonder why nursing retention rates are so POOR?? Can't you find nurses who CAN educate us with respect and make them the consistent "preceptors," and not just throw us in with the nurse of the day?

Coming from a prior career, I am just astounded at what nurses are responsible for, yet how poorly they are trained, how poorly they are treated, how nasty some of the nurses are that we are supposed to be looking to for guidance, and how little respect is given to individuals who were not only accepted to rigorous nursing schools, but managed to graduate, even managed to achieve very high marks in these schools of nursing. I mean, you're being given the most quality individuals around, yet you can't seem to teach them in a way that is professional, thorough, consistent, and even the slightest bit enjoyable.

In my own experience, my own management "team" did a really slick sales pitch for their unit. Once I joined the unit, it seemed their personalities changed almost overnight -- all smiles and wonder at the sales pitch, and all nasty, rude and demanding once you've been on the floor for a few months.

So, in summary, I hope it changes someday. I am really taken aback by just how unprofessional many of the nurses are -- the gossip and backstabbing is just pure evil, there is no morale or cohesiveness in the units, especially with all the travelers, and many of the management types just walk around like prison wardens, yet never bothering to take a patient of their own for a day to remember what the demands are like.

Do I plan to stay in nursing? No FREAKING WAY. I want to return to the corporate world where I came from in some capacity, where professionalism and respect for employees is the norm -- I have yet to find this in the nursing profession. Yes, perhaps I am one of the whiners, and need to change jobs, but it seems I'm hearing this from more than one person here, as well as many of my classmates.

God help the state of nursing and healthcare in this nation. ..something just needs to CHANGE. :(

It was quite confusing as I have been doinig well with 3 pts for about a good month. All of a sudden, it's all me?? I'm sorry, but I just can't accept that.

It's great that you have the inner confidence to not accept such inconsistent feedback as indicative of a deficit on your part. Imagine how those new nurses without such self confidence deal with the inconsistent feedback.

I don't know how an additional year-long residency could work -- I feel we should definitely have our licenses so as to be able to give meds and to get into that nurse role as much as possible, yet not have that whole weight on our shoulders and that pressure to get to 2 pts, then 3, then 4 within a matter of weeks.

I very much agree.

I appreciate your persistence in concern over this issue as opposed to just surviving for yourself and forgetting it. I'm very interested in these issues, though not sure how to approach it. Let us know what your plan with the letter is. Is the NCSBN your state board of nursing? You're inspiring me to do some research regarding what's in the pipeline for nursing education. Hope I can find some info!!

(NCSBN is the National Council of State Boards of Nursing -- the umbrella organization for all the SBONS.)

Well, a letter can't hurt. Best would be to have it backed up with signatures, I would suppose. I mean, one letter isn't something they're going to listen to.

I could draft something and post it here for feedback.

(I have a degree in journalism also, so I'm ok with writing it!)

Will work on it!

On a personal note, I'm seriously considering leaving my current position at the moment. I've got resumes into some other places. My issues are personal as to why I'm leaving. However, it would be very gratifying to work on this in the interim, until I get another less stressful job for the meantime.

I have sat and thought about the same thing Sound of Music. Maybe the NCSBN needs to made aware of the orientation/precepting that is going on across the board.

Ok, LOL, so interestingly enough, I was sent an email yesterday by the NCSBN to fill out a new grad RN survey!! So, in the comments section, I provided the following. I hope I hit the nail on the head, and that my comments communicated this issue well enough to the Board:

I would like to comment to the NCSBN briefly (and will follow up with a letter at a later date), that while I feel my nursing education was academically excellent and I was well prepared to pass the NCLEX exam, I do not feel I received adequate clinical time during school to prepare me to function as a nurse. Yes, we receive a 16 week orientation at the job site after graduation, but still, this amount of time is not adequate to enable us to function smoothly and confidently at the end of our orientation sessions to handle 4 plus patients well and with total confidence. We are taught to think critically, yet not taught or given nearly enough time to master basic nursing skills at a the speed necessary to function on a floor. The result of this is that preceptors get very impatient and have to slow down to teach us basic skills, while we lose confidence on the floor. I believe, along with several of my colleagues, that nursing students would be better served, especially those in accelerated programs, by an additional year of schooling just in clinicals, AND/OR through a nursing "residency" type of program, where perhaps a new grad could have a longer period in which to master an extensive list of basic nursing skills, as well as get a more thorough and long-term orientation to how a nursing unit AND a hospital functions. The drop out rate for new grads is high -- and this is why. We are sent out, unprepared, are belittled and at times, often demeaned by veteran nurses who don't have the patience, nor should they have the burden, of having to help us complete our formal nursing education. I believe this responsibility should lie with the schools of nursing in this country, not with the hospitals who are having to finish it. Starting out inadequately prepared leads to a much lower initial satisfaction with this career and an overall negative start. I myself would gladly accept a lower pay rate for a year-long residency after the completion of nursing school, much like residents have before they become physicians.

