Five week ER orientation

ERNurse752, RN · Jun 8, 2005

That is way too short. It should be no less than 12 weeks, especially in a Level I. My ER has started doing the 6 week thing, and guess what...all the new grads crash and burn, then leave as bitter old souls who hate the profession.

This is one of my passionate soap box issues, so I'll stop there. Good luck with whatever you decide to do.

mtnmom · Jun 8, 2005

I recently switched to the ER from another nursing field after 5 years as an RN. I have been a nurse now for 5 years - the hospital where I work is in a rural area with a 10-bed ER - a surprising diversity of patients and diagnoses despite our small size.

My orientation, which is just ending, has been 6 weeks. I am lucky to have a very supportive manager, staff and ER physicians who are good to work with- so I think I'll do just fine. Everyone has assured me that I will get plenty of support, and I believe that to be true.

Having said that, I cannot imagine having done this with such a short orientation right out of school. Maybe I was behind the curve but only in the past couple of years do I feel like I've really come into my own as a nurse, and I am still learning.

But if other new grads have done well, there must be a support system in place there for you. good luck.

Happy-ER-RN, RN · Jun 9, 2005

That is way too short. It should be no less than 12 weeks, especially in a Level I. My ER has started doing the 6 week thing, and guess what...all the new grads crash and burn, then leave as bitter old souls who hate the profession.
This is one of my passionate soap box issues, so I'll stop there. Good luck with whatever you decide to do.

What I don't understand is how it's possible that hospitals can continue to justify doing this financially. I mean, I know that orientation has been shortened because of the high turnover rate, they don't want to spend 6 months training someone and then have them leave. But if the new nurses can't handle the short amount of training and end up leaving anyway--how do they justify this. It's really frustrating that a corporation is willing to put their patients at risk by throwing new grads in with no training just to save a buck. Hmmmmm, I guess I shouldn't be so cynical yet...

Trauma Columnist · Jun 9, 2005

I work in a level one that sees 60,000 plus visits per year. Our orientation for new grads is 12 - 16 weeks. We use the ENA modules and we do a lot of trauma. Good luck. The ER is the best!

ERNurse752, RN · Jun 11, 2005

What I don't understand is how it's possible that hospitals can continue to justify doing this financially. I mean, I know that orientation has been shortened because of the high turnover rate, they don't want to spend 6 months training someone and then have them leave. But if the new nurses can't handle the short amount of training and end up leaving anyway--how do they justify this. It's really frustrating that a corporation is willing to put their patients at risk by throwing new grads in with no training just to save a buck. Hmmmmm, I guess I shouldn't be so cynical yet...

Yeah, really. It costs a *fortune* to lose nurses and replace them. We have lost probably close to 20 nurses in the last couple years...about half of that in the last few months. A few of us are actually planning on going over our director's head, b/c she and her clique of managers are the root of the problem. I figure the director's boss, a business admin-type guy, will care a lot more than anyone else, for the financial reasons alone. But that's a whole other story, hehe.

NYCRN16 · Jun 12, 2005

I started out as a new grad in a busy level II ER, and I got 12 weeks orientation (including the general hospital orientation) and still felt like I didnt get enough at first. I could not imagine having only 5 weeks! I would ask for more if its possible.

I may get flamed for this, but this is just my opinion...I am now working as a traveler at another facility, and they are hiring a lot of nurses from the floor to come work in the ER here..I have to say that these are good nurses, but the mindset from the floor is not productive to the ER. I tend to find that these nurses focus too much on things that are not a priority in the ER, and dont recognize the sick patients as good as the experienced ER nurses do, even if they have been nurses longer. A lot of them do not show the independance that is needed to be an ER nurse, and need a lot of hand holding.

I think hiring new grads in the ER and giving them time to learn and adjust makes a better ER nurse than putting someone on the floor for a year, learning those ways, and then getting them to "unlearn" most of that.

