Almost off orientation with little orientation time provided. Please help!

[gardengirl08]

I am a new nurse. I have been a paramedic for 9 years and I am starting a new job as a nurse part time at a local emergency department. The kicker is I have worked there for the last 5 years as a paramedic/patient care tech. On my 4th day of orientation I was told my my precptor that I know what is going on and to start taking patients and ask questions if I need help. I have had one other orientation day with a seasoned nurse and two other orientations with nurses that have been there 6 months.

I feel my knowledge of this unit is being taken advantage of because I know where things are, who goes where, the other nurses and staff, how things run, and problems they have encountered in the past. I feel very uncomfortable and feel like I have been left to the wolves. I do not feel comfortable being on my own yet.

That 4th day I hell for me... I had two critical patients that both ended up in the ICU. I recieved most of my help from a new nurse and my preceptor was off taking other patients and chiming on mine when she felt like it.

I am confident that I know when a patient is going south or needs attentioon quickly but I do not feel ready to be on my own.

My fear is they will be taking me off of orientation by day 6 or 7. Most new nurses get 6 weeks of orientation.

Can someone help me or have any suggestions on what I should do?

In need of help and STRESSED OUT!

[labrador4122, RN]

sounds like you have it pretty tough.

I was very lucky that the first 3 weeks my preceptor was very easy on me and taught me a lot.

My second preceptor.... well, I might as well already been on my own at that point.

As a new grad myself, I would suggest, just ask questions a lot, read the hospital policies on whatever you have other types of questions of and just make sure you follow the hospital rules even if you see that other's aren't.

A lot of hospitals train new grads exactly the way you describe it. here, my friend is going thru the same thing now at a facility where I was offered a sign on bonus that I eventually gave back ( and I am glad I did).

good luck. hang in there, and remember you have your RN so you don't have to stay there, and you can get a job anywhere else.

[TigerGalLE, BSN, RN]

Um.. I think that is unacceptable. You need to talk to the director or the nurse educator and express your concerns. You definitely deserve a full orientation. I would refuse to come off of orientation after only 6 days with a preceptor. That is putting your license on the line.

Be brave

Stick up for yourself

Tiger

[labrador4122, RN]

sometimes even if you speak up, the director and other nurses do not care about you.

you have to know the policies of the hospital, and do things right. it is your license.

[nursemike, ASN, RN]

I think it would be perfectly valid to voice your concerns to your preceptor and/or manager. Moving too quickly is in no one's interest. On the other hand, it sounds like you may well be at about the point many or most are by the time they finish orientation.

From what I've seen, and from some of what I've read on these boards, it appears that most ER staff are a bunch of adrenaline junkies who buy heavily into the "sink or swim" paradigm. In my limited acquaintance, paramedics don't seem immune to that mindset. I'm not saying that's all wrong, and even in floor nursing, there comes a point when you just have to take a deep breath and take the plunge. But I concur that you wouldn't be wrong to lobby hard for a few more swimming lessons and some water wings. On my unit, nurses recently out of orientation usually get a bit easier assignments than the more experienced staff. It seems like that might be less of an option in the ER. So, yeah, it might pay to remind them that if you run out the door, screaming, they're just going to have to start the whole process with someone else.

[SCDOHJohnRN]

Gardengirl,

First congtats on passing your boards. That is not easy step! Now that you have a license you MUST protect it. You have worked too hard. As an expierienced ER nurse, we are all adreniline junkies or we would not be there, I can say this is not the first time I have heard this. You need to talk to your preceptor. He/She is reponsible for your orientation. In our hospital, there is an orientation packet that is used to check off skills learned/mastered. This helps toknow what you still need help doing. Does your ER have an Education director? If so talk to that person. Many new grads leave the ER because of poor orientation. It is scary and frustrating. Even properly oriented, you will be shaky at first. Remember your first days as a paramedic. Trust your instincts. If you do NOT feel ready, let your preceptor of NM know. You are a familiar face so everyone just assumes you know how to do the job. We all know what happens when you assume!!!

Stay strong, fight for what you need.

[CABG patch kid, BSN, RN]

I think that you should really talk to your manager or follow up the chain of command (educator etc) to get the help you need to remind them that you were NOT a nurse for the past 9 years, you were a tech and paramedic who had a different role and responsibilities. I would go ahead and confirm with the manager that you are indeed on orientation for X amount of weeks, as they need to have that written in stone for their staffing purposes.

[gardengirl08]

Thank You all for your input. It has helped me confront some issues that I am dealing with. They have given me a couple of extra days to work on my orientation. I feel this has helped me. I am uncomfortable preparing a few of the medications but many of the nurses have told me to just ask and they would be willing to help me out. The staff has assured me that they will not let me sink or swim. They all seem to be pretty tight around the E.R. I am also very familiar with the inner workings of the E.R. and the hospital so that is not as much of a problem. The nursing director has been very cooperative and willing to give me more time if I need it.

Again THANK YOU all very much for your time on this forum and your input. I very much appreciate all of your help and support.

GardenGirl08

[NurseBrittney]

new nurses get a minimum of 3 months in my er, and 6 months in the er my friend works in. YOU NEED IT! even if you've worked there. There is so much, so fast, so soon. Talk with you nurse manager quick!

[cardiacRN2006, ADN, RN]

A few more days is not enough.

If something happens to one of your pts, and it goes to court, how is it going to look that you had 6 days of orientation instead of 6 weeks?

Protect yourself and your pts and demand full orientation.