How much orientation do new grads need? - page 4

I work with an RN who got her licence in December. She started working at the hospital in June of last year as a CNA. In August, they started letting her take her own patients, doing everything... Read More

  1. by   kimmicoobug
    Jean, just curious as to what you think about new grads being put in a float pool. I am a new grad who entered into an orientation program at the local hospital. 2 weeks of class, 2 weeks of ortho-neuro, 2 weeks of med-surg, then 6 weeks of OB. Well, I found that I am going to be put into the float pool. I have been in the OB unit for all of 3 days. I am taking full loads, with guidance (when to call docs, questions about taking off orders, various papers, computer questions...that sort of thing). So, since I found out that I am going to be a float, probably on-call or per diem, I feel my six weeks in OB will be a waste of time.
    I have also been told that a new grad shouldn't start in a float pool. I don't know enough to form an opinion at this point.
  2. by   NICU_Nurse
    Okay, you didn't ask me. However, I have to say that *I* think it's terrifically dangerous and poor judgement on the part of whoever allows new grads to be placed in a float pool at your facility. This is not a personal issue- you may be an extremely bright and capable person, but no new grad is an extremely capable nurse on any ONE unit, much less floating from unit to unit where you are ideally expected to rely on your experience and expertise to make up for the fact that you get minimal exposure to various unit policies, treatments, conditions, etc. No experience on any nursing unit is a waste of time, IMO.

    Did you *ask* to go to the float pool, or have you been placed there against your will? Are you on stipend with this facility or do you owe them money (which could allow them to place you where they want to?)?
  3. by   kimmicoobug
    Kristi--no, I didn't ask to be placed in the float pool. I was actually hired into OB, which is what I want to do. But in five weeks, my job is up. They hired me to orient, but not to stay. I don't get it. They have NO positions there. There are 8 new grads. Probably five of us will be put into the float pool. I only have 4 weeks of combined med-surg and ortho-neuro experience. and will have six weeks of OB. What the heck do I need OB experience for if I will mostly be floated to med-surg and ortho-neuro. This situation did make me uncomfortable because with only this much med-surg orientation, I don't think I will be ready to really provide care adequately. The staff on the unit is also not a very nurturing one. Recently, a memo was posted that overtime is verboten at my facility. At the end of the memo, they posted that 8 grads have been hired and many will be placed in the float pool to cover shifts that will prevent overtime. I am seriously considering looking elsewhere for work...I just don't want to and can't afford to move.
  4. by   NICU_Nurse
    Oh, Kimmi, get out of there NOW!!! I'm sorry, but not only is this hiring under false pretenses (they said you could work in OB and then placed you elsewhere without your consent) but it's BEGGING for disaster. Any hospital that would even CONSIDER placing new grads in float is one that I would NEVER work for. Are there other oportunities in your area? Perhaps you could get Postpartum if there are no L&D availabilities? This is your licesne on the line here, and if they're not going to absolutely BABY you (which, first of all, you mentioned they probably won't, and secondly shouldn't have to happen because floaters are supposed to be experienced on all units that they float to) then I would hightail it out of there. In my facility you are not allowed to float unless you've got a year of experience, and that's only because my hospital sucks and tends to approve dangerous practices for various reasons that are too complicated to get into here. Other facilities in our area require 2+ years of relevant experience (meaning, if you want to staff L&D but only have ER experience, you can't do it).

    I totally understand the financial aspects of it, because I was dirt poor in school and broke for months after I first started working, but truly, you need to investigate your other options. At the very least, please go to whoever is in charge of you and express your concerns and make ABSOLUTELY SURE that they can't place you in a regular staff position on one floor.

    It's not impossible for you to succeed here, it's just that not only is it dangerous (they're basically operating on the idea that you'll be lucky enough not to have a serious issue come up- how safe is THAT?), but they're making it SO much harder on you than your first nursing experience should be.
  5. by   kimmicoobug
    Well, yesterday I pretty much decided that I would explore my other options. I am picking up applications tomorrow at three hospitals an hour away, and the other hospital in town.

    It is good to get honest opinions regarding floating right out of school. The nurses, even one instructor at the school I went to say that this is common practice. With my limited experience in the nursing field, I do not know.
  6. by   kimmicoobug
    Forgot to mention. I think they are using us new grads as warm bodies. Cheaper to pay us an hour, and we will prevent overtime for the rest of the staff.
  7. by   flashpoint
    2. She should have 12 weeks in ONE area, learning how to set priorities, organize her time, & develop critical thinking, and doing that on fewer patients, until she has mastered those things. If she never does master them, then maybe nursing is not for her.

    Well, she had seven months as an RN in one area, plus a few months as an intern and a CNA. She's still not even getting the basics and she continues to struggle with even small patient loads. There's nothing I can do about it, but I'm (and my coworkers) are getting more and more frustrated when it takes her 45 minutes to give report on 5 patients and when new orders aren't initiated, problems aren't called to doctors until we ask several times, etc. Even though she is not in an idea situation for a new grad, after seven months, it seems she should be able to charge 5 stable patients (with two LPNs and a CNA to help). Maybe it's not right, but almost every other one of our charge nurses started as a new grad and they managed. I feel bad for her, but it is to the point that any advice or help anyone tries to give is ignored. I know she feels sort of picked on and since I've been there, I can relate to how she is feeling but it's time for her to either cowboy up and force herself to to it or she needs to find something new. Another hospital is not a good option because the closest one is 75 miles away and the load on the RN is much more (the RN is charge and ER there!)...she won't even consider nursing home or home care.

    It seems to me that the hospital would be much better served by allowing new grads to work as staff nurses and just to patient care for a year or so before shoving them into a more intense situation. I think it would improve care and help retain the newbies. In the small rural hospitals like this one, where the RNs are expected to be jacks of all trades, it would also give them the opportunity to float to ICU, OB, and ER to at least learn the basics of those areas too. Why aren't the people in management able to figure this out?
  8. by   Ortho_RN
    At our hospital whenever you are out of brackets (orientation) then they can pull you to other floors.... Which I feel is crazy.... Also they require any nurse who wants to be charge nurse go through a class....

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