New Grads

[lilone]

I am a new grad from a BSN program. I have a few questions.

Can you tell me what a new grad should expect from an orientation?

Are Nurse/patient ratios of 7-9 patients per 1 nurse on a specialty/telemetry unit safe/acceptable?

I am presently orienting on a unit like this right now and am feeling overwhelmed. I fear I can't provide good care to that many patients. This greatly troubles me. Another facility is presently accepting graduate nurses in their ICU for training. I am thinking that perhaps my perfectionistic personality may make me more suitable to care for one or two individuals rather that 7-9. What do you think? Is this something I should pursue?

[Genista, BSN, RN]

Personally, I think new grad RNs should get a longer preceptorship period than experienced RNs. I had 5 weeks of preceptorship as a new grad. On the first day I shadowed the RN. On day two I took 2 pts. Day three I took 4 pts. By week two I had her full pt load of 6 w/ her shadowing me.For the rest of the orientation, I had someone to ask questions & show me the ropes,etc. The preceptored period is a valuable time for orientation, feedback & advice. I felt pretty comfortable "flying solo" after 5 weeks (knowing that I could always ask another nurse for help or advice if needed). I've been an RN two years now & I never hesitate to ask for help or an extra opinion when I need it. As for nurse/pt ratios... I think 7 pts is too much for a tele floor. I work dayshift tele & have 4-5 pts (and that can be a handful if they are unstable!) Our ratios are 4-5 pt per nurse for days, 5-6 per nurse for pms, 5-6 per nurse for nocs.In the beginning, even these "safe" ratios may feel like a lot for a new grad. I started on med/surg pm shift w/ 6-7 patients. It was very tough in the beginning when everything is new! I would definately look around and see what other job offers are out there. 7 pts per RN is hard on tele/special care, even for the most seasoned RN. Congratulations & Good luck in your new career!

~Kona

[LaurieCRNP2002, MSN, RN, APRN]

lilone

First off, congrats on getting a job in telemetry! Hopefully you'll learn a lot and enjoy it as well. NO WAY is 7-9 patients safe on telemetry! I have cared for 7 patients (on night shift) but did not feel it was safe---all it takes is one patient to crash and you'll really feel overwhelmed! As far as ICU, I would recommend getting some experience under your belt in telemetry, at least for 6 months. However, if you think you would have a chance to get into ICU now, it couldn't hurt to speak with the manager of the ICU.

Kona, I'm very shocked that any facility would only give a new grad 5 weeks of orientation! It sounds like you had a good support system as far as the other nurses you were working with, but I think you got shortchanged.

Good luck to both of you in your careers!

Laurie, RN

[Genista, BSN, RN]

LLDPaRN-

Yes, isn't it sad that 5 weeks of orientation is considered "good" for a new grad these days? However, I'm grateful for what I did get...I spoke w/ a new grad today at work & she said they are giving her merely 2 weeks orientation (to step down unit, no less!!!!) This new grad has no floor experience outside of nursing school. It made me VERY angry to hear her tell me this. ;-( How can we expect good nursing care when new RNs don't even get basic precepting?! Nowadays, new grads are just thrown to the wolves & it's sink or swim. I read this article today, and it says the national avg of orientation is 4 weeks for new grads. Pretty sad commentary.No wonder there's a nursing shortage.

http://www.chicagotribune.com/news/nationworld/article/0,2669,2-46854,FF.html

[MQ Edna]

I'm a telemetry R.N. in a community hospital and I have 9-13 patients, mostly geriatric. I think 7-9 is pretty good. 5 weeks of orientation is not enough though, for a new grad. I got 8 weeks.