From SNF to acute care, a plea for help.

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I became involved in healthcare at a young age, starting at 16 working the front desk at a busy Boston Hospital and working up to become a UC, an LNA, an LPN, and last April completing my ADN to become an RN. Since 2010 I have solely worked in SNF and loved it. I developed confidence and skills, and whilst it was challenging when I first became an LPN, I quickly acclimated to my job after transitioning from an LNA to an LPN. Flash forward to a month ago. Despite my love for SNF I wanted to experience more so I accepted a job on a busy med-surg floor at a local community hospital. Because of my experience I'm not considered a new grad so my orientation is set to be 3 weeks long, and I have two more days before I go solo. I have yet to take a full 5 patient assignment and I am so overwhelmed. I know there will be an adjustment period, but with previous jobs I never felt so incompetent/exhausted/worn out/physically spent/mentally taxed. The expectation is that nurses do all the ADL care as well as their nursing duties as there are only 2 techs for a 36 bed unit. I have no issues doing ADL care, but when 4 patients are total care it adds another component to the already very busy shift. Today and tomorrow are my last days with a preceptor. These feelings I'm having, is this par for the course when starting on a med surg unit? The organization I work for is a fantastic hospital, and I'm working with a supportive team. Is asking for more orientation time ok, or will they think I'm just whiny? Will I get the hang of this job? Last night I cried for hours after work, it was so stressful. Any advice would be fantastic. Thanks ladies and gents.

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Specializes in CRNA, Finally retired.

It's not you; it's the lousy staffing. 2 tech's for 36 patients is obviously short staffed.

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Specializes in Psych (25 years), Medical (15 years).

I'm going to allow those who currently work med surge to say that your orientation period was far too short, shaykaitlin, since I have worked predominately psych for the past 20 years.

But I would like to welcome you to AN.com and relay my admiration for your ladder climb!

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I would speak with the person in charge of orientation, usually dept educator, and request a longer orientation. The Med/surg floor I am on has a 9 week orientation. It is not frowned upon to ask for a longer orientation if a nurse does not feel ready to be on their own.

After orientation is over, the nurse is only given 4 patients for the first 4 weeks. Our floor is crazy busy most of the time but I have great coworkers that all pitch in when needed. I hope your coworkers are just as supportive. Hang in there, it does get better!

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Specializes in SICU, trauma, neuro.
I'm going to allow those who currently work med surge to say that your orientation period was far too short, shaykaitlin, since I have worked predominately psych for the past 20 years.

But I would like to welcome you to AN.com and relay my admiration for your ladder climb!

Three weeks is ridiculous.

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Specializes in LTC, assisted living, med-surg, psych.
Three weeks is ridiculous.

I totally agree. When I first started at the hospital, I was not a new nurse but I was new to M/S nursing, and they gave me six weeks orientation plus classes. New grads got a full 90 days. I can't even imagine trying to take on a full patient load with only a brief orientation period. Ask for another four weeks' worth if at all possible; the worst they can do is say No, and you might at least get another two weeks out of it if your management is decent. Good luck.

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Thank you for your comment. The team I work with is wonderful, and I met with my manager today. She said my concerns are valid, but has been reviewing my progress and said I'm being too hard on myself and that I'm doing above what she expects. She also said that even though I'm not a "new grad" her expectation isn't that I get the job down pat immediately. After talking with her I feel better, and we did come up with a plan where I will have 3 patients max for two weeks, then 4 for two weeks, then we'll meet again to see where I'm at. It's really helpful having a manager who is understanding to how I feel.

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Thank you so much. It's been a long climb, but I'm hoping to complete my BSN by 2019. There's always room to move up!

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