What kind of orientation did you have? Am I expecting too much?

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    I just quit my first nursing job today. I was hired on the orthopedic floor on a temporary license, passed my NCLEX on the first try and really want to be a good nurse. The problem? I was given a preceptor who worked with me for four days and then our schedules diverged. After that, I was assigned, off the cuff, to whichever nurse agreed to take me on any given day. I felt completely lost and I could tell my constant questions were irritating to them. I'm still having problems with routine tasks, not to mention figuring out what to do in a crisis, and I was terrified of making a mistake. I asked that I be scheduled on the same days as my original preceptor, but last week she went on vacation, and the nurse who was assigned to me took two rooms, gave me five, and I never saw her again. That night I made a med error and ended up totally swamped. My nurse leader called me in for a chat today and told me that I wasn't getting things done in a timely manner and he didn't think I was making progress. He thought I should be ready to go off orientation and manage seven patients on my own by now. It's been two months. He said if I quit and worked at a nursing home for a couple of years I could come back and try again. So I quit, because I knew it was a matter of time before I got into a situation that would cost me my license or hurt a patient. Now I'm looking for employment and feeling like a failure. This whole situation has really cut into my self-esteem. How long a time is reasonable to expect to work with a dedicated preceptor before being "cut loose"?
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  3. 16 Comments so far...

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    First of all, I am sorry you quit your job but , honestly, that place sounds toxic to me. There are other jobs out there and you will find the one that is right for you.

    I also wanted to add(as a 36 year old) the staff might be looking at your age and expecting you to "get it" faster than the average 22 year old grad. Just sayin'. It might not be right or fair but it is a thought.
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    Few hospitals have the resources for the orientation a new grad might need. There is no hard and fast rule about how much, who does it, how long. It sounds like you are a good nurse with your heart in the right place. Your nurse manager is crazy if he thinks working as a RN in a nursing home is somehow easier than acute care! You sound exactly like me, it was pure luck I didn't end up killing a patient or getting fired when I was a new grad. When I graduated and didn't have my license I worked as a CNA in a nursing home. Maybe you could try that? Work under a CNA license, it is hard but a little less pressure, get your organizational skills up to speed? Or try and try again to work acute care You WILL find the right combination of management support and type of nursing that will be a better fit for you. Be honest at job interviews, tell them you have had a chance to evaluate your strengths and weaknesses and know "what you did wrong." on your first job and how you won't repeat those mistakes.
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    I'm sorry this happened to you. That's a lot of patients to be expected to handle after a month or so.
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    I'm sorry that wasn't a good fit for you but know that you will find a team that is more complimentary to your skill set and style. Please keep an open mind about having different preceptors. I found it invaluable as a new graduate because you can see different perspectives and use them to find your own style. When I was a new grad after the week long hospital wide orientation for all disciplines I got 8 shifts of orientation before starting a full patient load. As an experienced nurse I have not ever gotten the full length of whatever orientation I have been promised. It kind of seems like this is just the way it goes. Hang in there.
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    I'm kind of confused. Was this a nursing home or hospital? I hate to say it but for a nursing home it's pretty par for the course.

    But a hospital is a whole other ballgame! What happened to you is just not right! I hear people talking about 6 month long orientations on here and I think to myself, that is way too long for orientation but 4 days is certainly not going to get it!

    Many moons ago as a new grad I got 30 days orientation on med surg floor with the same preceptor and then transferred to my permanent assignment on night shift and I was just fine. But I know everyone moves at different speeds.

    I think you did the correct thing in quitting, something bad was bound to happen in that environment.

    Good luck at your next position.
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    Don't be too hard on yourself. Nursing school does not prepare you for the real world and it sounds like your orientation was inadequate. This job is very, very difficult and I learn something new every single day I work. It took me years to feel competent, and I was considered "a good nurse" straight from the get-go. I'd get report, thinking (with my stomach in knots) "please, Lord, keep this patient from going bad" and hoping like hell I wouldn't have to call a doctor for anything, as that made me incredibly nervous. It's only in the past few years that I go to work with a nonchalant attitude and the feeling that I can handle it. Nothing really bothers me now, except for abusive patients. That I will not put up with, I don't care if they fire over it. I think part of that is age, as well. You do obtain wisdom with maturity. Good luck to you.
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    Most of my friends who were fortunate enough to get hospital jobs got at least 6-12 weeks. But some facilities have realized they can burn a new grad and fill that position 10 times over until they find someone desperate enough to cope with their crazy expectations. I hope you find another hospital who is willing to train you properly, because LTC isn't going to be any better, believe me!
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    Thanks for the feedback...I'm getting the impression that six weeks is pretty standard orientation...for me, under these circumstances, it just wasn't enough. I have no healthcare background and I'm 56 years old...I think both work against me. I was hoping that long term care might be a little more routine...I'm also hearing that that's not true. There's only one major hospital in this town and I just quit working there. So it will be either a clinic, doctor's office or LTC...whichever one is willing to teach me what they expect of me. Maybe I'm a slow learner...
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    LTC is more routine, but you may not get better orientation. I got 3 days, the same as the other new hire with 2 years LTC experience. I keep reading here that it takes a while to get it down but eventually it will be managable. Keep looking though, there is a place for nearly everyone in nursing.


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