How long should I orient on Cardiac/Stepdown floor?

[BrayaRN]

I am a new grad who graduated in December. I am currently 2 weeks into my first job. It is on a combined Cardiac/Stepdown unit. I just spent the first 2 weeks on the Cardiac floor. This is prior to me even taking the telemetry class. I was with a different preceptor nearly every day to make things even more confusing. The next two days I will be in telemetry class and then I will spend 2 more weeks on the Stepdown end with a variety of preceptors again. After that 2 weeks I will meet with my nurse manager to decide whether I need more training or will be ready to be on my own. My floor is shortstaffed with at least 3 vacancies on my shift right now. I am afraid that I am going to be pressured to be off orientation quickly so I can take on my own patients. I know that the first year is going to be tough and that the patient load is barely manageable on the floor but I want to be set up to succeed. Do you know how long a typical orientation should be? I feel as though 1 month of orientation for 2 different specialties is not nearly enough. Any thoughts?

[sxybuttrfly]

this happens far 2 many times, we throw our nurses out on thier own, simply because of staffing issues!!! it is so important 2 stand up 4 urself and not let anyone rush u off of orientation, especially as a brand new nurse!

[dreamingofbeing]

I don't think that is even close to enough orientation especially for a new grad. I just started a job on tele/stepdown and I am getting 2 months orientation and I have a year of experience, although no tele. They won't even consider me being on my own until I am ACLS certified and have taken the EKG course.

[crunchymomx3]

Do NOT let them push you off of orientation if you don't feel ready. Be upfront and tell them you need more time if you feel you do need more time.

I'm interviewing for jobs now (I graduate in May) and one of the things I'm looking for is a good orientation program. A lot of other grads must be as well, because several of the hospitals I've interviewed with have really pushed the pros of their orientation. The hospital that is my current top choice orients for 5 months!

[robinbird]

I began working on a medical cardiology stepdown unit when I graduated. I had 4 to 5 months of orientation. We had many classes during that time, EKG, non-invasive hemodynamics, plus many other classes. We usually precepted with one nurse for a few weeks then we would switch to another nurse. That nurse would help us with our check list of tasks we had to complete, like starting an amiodarone, heparin and integrillin drips, participating in a cardioversion, learning all about the crash cart, etc. We also spent a day in the cath lab and in the echo lab watching stress testing etc, so we could describe the testing for our patients. Our educator had us fill out a summary once a week on of our patients designed to get us to think critically about the cardiac patient, medical diagnosis and the meds they were taking. The summaries became more in depth as our orientation progressed.

There was a lot packed into our orientation but by the end of it we were ready to go. Even with this extensive orientation I still felt like there was so much I didn't know. I know that not every cardiac stepdown had such an in depth orientation, but my advice to you would be to stay on orientation as long as you can if that option is available to you. I learned the most by watching and working with my preceptor.

Good luck to you. Robin :heartbeat

[purple_rose_3]

When I first started on Tele I had a 3 month internship. When I changed jobs after a year to a different hospital I had 6 weeks.

[WahooRN08]

I have accepted a job on a cardiothoracic/vascular step-down unit. In my contract, my orientation will be NO less than 4 months. They are ignoring my LPN experience of 4 years, which is awesome (I am still getting paid for my years experience of course). I want all the orientation I can get. 1 month is not near enough for a CSU. I would do some serious evaluation of the situation. Ask for more if you are not comfortable. If they are even hesitant to give you the additional time of orientation...definent red flag .

I had 6 weeks on a Med/Surg floor when I graduated from my LPN program...including ventilator courses and other classes. Just some random jibberish.

[New2ER]

I've never worked CSU but when I started my first job 2 years ago it was in ICU. I had originally interviewed for the ER but the director conviced me that I should start in ICU instead. The hospital promised 8 weeks of orientation. The orientation ended after only 5 weeks because that director "felt" I was competent enough to handle patients on my own. (Not the mention that I had different preceptors on different days of the week. And for the first 3 weeks, my preceptor and I were given 3 ICU pts 'cause I could "help" her.) A new grad on my own in a very critical surgical/medical ICU after only 5 weeks. Not to mention they we're calling me constantly from week 3 on asking me to come in and take "easy ICU patients" on my own.

I found out later that that unit was losing experienced nurses left and right and were desperate for warm bodies. They didn't care about my license or the patients and we cutting short orientations way before the new grads were even remotely competent (let alone ready).

After 2.5 months there I asked for a transfer to psych (which is where I am now, though at a different hospital). Instead they offered me a transfer to ER where I was told by the (same) director that I would have one week orientation since I was already off orientation in ICU.

Turns out she was using me to fill short staffed departments at her convienience. I've learned now that orientation to most places should be measured in months, NOT weeks. YMMV

[CABG patch kid, BSN, RN]

My orientation in tele is 8 weeks, and that is just for our tele portion. The stepdown area, in the same unit, has a separate orientation that you aren't even considered for until you have completed tele orientation and have been on your own for about 4-6 months. We are supposed to have our dysrhythmia and ACLS done by 6 months and are strongly encouraged to take a stepdown class before orienting in stepdown. Fight for your orientation, you deserve it!!!

[Morettia2, BSN, RN]

I am on an Interventional Cardiology Unit/CCU Stepdown unit....I oriented for 12 weeks I think and I know it wasn't enough..I have been working now for about 8 months but those first few months off orientaion were AWFUL..plus I had all the classes to go to and I am still going to classes even 8 months into it that were for orientees, I actually have my lasat Critical Care class tomorrow and I my educator should have had me in this class during orientation but she forgot to put me in the class cause I work nights, the info from the Critical Care class would have helpful when I was on orientaion but insted I learned the hard way, my first code I was like a deer in head lights..but I am glad I did learn the hard way..the critical care teacher always refrences me in class b/c i have the most time on out of the nurses in it. and everyone asks how did u know what to do..I say when the situation is right in front of your face you have to learn what to do! but Cardiac nurses need a good orientation, as with all nurses. But you learn as time goes by and don';t be afraid to ask for help, if you don't know how to do something always ask for help and even though you make think you have a dumb question ask anyway no matter how stupid u may feel. Even if you feel like you are bothring fellow nurses with a question that may seen totally assanine, it's always better to open your mouth cause I learned it's when you don't ask the one ridiclous question is when you get in trouble..good luck!!!!