Being thrown to the wolves during orientation

[BSNbeauty, BSN, RN]

I started in the ED last week and have 8 weeks of orientation. The first day I was given two rooms that I was 100 percent responsible for. The second day, I was given a full assigment with just the assistance of my preceptor. The third day, I was given a full assignment as well. Each day I had a different preceptor.

This is going against what my orientation schedule is suppose to be. I was given an oreintation scheudule that consist of weekly goals and assisgments. The first week I'm just suppose to observe and sort of learn the ropes. The second week I take 25 percent responsibitity, and the responsiblity percent increases throughout orientation.

I learn best by doing however, this is way too much! I'm always behind on charting and it is hard learning the paperwork and their system while having a full assigment. I've four years experience but not in this speciality. They assume because I'm experienced " I already know" this and that.

My question is: Is this how all ED nurses are oriented? All you just thrown out there and expected to sink or swim? Just curious.

Thank you.

[prep8611]

Sounds like a good way for people to die, no offense to you just sounds unsafe.

[JDougRN, BSN, RN]

I guess it would depend- If both of your patients were level 1 or 2- active bleed, acute MI- something really sick and time consuming then yes, they are being unreasonable. But if it was something failry common like abd pain, ect- 2 patients really isn't a lot. Unfortunatly, ED nursing tends to be very fast paced and autonomous. Hang in there, ask questions, and always be willing to learn something new. ED nursing isn't for everybody, but if it's something you want, I'd suggest getting an ER education book and reading up- also, there is a lot of good information on these boards to new ED people giving aadvice on how to streamline the process. Good luck and congrats on your enterance to the "PIT"

[nmlola]

Wow! Congratulations! Im an ed nurse too but thats back home in the Philippines.. So maybe i should say i was an er nurse. Im still waiting for my assessment from the CNO, mu goal is to become an ED nurse here in Ontario! :)

Im sure the situation you are in makes you a little bit anxious about making mistakes because of the fast paced setting but you will get the hang of it. Have fun stay focus and just bring it! :) good luck!! Reading your story makes me miss being an ED nurse and can't wait to be back on the game! :)

[360jRN]

What kind of nursing did you do prior to going to the ER? I know the biggest hangup that most nurses have is learning how to get away from the full assessment and doing a focused assessment. This can get you behind and quickly! It's going to take time to know how that facility operates as far as what they do for this and that and doctor tendencies. One doc may have you starting IV's/checking cardiacs/CT's/etc while another may do a KUB and be done with it. People always talk about being afraid of doing something and losing their license; if you ever don't know what to do or have questions -ASK! Good luck! Have fun! You'll have infuriating nights and very rewarding nights!

[BSNbeauty, BSN, RN]

I've done LTC, ICU, and school nursing.

[XmasShopperRN, ASN, RN]

If you were promised one thing but being given something else, something that you're not comfortable with, speak up. With an ICU background, you probably know how to handle the critical pts, but add all the other million factors that come with the ED, and it takes some getting used to. Let your preceptor know what you're having trouble with, and see if you two can't come up with a better orientation/preceptorship.

[sofiamcclain]

I just started working in the ER myself, just finished my orientation (6 weeks).I guess it really depends on what are your hospital settings are. However, the reason you are with a preceptor is to be oriented and no to be on your own in a first few days. I agree with XmasShopperRN, you have to speak up if you are uncomfortable.if you don't ask questions people assume you know things. We learn daily something new. On my last day of orientation I had my first code, next time I was on my own and had another one,but I am very blessed to work with a very supportive team. Hang in there!

P.S. Chart right after each pt is you can, otherwise you will be extremely overwhelmed.

[T-Bird78]

I'm not in the ED, but I had a working interview for my first nursing job (from 9:00--4:00) and when I got there I found out the only other nurse was on her first day; her working interview had been the day before. Talk about being thrown to the wolves! Fortunately we had a wonderfully patient PA who showed us where all the supplies were and helped show us the ropes despite a full schedule. The doc had 9 on his schedule (half day) and the PA had 25. If you were given a copy of your orientation breakdown I'd bring it to your supervisor's attention. The next job I worked had a 6-week breakdown and each 2-week segment was categorized for specific goals and it all had to be signed off by my manager, so see if that's the case with you. Good luck!

[Racer15, BSN, RN]

I'm new to nursing, period. I was just licensed a few weeks ago and started in the ED last week. It's a little overwhelming for me as the charting system we use is not the same as other areas (the system I learned on in school), plus I feel like I am supposed to know a lot of basic ED stuff that we never learned in school. I am sure I annoy my preceptors, as I ask questions constantly, I take notes on everything and I still feel stupid. Everyone I've worked with so far though has been patient with my questions, and gladly talks me through things I'm not comfortable with. They call me "the student" lol, which I guess is fitting because the ED sure does make me feel like I'm still in school.

[ncaru01]

ICU is probably great experience for the ED though I had little experience going in but I didn't have a full assignment until probbaly 4 weeks in. It is very different than what they teach in school. I almost didn't make it through orientation but once I got out on my own it went much better. I just didn't work well with my preceptor and I couldn't keep track of what was going on because she would be doing stuff for me. 6 Months later I was much more comfortable and at 2 years I feel like I know what needs to be done on most patients.

[Rhi007]

The 'sink or swim' method seems to weed out those that thought they were 'ment' for the ER but really, when in a high and fast paced environment really don't cope.