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 Cardiac Telemetry, ED.

Scrubby,

In theory I agree with you, but what we think "should" happen and what really happens are two different things. I cannot believe some of the patients that were assigned to me when I was brand new, and I was too green to know better at the time. If I were ever in a charge nurse position, I would definitely keep that experience in mind when making assignments. However, sometimes it's out of the charge's hands, like when the unit is so understaffed that all but a couple of nurses are floats, or when new grads make up 80% of the unit's core staff.

I would love to see extended training programs for new grads, and there are a few hospitals in the US doing this, but I don't believe it is the norm.

As much as I would like to tell lovehospital or any soon to be grad that they will receive a lengthy orientation and will be given patient loads appropriate for their skill level, I cannot make that promise, because I don't think it's very likely. It certainly hasn't been my experience.

The next phase for lovehospital is what we call "reality shock", when she is thrown out on the floor to sink or swim, and she realizes how woefully inadequate her nursing school preparation was for the reality of being an actual nurse. Hopefully she will learn how to make allies of her more experienced coworkers, because they will be her resource and support system.

Yeah, it seems wrong, but it's reality for many of us.

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Specializes in Operating Room Nursing.

I'm not saying that we get babied or anything like that in 1st year, far from it. But the expectations of new grads in Australia seems to be different from what's going on in the US. I can't understand how anyone can justify giving a brand new nurse the same patient load and acuity as a someone with more experience.

I guess all I can recommend Lovehospital if they 100% disagree with the way graduate nurse system is to come over to Australia, do a graduate nurse program.

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Specializes in Cardiac Telemetry, ED.

I don't think any of us are justifying it, just explaining the way it is. I think you raise valid points.

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Specializes in ICU/Critical Care.
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.

I was never babied. Period. I worked on a stepdown with vents and drips and as soon as I got off orientation, it was a free for all. They didn't pat me on the head and say "here new nurse, here's your assignment, they aren't too acute"...No, I had two vented patients who were total care plus two other patients of varying acuity, mostly bedridden. They didn't care. But you know, I learned and I had to do it the hard way. It sucked but I think it made me a better nurse for it. I stuck with it, didn't give up and quit. No one cared that I was a new nurse, they expected that I function just like the other RNs who had more experience than me. And they couldn't taylor my assignment to fit my skills because had they done that, the other nurses would have most, if not all of the total care patients.

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Specializes in Operating Room Nursing.
I was never babied. Period. I worked on a stepdown with vents and drips and as soon as I got off orientation, it was a free for all. They didn't pat me on the head and say "here new nurse, here's your assignment, they aren't too acute"...No, I had two vented patients who were total care plus two other patients of varying acuity. They didn't care. But you know, I learned and I had to do it the hard way. It sucked but I think it made me a better nurse for it. No one cared that I was a new nurse, they expected that I function just like the other RNs who had more experience than me.

See I read what you wrote "no one cared that I was a new nurse, they expected that I function just like the other RNs who had more experience than me" and to be honest this sounds alarming to me. I wouldn't want to be a patient in a health care facility with this sort of culture amongst the nurses. It's great that you managed to survive this experience but the unit sounds completely unsafe for patients.

I'm not arguing that new grads should be pat on the head and told they haven't got too acute patients. What I'm arguing is that the role expecations from what you and others here have described sound completely unrealistic. Until nursing schools can churn out grads that can function like an RN with years of experience they need all the help they can get in making the transition from student to nurse.

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Specializes in ICU/Critical Care.

Maybe it's different at other hospitals. Where I worked when I graduated, they just didn't care. And I was a new nurse and didn't want to leave because thats where I had worked as a CNA so I was comfy because I knew everyone and I knew the unit.

And on top of having the stress of being a new grad, I had to deal with the CNAs who thought I could do it all because I was a CNA once myself. Maybe I made a mistake staying there for 5 years total. 3 as a CNA, 2 as an RN. But hell, I was scared ********. I thought, if it's bad here, it's bad somewhere else.

The problem with nursing programs is that its almost like "just the basics"..how about throwing the students into some critical care. I never had that. And the hospitals where we were at for clinicals didn't exactly foster education. Even in the ICUs at the smaller hospitals, the nurses didn't want to deal with you or show you anything. My ICU "experience" in school consisted of me sitting on my duff with no one to talk to because the nurses didn't want to deal with me. I was in their way even though they were sitting most of the time. Talk about uncomfortable. I had to do that for FIVE hours.

My point is it would be nice for these schools to offer more hands on opportunities.

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Specializes in Operating Room Nursing.
Maybe it's different at other hospitals. Where I worked when I graduated, they just didn't care. And I was new and didn't want to leave because thats where I had worked as a CNA so I was comfy because I knew everyone and I knew the unit.

Imagine then that you hadn't worked there as a CNA and knew the unit. Do you think you would have coped as well as you did?

Not caring and fostering new grads is not long term thinking. If you invest time and support you just may keep a nurse in the profession that would otherwise leave from burnout, going somewhere else where people do care, going into another profession.

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Specializes in ICU/Critical Care.
Imagine then that you hadn't worked there as a CNA and knew the unit. Do you think you would have coped as well as you did?

Not caring and fostering new grads is not long term thinking. If you invest time and support you just may keep a nurse in the profession that would otherwise leave from burnout, going somewhere else where people do care, going into another profession.

No I probably wouldn't have coped well. And let me tell you this. In the five years, I worked there at least 15-30 nurses jumped ship. By the time I quit that place, I was burned out, on the verge of a nervous breakdown and ready to throttle someone. They didn't make things any better when newbies got better reviews than me and I put in all this OT to help them out. I said forget it. I'm done. I found another job and then resigned.

And the reason I'm saying that they didn't care is because the patient was NOT the bottom line. The care wasn't the bottom line. The bottom line was the budget.

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Specializes in ICU/Critical Care.

I need to go bang my head against a wall, I'll be right back.

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Specializes in NICU Level III.
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!

It's definitely not a place to be standoffish. Nursing is very much teamwork..that's why you do so many group projects in school! If you don't get along with your coworkers, you're going to hate your job.

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Specializes in ICU, ER..

If you have a good preceptor, getting harder patients should be better. As long as the preceptor understands that you are green and guides you in the right direction, you will be ok But not all preceptors are great. You will learn a lot from the more complex patients, but most places are pretty good about not slamming you with the most complex people. If I were you, I would want the harder ones, because you will remember the most about what you did with them, and it will stick in your brain like glue, preparing you for future run-ins with similar, difficult patients. Trial by fire! Good luck with your career!

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Specializes in tele, oncology.
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!

This makes me feel kinda sad for you...some of my best friends are people I work with. We hang out whenever we can, call each other on our days off, e-mail and text each other fairly often, and know all about each others kids and families. But I'm one of the lucky ones who works in a fairly good environment, despite management's best efforts to toxify it.

I hope that you will find a job right off the bat that's in a good environment with a great orientation and competent, patient mentors. Unfortunately, with the culture of the bottom line being the most important, those kinds of jobs seem to be few and far between. If you wanna come to St. Louis and work with me though we'd show you how new grad orientation and mentorship is supposed to be done :)

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