Eek! Almost done with orientation

[Listeningbee]

I am a new-grad, just starting my first job in inpatient psych, and so far I am loving it! I have about three weeks left of orientation, and while I am learning lots, I imagine there may be things I do not have a chance to practice before I am off orientation and on my own. From your perspective, once a new hire is off orientation, are other nurses still willing to help guide them when situations arise where the new nurse doesn't have much experience?

I am an eager and fast learner, but I also like to make sure I'm being safe, and therefore often ask for help if I am unsure. Is it still ok to ask for help with unfamiliar tasks even when I'm off orientation? I think I know the answer is yes, but I suppose I'm more wondering how seasoned nurses actually respond to new nurses asking for help. Will they continue to teach me, or feel annoyed? Suppose it depends on the individual, but still

curious for your thoughts. Thanks!

[Ruby Vee, BSN]

How do seasoned nurses actually respond to new nurses asking for help? It depends. It depends upon the new nurse, the seasoned nurse, the situation and your reputation.

In general, most seasoned nurses continue to mentor and teach new nurses. We all know that learning doesn't end on your last day of orientation, and the best among us don't stop learning until the last day of our career. As you're nearing the end of your orientation, your preceptor should be helping you to identify your resources for when you're out on your own. Don't rely on other new nurses for help or advice; I've seen more situations where a new nurse asked another new nurse who didn't know but didn't want to admit it and the two of them made bad decisions and worse mistakes. Identify senior nurses who seem willing to help. At the start of every shift, look around you and identify your resources. Olga may be an ornery old witch, but if she's the smartest nurse around, screw up your courage and ask HER rather than the popular yearling down the hall. You owe it to your patients to get the right answers, not just the easy answers. There is an Olga in every workplace. One of the worst ones I've ever met was working in a Holiday Inn restaurant when I was working my way through nursing school.

No experienced nurse is going to be cheerful about helping you if she's drowning. Most of us will help, but try to choose your timing if you can. The nurse who is up to her elbows in poop may not give a thoughtful answer to the question "Is Clindamycin compatible with XXXX drug?" (You know to offer to help with that, don't you?). The one who is running to a code isn't the one to ask for a second opinion on those lung sounds. Be aware of what's happening around you and never ever bash the senior nurse for not answering your questions when she's having problems with her own assignment.

I'm sure this doesn't apply to you, since you're asking the question. But there are newbies to whom this does apply, and this is for them: Ask intelligent questions. If you have a reputation for being "helpless", senior nurses aren't going to go out of their way to help you. If you consistently ask for help before you've even evaluated your problem and looked for your own answers, you won't be a priority when you ask for help and some will tell you to ask someone else.

The wrong way to ask a question is "Help! How do I do a Foley?" The right way would be "Mr. P has an order for a Foley. I've read through the procedure and I think I have everything I need, but I've never done this before so I'm wondering if I can ask you a couple of questions before I start." It's even OK to ask the senior nurse to go into the room and help you. EVERYONE "misses" a few times, especially on obese female patients. Most experienced nurses will talk you through the procedure and offer up their own tips.

The first year of nursing is tough and it takes that long to start to become comfortable in your job. It takes two years to be competent. As charge nurses and preceptors, we know this. We watch out for the newer nurses on our unit. The charge nurses will try to give you an assignment that is within your fledgling nursing abilities and geographically near someone who can answer your questions. Your former preceptor is watching out for you, ready to answer your questions and answer questions you haven't even thought to ask because you didn't know you'd screwed up your I & O or your transfusion vital signs or your prn pain medication charting. The "guest preceptor" you worked with once for 12 hours six weeks ago knows your name, is aware of your inexperience and is keeping an ear on your assignment so she knows when you need help, even before you do. The nurse who gave that lecture on balloon pumps to your group may call you into a room with a balloon pump patient and show you how it works or, more importantly, when it isn't working and why.

I'm sorry this got so long. The short answer would be seasoned nurses will try to teach you even when they feel annoyed, and as long as you're doing your part, their annoyance is not your problem. Good luck. I'd love to hear that you're doing great and loving your job.