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

Turnover has a lot to do with the culture of the unit.

I have a job where I go all over the hospital now. I have the opportunity to see every floor, and I notice which ones have a stable staff of nurses and aides. (Now, granted this is day shift only). The floors with the lowest turnover aren't the easiest, but they have nurse managers who support their nurses and who are in there along side the staff doing what needs to be done to take care of the patients. They don't throw the nurses under the bus if there's a complaint. They don't belittle their staff if the Press Ganeys are down...they figure out what needs to be done to improve them. They work hard to give their nurses what they need to get the job done. They put on scrubs and take care of patients when that's what needs to be done. They don't allow the "seasoned" staff to eat the new staff. They nip problems in the bud instead of letting them fester and grow.

The floors with the highest turnover have the hands-off nurse managers. The ones who show up weekdays only, in business dress and heels, and stay in the office all day. The ones who don't even come out to answer the phone when the unit secretary is sick and there are 10 new admissions. The ones who haven't touched a patient in years, who allow the bully to run off every new nurse and make the new grads not even want to apply to that floor.

I've worked for both kinds of nurse managers, in the same unit. I watched that place go from the elite place to work to absolute chaos. I'm sure management was not the only factor, but it was a big one.

Culture is the key. It's not just nursing, but everywhere.

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Specializes in ICU/Critical Care.

I agree with Whipping girl. Turnover has more to do with the culture of the unit rather than getting the easier assignment. I worked on a ICU stepdown with crappy ratios and watched 30 nurses leave over 5 years. The work environment was toxic to say the least. The culture of the unit made people leave, not the assignments. On a stepdown, you have to expect the acuity to be higher because patients are sick.

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Specializes in tele, oncology.

In order to be a successful new grad, there are a few key needs in my opinion:

1. You must be willing to continue to learn. I've been in healthcare for a decade now, been a nurse for nine years this month, and I still come across stuff that I don't know. I carry a binder to work with me that I put printouts about all the interesting stuff I come across into.

2. You must find a supportive environment to work in. This does not by any means mean a place where you will be catered to or coddled. This means a place that has staff that is willing to teach and is supportive, which also means sometimes they'll tell you things you don't want to hear.

3. You must be willing to accept criticisms, and to put forth the time and effort to reflect on what your shortcomings might be and how to fix them.

4. You must be willing to step outside of your comfort zone, or you will never be successful.

5. You must be willing to pull your own weight. There is a profound difference between "I'm new, can you show me/explain to me how to do this" or "I'm not exactly sure what's going on with my patient, can you take a look" and "I'm new, so I shouldn't be expected to be able to do this job."

You're right, humans aren't cash registers. That's why so much is expected of nurses and why the learning curve is so steep. It does not matter what environment you are in to start, or as you progress through your career, there will always be a little "sink or swim" as you start in a new place. Those who are smart enough and willing enough to learn, work hard, and adapt with grace under fire are those that are the best nurses. Those who can't are the ones who create more work for others, endanger patients, and continuously question why they are nurse to begin with. A lot of which kind of nurse you'll become depends on you.

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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.

You haven't even graduated or gotten a job yet. Why are you getting so riled up before you even know what kind of new grad orientation you will get? You aren't expected to know everything right out of school. You might land a job with a great orientation. Many hospitals give new grads 8-12 weeks, at least where I'm from. At my hospital, we get classroom time in addition to time on the unit. I felt as prepared to be on my own as I possibly could have at the end of my orientation. You will learn so much more once you are off orientation as you develop your own style of nursing and time management. You have to be willing to put in the hard work and be open to the direction and feedback from your preceptor. There are plenty of new grad nurses who make it! All nurses were new at one point.

Nurses DO give bedbaths, take vital signs, do finger sticks, etc. It's not just CNA work. It's the nurses' work. The CNAs are there to help us with those tasks when possible. I wash up my own patients everyday, as do the other nurses I work with. You have to learn to manage your time in order to get it all done.

I've never heard of someone becoming a nurse manager after one year of experience. I wouldn't work on a floor like that. The managers at my hospital have Master's degrees.

