Help with med/surg

Long Term Care Columnist / Guide · Apr 19, 2012

How long is your orientation period? Anything less than 4-6 weeks for a new M/S nurse, or less than 3 months for a new grad, is simply inadequate. Not only that, it takes the vast majority of nurses anywhere from 1-2 years to establish competence in such a job, and sometimes even longer to feel totally comfortable in the role. You can hardly be expected to have it all together in three days!

Take it easy......you've got a lot of learning ahead of you. :hug:

BostonTerrierLover, BSN, RN · Apr 19, 2012

Unfortunately, It won't come in any encouraging words I can give you, except be alert, as prepared as possible, and open to new learning.Then, just like Algebra, on day on a shift, you will realize- "I get this!" It will hit you like a ton of bricks. You will get that confidence- but ALWAYs keep that scary little gut feeling alive- It saves lifes, limbs, and licenses! Best of Luck to you!

kcardinalrn · Apr 19, 2012

You will be surprised how much you will learn during your orientation. At my facility, there is a minimum of 14 weeks of orientation for a new grad. During that time, you should be asking questions about what you are seeing, especially things you are not familiar with. Things like that are going to come up throughout your entire career. Look the surgeries up during down time (yeah right) or on your own time. You will want to know this information, and you can be a resource for those who have questions in the future. I have worked on an extremely busy surgical unit for five years and I have seen so much, but there is always something coming in that I haven't seen. Basically what I am saying is, ASK QUESTIONS!!! Try to stick it out through the hard times, they will get better and we really need med-surg nurses!

Tsatalstrana · Apr 20, 2012

So, my fourth day on the floor and I walk in and my preceptor hands me the full patient load....I thought ok, by this time I guess I should have a full patient load i guess! What a total disaster to say the least. I was sooooooo overwhelmed I had no idea where I could run to. My unit manager and educator called me into their office just to see how things were going. So I told them I was not ready to walk in here and do a full load and this was going way to fast for me. I cried all the way home (i hour drive), did not eat or drink for over 14 hours....I basically don't even THINK I can return to another shift on a med/surg floor.. I could not handle this in the least way...

kcardinalrn · Apr 20, 2012

Why are you getting a full patient load on your fourth day? How many patients? At my facility, you start with two patients and work your way up to 5-7 depending on the shift you work. Is your preceptor helping you at all? You really need to speak up for yourself and voice your concerns. That is the only way you will get support from your manager, trainer, or preceptor. I'm sorry you had such a bad day

Katie

Tsatalstrana · Apr 20, 2012

thanks Katie....still crying...and crying....and more crying....

tokmom, BSN, RN · Apr 20, 2012

Wow, that is not fair to you at all. How do they expect a new grad to survive? That's insane! I started out like that years ago, in a facility, but I had been an LPN prior so I knew the ropes. I can't imagine being a brand new grad!

Our facility gives 12 weeks with a preceptor and like others have said, you work up to our max of 5 pts. If you stumble, you are taken down to 3 and given time again to get to the max again over a few extra weeks.

This is setting you up for failure. You are not a bad nurse and it's not your fault.

They need to keep you with one preceptor and give you weeks of orientation. You will have to speak up. Practice at home if you need to, to reheorifice your speech. Are the preceptor and boss supportive?

kameera · Apr 20, 2012

Gud luck, I was i was slected for post surgery, I have confidence but i do not understand why do not they pass me in interview

0402 · Apr 20, 2012

That sounds rough. Even when I started a new m/s job at a new hospital (with experience), I only shadowed the first day, trying to get the lay of the land and mostly observe the charting and procedures with calling docs, etc. The next shift, I think I only took 2 or 3 pts and did that for about a week, because I was so slow with the charting system that was so unfamiliar to me. After that, I took a full load, but again, I was not a new grad. I cannot imagine doing so as a new grad.

When I precepted at my last hospital, our new grads got 12 weeks, and the first day, we did shadowing, and the next 2 shifts, I only gave them 1 pt, so that they could do things at their own speed and have time to get used to things and get more familiar with where things are and I also brought them with me to do things with the pts I kept, for learning purposes, but their primary responsibility was their one pt. We moved up from there, at their speed, with most carrying a full load after the first 5-6 weeks, so they got about 6 weeks with a full load and a preceptor.

Tsatalstrana · Apr 20, 2012

Well, I am a new grad to RN, but have been an LPN for 5+ years, all of which were in LTC. I still had a tremendously hard time. It is like moving to another continent!! The PACE is way too fast for me...I will not be offended if someone tells me that this area may not be right for me. It was a miracle I did not kill anyone yesterday!! I still haven't recovered, spent all night crying and woke up crying....my poor husband...glad there is this site for some relief..

kayern · Apr 22, 2012

First, three different preceptors = unacceptable.

In our program there is a three week classroom orientation then a four week clinical preceptorship (and additional shifts if needed).

Our new grads take a full patient load Day #1 but with the preceptor holding their hand as they go. The preceptor guides, mentors, coaches, assists and helps introduce our new nurses to the world of real life nursing and into our culture. As the manager, I meet with them formally on a weekly basis with our Clinical Nurse Specialist/Educator. I go in early daily, especially if I have night orientees, I want them to know who their manager is, just as the day orientees get to see me daily.

Good Luck to you.