New Grad pulled off orientation for a shift due to short staffing

Nurses Career Support

Published

This might be lengthy but here goes: So my second day of orientation as a new grad RN, I was asked to take a group of patients on a neuro rehabilitation unit because of several call offs. I was sent to the unit with my preceptor, but he had 8 patients of his own and I was given four total care. Aside from that he seemed to be very angry for the first half of our 12-hr shift. Granted, he was probably angry at being floated and at the situation at large, but it meant that he was just not available to help me for several hours. He would answer questions but was visibly irritated and short. My first night with him, he was nothing but nice and helpful, so again I just figured he was angry more at the situation.

Having several years of experience as an LPN I quickly identified the tasks I was immediately comfortable with (VS, head-to-toe assessments, safety, etc) and got to it. I was told at the early part of the shift that another nurse was coming to take over my patients--then several hours later told that nurse wasn't coming after all. Of course, my biggest anxiety was maneuvering through the EMR because I'd barely started being trained on it the day before. I quadruple checked meds and made absolutely sure that I was following the 5 rights each time. Beyond that, I made frequent rounding to ensure patient safety. When I got home to decompress and dissect what happened, I felt mostly very good about the care I gave and how I handled the situation.

However now I'm super anxious because I don't feel I documented or charted appropriately--at least to the standard that I'm used to, and I don't feel like I covered my butt in my documentation, mainly because of not being familiar with the electronic charting system used. I'm just in a blur about what I wrote honestly. I feel like when it was time to chart I went blank. I did get some help from my preceptor toward the later end of the shift, but again, he was also needing to chart on his 8 people. Meanwhile, the tech sat watching movies on her cellphone and while she did some things without being asked, she needed a lot of prompting. At the end of my shift, my preceptor told me to make sure I did things like take trash from the room--really?! I normally do that and have zero problem with it, but how about asking the tech to get off her butt because she's not being paid to watch movies :madface:.

It's almost time for me to go back for my next shift again and I just don't want to go. Granted the nurses there seem, in general, to be very friendly and willing to help. I know there are good and bad staff everywhere. I'm supposed to go back to being on orientation but who knows now? I'm the kind of person who doesn't have a problem speaking up usually. I also don't like to "rock the boat" so to speak as a newbie. Had I been there for some time, I would've been all over the tech to get off her butt and if that didn't work I'd report her. But I'm new, and I'm not wanting to make enemies out of the gate.

I still think that overall this hospital is not a bad place to work. I want to hang in there and at least capture that golden year of RN experience, if at all possible. I will speak up though, if I'm asked to take patients again due to being short-staffed. It's only fair that I be given proper orientation so that I can be a safe nurse and do what's expected. Right now my anxiety is through the roof. I'm worried about having missed something/not documented something and having it come back to bite me. I'm worried about future attempts to pull me as a staff nurse and not orientee when they're short again. And all this is in addition to the usual newbie worries of getting the hang of things, time management, etc. I appreciate anyone who reads this novel lol. I just needed a safe place to vent and air my feelings.

Up Vote Up Vote ×
Specializes in Medical Oncology, ER.

I feel your pain! granted it was at a SNF so i traded high acuity for high pt:nurse ratio but still, to be taken off orientation early is frightening! I was also pulled the 2nd/3rd day of orientation to work the floor. But, you made it through, you survived, you didn't panic, you were cautious with your med administration, your patients are alive. We all go home wondering if we forgot something, if we charted enough, if we actually hit start on that IV pump, etc. Idk what the other experienced nurses on this site would recommend, but i would say that if it were really bothering you, bring it up with your sups and just explain how you feel. Wishing you the best of luck with whatever you choose to do!

Up Vote Up Vote ×

Thanks for the insightful response nursephillyphil! Sorry you're kind of in a similar situation and I hope you're thriving in spite of it. It's extremely frightening, but I'm hopeful that I did the most important things right. I am back to orientation status as of now, but I tell you, since that experience didn't kill me it has definitely made me stronger. It's motivated me to dig in and really start formulating my own system of how to organize and prep for being totally on my own soon. I've read through several threads on AN and, from the looks of things, my situation could be a lot worse so I'm trying to focus on the positives :).

Up Vote Up Vote ×

To the OP: Sorry that happened to you! Your unit should have a better "plan" if things change like that! If you float with your preceptor, you & they should operate as 1 person only, not 2. Your preceptor should help you through the shift and not leave you alone as you had only been orienting a few shifts.

On my unit, preceptors don't float until orientees are very independent. But they also are reassigned to someone else for the shift. We typically do not float out the orientee/preceptor because the point of orientation is to learn our unit, not some other unit!

