Difficult orientee

[jenvankempen]

Hi everyone. I am a critical care nurse. I love my job and everything that comes with it from my fellow staff members to the puzzles of patients. I was given an orientee who will be transferring to the ICU after 8 months on the floor floating between med surg and tele. DUring her two weeks with me, I noticed some red flags. She has a lack of interest in new things ( a code was called and when I told her to jump in she responded with "do i have to?") She has a very blase' about the ICU. Because it was her first two weeks in ICU, the two of us had fairly simple patients, liver failure and respiratory distress/ pneumonia. This was perfect for her to time manage two patients with a lot of charting. She was drowning, even with constant reminders and prodding (and I do realize time management does take time) But most concerning was her lack of basic learning skills. Inability to read basic ekg, what labs pertain to what, what some medications are for, placing a pt on NC at 15L, skin checks, etc. I am concerned enough to give me supervisor a little heads up but i'm unsure how to write an email regarding this type of situation without coming off like a bully. Can anyone give any advise how to word these concerns in a professional manner?

thanks in advance for your help!

Jen

[msteeleart]

Maybe she doesn't like floor nursing but she wants to get that magical year of experience behind her. Not everyone is cut out for med/surg or ICU but all the instructors pressure you as a new grad to get that year of experience on the floor. A year is a long time to do something you have no interest in. I am going straight into community psych nursing because I really don't enjoy med/surg. I tried to get that year of experience just to get it out of the way but hospitals around here won't hire new grads unless you know someone that can hand them your résumé.

[lmccrn62, MSN, RN]

If that is her attitude the unit needs to cut their loses. I would sit with your manager and discuss the situation. She should then be brought in to discuss the issues and develop a plan. If she doesn't comply say goodbye!

[One1, BSN, RN]

Is she learning what she doesn't know at home? IF (a big if in my opinion) her attitude is a sign of insecurity and anxiety rather than disinterest then she would be studying at home to fill her knowledge gaps. If she still does not show improvement in her lab values/EKG skills then you know that she is not interested in advancing.

[canoehead, BSN, RN]

I'd be interested in what she's doing at home. Is she looking up everything she was unsure of, or buying texts? Perhaps she felt ICU would be easier, since it's a 1-2 patient assignment. She doesn't realize that she needs to double her knowledge, and be willing to put in some hard work on organization.

In the end, if she's someone that needs to be told specifically to do every little thing, it's not going to work out. She has to self identify learning needs, and patient needs and jump right in. You can't just follow a prewritten care plan in ICU and expect the patient to be alive in the morning.

[dirtyhippiegirl, BSN, RN]

Sounds like she's putting in her time until she can get into NP/CRNA program. One of our (very high acuity) SI nurses was complaining to me about how their new grads don't want to get dirty and don't really care because they're putting their time in before -- usually-- getting into a CRNA program.