[jjjoy]

Originally Posted by SoundofMusic

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!!

[elkpark]

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

[SoundofMusic]

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.

[2bTraumaRN2008]

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.

[SoundofMusic]

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 ....

[elkpark]

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

[nursemike]

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.

[bri0209]

Originally Posted by ranaazha

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

[Nurse_Newbie]

Originally Posted by jjjoy

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."

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.

[Deetonia]

I'm a new RN, I've been working for less than 8 weeks . I'm apart of a nurse residency program, which is the reason why I choose the hospital. Let me just say that the training is NOTHING like I thought it would be. Quite frankly, the training is horrible. The orientation is only 8 weeks, most of it is spent in class (not lab). At the end of training I will have a lousy 19 days of actual orientation, 4 of those days were spent in the post-op unit which is for patients who aren't stable enough to go to the regular floor. So with just 4 days of training in that unit, I will be expected to know how to care for these patients in two weeks when I'm off orientation. The nurse educator for my department isn't attentive to mines or the other orientee's needs, she or my manager has yet to ask me how I feel so far or if I'm ready. My manger did however make it clear that they do not extend training. I thought this was going to be my perfect job but it's turning out to be a hell of a nightmare. Simply put the training is just not enough and did I mention I've had 4 preceptors (will be 5 once I start nights) in just 19x being on the floor.

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.