I'm currently orienting a nurse to our ICU. She has 1 year med-surg experience. We are going into our 14th week of orientation. She still doesn't seem to get it. It seems as if she still doesn't see the big picture. She is very task oriented. Completing her "tasks" without knowing the reasons or importance for doing so. I have to repeat the same things over and over without her showing signs of remembering to do these things on her own. She doesn't do any "homework." Even misses educational opportunities that are provided for her. I encourage her to study drugs, shock states, and other common diagnoses at home. But when asked about these things she continuously fails to know the answers.
On week 14 she still cannot tell me how dopamine, levophed, fentanyl, vasopressin ect are routinely ordered. She was going to give IV digoxin thinking it was an antihypertensive. She doesn't recognize subtle changes in vitals. HR trending up, BP trending down, UOP non-existant.
We have met with my director on many occasions and continue to talk about goals for the upcoming week.
Her bedside mannor is wonderful, she develops great relationships with patients and families. But her knowledge of nursing and drugs is so far from where she should be at this point. I'm afraid she will not succeed. I want her to succeed.
She is late everyday. This has been addressed but the behavior continues. She is unaware of what is going on in the unit. She goes to lunch without telling me or other staff. Without handing her patients off. And then will sit and eat a 45 minute lunch while her patient is crashing. She gives almost all of her meds late. And i mean hours late. She forgets to check temps, blood sugars.
Usually our director gives 8-12 weeks of orientation to nurses with prior hospital experience. At week 14 I do not see the light at the end of the tunnel.
Other nurses tell me I'm too patient, I should fuss at her and "light a fire under her" so to speak. I've attempted that approach before and have found that she freezes when someone is harsh with her. I've taken the more patient, stand back and see, intervene when necessary, drop clues kind of approach. I try to educate her. I give her websites and books to read/study.
