Inefficient training at first job, considering quitting

Nurses General Nursing

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I got a job as a graduate nurse/RN at a nursing home recently here in California. I've been training in a very fast-paced busy hectic environment. I'm not learning a whole lot (atleast not enough to be completely on my own) because of the environment. My nurse (LVN training me) has been very patient and as helpful as she can be while still taking care of 17+ patients at a time. She said she wishes she can go more in depth with all the paperwork and things like that if she had the time. I asked to be moved to a slower unit of the nursing home. But I was told that there is only 1 nurse per unit of the nursing home for every shift (~20 patients per nurse). And if I were to move to another unit, I'd be completely alone and I'd have to be READY to be on my own.

This place is SEVERELY understaffed. There is no unit secretary to call doctors, fax papers, deal with jammed copiers, etc. No wound care nurse. Not enough nurses. You have so much to do. Nurses stay atleast an hour past their shift just to catch up on what they need to do. The nurses are constantly overwhelmed. One says that she thinks about quitting every other day. There's a nurse who doesn't even document correctly. She documents about a right arm PICC line when the patient actually has a left hand peripheral line... That is how crazy it is. And people get written up a lot... I wonder why. Maybe because they're overwhelmed and can't possibly do everything. And we only get 30 minutes lunch. The nurse training me doesn't even have time to eat... I don't have time to actually sit down with my patients and have a nice conversation with them. It's just like, "Hi. Here's your meds. Gotta go now bye."

I've only been given 5 days of orientation. How is anybody supposed to learn how to do their job in 5 days? Apparently they'd give me more time to orientate if I need it. But I need like 6 months (like new grads at hospitals get). I'm supposed to have a sit-down discussion with the DON and whoever else on Monday. I don't even know if I should show up. They won't even give me 1 week off to study for my NCLEX. They'll just give me 2 days off before my test to study. I need to pass it the first time to start my BSN program. They said the job is more important than the NCLEX...

This is my first job. So I don't have anything to compare it to. But I know this isn't how it's supposed to be. New grads should be trained well to do their job in a reasonable amount of time... especially when human lives are involved. I don't want to screw something up and lose my license before I even get to RECEIVE my license.

I want to just quit and concentrate on the little time I have to study for my NCLEX and then focus on getting my BSN. Apparently some hospitals won't even accept nursing home experience anyways. And I don't NEED a job right now. I don't have kids to support or an apartment to pay rent.

What do you think I should do?

If you don't need a job, then leave, if that would be better for you. But do not leave thinking the next job will be better, because chances are high that it will be worse. The person who is orienting you probably would not be as nice about the situation. What you describe is common in LTC facilities.

Specializes in Gerontology, nursing education.

Caliotter3 is right. What you describe is common at many LTC facilities. It sounds like you have an excellent preceptor but she's way too busy to devote time to giving you an adequate orientation and taking care of her residents.

I would be concerned about the incorrect documentation and people getting written up frequently. Why are they getting written up? Are they not doing their jobs or is there an absenteeism problem? Either one is a bad sign. If people aren't doing their jobs, it may be because they don't have time and feel they have to take shortcuts. If there's a lot of absenteeism, it could be because staff are burned out and can't emotionally handle another shift. I would also wonder about administrative support for the staff. In many LTC facilities, there seems to be a revolving door philosophy about the staff. Management and administration don't count on people staying and will hire and fire quickly because they figure new hires will always be coming through the door.

If you don't need the job, quit now rather than put yourself through any more angst. Take the time you feel you need to pass NCLEX on the first try as this is important for your educational goals. You know, if the institution is so unsupportive of you needing time to study for NCLEX, it won't be supportive of you going back to school. You would be much better off taking a per diem hospital job even if it means waiting a while to find employment.

Good luck to you in this. It sounds like a situation that would be overwhelming for any nurse, not just a new grad.

Specializes in LTC, Med-SURG,STICU.