Up Vote Up Vote ×

Sounds like you made the most of a bad situation. I would not let them make this a regular thing. Hopefully this was a bad mistake on someone's part. In any case stand up for yourself and get your training.

Up Vote Up Vote ×

Thanks dah doh. It does seem like a poor decision to float an orientee and expect them to perform independently. I just want to get the experience I need to be able to move on in time.

Up Vote Up Vote ×

@NightCrow I really did try to do so. I had a chance to really evaluate things and I've decided that I need to definitely speak up for myself. I don't want to be taken advantage of. I was put with a different preceptor for a shift, and what a difference that made! Much nicer, and I learned a lot, even took two of her patients and had a great experience overall. I think I might be put with the original preceptor again for my next shift, and I know I might need to speak up to advocate for myself. Thanks for your input!

Up Vote Up Vote ×
Specializes in hospice.

Thank goodness you had LPN experience to help you get through that! Can you imagine if you had been truly without nursing experience? I think that would have turned out very badly.

Up Vote Up Vote ×
Thank goodness you had LPN experience to help you get through that! Can you imagine if you had been truly without nursing experience? I think that would have turned out very badly.

Oh man the LPN experience really gave me at least something to fall back on. I agree that without it things could have quickly turned for the worse, and that would've been extremely unsafe for both the patients and myself. Funny how LPN experience doesn't count in the hospital until they need to justify staffing decisions.

Up Vote Up Vote ×
Specializes in Critical Care, Education.

OMG!!! Horrible incompetent management strikes again. There is absolutely no way to justify the situation that OP describes. One of the most essential functions of a manager is to ensure that all new staff are competent to perform the job duties... BEFORE asking them to do so independently. From the description provided, OP was too new for this to have happened. That manager/organization was unbelievably lucky that OP had previous LPN experience to fall back on.

We all know that if "anything" had happened as a result (of being pulled out of orientation to take an assignment) - that manager & organization would be looking for scapegoats... with the preceptor being #1 & OP joining him under the bus shortly afterward.

A competent manager would have addressed the situation very differently... in a way that reflects a clear understanding the importance of orientation & competency validation PRIOR to independent practice. If there was no other way, S/He would have taken the assignment rather than throwing OP into such a terrible situation. Lemme guess.... this unit has a lot of turnover????

Up Vote Up Vote ×

I think you should talk to whomever directs your orientation whether it be the unit manager or educator. Let them know what happened. Maybe they were not aware and it will be a non-issue. If they were aware make it clear (with a smile) that you were promised x amount of training and while you were an LPN before the job is different and it is a patient safety issue taking your own assignment prior to completing orientation. Be apologetic, let them know you are a team player, whatever but make it clear that as an orientee you are not part of the nursing census and at this point in tour training you do not feel comfortable taking your own assignment. They cant fire you for this and wont take the blame for you if something goes wrong.

Up Vote Up Vote ×
OMG!!! Horrible incompetent management strikes again. There is absolutely no way to justify the situation that OP describes. One of the most essential functions of a manager is to ensure that all new staff are competent to perform the job duties... BEFORE asking them to do so independently. From the description provided, OP was too new for this to have happened. That manager/organization was unbelievably lucky that OP had previous LPN experience to fall back on.

We all know that if "anything" had happened as a result (of being pulled out of orientation to take an assignment) - that manager & organization would be looking for scapegoats... with the preceptor being #1 & OP joining him under the bus shortly afterward.

A competent manager would have addressed the situation very differently... in a way that reflects a clear understanding the importance of orientation & competency validation PRIOR to independent practice. If there was no other way, S/He would have taken the assignment rather than throwing OP into such a terrible situation. Lemme guess.... this unit has a lot of turnover????

You've made a lot of valid points. I've been a nurse long enough to know (and unfortunately witness) how easily management tosses nurses, and staff in general, under the bus. I identified, along with my preceptor and the off-going RN, patients who were stable. You are right that the manager should have, given the situation, stepped up and took the patients herself, however, I'm all too familiar with lazy and/or incompetent managers who will pass the buck by any means necessary.

I keep trying to see what I could've or should've done differently that day. I'm just glad that I felt confident about assessing and providing nursing care to the patients I had, and a couple of them even thanked me for the care they received. I was talking with a tech there after this incident, and she did tell me, HouTx, that they had a lot of turnover. Another RN told me she's been there nearly 10 years and that they have "bad cycles" like that, but it gets better. She then told me "that's why we need amazing nurses like you here." I've been back on orientation for another 2-3 shifts and I've been doing very well thankfully. The original preceptor has returned to being super nice even lol. I'm soooo thankful to know how this all works--I'm there to grab all the RN experience I can for a solid year or two, if it's safe to do so, and move along.

Up Vote Up Vote ×
+ Add a Comment