Do new graduates RN's get ,easier patients?

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I'm about to graduate soon and will apply for a job obviously in the hospital (as my name suggest it).I was wondering how true is that at the beginning of their career/training,after orientation the nursing manager tries to assign more stable,easier patients to new graduates....and for how long or am I living in fantasy world?

Specializes in ICU/Critical Care.

When you are in orientation, you will start off with the more stable patients and work your way up to the amount of patients each nurse gets on the unit. When you are off orientation, you are expected to function like the rest of the staff nurses, taking a variety of sick and stable patients just like any other nurse you work with. I was never given the "easier" assignment because I was a new grad and neither will you.

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Specializes in LTC.

Our new grads go through an extensive orientation that lasts 2-3 months where the first two months they rotate all the med-surg units first, then they get their job assignments on the floor and spend another month in orientation on the floor. Through this they are working up from 1 patient to 4 or 5 depending on the shift.

Once off orientation they take the full load that everyother nurse on the floor takes. They have resources to help out, but they are still expected to pull their own weight.

I find that most of our new grads are VERY safe. Anything they are unsure about or uncomfortable with they ask about. I also work on the floor where team work is AMAZING.

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Specializes in NICU Level III.

The people most recent off orientation on my unit are always on admit and usually get the harder pts.

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Specializes in Emergency, Cardiac, PAT/SPU, Urgent Care.

When I have been assigned charge (in the ER), I would never assign a new grad to the more critical rooms until I was personally very comfortable with their skill set and knowing what they could handle. I think it is a very dangerous practice to give the new grads the more "difficult" patients because if something goes seriously wrong, the charge nurse can be held liable, too, since she/he made the assignment knowing that the new grad is less experienced. Yes, in a perfect world we can all jump in and help out the new grads, but how often does that really occur in a busy, fast-paced setting?

I think the best way for new grads to learn is to be allowed to assist with higher acuity patients while on orientation so that they learn how to handle such a patient without having the responsibility of being the primary nurse. I used to grab nurses on orientation if I had a code or an acute MI, etc., in one of my rooms so they could assist while learning what needed to be done.

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Specializes in Telemetry & Obs.
Excuse me,I think someone forgot how it is like to be a newbie,haha walkie talkie,I'm a senior nursing student and run around like a chicked with a chopped of head trying to take care of my patients.I dont even imagine having some down time while working in this stresful profession.The reason I want to take easier/stable patients is because I want to be safe not lazy if that is what you are implying.I guess nurses eating their young is still a very common thing!

You can only play the "I'm just a student" or "I'm a new grad" card for so long. Eventually you'll be expected to pull your own weight and quit whining about it...the sooner the better. If that's eating our young, then pass the ketchup!

Of course, that's the generic "you".

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Specializes in CRNA.
Excuse me,I think someone forgot how it is like to be a newbie,haha walkie talkie,I'm a senior nursing student and run around like a chicked with a chopped of head trying to take care of my patients.I dont even imagine having some down time while working in this stresful profession.The reason I want to take easier/stable patients is because I want to be safe not lazy if that is what you are implying.I guess nurses eating their young is still a very common thing!

Your nursing education, the skills you gain and the knowledge you learn is entirely dependent upon YOU. If you feel that easier/stable patients are the only ones you can handle because that makes you feel safe...fine. However, do not expect to get far in a hospital setting as your name implies. Hospitals hire nurses to be productive. Unfortunately, this is usually done by maximizing nurse to patient ratios. RNs, LPNs have to be capable of handling any patient admitted to their floor. If the patient needs do not meet the criteria for the floor or if the patient deteriorates....send them to a higher level of care. The nurse responsible for them should still be capable of providing care until the transfer occurs. After all, that nurse did go to nursing school.

Just imagine for a moment going to your first job interview as an RN.

You: "Hi, I want you to hire me to work on your floor, but I am only willing to take easier/stable patients because I want to feel safe"

Nurse Manager: "Have an nice day, NEXT candidate please"

As an added note.... As a SENIOR nursing student you should not be running around like a 'chicked(?) with a chopped off head' trying to take care of 3 or 4 patients as you have indicated in previous posts. You need to get yourself at a level where you are asking for higher acuity patients and functioning as independently as possible. This will make you more prepared to handle the real world of nursing where you cannot fall back on a guide to hold your hand if something becomes stressful.

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Specializes in private duty/home health, med/surg.

Since the easier/stable patients have been discharged home to make room for the patients sick enough to stay in the hospital, no one on our floor gets to take care of them.

The reality is that there isn't very often a patient load that won't challenge the new nurse (or seasoned one, for that matter). Don't go into your job expecting to be coddled. Nursing is hard work.

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Specializes in LTC,Hospice/palliative care,acute care.
Excuse me,I think someone forgot how it is like to be a newbie,haha walkie talkie,I'm a senior nursing student and run around like a chicked with a chopped of head trying to take care of my patients.I dont even imagine having some down time while working in this stresful profession.The reason I want to take easier/stable patients is because I want to be safe not lazy if that is what you are implying.I guess nurses eating their young is still a very common thing!

