help with management decision on new grad

[aainme]

i just need some help with a management decision to place a new grad in our unit on the night shift.... we have a small unit only 6 beds...we usually work two nurses alone on the the night shift...we have been short handed and the manager hired a new grad right out of nursing school..... she has had a few months of orientation but failed her boards and had to work as a tech for 6 weeks until she could retest....she passed her boards a few weeks ago and will have three more weeks of orientation on days ...then she will work as the second nurse on the night shift with me......i have nothing personal against this new nurse....i am just uncomfortable working alone with a new grad in the icu....we have some very crazy nights there, as we are alone without the benifit of all the resources they have on days....( managers, extra resp people, techs).....to work with only two nurses we have to be very resourseful and be true team players to cope with some of the critical care patients that come in on the night shift....am i crazy to be so afraid? i think back on my first year of nursing and can see how difficult the transition was....i really learned how to be a nurse after i left school and worked on the floor....if this was a three person unit i would have no problem with this decision...that would be a good learning environment for her and there would be two experienced nurses to provide resource for her and care for the patients ...please help with advise....or your experiences, or just some new ideas for management.....thanks again

[meandragonbrett]

I think it greatly depends on the specific individual. Some people who are coming out of school are more intelligent and have more common sense than some with experience. You all could always look into have the person do the Essentials of Critical Care and the Critical Care Nursing Core curric. from AACN. AACN has some great resources out there.

[samswim4]

Well, coming from a student nurse who hopes to be hired on in ICU after graduation, I think this will be a great opportunity for you both. With your wealth of knowledge and skill, I think you will have the opportunity to show not just the new grad, but yourself as well, how capable you are of managing your patients and a new hire at the same time. Although she may be "green," if this is what the new hire wants to do, she will do her best and learn as much as possible from you and perform to the best of her ability. I'm sure it's going to be tough for you both for the first couple of weeks, but you will learn how each other functions, and become more of a team.

All that new grads ask, is that you give them a chance, which I know you are well aware of. I'm sure in the end, it's going to be a rewarding experience for you, knowing that you were able to teach your knowledge and skills to this new hire. Good luck in your decision!

[bluesky, BSN, RN]

Night shift when there is no one around to competently mix a drip you need or set up a transducer is DEFINITELY NOT a safe time or place to be a new grad. If I were in your shoes I would politely share my concerns with the manager. I would ask to have her on days or to orient for longer if she is going to be the only other RN on. Absolutely not. If you are one of the 2 only nurses and the other is a new grad, you would be charge AND teacher AND nurse. No way. Your first priority is to provide safe patient care. Your second priority is to protect your license. Good teaching occurs in an atmosphere where the first 2 priorities are met so you can be a good role model.

I myself was a new grad in ICU at a level 1 trauma center with lots of support who went to Night shift way too early. While I made no major mistakes, my learning was completely stunted on nights because I was not able to attend rounds (which is where you learn a lot of ICU thinking) and most of the other resources (such as CNS') Furthermore, adjusting to the sleep deprivation on night shift is not the best time to learn.

To the student who responded so enthusiastically to this post. I am in no way criticizing your aspirations to go to the ICU as a new grad. Many of us have done it successfully and proudly. This is a very specific situation with a very small ICU and a skeletal staff. If one patient starts to go down and she is busy doing CPR or calling docs or starting ACLS, do you really want the responsibility of trying to find a drug or perform a procedure you have seen once or not at all because she is too busy to show you? Futhermore, all the experience that goes into critical thinking cannot be expected of a new grad on nights by herself. Or what if god forbid both patients get unstable at the same time... is it really fair to expect the one nurse to play charge, be a consultant to you, and manage her own unstable patient? When you graduate, I strongly recommend that you go to a big teaching hospital. You will get lots of great experience, with sicker patients, more nurses and plenty of teaching going on.