Happy-ER-RN, RN · Jun 29, 2005

Hello everyone, just wanted to post an update. I am now in my 3rd week of orientation, I went to my manager yesterday and said I am not going to be ready in two weeks (most of it is general hospital wide classroom orientation). Apparently the majority of new grads get an extended orientation. So to answer my own question, no 5 weeks is not even close to enough. We see about 60,000 pts a year--and are the only level 1 trauma center in the area.

Anyway, they gave me about three weeks more of orientation, and if I am still not ready I will ask for more. I absolutely refuse to put my patients lives in danger and my license on the line. I still don't know how to find a freakin' alcohol swab when I need one, much less manage my patient if they crash all of a sudden.

This trend of shorter orientation time is soo soo soo scary. What would the general public think if they knew hospitals where willing to let a nurse with a few shifts of experience care for their critically ill family members.

Dixielee, BSN, RN · Jun 30, 2005

I am glad your manager is understanding and did not give you any grief about this. As far as I am concerned, YOU are one of the smart ones. You recognized that you are not ready and you did something about it. My big concern is for those who don't realize or don't care if they are not ready and proceed anyway.Those are the ones that are a danger to their patients and themselves.

It will take you a while to feel comfortable, even a year or so before you have any real confidence. But, just keep plugging along, you will learn it, and you will live thru it. You have bitten off quite a large bite, so don't let anyone put you into a dangerous situation. Even as an experienced ER nurse, there will be times you need back up. That is why we have more than one nurse per shift! Don't ever, ever, ever be afraid to ask questions, ask for help or just for a consultation. No one will think you are stupid for asking. I still have questions, new things come up, etc. Just when you think you have seen and heard it all.....something unexpected will come alone. That is the nature of ER. That is why I love it!

By the way, the alcohol swab should be in your pocket....along with a roll of tape, hemostats, scissors, extra angiocaths, a few butterflies, tournequet, your PDA, calculator, and some sort of cheat sheet with important phone numbers such as lab, CT, X ray, floor numbers, poison control, animal control, taxi, social worker, etc. Don't forget the key to your locker. Why do you think we look like security guards with stuff hanging off our pockets! That is why I love those cargo pants. Of course you also have to have your stethescope, name tag, card to swipe and out of you are in a locked unit....now what am I missing??????????

ERNRS · Jun 30, 2005

Hello, well I was a new grad in the ER as well... My orientation was to be 8 weeks long, and I extended it to 10. Five weeks is short, and I would request longer, I am sure they will understand WHAT do they expect!

Always speak up for yourself, I learned that real quick. It's your license! Although be sure the ER is for you, which you will find out soon. I work with many who were new grads and they are great.. ER is the BEST :

Hello.
I am a new grad starting my Orientation in a busy level 1 trauma center next week. I will have 5 weeks of orientation before I will be on my own. I was never a Tech or anything, just had a summer internship in a small ER. My question is, is 5 weeks ridiculously short and will I be a danger to my patients? I know that I will never do anything I am not comfortable with without asking for help, but still, FIVE WEEKS! I have heard some have 6 months. I would hate to request a longer orientation time and appear to lack in confidence right off the bat.

snowfreeze, BSN, RN · Jun 30, 2005

You will not be comfortable for about 2 years, if you have a mentor to work with and good teamwork you should be fine. If the unit is chronically understaffed, no on call staff to rely on, poor continuing education for staff on new procedures, equipment, meds etc. then go somewhere else to learn and go to that unit after you have a few years under your belt.

srknurse · Jul 1, 2005

Hi there!

I, too, will be starting in an ER in August with a 5-6 week orientation. I have 1 year experience as a public health nurse and 4 years experience as an ER tech....and so feel somewhat familiar, but am SCARED to death.....

Know I'm here for you and I love reading all of everyone's replies! Keep the good thoughts coming!

SRKNurse

barefootlady, ADN, RN · Jul 1, 2005

Love those ER nurses. They do a hectic, stressful, demanding, physical job and continue to manage to smile every once in a shift or so. Go Guys! :balloons: