Hospitals SUCK at orientation!!

elkpark · Mar 16, 2008

Wow -- after reading your post above, I checked your old posts to see what your other posts have been like, and, less than three weeks ago, you were posting that you loved your new job on the med-surg unit. Did something in particular happen to change your mind?

I'm certainly not going to try to talk you out of how you're feeling about nursing at this point -- best wishes for your return to corporate America.

SoundofMusic · Mar 16, 2008

Wow -- after reading your post above, I checked your old posts to see what your other posts have been like, and, less than three weeks ago, you were posting that you loved your new job on the med-surg unit. Did something in particular happen to change your mind?
I'm certainly not going to try to talk you out of how you're feeling about nursing at this point -- best wishes for your return to corporate America.

Elkpark, I do like my job. Despite the orientation, I am learning a lot and doing well with my assignments. I am just stating the truth here, that orientation at many hospitals is sorely lacking and that many of the experienced nurses (not all, but many) are very unprofessional and rude. Perhaps it is not ok to speak the truth here - but it is the truth. I'm sorry if it offends, and it looks as it has offended you, and perhaps the site in some way -- but if you can't listen to nurses that are out here, then what good is it to even have a site or a forum to support new nurses?

cardiacRN2006, ADN, RN · Mar 16, 2008

I had a wonderful orientation! I can't think of anything I would have changed. I felt it was quite typical. There were some times where I felt confused, abandoned and also picked on, but a little soul searching on my part helped me through those times.

In retrospect, that's just the way most new nurses feel. It's normal.

Nursing isn't a typical, corporate world type job.

You are left to flounder around for hours on the floor, and if you attempt to ask your Preceptor of the Day a question, you get the look and that attitude that you are just plain stupid and how dare you even ask such a question because, well, "you should know that by now," or some other such comment. Many times you are treated with outright hostility when you are just an honest person trying to do an honest job, and busting your butt in the process.

Now that I'm on the other side of the fence I can ask....Are you sure that your preceptor is really looking at you like this? I've seen lots of new grads say the same thing, but I'm observing the interactions and it isn't' always this way. Lots (and I mean LOTS) of times, we project our feelings of inadequacy onto others. This is a normal new grad response. Take some time to soul search yourself. If you feel that you can't handle being a bedside nurse, then perhaps there is another role for you in nursing someplace else.

Pediatric Critical Care Columnist · Mar 16, 2008

I don't think elkpark was offended at your post, only concerned for you that there'd been such a radical change in the tone of your posts.

I agree with you that the orientation process in many hospitals isn't doing a good job of preparing new nurses to work in them. Our unit is a perfect example of how NOT to do it! Many of the things you pointed out in your post are happening here too. The new staff are being bounced around from "buddy to buddy" and not really being precepted at all. Most of the new staff that I've been involved with in that sense have been dropped in my lap and I have no idea what they've already learned, what they can do independently and what they need help with. I don't resent being placed in that situation so much because of having responsibility for the new nurse but because it's not fair to them. I love to teach and often talk myself hoorifice, but it isn't fair to either of us if we've never even met and now s/he's expected to give me a rundown of all those things I need to know about working with him/her, who has already worked with him/her and what gaps there are in the education. I try to give them the best experience possible and the feedback I get from them is always positive. Recently I had my assignment changed shortly after the shift had already started and found myself with a preceptee. No one introduced us, and he didn't tell me he was a nursing student. I found out by accident when I looked at the signature log on the patient's chart (we're assigned 1:1 usually in the PICU). His assigned preceptor was a no-show that night. It could have been a disaster, but we managed to have a good shift, and he learned a lot about handling difficult parents...

We have a new nurse educator who is trying to fix the broken system, with only limited success. She doesn't make the assignments and so the new nurse may be buddied with someone who must take a patient that is well over the head of the new nurse, because our staffing sucks so bad and there is no one else. So the new nurse learns very little on that shift and is allowed to do virtually nothing. This is particularly a problem if the preceptor has been chosen poorly and won't take the stable, simple patients because they're "boring". (We have a lot of those!) I'm hoping that our new CNE is able to make things work better, because we're losing our new nurses almost as fast as we're losing the experienced ones. Not a good scene.

elkpark · Mar 16, 2008

Elkpark, I do like my job. Despite the orientation, I am learning a lot and doing well with my assignments. I am just stating the truth here, that orientation at many hospitals is sorely lacking and that many of the experienced nurses (not all, but many) are very unprofessional and rude. Perhaps it is not ok to speak the truth here - but it is the truth. I'm sorry if it offends, and it looks as it has offended you, and perhaps the site in some way -- but if you can't listen to nurses that are out here, then what good is it to even have a site or a forum to support new nurses?

