Renal floor for new graduate?

  1. Hey everyone! I just went on an interview for my first nursing position and I want to know what you all think. I feel like I have no idea what I am getting myself into here.....

    -It is a renal/med-surg floor...mostly renal, but the manager claims there is an even mix. I would be cross-trained to do dialysis in the future, after about 6 months or so (sounds good to me).
    -Patient/Nurse ratio 8:1 (SAYS she's trying to get it down to 6:1)
    -orientation 6 weeks!!?!?!?! 2 weeks not even ON the floor (general hospital orientation)..then 4 weeks on the floor. This is the part that makes me nervous! Manager says I will be allowed an extenstion, if needed.

    So, how does this sound? I don't even know. It could be obviously wonderful....or obviously hell and I wouldn't know the difference :uhoh21:

    Is this the kind of floor a new graduate should be on?

    Thanks in advance!
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  2. 8 Comments

  3. by   Kinjo
    I don't know the nurse to patient ratio is very high, and when the NM she's trying to bring the ratio down ???? I have heard that before and it never usually happens like that. I hate to discourage you but you know what they say don't take the first available job , you may want to look around a little bit more.
  4. by   Chiefy
    I am a new grad on this type of floor. We have a dialysis center right on the floor. But it is not run by the hospital. Most of our patients are renal issues but we do have a mix of med surg in there without out renal issues.

    I love my job.

    I have been through a class and now can do peritoneal dialysis runs on my own.

    In the dialysis center there are nurses that do the dialysis but that is all they do. What Im saying is that they don't work out on the floor.

    On days the nurses usually have anywhere from 4 to 6 patients. Same with evenings. On the night shift can have up to 10.

    5 patients can be plenty. Most of the patients we have are the older population. So at times they can take up a lot of time because they may need a lot of assistance.

    We don't have good luck with aides. We are always short. I don' t mind doing ADL's with my patients. Im working days right now.

    My orientation with a preceptor is 400 hours or 10 weeks. Mine is longer than 10 weeks because Im not working 40 hours a week.
  5. by   Chaoticdreams33
    Is it nights or days? personally I think that 8 patients is too many regardless. I would be concerned about that.

    I would also be concerned about the orientation. 4 weeks on the floor seems like almost nothing. But if the other nurses will continue to help you and support you after orientation it wouldn't be as bad. But I know sometimes it's hard to find someone who will help you when they are so busy themselves.

    How many patients have you taken care of in clinical? I know that we will only have 4 by end of next semester, so going from 4 to 8 in 4 weeks seems like it would be really hard. But everything is relative.

    You might want toshadow a nurse on the floor for a shift before you take the job. And check other jobs out too. Good luck!
  6. by   Tweety
    I too would question the ratio if it's days or nights. What kind of support in the way of CNA's do you have. Six weeks is definately not long enough, we give our new grads twice that amount.

    I wouldn't say no, but I'd keep looking.
  7. by   Imafloat
    Trust your gut, I don't think I could juggle 8 patients after a 4 week orientation.
  8. by   DolphinRN84
    Yeah same here....I couldn't imagine juggling 8 patients with only 4 weeks orientation...that's just kinda scary to me....I wish you all the best.
  9. by   augigi
    I'd be concerned about the ratio and want to know what sort of support staff you have. If it's just you and 8 patients after a month, it's too much! I would also get in writing that you can have an extension of orientation if either you or the nurse manager think you're not ready after a month - they all say that, but getting them to actually extend it once you're employed if often a different story.
  10. by   Fiona59
    Our dialysis programme asks for one year's acute experience. Dialysis is a specialty that takes time and a certain mindset. I found it to be very repetitive and at times very dull. You wind up with carpal tunnel from setting up and stripping the machines (yes, we had service aides but everyone has to pitch in). The change over times are hectic. When a patient crashes they crash hard and fast.

    It takes a special person to work on a dialysis unit and I'm not ashamed to say it not me.

    If dialysis training is being held out as a carrot to keep you there and its what you really want to do consider it. But even as a new dialysis nurse you will still wind up with four patients on during one run.

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