First 2 weeks as a nurse - The impressions of a newbie.

[clee1]

Hey folks!

As some of you may know, I am a newly-graduated and licensed LPN. I was hired at my local hospital on a Meg/Surg floor, and have completed the first two weeks of an orientation period of indeterminate length (I'll be turned loose on my own when the NM, my preceptor, and myself all feel that I am ready - not before). I wanted to report my impressions of these first two weeks to any who might be interested.

So far, the pace has been reasonable. My preceptor and I have had no more than 4 pts at a time, and at least one of these has been scheduled for discharge each day - also, the first admission after a discharge is ours as well. It has been explained to me that this is d/t the need to learn both admission and discharge procedures fully. Also, we share a tech with two other nurses, so I have extra time to worry about charting in the computer instead of constantly dealing with "code brown's". LPNs here do everything the RNs do except admission assessments and careplans.

My preceptor is an uncommonly capable LPN with more than 30 years experience. In our first 30 minutes together she assessed my comfort level and skills levels (I have some prior healthcare background), and then asked me three questions: 1) What is it that you expect to learn from me? 2) How best do you think you'll learn them?; and 3) What skill/area/procedure set, etc. do you think is your weakest?

I answered her just as directly. "My skills and basic knowledge level is pretty good, and I am comfortable dealing with patients, but I will have the most trouble with unit and facility P&Ps, and the specific way we computer chart and document meds. I desperately need a good understanding of the work routines and expected duties. As to how I learn best, I wish you'd throw me in the deep end and be standing immediately by to toss me a life preserver as needed." So... that is how we're doing it.

The first day, I mostly trailed her, doing tasks as directed and watching everything she did and how she did it. Starting on day 2, I did nearly everything with her watching my every move, directing me anywhere I asked or with anything she could see I was unfamiliar with. This progression has continued. She has so far maintained the "organization" aspect of our shift: what needs to be done next, and for which pt, etc. Starting tomorrow, all that changes. She told me today that from now own, our patients would be my patients, and she would only "keep you from messing up". I promised to ask any questions I had before doing anything.

My floor is busy, with barely enough time to do everything we need to for our patients. However, I do not feel as if the pace is impossibly frantic, or the workload on any of our staff is too great. Day shift averages 1:5 nurse/pt ratio, and the processes seem to be 95+ percent optimized. Not saying we haven't had a few hectic days, but on the whole they seem manageable.

Let me take a few lines to address "eating new nurses" and toxic environments. While some of my new coworkers are not terribly outgoing or overly friendly with "the new guy", all without exception have been helpful and professional to/with this new nurse. I haven't seen any of the "cattiness" or negativity others have suggested is routine.

Overall, my initial impression of this profession and my starting position within it is positive. I have seen a few things that I'd adjust, had I the power to do so, but on the whole, I have found satisfaction with my new career.

Any "words of wisdom" would be appreciated.

[Haunted]

Wow! You sound very professional, very caring and thoughtful and you also sound like you have a lot of self respect . Very insightful post also. My only advice would be to make sure you take care of YOU during your shift, remember to sit when you can, grab a bite to eat, don't get dehydrated and continue to be a great teamplayer. There is a reason why they have more than 1 shift in a day, you are just 1 person and if you did not complete every diddly darned thing during your shift just hand it off to the next shift and don't let anyone lay a guilt trip on you. Get posting your progress!

[clee1]

Wow! You sound very professional, very caring and thoughtful and you also sound like you have a lot of self respect . Very insightful post also. My only advice would be to make sure you take care of YOU during your shift, remember to sit when you can, grab a bite to eat, don't get dehydrated and continue to be a great teamplayer. There is a reason why they have more than 1 shift in a day, you are just 1 person and if you did not complete every diddly darned thing during your shift just hand it off to the next shift and don't let anyone lay a guilt trip on you. Get posting your progress!

Thank you for replying. So far, I have had sufficient time for breaks and for lunch. Also, there seems to be no problem with saying "I need to take 5..." (our code for a bathroom break). Folks pretty well cover for each other here, and just today I saw the NM go in to start an IV on a particularly difficult stick.

I can just about guarantee that I'm not gonna accept a guilt-trip about anything. I know I do the best I possibly can, and that's all I can do. If something gets left over, it gets left over.

[sissyboo]

That really sounds like a great learning environment! I'm glad everything is going so well for you. Even though I am not a nurse, I'm sure you'll do just fine on your own. Good Luck!