Does Orientation Really Help?

NurseLeia · Jul 23, 2015

I felt like orientation was very different from clinicals. A nurse who may not appreciate having a student following them for a day may be comfortable with assisting to train a coworker, someone they must work with several times a week. I had negative preceptor experiences during clinicals, but none during orientation.

Orientation is a learning curve because you learn specifics to your unit and specialty. This is also the time the reins are freed, so to speak. You are much more independent on the first day than you were during all of clinicals. For me the learning really happened when I reached Independence, when another nurse wasn't looking over my shoulder.

HouTx, BSN, MSN, EdD · Jul 24, 2015

I understand your anxiety. The unknown is always pretty scary - especially when so much is at stake.

Orientation is simply the process whereby a new employer: 1) validates competencies & 2) teaches you the organization-specific information, policies, procedures, rules, etc. that you need to know in order to do your job. A normal 'orientation' is NOT sufficient for inexperienced staff, particularly new graduates. You'll need a more comprehensive 'transition program'.... that is much more than simply orientation. It doesn't have to be a formal residency or internship, but any employer who hires new grads must be willing to provide it.

A transition program means that in addition to learning the organization-specific stuff, you will need to master the underlying processes. This will include things like: giving and taking shift report; admission, transfer & discharge of patients; communication and collaboration with other departments, accessing and utilizing knowledge-based resources; functioning in the care delivery model; documentation systems, managing a full patient assignment, etc., etc. You may begin the process by watching over someone's shoulder, but as it progresses, they will be watching over your shoulder as you assume more and more responsibility.

Everyone is unique, and there is no 'absolute standard length of time' for a new grad to successfully transition into a fully-functional staff nurse. Overall, there is a preponderance of evidence that it takes about 12 months for this to happen but it may be much faster for some new nurses. Be patient with yourself at this critical juncture as you begin your career. We've all been through it.

You can do this. We've got your back.

Awesomocity0 · Jul 24, 2015

So I am going to be a senior in nursing school, but I don't feel ready to call myself that at all! I keep hearing that senior year is when you learn the most and become more confident in yourself as a nurse. I feel like that is where I really lack is in the confidence area.
I am a good student, but sometimes I feel as though I can't critically think good and fast enough to take what I have learned in the classroom and apply it to real life.
As I experience more in clinical, I do feel more confident, but after NCLEX and graduation have passed and my new job orientation rolls around, I hear that you relearn everything, and I was wondering if that was true. Also, I am interest to hear how long it took for you all to feel 100% comfortable after starting your first job as nurses and if any of you have experienced lateral violence.
Lateral violence also makes a bit nervous, because I feel like during clinicals and when I am in orientation that it is going to be an inconvenience for them to teach me things and have me hanging over their should for a whole 12 hour shift. I feel bad if I mess something up and then they get frustrated at me because they have to clean up my mess. There a ton of great nurses who don't mind teaching a being a preceptor, but not all nurses are going to be like that I'm sure, so if any of you have experiences you'd like to share and how you got through it, I would greatly appreciate it!
Thanks all!

I still don't feel 100% comfortable two years out. And I think any nurse with even a few years of experience who says she's 100% comfortable with everything is probably a dangerous nurse. I'll be honest. When you get your first job, you're going to feel like a fish out of water. There is a HUGE transition between being a student and watching and actually doing. You never get to the point as a student where you do everything, and someone just comes in and checks after you. In a residency, you transition to that point over several months. And when that point happens, and then you're on your own completely, it is terrifying. It will be the most terrifying thing to happen to you.

And if you work in a more critical care environment, or any environment really, and the first time something bad happens, you will not feel prepared at all. You will hit that button on the wall and pray that it wasn't something you did that made your patient code, and you will hope to God that it turns out okay. And then you will take a deep breath, you will remember your preceptorship, and you will remember that you are a team. You have co-workers. You have a charge nurse. You have a manager. And they are all there to support you. And they will have your back. (Hopefully.)

After two years, I still regularly ask questions. "This is what happened. What do I do?" "This is what happened. Did I do the right thing?" "This got me thinking about what would happen if _______. What would I do in that situation?" "How do I do this?" "Do you mind checking over this?" "I don't feel comfortable with this. I think it's this. Can you assess the patient and see if you agree?"

I think the most important part of a new nurse is having confidence in what you do know and KNOWING what you don't know, so you can ask for help, and learn, so that the next time, you do know. And I've yet to have my team members be frustrated with me. We're all here for the patient. Just do your best.