Bad new grad experience...Much needed advice!!!

tokmom, BSN, RN · Apr 2, 2012

I would be checking out the nurse/pt ratio in your local hospitals. Eight pt's is a lot for a skilled nurse, let alone a new grad, especially if they are high acuity.

nurse_pam · Apr 2, 2012

I am a fairly new nurse and I am currently doing home health. I would love to get back into the hospital setting to gain more clinical knowledge, but I had a bad first experience as a new grad in a facility where they gave me 8 pts right off of orientation. It was just to much, Im feeling like such a failure and starting to wonder if I made the right choice by becoming a nurse. I work my butt off to get my degree with many road blocks along the way, so Im NOT a quitter, besides Im no spring chicken...any advice would be much appreciated :-)

It is a very different experience going from home care to a facility. There are many things that happen in facilities that they don't teach you in school. A pt load of 8 on an acute floor without any assistance is just crazy. Hopefully, you have an LPN or an aide to help you with your assignment. Did they give you an orientation? You could ask for a little more orientation if you feel your's wasn't long enough. The facility would rather give you a little more than have you quit and wasted all the money they've invested into you in the first place. When you get your orientation pay special attention to how the nurse you're with organizes her workload and her day. Most times it's get everyone's vital signs, doing quick 5 min head to toe at same time, meds & then break. Dr's orders & sending pt's for tests kind of throw you off but be flexible & move to the next pt. Don't let it slow you down. Good Luck. Just getting into a routine will help you organize your day better. There's not a lot of time for chit-chat with the pt's...that's the stuff they don't teach you in school. Take care! Let us know if it improves.

BostonTerrierLover, BSN, RN · Apr 2, 2012

I agree with above posts completely, if its not a "team nurse" setting, and your alone with 8 patients, I would definetly consider that unsafe, and you need to advocate for yourself whatever it takes, your future licensed self will thank you.

When your "Gut" screams for help, listen to it.

You worked too hard for this, and until you get your feet wet, a few less than that are too many for you. Always consider safety at the top of your priorities, if you keep them safe, all the rest can fall into place.

HouTx, BSN, MSN, EdD · Apr 2, 2012

Devil's advocate here. Some facilities have revised the old "gradual immersion" process for new grad orientation. Rather than starting slowly with a couple of patients and ramping up each week, they are assigning the orientee a full load - WITH a qualified coach/preceptor. So, the orientee has the patients, and the preceptor has the orientee.

Arguably the most difficult skill to master for a new grad is the continuous prioritization that is needed to effectively manage time. The only way to develop a skill is to practice it ... therefore, this 'new' method will provide the orientee with a lot of practice in an 'safe' environment wherein the experienced nurse will step in to help whenever needed. This type of precepting is very different from the classical "show and tell" model, cut it can provide a much more rapid boost in confidence and productivity. By the end of the orientation period, the coach/preceptor should seldom have to step in to help.

That being said - if the OP was simply given 8 patients with a traditional type of orientation, I agree - it was too much.

RNfaster · Apr 3, 2012

Eight patients in acute care is difficult. I wouldn't want to do it. If there are other hospitals in your area with a better nurse-to-patient ratio, pursue them. If not, at some point, you might consider moving to an area where they have better ratios.

My first nursing jobs were not easy. Too many patients, not enough help. As I got experience, I was able to get into a better situation.