You have a few weeks left of nursing school. Make the most of it! Take the initiative to learn all you can and seek out tasks in clinical that you don't have experience with like dressing changes or new equipment.

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Specializes in Telemetry & Obs.
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.

Awwww, am I sensing a bit of panic??

lovehospital, you're no different from the tens of thousands of nursing school grads entering the work force each year. If they can do it, why shouldn't you be expected to?

Btw, there honestly isn't that much of a disparity between new grad and experienced nurses wages. I was surprised to find out what some nurses with 20+ years of experience make on the floor. THEY'RE the ones with the legitimate gripe!

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Specializes in ICU/Critical Care.

I don't really know how you expect to learn if you are just taking the easy patients when you are off orientation. It's good to have an assignment with patients of varying acuities and getting yourself a routine and becoming organized. If you are more concerned about getting a break and having "easier" patients once off orientation, you are not going to be making many friends and the last thing you want to do is alienate your co-workers to the point where they won't want to help you.

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Specializes in Med Surg, Ortho.

NO they don't.

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I don't really know how you expect to learn if you are just taking the easy patients when you are off orientation. It's good to have an assignment with patients of varying acuities and getting yourself a routine and becoming organized. If you are more concerned about getting a break and having "easier" patients once off orientation, you are not going to be making many friends and the last thing you want to do is alienate your co-workers to the point where they won't want to help you.

First of all a hospital is not a place to make friends,it is a place to fulfill your obligations as nurse and punch out and go home and then make some friends.Anyway decide,is it really wise to make friends in a hospital since it it is a place of a toxic environment about which you mentioned in your previous post,I just want to be treated professionally and fair,that is my one and only standard and expectation.And no,definitely I dont care about breaks too much and they are not on my priorityllist although nothing is wrong with taking care of your body (Maslow Hierarchy of needs).However I am not looking for an easy ride ,or I definitely would not pursue a career in nursing,so you got that wrong,I think anyone who decides to join nursing definitely enjoys chalenges.All I'm asking is for a safe learning envinronment,patience so I can make a safe transition into becoming a competent as well as productive nurse but I doubt that will be happening,oh well it is good to be dreaming!

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Specializes in ICU/Critical Care.

If you want to be treated professionally and fair, then when you are off orientation, expect to have the same type of assignment as any other nurse on your unit.

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Specializes in Cardiac Telemetry, ED.
First of all a hospital is not a place to make friends,it is a place to fulfill your obligations as nurse and punch out and go home and then make some friends.

Nor is it a place to alienate the people you will count on to support you in the transition from student to working nurse.

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Specializes in Operating Room Nursing.

I 100% believe that new graduates should get the more stable patients, then move on to more challenging patients as they gain more confidence. I think it is completely unsafe to put a new grad with an unstable patient. It just doesn't make sense, it is UNSAFE and if the new grad is smart they'll be asking more seasoned nurses for help all the time which just puts more workload onto the other nurses. I'm not saying that new grads should have it easy but if we want to retain new nurses, promote morale and teamwork then we have to give them all the support they need. Otherwise we have nobody to blame but ourselves for the nursing shortage.

In Australia we have pay differentials, a new grad earns much less than a nurse with 20 years experience. Each year up until your ninth year you go up a pay bracket.

We have graduate nursing programs in hospitalswhich run over 12 months that allow new nurses to do 2-3 rotations in the hospital, with extra support during your first year such as study days, a team of preceptors etc. I found this incredibly helpful and I really believe this system needs to be adopted in the US, given some of what I've heard here on allnurses about lack of support and mentorship during first year, even people getting fired in first year which is practically unheard of in my state. While it is not a perfect system, it's better than expecting new graduates to take the same acuity as seasoned nurses.

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Specializes in Operating Room Nursing.
If you want to be treated professionally and fair, then when you are off orientation, expect to have the same type of assignment as any other nurse on your unit.

How on earth do you expect a new grad to have the same level of knowledge on looking after an unstable patient than a seasoned nurse? Does this knowledge and experience magically enter ones head after obtaining an RN licence? Damn, I must have missed out somehow.........:banghead:

Anyone who doesnt' allocate patient load according to skill mix IMHO is not doing the best by the patient, the new nurse and the profession as a whole.

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