Feeling down; Received first bad evaluation

umcRN, BSN, RN · Oct 29, 2012

our new grads get a 6 month orientation, so 3-4 months doesnt seem that adequate to me anyways. At two months we want our new grads charting everything, starting to talk with doctors and starting to use critical thinking more but at 8 weeks I don't think thats a time (on my unit anyways) to truly judge whether the orientation is going that well if you can't yet handle two patients at once. Take the extra time, it's only going to make it easier for you to get off and don't worry about it just work on the areas they want you to improve. Critical care is a very hard place for a new grad to start

Sinman · Oct 30, 2012

Getting straight A's is really no indication of greater intelligence or an indication that you will be a better nurse. I am still a student but I agree with the previous poster that 3-4 months of orientation seems short for a critical care setting. Don't be too hard on yourself you want to be a good nurse and say you love the job I think you will do great and take the opportunity of extra training to learn as much as you can it will only help you in the end

Steph

Sloan RN · Oct 30, 2012

Your orientation is only 8 weeks?! I agree with previous posters, that's really short...new grads on my unit are on orientation for 4-6 months. How's the retention of new grad hires on your unit? Do a lot of them leave shortly after coming off orientation?

Kooky Korky, BSN, RN · Oct 31, 2012

Hey everyone,
I have been working in a pediatric Cardiac ICU for the past 8 weeks as a new grad. I love my job and the fact that I am learning new things everyday! I just had my first evaluation today and it was not the best. They are extending my orientation by 2 weeks so I am on orientation for 8 more weeks. While I do understand why they did it (I need to read more and get better with handling 2 patients AND just to be extra safe), at the same time I can't help but feel defeated and not smart enough to work there. I was never the straight A student so I am not very smart and having this makes me feel like I don't deserve to work in such a great unit. Any pick me ups/advice?
Thanks!

How bad is "not the best"?

Did they give you specific things to work on? Are you getting enough rest & refreshment in your private life?

You are smart enough to know that you need more study and learning. That's the beginning of "smart". Getting A's in school doesn't really translate to A's at work, so quit telling yourself you're dumb. Soon enough, someone will be seeing you as the expert, not the novice or even the beginner or semi-expert.

Don't get into thinking you don't deserve to work where you are. Just start counting your blessings and do that several times each day.

Make a study plan. What topics do you need to study? I know you probably think you need to study everything. Well, just make a list. And when will you do this? Each evening after work? And several hours on your days off?

Do you need more hands-on with various equipment? More practice charting? Assessing? Other areas?

Make a specific plan of attack. Ask for feedback each week, at least.

Start imagining yourself orienting another new grad and make a curriculum that you would want her to master. When we teach a topic, we really learn it.

Best wishes. Oh, BTW, it takes a solid year to feel good on a job.

harryalexx · Nov 1, 2012

Like everyone else has mentioned, 8 weeks is such a short period of time in the grand scheme of things! The orientation the new hires on my unit get STARTS at 8 weeks, and goes from there. It's kind of an expectation that everyone comes with different experience and learning styles. I work peds cardiac ICU, and it is a very tough job. The learning curve is gigantic! Be easy on yourself, friend :up:

As for how to improve and get more efficient, try asking a preceptor/charge nurse/experienced RN their opinion. The managers get their information from these people and are forming an evaluation based on the collective response. Go to the source and figure out areas that you can work on. For what it's worth, 2 patients in a CICU is very tough. The acuity and pace of the patients is unlike anything else. I would recommend getting very familiar with the routine meds on the unit...major safety issue and tends to slow newer nurses down. Also take a bit before starting your shift to choose the most important things to do. Separate out the "do by the end of the shift" stuff from "Oh crap! I needed to do that 10 minutes ago!".

Finally, of course you need to know defects. Cincinnati has a good interactive website for the defects and their repairs. Or maybe your hospital has an internet resource. You don't need to know every surgical intricacy at this point, but major nursing considerations as well as "trace the blood" type of stuff.

Stick with it :) This is a super rewarding area to work. And in a year, you'll see how far you've come!

dankat · Nov 6, 2012

Thank you everyone!!

First let me clarify the time of orientation:

We do 6 weeks on a the step down unit and then 14 weeks in the ICU. So it still is quite some time. I now will be doing 16 weeks instead of 14.

my strengths have been great charting and keeping up with my "tasks". It is just that when the unexpected happens, I get thrown off a little bit.

I am taking all of your advice and thank you for the encouraging words. I have made a list of topics to study by studying the previous patients' diagnoses. So if I had an ASD that day, I will read about the surgery and diagnosis the next day. I figure that's the only real way to tackle so many of these cardiac diagnoses. I think the problem I had (after coming down from my initial shock) was that my preceptor would tell me I was doing a great job every day and then have such an evaluation; Basically my boss did not think I was independent enough to be on night shift and I have been working on that!

I have asked my preceptor to step back and not jump unless she sees something grossly wrong and allow me to talk to the doctors myself. I realize to work in such a unit I have to really use my critical thinking skills so it was hard to not compare myself to my friends on med/surg floors who are already off orientation. I am happy to announce that as long as I keep on track, I start nights this upcoming Sunday. I will keep everyone updated.

harryalexx · Nov 7, 2012

Good luck, dankat! It sounds like you have a good head on your shoulders.

natashakin · Nov 13, 2012

It is very stressful area.

Dont be surprise that, every friends of yours are getting promotion faster than you do in other department.

The workload is hectic all the time. It is crazy if u wanna keep up with the nursing documentation, nagging of ur charge, and completing all the nursing care for ur patient.

If you think you cannot constantly handle complains, rejections. Or your team or charge or manager not being supportive. I suggest you to leave this area.

Definitely "lack of knowledge" is not an obstacle, as long as you are willingly to learn.

And remember this is not just only an area for you to reach to the top.