I would have to agree with caliotter3. I will add that I personally would have loved to have only 17 residents on my hall when I worked at a LTC facility. I had 30 to 33 residents on my hall. That was with me doing all the treatments, calling the doctors, faxing, anwsering the phone....

My advice would be to quit if this is not working for you. However, do not go to another LTC facility thinking that it will be better because it will be the same if not worse.

Any place that says that the job is more important than passing NCLEX is wrong. They will let you go real fast when you do not pass.

Specializes in Ambulatory Care, Case Manager.

I posted the other day about having a crappy orientation. I started at a per diem job about two months ago, haven't completed my New Employee Orientation list and they expected me to be on my own. My supervisor doesn't bother returning my phone calls or emails.

I just submitted my letter of resignation stating my reasons. I don't want to work for a company who doesn't have the decency to give you a proper orientation. I have better things to do with my time, especially now that I have a new full-time job.

So, my advice to you is focus on your NCLEX and start applying at others jobs. Your facility doesn't care about you.

I am in the exact same boat you're in. But I will say this is just common for most of LTC. I'm starting out on a SNF, in a hospital, and I was on my own on day 1. Still haven't completed orientation. I know NOTHING about the paperwork. I just ask as many questions as I can to anyone I can. The only difference between me and you is that I can't quit, because I was on the hospital's scholarship and am required to work for one year anywhere they wanted and they chose SNF.

Specializes in CICU.

There are probably very few places where you will get a 6 month orientation. I got 5 weeks for step-down.

Specializes in geriatrics.

Sounds similar to where I work. I'm one RN in charge of 30 residents. We have no unit clerk. At night its me and 1 NA. I've given up worrying about what doesn't get done, because sometimes its impossible. My priorities are the resident care, processing orders, documentation. All the other little things....if I don't have time to get it done, too bad. I leave on time most of the time and whatever might be left can wait for the next shift. My boss is fairly understanding though, which helps. As others have said, in your situation, I would focus on the studying for now. That should be your only job.

Specializes in Family NP, OB Nursing.

I agree with the others, though when I was working OB, the orientation was 3 months. I will add one thing though: How can they really believe the job is more important than NCLEX. If you fail the NCLEX you can't work as a grad RN anymore...how is that going to help them?!

Specializes in Gerontology, nursing education.

I know of a facility that kept a new grad working in her position even after she'd failed NCLEX the first time. The DON told her to continue signing "GN". :madface:

If something would have happened, the DON surely would have thrown the nurse under a bus.

That sounds like an unsafe place to work, with falls and med errors just waiting to happen.

I actually feel really lucky now! Started my 1st job as a GPN in May and I basically got 2 days "orientation" (okay, you do this patient and I'll do the next one, I'll be right back, going on break and you can go next... ok, now do the next one...meanwhile I got no break) before I was on my own.

So, I am learning on the job, have around 15 patients, and my first night on afternoons was with an agency nurse who had never worked there before...but she was fantastic! I must say most of the nurses have been great whenever I asked a specific question, and the DON and ADON have been completely available in person or on the phone. Oh, and we do have a unit secretary. This is supposedly one of the best facilities to work at in the area and it still has call offs, people quitting, and lack of orientation.

I don't think you ever feel READY before you are on your own regardless of how much orientation you get, but a couple of days for a new grad is really minimal.

My advice is to look for another facility. Also, now you know a little more what questions to ask before accepting a position, and maybe you can even shadow for a shift or two.

Good luck!

Specializes in Family NP, OB Nursing.
I know of a facility that kept a new grad working in her position even after she'd failed NCLEX the first time. The DON told her to continue signing "GN". :madface:

If something would have happened, the DON surely would have thrown the nurse under a bus.

WHAT!!!!

Yes, I'm sure she would have, but the organization would have been at fault as well. Unfortunately, if that grad did that the BON found out, I'm pretty sure her chances of ever getting licensed would be slim to none.

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