What do I tell her?

[HisHands]

Today my girlfriend confided in me regarding a situation she recently went through. I just don't know what to tell her.

We are both relatively new nurses (2 years on the job). We work together at a fantastic rehab facility. To supplement her income, she started a position at another facility on her off days. She told me that her first day of orientation at the new facility, her preceptor had another orientee with her. One preceptor and two orientees. The other orientee was on her last shift of orientation, so the facility justified to her that she would still get most of the preceptors attention. Well, apparently it wasn't so, and my friend felt like she didn't get any orientation at all. Ok, so 3:00 rolls around and my girlfriend is fed up. They gave her an admission to do basically by herself since her preceptor was no where to be found. She told me that she wrote out the patients meds and faxed them to the pharmacy, did as much of the paperwork as she could figure out on her own, and then told her preceptor she was going on lunch break (they got off at 7:30pm). Well, she never went back after lunch. Now the DON is threatening to call the state because they say she abandoned her assignment. My friend feels like she didn't have an assigment to abandon. She did not receive report, and did not count the narcotics. Her only responsibility that entire shift was to do the admission.

I have a hard time believing they can revoke her license for job abandonment, since she hadn't taken report on any patients and had no real responsibilities other than to do as much of the admission as she could. But, I haven't been a nurse all that long either and haven't known anyone to be in this situation.

We are in Michigan. I sure could use some guidance. My friend is torn up over this. She's afraid that she could lose the job that she currently has and loves.

Any feedback?

Thanks a bunch,

HisHands

[Miss Ivy]

A nurse of 2 years is not a new nurse. She should have known better. And no, being 23 does not excuse it at all. I have been in the situation where I have had to share a preceptor for a day. You just have to deal with it the best you can. She should never have left. And she's really lucky that DON did not report her.

[Mags4711, RN]

Is it normal to have more than one orientee with a preceptor? I've never had to share an orientator before, so I don't know. I can only think that by having two orientees with this poor lady, this facility was setting up for failure.

Even though my friend "accepted" this admission (ie. Preceptor says, "Do as much as you can and I'll come help you") how can she be solely responsible for this admission since she doesn't know how to do any of this? Why does the preceptor hold no responsibility? Mind you, this was my friends first day. She doesn't know how a chart is set up here. She doesn't know any of the paperwork for admissions, discharges or transports out. She doesn't know how the med carts are set up. She doesn't know squat about this facility. I just think it was unfair that she didn't know how to do anything and suddenly was thrown into a situation to do more than she was capable of doing, and the person who was supposed to be this great resource was nowhere to be found. (She later found out her preceptor left work early to visit her husband in the hospital. My friend didn't even know!)

I'm not trying to make excuses for my girlfriend or anything. I'm just trying to understand how a situation goes this bad... how does a situation come up that puts a license in jeopardy? I'm just trying to understand how my friend was feeling.

Please keep the opinions coming

No, I've not been in a situation where a preceptor has two orientees that need to be fully precepted. However in your OP you mentioned that the other orientee was on her last day and I'm guessing that the facility/charge RN thought she would only need a buddy and not need someone to be at her side all day. That *is* a situation I've been in. Sometimes staffing is very tight (though that's a cop out to some extent), and if someone is almost off orientation, you have to technically double up. It should be a rare occasion, but it has happened in my career a couple of times (15 yrs). On that note, you can't plan for situations to arise, perhaps the first orientee had quite a few things come up she'd never seen before and that required the preceptor to spend more time with her than originally intended. If that was the case, the preceptor should have said something to the Charge RN or the DON or someone with authority so that your GF didn't have to go through what she did.

Do I think the DON should have threatened to call the state for abandonment? No. Did your GF abandon her patient(s), YES!

Because she was on orientation, I do not think she could be held fully accountable for that admit. But she's also NOT a new grad. I don't give a rat's patoot that she's 23 and "young," that's a load of hooey. When I was 17 and had my first job cleaning a furniture store, I knew better than to walk off without telling anyone! That is the crux of this. I don't think your GF should be threatened with her license (thankfully for her the DON isn't going to call the state), but she should be spanked and have her toys taken away for acting like such a child.

