Been there done that..or have I?

[newbie99]

Before I began nursing school I was a CNA in LTC for years. As a new grad LPN FEW months in now in LTC, the transition is easy but different. Now i realize that each state is different in their ideals for healthcare within facilities however, Is 3-5 days sufficient time for a new grad to have orientation?

Each state varies on the healthcare team, there are CNA 1 CNA 2 MED TECH HHA ETC. NOT ALL but some of these individuals can pass the medications, all except injections and any type of blood thinners particularly coumadin. Now as a new nurse I felt it was important to engage in the entire experience and I did my fair share of reading and knew well enough that an unlicensed personnel should not be training a nurse and that an RN should be providing any member of the healthcare team with guidance and providing corrections when necessary, this was not the case.

Facilities APPEARED as though they were more organized and routine yet equally disheveled when it came to preparing new-hires for task based protocol and procedure the talk was there the walk not so much. For example, orientation verbally explained that it would last 2 weeks 3 days in a classroom the rest on the floor. Instead it was 1 day in a classroom and 4 days on a unit and then you fly solo. Not only did I feel unprepared I felt as though I was being thrown to the wolves and set-up to fail! Some may call it exaggeration others who have experienced this may agree that I felt as though I was going to lose my new nursing license quicker than it took for me to get it.

Now this does not only apply to nurses the CNA's in my opinion have it worse. They get 1 classroom day and 3 days on the unit if there are 3 assignments and they're fresh out of class with no experience and limited to 1-2 patients during their clinical experience they're set up to fail.

Personally I feel this is unsafe practice. Unsafe for the patient first and foremost but also unsafe for the employees. Now couple the 3 day orientation with a mentor who is unwilling to speak to you, interact with you and "show you the ropes" Would you stay?

What do you feel is adequate for orientation for a Nurse RN and LPN alike?

Do you feel that 3-5 days is sufficient? Despite the fact that every day is a learning experience in and of itself,

As a new nurse would you feel that you're capable of speaking to a Doctor about patients you just met and providing them with adequate information when the charts and where things are located within the chart are not always adequate even though its "properly labeled dividers" are intact?

As administrative staff that facilitates the " we stand by the nurses and their decision as the charge nurse on the hall" ideal in fact DOES NOT and chooses to yell at the nurse for correcting a CNA of how to properly address and speak to residents. Then encourage the CNAs' whining and crying about how there are not enough staff when each of them has 8-12 patients a piece while the nurse on the unit has 25-30 but comes and scolds the nurse for not providing incontinence care to a resident while you were addressing a family members concerns of a patients pain level during the dying process of their loved one?

Now I get it, alot of the comments that may present themselves here after taking the time to read this long over-versed article may read, find a different job. Go to administration etc. I find it difficult to walk away from such a disheveled place that, despite its negative qualities, yearns for common ground a level playing field so to speak. How can I make this better? How can I make an impact? Is this place willing to adapt to change and new ideas that I am willing to present? Or is it just a lost cause? HOW CAN I IMPACT MY CNAS TO WANT TO WORK TOGETHER WILLINGLY NOT JUST FOR THEMSELVES BUT FOR THE RESIDENTS. I NEED SOME IDEAS ANYONE?

[CelticGoddess, BSN, RN]

I am only going to address the issue of orientation: IS it enough? No. I worked LTC for 2 years and was sold the same bill of goods. I would get so many weeks of orientation then started and wham, I am out on my own after 3. I was orienting new nurses after 2 mos. It's called the bottom line. They just don't want to expend the money. And staffing does suck.

As far as your CNA's, try to cultivate a working relationship with you. If you work at a place like mine, you'll never get admin to back you up. I can't tell you how many time I wrote up CNA's for not doing their jobs and the DON just wripped it up. You're best bet is to cultivate a working relationship and try to help them as much as you can.

[Libby1987]

Re the last question, I don't think so. The responses to your small individual corrections don't bode well for you being their inspirational leader for big change.