Day 8 and I'm expected to take 4 patients?

calirn05 · Aug 18, 2005

After reading all the replies, I'm starting to worry about what I got myself into. They keep telling me "ask questions of anyone, there's not one person here who wouldnt help you". But you are right, I have worked hard to earn my RN license, I dont want to jeopardize it. I was hired for nights and was told that the load is usually 4-5 per nurse. Well everyday I see on the board under the night nurses' assignments about 6-7 patients each for the experienced ones. The LVN training right now, hired the day as me, she's taking 4 starting tonight.

I'm training days for another 3 days then I go to nights. They tell me "call for help, ask questions". Doesnt sound like orientation to me.

So tell me, how many patients should an orientee take, and how long is an expectable orientation? How long with a preceptor? And having a preceptor, does that mean she's just there for me, checking on me, helping me, or am I helping her with her patients, and not taking my own?

Thanks for all your replies, I have alot to think about. One last thing, how bad does it look to the next place I apply, if I do chose to run? I hate to look like a quitter, but I dont want to jeopardize my license or harm anyone.

Cali

christvs, DNP, RN, NP · Aug 18, 2005

Hi CaliRn. I'm a new RN in my 4th week of orientation (I'm doing 40 hours/week). We're orienting on the day shift now (for the first 6 weeks) & then I'll orient for 6 more weeks (total of 12 weeks) on my 3-11 shift. My first day I shadowed my preceptor. The second day I had two patients on my own & had two patients on my own up until the end of last week. Since then I've had 3 patients on my own-but one of the three patients i've had all of this week is such an insanely involved exhausting patient (although-a really good learning experience I have to say with 25+meds to give-Po, IV push, IV antibiotics, creams, powders to mix, a PICC line, blood sugars, CPM machine, you name it!) that I felt crazy & frazzled today. And in the course of my 4 weeks of orientation, I've worked with NINE different preceptors-really! But honestly, I've been basically on my own from day 2. My "preceptor" for the day is there for me to ask questions, but I end up doing most things by myself. i'm fine with that though (for the most part) because i'll just ask any nurse who is around if I need help with something or some new procedure I have not done before. I guess I'm just used to how it is on my floor-everyone is helpful & nice when I ask my questions-& I have really learned a lot by doing it on my own (like admissions, discharging patients, IV pushes, hangin up antibiotics, etc) But even though I feel I can do a lot now, I'm still all frazzled when I have nutty days like today when I am constantly running around trying to get things done.

-Christine

BETSRN · Aug 18, 2005

Am I the only one who finds it a bit troubling that only after 5 days this brand new RN is taking her own load???? What ever happened to adequate orientation??? Heck, my first job when I was an LPN was as a med nurse and I got a 4 day orientation...just to pass meds all day!! :uhoh21:

You're not the only one. This is crazy. I am in CT where new grads get about 12-16 weeks of orientation. Now they will move into patient care but will do so slowly.

I precepted a nurse (new to us but had over 15 years experienc) and she still got about 12 weeks. We don't expect our brand new nurses to L&D to even begin to feel competant (and be able to do any part of a labor alone) for at least 4-6 months.

I ahve said it before that this gross lack of orientation is what is burning out our new grads (and nurses new to an area).

Tony35NYC · Aug 19, 2005

Hi-I am working my first RN job on a med-surg floor and had a preceptor for 5 days. The past 3 days I was on my own but was encouraged to ask lots of questions of anyone, "everyone will help you". Well these 3 days this week, 2 of my 3 patients had between 12-14 9am meds and with checking the dr's orders with the MAR on those, doing assessment, charting, running around for each of them, dressing changes, I am swamped and find myself about 45 min behind each morning on my meds. I didnt grab a bite to eat until 6.5 hrs into my shift. Well one nurse, the one who precepted me last week said when I turned down the offer of a new admit this morning when I was bogged down, said "you gotta take four sometime". Well is "sometime" being day 8 and trying to keep my head above water, enough time? They sure are pushing me to be as good as the rest of them in only 8 days!

It is not a secret that some unit managers will try to cut you loose after a short orientation period because they are trying to save money. But, if you feel that you are not yet up to par then you should ask for more time. Besides, eight days is FAR from enough time for any new grad orientation. You need months, not days, of orientation when you are a new grad. You need to speak to your unit manager about this.

grinnurse, RN · Aug 19, 2005

CALIRN-

The way my orientation/preceptorship went was I had it for 6 weeks. The 1st and 2nd shift, I shadowed the RN and assisted where I could. The 3rd day I took one pt, and with each shift I worked I took more responsibility to where at the 3rd week I was taking 4 pts. At that point for the remainder of orientation I had 4 pts and the preceptor "shadowed" me. All the while I was asking tons of questions of all the nurses that I was precepted to which I thought at the time stunk, but, have realized that I learned alot of different things from each of them.

IMHO I don't think the next place that you worked would frown upon the fact that you left for the reasons that you stated-being worried about pt care and your license. In the long run, you would be saving a hospital money from possible lawsuits not to mention the fact holding onto that hard earned degree!! I have been a working RN since June 13th and when they told me I would only be getting 3 (9 shifts)weeks, I was in tears talking to the nurse manager telling her that I was NOT ready to be on my own. Heck, at that point I was still wrestling with the pumps, lines, etc. Luckily, I have a great charge nurse and co-workers who stood up for me. I was ready to walk if they refused to give me the full time. My license means so much to me not to mention my family who sacrificed right along with me to get it!! If you can see on the board what's going on with the night nurses and they are taking 6-7 pts, that's what's going to be expected of you too when you get there!!

Good luck and continue to let us know how it's going ok.

calirn05 · Aug 19, 2005

Thanks so much for your replies. I had a long talk with my manager today and she did not want to lose me and has me set up to work side-by-side with the nurse educator all next week and keep me paced. We will re-evaluate after next week. I know it's only one week, but now that they know that I felt like I was drowning and not being safe, they slowed down and spent more time with me today and offered more help. I hope this made a difference in my orientation.

Cali