You said your GF found out later that the preceptor left early to visit her own hubby in the hospital? Why is that relevant in any way? I'm guessing she didn't walk off and leave her patients without a nurse!

I'm sorry if you think I'm being harsh, but I'm sick to death of the way some people treat this profession (actually I'm sick of the lack of work ethic these days). If you get mad, you don't just walk away. People need to take responsibility for their actions, right or wrong.

[scrubsnhugsRN]

This is my take on the situation. Why didnt she know her preceptor left early? As an orientee, she should have been following her preceptor everywhere she went, even though she was orienting another person she should have been following her footsteps. Everything the preceptor was teaching the other nurse would have been valuable for her to learn. It is called initiative.

My preceptor on my first day was teaching a nursing student. So she had the both of us. I was given three assignments on my first day. I am a new nurse too but I know that basics of what I have to do, just because I went to school. Bottomline I knew where my preceptor was, and I followed her even when she was teaching the student, I went in and watched everything. My first two weeks were very frustrating, not knowing anything and feeling stupid, and even overwhelmed, but I would never have walked.

I believe there is no excuse for your friend, she should have been following her preceptor regardless, if she does an admit it is common sense that the patient is her responsibilty.

I think she is lucky the DON does not report her, and personally believe it is a lack of good judgement on your friends part to have walked. This is probably the DON's concern.....lack of good judgement.

[RNOTODAY, BSN, RN]

Well, she admitted the pt, so, wasnt that *her * pt after? Either way, I feel it is abandonement...

[PralineLPN]

Yes, she should have at least told someone she was leaving.

[Mulan]

How did your friend know the preceptor left work early if she didn't even come back after lunch??

My question also, there seems to be a contradiction in the story.

[lupin]

I don't know about your state but where I work here in TN I don't even have to have an assignment to be slapped with abandonment if you just clock out. That may be the hospital policy of where I work and not the state's but since the company I work for owns most of the hospitals in my region that would vastly cut down my employment oppurtunities here. You GF made the agreement to admit a pt and then left at 330pm? That is technically abandonment. She should have just stuck it out the last four hours.

Walking off the job in any career is very unprofessional. There is a reason there is an orientation period, one of them is to see if the job is right for the person and if the person is right for the job. Your friend may not be disciplined for this but if she doesn't gain some professionalism soon she will be eventually.

[burn out]

Personally , I would keep my mouth shut to the DON, it could back fire and anything you say to her or admit to her could further be used against you.

The best thing your girlfriend could do is to see an attorney and plan a good offense...like why was a brand new orientee that was not being surpervised properly allowed to take on a new admission, is this their policy. I am sure they don't want their door open for inspection either.

[Keepstanding, ASN, RN]

Aside from your friend....what happened to the other orientee ?

Did she continue on after the Preceptor left for the day. What did she do ?

Sounds like an immature decision was made by your friend. She needs to think about this for a long time.

[wonderbee, BSN, RN]

What do you tell her? Maybe she should consider another line of work. Seriously. This occupation requires fairly good judgment. This whole thing may come to nothing. Perhaps the DON was making an idle threat. But either way, something's wrong with this picture. If she gets suspended or gets a reprimand from the board, it may be what she needs to wake her up. I know the OP feels badly about this. All I can say is that this is what we signed up for when we accepted our licenses. We all make mistakes. She made a mistake. But this is the kind of mistake that has a STOP sign written all over it.

[TazziRN, RN]

I hope the OP sincerely had read all of the replies, because we're all telling him the same thing. If he really cares about his GF he will tell her about this thread and the replies, and hopefully she will learn from it.

[Jules A, MSN]

I hope the OP sincerely had read all of the replies, because we're all telling him the same thing. If he really cares about his GF he will tell her about this thread and the replies, and hopefully she will learn from it.

He is is entitled to his opinion of course but it seems to me from his posts that he keeps seeking ways to justify her walking off the job. I don't think there is an excuse no matter how poorly the orientation was going or how crappy the unit was but thats just me. I wouldn't excuse leaving for lunch and "not going back" no matter what type of job you have. Have the decency to tell someone that you quit if that is what you need to do but just slinking off doesn't sit well with me especially for a nursing professional.