I was not at all offended :) -- just attempting to not insult or offend you by telling you that you "shouldn't" feel the way you're feeling, or suggesting that I know better than you what you should do with your future ... I apologize for not communicating that clearly enough. As a "second-career" person, you are obviously an adult, and know your own mind and goals. You sounded like you were using your post to "sign off" on nursing, and I respect that.

SoundofMusic · Mar 16, 2008

because we're losing our new nurses almost as fast as we're losing the experienced ones. Not a good scene.

No, it's not. It's a terrible scene, and with the coming Baby Boomers aging, this is a recipe for utter disaster in our healthcare system which is already imploding in so many ways.

I have only posted my statement truthfully to try to help this profession in some way. By being typical females and just allowing it all to go on as it has, we will NEVER remedy this situation. If a new grad like me does not speak up -- what will happen?

I believe it could happen, with a total overhaul of how nurses are brought into the profession and trained. I have said it before -- nursing needs a "preceptor" corps. They need to find and identify those who CAN and enjoy teaching! There ARE great preceptors -- I know they're out there. You hear about them, but they're not the common experience.

And they need to get paid well for their ability to do so -- not some piddly $1 extra an hour and take a class -- I mean, they need to be paid a speciality rate and be specifically trained -- perhaps even with a masters degree educational level?? I believe a development of this kind could even increase the numbers of those who desire to go into nursing.

This would solve the dang nursing professor shortage crisis as well -- and honestly, God bless those professors I had in nursing school, but not many of them had a clue about nursing as it is today and none of them had stepped onto a floor to work in 20 years! We truly need to learn from nurses who are doing it now and who have current skills.

I guess I'm probably naive, as hospitals are a business and this can't be done affordably. But it needs to be done, or there will be enormous trouble in the years to come.

Miss Mab · Mar 17, 2008

Do I plan to stay in nursing? No FREAKING WAY. I want to return to the corporate world where I came from in some capacity, where professionalism and respect for employees is the norm -- I have yet to find this in the nursing profession. Yes, perhaps I am one of the whiners, and need to change jobs, but it seems I'm hearing this from more than one person here, as well as many of my classmates.
God help the state of nursing and healthcare in this nation. ..something just needs to CHANGE.

Hello!!!!

Deep breath.... You are not alone! :)

I'm so sorry you're feeling at the end of your rope.....the "orientation" period you describe appears to be, sadly, not that unusual. There will always be places that are still able to do things the proper way but using the experiences told on this site and of new hires i interact with in a different RN capacity anecdotally, I don't see the trend heading in that positive direction.

I have no great words of wisdom excpet to remind you that you DID graduate and pass NCLEX and land a job and so you are obviously quite capable of succeeding as a nurse, depite what must seem a million stumbling blocks on your road to get there. Hang in there. Nursing may not be for you after all but I think you owe it to yourself to give it a fair shake---at least until it or unless it physically/mentally makes you ill....

I've been wondering something myself lately. I think it's a given that there is an accepted "new grad" reality shock and some pretty predictable patterns that most of us seem to go through. I wonder though, if this culture shock is made even more glaringly apparent and disheartening for those who come from other careers/ljobs, as opposed to nursing being the first "real job" one has experienced for any significant length of time.

I don't have the answer on this one. It's just been something going through my mind during this little period of down time I've afforded myself. As a second(or third, really) career nurse I find the most jarring reality to deal with is the stunning amount of disrespect toward the job, both from within the field and without, and the disregard for the education and responsibility that nurses hold.

In my experience, those that say 'no one can disrespect you if you don't blah blah' either have never been significantly involved in other professional areas to be able to objectively compare and contrast workplace environments or else have an exceedingly stunning amount of self fortitude and esteem. Who knows? Perhaps it is the latter....

I don't know if that's what you're feeling but if I'm anywhere close I just wanted to tell you you're not the only one---good that you have contacts from nursing school to help you through.

I get nervous when it appears to be generally accepted that one has 'succesfully' made the transition once they've become entrenched in the culture and accepted the negatives you've highlighted as the norm......

Nursing against the odds! Suzanne Gordon book we were supposed to read in school and I never did , she admits sheepishly. It may not have all the answers but it does at least confirm that, no, it's not you, it's them! :))

Good luck...sorry for the essay:typing

BrokenRNheart · Mar 17, 2008

"In my own experience, my own management "team" did a really slick sales pitch for their unit. Once I joined the unit, it seemed their personalities changed almost overnight -- all smiles and wonder at the sales pitch, and all nasty, rude and demanding once you've been on the floor for a few months."

