This has been my first week on a med-surg floor. I just graduated from nursing school(practical nursing), and have never worked in healthcare before. When I interviewed for the position I specifically asked, will I have a preceptor? Nurse manager says yes. Monday was my first day and of course I was really nervous, but I was expecting I would be working with a preceptor. Well I get up to the unit and the charge nurse says ok I'll give you one patient, let me know if you have any questions. So basically I took care of that patient by myself, gave meds, etc, and tried to ask questions when I could, but of course she is the charge nurse and has things to do. I didnt feel like she was really one on one with me, although she did help me when she could. Tuesday was the same way. Today that same charge nurse gave me 2 patients, and said the same thing, come get me if you have questions. I dont even feel like I am learning about the unit as much as I should be. Also, the unit is pedi overlflow, and I have not learned anything about caring for pedi patients on the unit, like what I need to do, etc. I have not learned anything about how to run codes, besides "theres the crash cart" I have not learned anything about admissions and discharges, and the unit rarely has a unit clerk to put charts together, so that will also be my responsibility. Not to mention there is not going to be an aide either. I guess because it is a smaller unit the clerks and aides "need to be in other units" or whatever. I am just running around all day trying to figure out where things are and figuring out how to use the computer charting system. Just wondering if this is usually how it goes for new grads......
Aug 30, '06
Wow -- that just sounds plain scarey and so unsafe for patients! I'm having a tough time too (brand new grad), but at least I HAVE a preceptor and I do feel I have a safety net where I work.
I'm new and don't have experience, but I would be curious as to how seasoned nurses would respond to your situation. If it were me I'd go to the powers that be and request (INSIST) an adequate orientation (tell them all the things you need to know, e.g. admissions, discharges, how to run codes) and if they don't give you adequate training/orientation, I'd quit -- remember it's YOUR license on the line!
Aug 30, '06
Dear Fellow New Grad,
No this is not how it goes. You should have a preceptor. I did for almost twelve weeks and before that I was in a critical care internship for three months. It sounds like they are trying to "break you in" the hard way hoping you will scramble to learn info on your own of what they should be teaching; leaving you to sink or swim and left floundering out there on your own and that's just wrong. I've been there. I would go to the nurse manager, be professional about it of course and let him/her know whats going on. If you don't get positive feedback, I would almost consider going to a bigger facility or one that has programs set up for new grads like mine did. Most likely, without intervention, next time you work, if you did "ok" with two pts on your own, you will get 3 next time until they "titrate" you up to their expected nurse to pt ratio. I'm sorry that you've had this experience. I loved/love my preceptors. They are a wealth of information. Even though I'm flying solo now, I still will go to them as a resource and it's great to have that. Good luck with everything, keep us updated on the outcome, I will be wishing the best for you.
Aug 30, '06
Well this is the biggest facility in the area, trust me its big...its a level 1 trauma center....and a "teaching hospital". THis is why I chose this hospital as compared to others, I thought I would get the best orientation at this hospital
The have internship programs for new grad RN's on some units, but nothing for PN's, but there a lot of RN's on the unit who have not been there more than 2-3 years, and my orientation seems normal to them, they just say "dont worry you'll catch on".
Aug 30, '06
Hunh??? I would be running out the door...what kind of place doesn't have orientation? Or a preceptor? This is totally unsafe.
Aug 30, '06
Good Grief! What is going on out there in America? I keep reading these posts about what all of us new grads are going through. What a terrible experience...
Aug 31, '06
Wow! Like the previous poster said, I keep reading about these horrific "orientation" experiences where you have a preceptor that just abandons you, or (in this case) no preceptor at all! I don't know how you guys are coping and dealing with this. I had a hard time on orientation .... I'd cry and get so stressed out, and I had a great preceptor and a ton of support. I feel for you ..... I can't imagine how horrible this is to go through.
You say this is a teaching hospital, so PLEASE PLEASE PLEASE get with your unit educator and/or nurse manager and tell them that you need a normal orientation. That you need to be paired up with someone. It sounds like they're putting you into the count, counting on you to take your own assignment, even if it's just 1 or 2 patients ...... you are TOTALLY responsible for those patients and have no preceptor to fall back on?! That is not right!! This is your orientation .... this is your license!! Please let them know you won't tolerate this. I wish you all the best of luck. Let us know how it goes.
Sep 2, '06
WOW! If I was in that situation, I would find a hospital with an actual "RN new grad program" which is 8-12 weeks of preceptorship often including didactics. You just got your license.... be careful!
Sep 4, '06
This is completely unnacceptable and unsafe. I would run not walk out of that place and find somewhere else to work.
Sep 5, '06
At least 1 year ago I could've written your post. I had no preceptor, or never knew who it was until late in the day where they start pointing out things I missed. I started with 2 patients and they kept adding on daily, not asking if I was ready or nothing. Oh it was bad. I finally decided that all those years of my education was not worth this ONE job, and quit. Found myself a new hospital and in the interview process when asked why I left my previous job I quickly stated, inadequate orientation (in fact when I started that job my nurse manager said - you don't need orientation - since i had worked as a nurses aide there 10 (thats right 10 years) prior - and had not stepped foot in the door since then! While in the interview I would specifically ask how long the orientation would be, and would I have just ONE preceptor or would it change nightly, and if it changed everyday then how would i know what is the right way to do things when everyone had a different way of doing things.
Yes these things are important, and if things change once your past interview stage you find you don't have orientation, then find another place. It sucks but the fact is, if they won't give you the skills to keep your patients safe, then would you want a family member in that hospital? I don't think so.
Sep 5, '06
RUN for the nearest exit! No job is worth losing your license over.
Not all facilities treat new grads that way. The first hospital I worked at as a new grad RN....we were with the nurse educator for at least 6 weeks. Checked off on skills...always had her with us until she decided we were competent to perform that skill on our own. Have things changed so much??
I precept new hires where I work now. Have seen varying degrees of competency with new grads....some have never started an IV, cathed a pt, or put down an NG. Orientation here lasts at least 8 to 10 weeks....longer if necessary. We invest a lot of time and money...we want you to stay!
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