orientation issues!!

[akint19]

hello everyone.. so i am a new grad.. graduated may from nursing school and got a job at a hospital.. started orientation and i have no nursing experience before graduating except clinical experience and this is my second career. at first i was excited to start at the hospital since classroom orientation was so fun... it lasted for 2 weeks..... and made me feel i was going to learn so much since it is considered a "teaching hospital". i got hired for a medsurg unit where ratio is 1:7 or 1:8.. my first day, i observed and was trying to orient my self to the unit and see where things are.... second day.. i got 3 patients and gave meds on my own without supervision... until it became a habit that i did things without supervision and had to go back and forth to find my preceptor if i didnt know how to do something.. my patient load had increased by week two.. and i got 4 patients. my manager was pushing me to do more patients but just couldnt do it since im not so confident. preceptors are saying im too slow with giving medications but im still learning and said i ask stupid questions. but how am i supposed to learn if i dont ask questions??? manager isnt supportive at all and wants me to have more patients.. i am going crazy in this place!! please give me your feedback

[akint19]

wow... yeah i dont think i can even stay another week!! lol but il look for other places in the meantime.. dont want to quit without having backup.. thanks for ur advice

[Been there,done that, ASN, RN]

wow so we both experienced this type of setting. the aides on my unit... are another story. they want to sit all day and when you ask them for help, they say they are unavailable. so i have to do everything myself. its hard enough to handle 4 patients on my own.. imagine double! trying to find another job but job market isnt that great for new grads since all want experience. i dont think i can stay here and do my one year experience

Directing lazy aids is another thread. Write them up; each and every time; when they do not follow your direction. YOU are the boss.

[caffeinatednurse, BSN, RN]

My first medical-surgical RN job was 1:9 when I started, then it dropped to 1:8 when I came off orientation. My first night on orientation, my preceptor handed me 4 patient summaries and a pager and wished me the best of luck. From there on, it continued to go down hill. It sounds like you're on a similar unit.

There's better units out there. I'm currently working on a medical-surgical unit at a smaller community hospital. The ratio is 1:6 with the very slim possibility for 1:7. Usually it's 1:6. I'm used to crazy ratios, though - like 1:16 with 1 CNA. Or 1:20, or 1:27.

Hang in there. Don't quit without giving a notice, and try not to leave without having another job lined up. It's true when people say that it's easier to get a job when you already have one. If you can stick it out for 6 months, you'll be in an even better position.

Oh yeah, and ask for the rest of your orientation. Are there any other new grads on your unit? Talk to them and ask them what they're doing to manage the workload.

[akint19]

wow sounds so similar...yes i am still looking for a job and wont quit until i have one secured - thanks for the advice.. iam the only orientee on that specific floor but another orientee on another MS unit observed the first week, second week had 1 patient, and is slowly increasing her patient load while learning. thats what i wish i had. not to be bombarded first week with patients and its much harder to learn. i ask questions and sometimes they dont want to be bothered but I am taking care of their patient! sigh... how long did you stay at that job? the one where u started off with 9 patients... again thanks for the advice

[caffeinatednurse, BSN, RN]

Four months. I was utterly exhausted, fed up, and wondering why I even became a nurse by the end of those 4 months.

In my humble opinion, there's short-staffed with high ratios, and then there's short-staffed with high ratios and no help. I can handle the first. I can even handle the second for a short duration...but as a new grad nurse, you shouldn't be expected to. It takes time to acclimate to the heavy workload of nursing and particularly med-surg. I would ask to be backed down to 1 or 2 patients and then work your way up from there. Your manager or supervisor should be able to help you create a game plan for the rest of your orientation.

[akint19]

thanks. i did ask for a back down of 1 to 2 patients and manager told me no that i need to be faster too but i keep reminding them im a new grad and they just dont care

[beachlover]

Completely sounds like my first RN position. I had worked at the same hospital for 3 years prior as a unit secy and Er na. By the end of my first week, I had 4 patients, unsupervised. Then it got real- my preceptor didn't want to train me, was not available, however would constantly interrupt my shift reports, drawing up meds and phone calls to Drs with non- urgent, non- related things. It was baffling and stressful. I had one staff meeting and was told I was meeting expectations and doing great. Two days later, I was let go for being "disrespectful to my preceptor". No discussion, no answer as to how I was possibly disrespectful. Don't let this happen. Speak up for yourself. Ask your training staff and/or manager for a guideline on training- see if you are meeting goals. Don't whine, don't complain, just ask about your position. Speak to your preceptor! Go in a little early and say something like, I was hoping this morning you could shadow me closely so I know I am doing everything right for our patients. I feel that your experience will really help. ?! Good luck!

[akint19]

Hey thanks for your reply. That sounds so hardh to say you're doing well and then 2 days later you were let go! that's so mean! But maybe it was a blessing in disguise... I get tossed around from preceptor to preceptor and they all tell me they are so busy. I ask them to check my notes and documentation and replies are usually "I will do it later" Had admissions thrown at me with no guidance so who knows if documentationare right. Sad but true. I do get weekly reports and they say I need to be faster with medications but they offer no help. I do ask for help but they are so busy with "their own" patients and don't realize i am taking care of their patients as well... I ask to slow down with patient load and they said I need to be fast. So unsafe!

[rnmatchmaker]

I work in HR at a small hospital in the South. New grads LOVE to start out at our hospital because we tailor their orientation to THEIR needs, their learning pace, and there are no stupid questions. So, think about applying to a small community hospital where the pace isn't as hectic and the people are more like a team and a family. The pay may not be as much but while you're learning, the decrease in stress and support you will receive is invaluable.