In a supportive learning environment you'll be as capable as anyone else when you are off of your orientation. You WILL need many months to learn time management. That's why you run a round like a chicken while others are taking breaks. This mindset seems to be common in the population of nurses now entering the field. Many think they are due the "easiest" patients and "best" schedules.I've seen several just up and quit over crap like being pulled or working a holiday or getting a crap assignment.. As someone else stated you can only play that card for so long then you have to start bring it to the table.If you don't know your butt from a hole in the ground your co-workers will find out soon enough and you'll be gone...

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Specializes in ICU, nutrition.
In my first hospital position as a new grad, I had all the easiest patients when I was on orientation because my preceptor was the charge nurse. When I was on my own, however, I was given the most difficult assignments because they were "good learning experiences". Most of these were patients with high acuity and I had never had the experience of caring for this sick a patient while on my orientation. I got the heck outta dodge pretty quick.

This is really not good practice. The charge should not be precepting as well. That's a terrible experience for a novice, especially when you don't learn the time management involved with busy, difficult assignment while you are orienting and then are expected to be able to handle it when you are on your own.

When I was a new grad, fresh off ICU orientation, I was left open to admit nearly every time I worked. I'd start with one patient and get another through the night. It helped me learn how to handle admissions and I got a variety of experiences with different kinds of patients. It also helped me with learning how to prioritize and stay "caught up" because I didn't know what was coming. I'd knock out the bath, dressing changes, and treatments early and keep on schedule with meds.

At the time I didn't like it but six months in I realized the CN who did that to me (Marla...thank you!!!!) gave me a HUGE advantage.

In that ICU, they split assignments fairly, IMO. After a year of orientation, you oriented to open heart recovery. Everything else was fair game both during initial orientation and as a new unit nurse off orientation.

In the ICU I recently quit, though, they'd give the 1:1 assignments to the new grads and the less critical patients to the more experienced nurses. It made no sense to me. It seemed like the longer I was there the crappier my patient assignments were. Isolation, multiple IVPBs, trachs, call bell abusers, crazy families, climbing out of bed, and on and on and on. I'd be drowning and some "kiddo" would be sitting there waiting for her heart to come out. :banghead: But I digress...

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So now I'm begging to understand high turn over rates.

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The short answer, no we don't. I am a new grad still on orientation at my hospital and I do not get any easier patients. I am still not getting a full assignment, but the acuity is no less. Each week I get more patients and in 2 weeks I will be up to a full assignment. Depending on our census, that is 3-4 patients on day shift and 4-6 on nights. Not too bad from what I have read on other posts.

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Your nursing education, the skills you gain and the knowledge you learn is entirely dependent upon YOU. If you feel that easier/stable patients are the only ones you can handle because that makes you feel safe...fine. However, do not expect to get far in a hospital setting as your name implies. Hospitals hire nurses to be productive. Unfortunately, this is usually done by maximizing nurse to patient ratios. RNs, LPNs have to be capable of handling any patient admitted to their floor. If the patient needs do not meet the criteria for the floor or if the patient deteriorates....send them to a higher level of care. The nurse responsible for them should still be capable of providing care until the transfer occurs. After all, that nurse did go to nursing school.

Just imagine for a moment going to your first job interview as an RN.

You: "Hi, I want you to hire me to work on your floor, but I am only willing to take easier/stable patients because I want to feel safe"

Nurse Manager: "Have an nice day, NEXT candidate please"

As an added note.... As a SENIOR nursing student you should not be running around like a 'chicked(?) with a chopped off head' trying to take care of 3 or 4 patients as you have indicated in previous posts. You need to get yourself at a level where you are asking for higher acuity patients and functioning as independently as possible. This will make you more prepared to handle the real world of nursing where you cannot fall back on a guide to hold your hand if something becomes stressful.

I'm a senior nursing student with two days of clinicals (couple of hours).How on earth the health care system expect the new graduates to take high acuity patients,with so little practice beats me and reminds mysterious to me (not to mentioned with did one semester of psych,OB,peds,and many times we dont have the opportunity to pratice skills that we "productive" new generation nurses suppose to master while in nursing school.......The reason I run around like a mad woman in clinicals is because I still have to do bath baths,all 9 yards of care,and I dare you to mention to my instructor you are not a CNA,but graduating nurse,she wil eat you alive and write you up for being stuck up little nurse.We actually dont get enough clinical exposue,and that is why it is simple insane and unrealistic to throw us to water and expect us swim or sink,ok some can do it but many cant!!!!!! and the New RNs leave to seek more safe envinronment,then go to psych or work in doctor office for little money.

It is insensitive to expect new RNs to know what the seasoned RN knows,we are not talking about learning cash register we are talking about human life.And as someone else mentioned give us the pay of the seasoned nurs if you expect us to be so knowledgable,not that I'm money hungry,but you get my point.

Also I cannot believe what I read on this board sometimes,like people saying they became nursing managers within a year of their newly started career,oh my God I had to ask was that comittee right in their mind????Just because someone has a bachelor but is freshly out of schoo,that doesn mean they l deserve to be picked over seasoned nursewith Associate degree but extensive experience.Flame me all you want.

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