Am I making a mistake? Help.

[pancake]

I'm a new grad and was offered a position on a CCU. I'm going to meet with the mgr again this week, but now I'm getting a little worried.

The hospital has already had its new grad training this year, so I will be brought in alone. That means I won't be getting the classroom experience. This is what's making me nervous . . .

When I meet with the manager, how can I ensure that I'll be adequately trained for this position? How long should I be precepted? Is it reasonable for a new nurse to start without benefit of a new grad program? Should I just trust that the mgr knows what she's doing?

I don't want to set myself up to faill and I don't want to be a danger to anyone.

Advice please. Thanks

[moskeetus]

Hello Pancake,

Since no-one has replied to your question, I thought of sharing what I experienced before....

First of all, congratulations for getting a position at the CCU. If that is the area that you're interested, I think you will enjoy it as you get used to it.

I understand your concerns and apprehension towards the unknown.... you are a new grad, so I suppose that you haven't had any nursing experience before (except during the clinical prac)? I don't know if this helps, but let me share the experience I had at a CCU when I was a new grad.

I used to nurse in one of the Asian countries, and when I started I was thrown into a CCU all of a sudden, as a new grad (initially, I got a position in a general ward and then I was transferred to the CCU after a week or so). It was very fortunate that the unit was very prepared to work with new grads, they understood that we knew NOTHING. Our training at a nursing college was very much theory based, so we weren't even able to prepare an IV line or mix up antibiotics.... Also no-one knew how to read ECGs... We couldn't do anything practical at all, to start.

The unit had this 3-month structured orientation program. We had a preceptor for each new grad, and we worked one-on-one for 1 month. Most of the time, the pair had to look after 1 or 2 patients with various levels of dependency to start, and at the end of the month, I think we started looking after up to 3 patients. In the second month, the new grads started becoming a bit more independent, having 1 or 2 patients on our own, but there were always the preceptors in the same shift (so that we could ask questions to our own preceptor). The third month was designed so that the new grads took a bit heavier responsibilities and become independent, so I think we started looking after more severe patients i.e. IABP or ventilators, or getting involved in cath lab duties etc. At our CCU, the nurse in charge (a nurse leader?) did handovers, so we didn't need to do it for another 3 months (6 months from the start)..... I think the induction program that we had was very thorough and it couldn't be any longer! But still we didn't think we were prepared even after spending 6 or 7 months in the unit.

This wasn't in the US (and also a long time ago), and what I went through may not be relevant over there. I know the nursing education at an undergaduate level would be a bit different there, so I am not sure how much you're actually prepared to nurse the patients at a very acute stage. At CCT, in many occasions, I think speed is really the key in the end (I mean, how fast and accurate you can respond to the situation e.g. arrhythmia, chest pain, shock.... etc). If you're like me when I started nursing as a new grad, like "knew absolutely nothing practical", you would need a lot of education and training to assess and respond to patients' conditions as quickly as possible, in many different critical situations.... moreover, all those highly sophisticated machines.... (they gave me headaches!). I think it is normal that it takes time for new grads to become fully competent, and up until then they always need constant attention and support - this is my opinion.

I hope this helps .... but I wish someone else would give you advice on this - I'm not sure if my case is relevant to your situation! Anyway, all the best and good luck.

PS: English is not my native language, my apologies if there is anything that is not clear.... please let me know if any, and I'll try to clarify it as much as possible.

[pancake]

Dear Moffett,

Thanks so much for your thoughtful reply. You gave me a good idea of what I might expect. I'm so excited about the new position, but also humbled by the amount of learning and responsibility. I will do the best that I can. Thank you too for the support. I really appreciate it.

Take Care,

pancake