The fact is, the culture of hospital nursing, along with the extensive skill set necessary is a lot to learn for a new grad who has has only the minimum of clinical experience. Also, in school clinicals, it's more observation than anything -- one does not actually fully understand the "pace" of nursing until you are thrown into it your first days with 2-3 patients.

For many of the above reasons, I am at this point, very disenchanted with nursing, with my preparation, with the training that I have received at the hospital where I worked, and how I feel about myself and my ability to handle a full load of patients in a few short weeks once I come off orientation. I am seriously considering returning to my former career, because I just don't want to go through the pain and chaos I eventually will go through because I will still be learning SO much while being expected to function as professional nurse with a full patient load. I am just not ready. I needed much more time in clinials looking back.

I hope the NCSBN will take the time to investigate the education new nursing grads are receiving, and if there is a better way to prepare them to function as professional nurses. Something obviously has to give, as drop out rates are high and many nurses do not remain in the career past a few years.

Please contact me for additional information. I would be happy to discuss my experiences further at any time, for the betterment of this profession.

We'll see if they call or contact me ....

Excellent statement, SoM! I hope v. much that they'll listen.

Specializes in Rodeo Nursing (Neuro).

I plan to bring up the idea of some sort of "residency" or "apprenticeship" with my Nursing Preceptor and Nurse Manager. Wheels grind slowly, but it might be something our facility could do on its own--someday.

Meanwhile, though, I have to say that during my orientation, I never once had to feel that any of the nuses I worked with wanted me to fail. Of course, I was already acquainted with many from working the unit in an unlicensed capacity, and many (though perhaps not all) were actively pulling for me to do well, but it appears to me that nearly all GNs received, and continue to receive, similar treatment (I can think of one graduate many nurses, including her fellow GNs, thought would be a bad, dangerous nurse, but that was a pretty extreme case.)

One reform we can implement, today--and I'm sure most on these boards already do--is to try to be as welcoming and helpful to newbies as we possibly can. I'm sure the vast majority of graduate nurses want to be good nurses, and our jobs will all be easier if we have good nurses to work with.

ETA: I believe the education and orientation I received were at least adequate. I was lucky and/or wise enough to recognize the favors my instructors, preceptors, mentors, and peers were doing for me, even at the time. Still, if you'd have asked my opinion of school, orientation, my first year of practice, or the last shift I worked, while I was going through them, I'd have probably said they sucked. I don't think anything will ever make becoming a nurse, or being a nurse, easy. But I think we're on the right track, looking for ways to make it a bit less horrible.

Do you have other options? I've encountered a couple nasty nurses but nothing that sounds as heart-breaking as your situation. When I don't know how to do something, I ask and receive the help I need. If people are complaining about me, I don't hear about it. I don't know if I've risen to the challenge, the nurses are good-natured overall, or it's a combination of both. I've had days where I've cried (either during or after work or both), but it's usually because I'm being hard on myself. I don't think I could handle being in your situation at all though. I'd be dehydrated from all the crying I'd do! Good luck on whatever you do!

Yes there are other options and I am now looking. I kept feeling like a failure so I did not want to give up. But truth be told I am only hurting myself by staying. I feel I should of known this by now, but now I can see this is so common to feel this way. I am so glad that I found this forum. IT has allowed me to not be so hard on myself. Thank you

Even those skills we did cover in class, instead of coaching us as we practiced, they'd leave us to practice on our own and then threaten to fail us with nitpicky critiques that seemed more about creating nervousness and fear of failure from any small, though harmless, deviation in procedure than fostering confidence and competence. Care plans were also often hit or miss, without clear guidelines on expectations and different instructors giving more or less emphasis to this or that point. If we'd ask what exactly they wanted, they'd say "use your critical thinking skills... what's most important?" Ugh!

This is soooooo familiar. Even when you are doing the clinicals, there was 1 instructor per/10 students giving out medications to 2-3 pts each student. That instructor was responsible for meds for a whole unit. Uggghhh God forbid you looked cross-eyed b/c that would be a med error. I would have rather learned how to insert a foley, change a central line dressing, etc. but there wasn't enough time in a school day. Nursing school felt more like "boot camp." :banghead:

When I started orientation, thankfully I was blessed enough not to be shifted from preceptor-to-preceptor. My preceptor asked me each week was I comfortable picking up another patient or did I need another week AND she approached me in a non-threatening manner. To learn more, I would ask other nurses could I start their IV's, foleys, drips and the nurses would call me into rooms to teach new skills and assist me. If you are fortunate enough to learn a skill in clinicals, you may just have that one experience however, practicing the skill frequently is how you get better.

Nursing schools should teach, teach, teach and they do........ they teach FEAR........ I'm not speaking of ALL nursing schools but definitely the one I attended.

Specializes in Med/Surg.

I've already started to look at other hospitals and even the military because at the end of the day I feel I've worked too hard to obtain my license just to give it back so easily. I also believe the training you get as a new nurse will follow you for the rest of your career, and possibly determine what kind of nurse you'll be. I got into this career to be a good and proficient nurse so I'll do whatever it takes to become one.

+ Add a Comment