Here is a joke I was told about nursing recruitment:

There was this guy who passed on and he was given the opportunity to decide if he wanted to go to He** or heaven. He was taken on a tour for an interview to both places. When he got to heaven it was quiet and and pleasant and certainly looked like a place he could be happy at. But when he went to He** they were all partying and friendly and so happy. Everyone was so glad to meet him and telling him what a wonderful place it was and begging him to come stay there. After all that he heard about He** he just couldn't believe what he saw. What a wonderful place! It wasn't hard for him to make his decision. On his first day in He** it was hot, every one was nasty and mean and treated him aweful. When he asked what had happened, why they were so friendly and nice when he interviewed them, the Devil told him "That was the interview, we are always like that when we interview. This is what it's really like here."

:mad:

I have been hearing more and more about how disappointing orientation has been for new nurses. I think a lot of it has to do with the high turn over. These preceptors are having to train nurse after nurse after nurse. Same thing with techs. They probably get burned out. Also....some personalities do not suit teaching. When I train, I do NOT belittle or make anyone feel uncomfortable asking questions. But, see....I don't fit. I should be a nasty sour prude.

allthingsbright · Mar 17, 2008

Though I have had a great orientation, I have kept up with many of my classmates who would say the same thing! I think it really depends where you are--specialty-wise, institution-wise, etc. I went straight into the specialty and while orientation has not been perfect, it has been a 95% positive experience.

Whatever you decide to do, I wish you the best! I am sorry to see the nursing profession lose another nurse!

shellsgogreen · Mar 17, 2008

my orientation was ok - but i also think it depends where you work; if it's a good team or not; i got pretty lucky with my unit, as when i got off orientation and started with my preceptor, they all were very helpful, plus we have instructors who are designated to certain floors and they checked in with us too frequently enough so we weren't feeling abandoned.

original poster - i wish the best for you, whatever you decide to do

SoundofMusic · Mar 17, 2008

I'm so sorry you're feeling at the end of your rope.....

Well, I may have been misunderstood here. I'm not at the end of my rope in any way and plan to finish out all of my obligations to the hospital that hired me. Maybe this is all in the cycle of how new grads feel, but is it really a part of a cycle or a true symptom of an illness that is ailing this profession?

Yes, nurses sure do get burnt out on precepting . .and I wonder why? In addition to their shift duties, they're supposed to TEACH another nurse along the way. Teaching is a skill in and of itself!!! It helps to know teaching styles, what motivates an adult learner, proper teaching principles, etc. If preceptors are not "taught" to be preceptors, then who and what IS exactly the teaching process here with new orientees? I know at our hospital there is a preceptor course of some kind, but it's completed in a matter of days whereas true "teachers" take years to develop.

In my case, it's get out there and do it, come to me with questions, and maybe I'll answer them, maybe I won't, depending on my mood and my own current level of stress and responsiblity (my own preceptor sometimes even is assigned as charge nurse on the days she's also precepting me.) Maybe I'll answer politely, and maybe it will be with disrespect and hostility, especially if you annoy me with a question I think you should already know or that I dont have time to answer because I've got a million concerns of my own. Not to mention, I'll warn you over and over that if you DON'T do as I say that your license is "on the line" and several errors will lead to the loss of it.

I mean -- what is this? Is this really teaching? I blame it not on nurses, but on hospital administrators/powers that be for loading nurses up with such a huge responsibility beyond their scope of duties and not paying them more and giving them the adequate training to do it. I think nurses are doing the best job they can with what they've been given to work with, as always. But it's really not fair to them and definitely not to new grads who really need a good foundation to start their careers.

Again, I will say this: my hospital does an outstanding job at allowing us to attend classes, of providing us all the information we need to do our job. I get handouts, notebooks, guidebooks, everything I need to succeed. But out on the floor, you can't keep running to the books. You need the guidance of a kind, firm, knowledgeable and patient nurse. At least for a little while. And when you make mistakes, you don't need a brow beating. Yes, if you're making the same one over and over, there's a problem -- but if its something you've never been exposed to -- allowing room for error at least once or twice would be the humane thing to do.

I also apologize for the essay -- I hope I don't sound like I have some huge axe to grind, because I don't. I'm just offering this in hopes that maybe someone will really listen to it and make change. Maybe I myself need to come out with this to my own adminstration and effect change in my own hospital. Probably should. I know managers must go through hell listening to all the whining from their staff, but it might pay them to listen to it once in a while and take care of it -- maybe they would ease up their own headaches with staffing if they did.

I am trying just not be point out problems, but to offer a solution: a solid "preceptor' corps, brigade, whatever you want to call it. Identify those who can teach without belittling, pay them extra, and develop a stronger orientation process. The solution is just NOT that hard!