I'm sorry, but this needs to be said. I hope there are some nursng management types reading this:
I graduated from nursing school last August. I went to one job and the experience was so horrible I found another position on a more med surg type floor in one of the so-called "Top 50" hospitals in the nation. Now, granted, this position seemed to come with a better orientation process and they at least try to orient us in some ways with special classes and pull outs, but it still SUCKS.
Hospitals, administrators -- you are failing at orienting us. Just look at the unhappy posts here by dozens of new grads. The typical experience seems to be: You walk on the unit your first day, no one is expecting you, none of the other nurses bother to introduce themselves or welcome you (they usually think you're a travelor or a float nurse), you are given an "official" preceptor, but then in the following weeks, you may never see this official preceptor again. You then follow ten different nurses who do things ten different ways, and in total, have about 30 different personalities between them all.
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.
Come on, hospitals - take a look at corporate America or some other large institution, and try to figure out a better way to train the BACKBONE of your business!!! I mean, I can't figure out why it isn't any better than this?? Do you EVER wonder why nursing retention rates are so POOR?? Can't you find nurses who CAN educate us with respect and make them the consistent "preceptors," and not just throw us in with the nurse of the day?
Coming from a prior career, I am just astounded at what nurses are responsible for, yet how poorly they are trained, how poorly they are treated, how nasty some of the nurses are that we are supposed to be looking to for guidance, and how little respect is given to individuals who were not only accepted to rigorous nursing schools, but managed to graduate, even managed to achieve very high marks in these schools of nursing. I mean, you're being given the most quality individuals around, yet you can't seem to teach them in a way that is professional, thorough, consistent, and even the slightest bit enjoyable.
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.
So, in summary, I hope it changes someday. I am really taken aback by just how unprofessional many of the nurses are -- the gossip and backstabbing is just pure evil, there is no morale or cohesiveness in the units, especially with all the travelers, and many of the management types just walk around like prison wardens, yet never bothering to take a patient of their own for a day to remember what the demands are like.
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.
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
i see that you're in ny. what hospital did you have your orientation at?
Specializes in Trauma acute surgery, surgical ICU, PACU.
Now, your school tells you (as they deposit your tuition check :)), "Sure, you're not really learning anything in school, but that's okay, because you'll learn everything you need when you start working." I can't imagine why anyone, students or academics, considers this acceptable (I certainly wouldn't have when I was a student).
I consider this to be a MAJOR problem.
We're just learning now that more than 60% of our new grads quit nursing within the first two to five years, and at two years they are identifying in surveys that they want out.
Either people got into nursing school who didn't really suit the profession (or they didn't really want to be a nurse but needed a job, whatever the reason is), or something has changed about the preparation for the job.
I used to work on a trauma/surg ward that was very busy. We had a lot of busy, sick pts, discharges, admits. But also a lot of drains, tubes, IV's, funky dressings, etc. We had a couple of senior students and also new grad BN's that came to our ward because they really hadn't absorbed enough learning in Skills Lab and so they were gonna learn it with us. It was HEAVY, as a preceptor and as a senior nurse on that ward to have to play nursing-school-teacher to people who needed to be shown so many skills, or who after having graduated were still at the "can you watch me do this" stage. There's always things people don't know, sure. But some are at more of a "beginner" level than others right out of school, and I don't know if it's right to expect employers to absorb that. People have already made the points that bedside nurses aren't trained in how to teach, don't get paid to do that, don't have time, etc.
I really feel that more of what the newbies are calling "orientation" should be under basic education and practise in school.
See, I take issue with the statement that many of us are in this for the money. Well, people are in a lot of other professions for the money also.I could do other jobs for money, but I chose nursing. I chose it for a reason -- because it interests me and I do entertain the thought of doing something significant vs. sitting at a computer all day. Yes, I need to be paid a salary, though and that is the "reinforcement" that keeps me at any job.
These skills CAN be taught to most people with average intelligence. But it takes repetition sometimes and just training.
I think it would help if nursing schools requires a year of tech experience from their applicants. That, or extend the schoolinjg or provide a nursing residence as we've discussed. You can't make a Nurse in Year -- just isn't going to happen with someone new to the profession.
Specializes in Peds, Home Care, Cardiology, Pulmonology.
After being in nursing for 34 years here is my take ......
Orientation is not there to teach basic skills. That should have been done in school.
The purpose of orientation is to orient the new nurse to the policies/routines etc of the specific unit/hospital where they are employed.
It is frightening to me to have seen how much these 'new' nurses do not know!!! I have worked with BSN's who have said "I would like to see a delivery, because I never saw on in school" YIKES!!!!
Although my diploma program was back in the dark ages......when I graduated I KNEW felt confident being on a unit and having a grasp of most nursing procedures. My program was 36 months, with two weeks off each year for 'vacation'. We didn't have summers off for 'externships', we had clinical at least 2 if not 3 days per week beginning at the end of our first year....8 hour shifts. By the third year, we had clinical every day, with one hour off on Fridays to meet with the instructors for a 'conference'. We worked 2 weeks of 3-11, and 2 weeks of 11-7
Orientation was a laugh back then!!! I graduated from a small school in the sticks and went to the big city to begin a job in Pediatrics. The first weekend I was scheduled to work....I was the only RN [actually a GN] and I was in charge and had to give all the meds, my 'staff' was two LPN's !!!!
Students today need much more clinical experience, and less time writing extensive care plans. Honestly , in 34 years of practice, I have never felt the need to refer to such a document!!! Writing a five page care plan but not knowing how to use it is a total waste of time!!
I don't know what the answers are and I apologize if this is rambling on . My co-workers and I have had this discussion so many times.
After being in nursing for 34 years here is my take ......
Orientation is not there to teach basic skills. That should have been done in school.
The purpose of orientation is to orient the new nurse to the policies/routines etc of the specific unit/hospital where they are employed.
It is frightening to me to have seen how much these 'new' nurses do not know!!! I have worked with BSN's who have said "I would like to see a delivery, because I never saw on in school" YIKES!!!!
Although my diploma program was back in the dark ages......when I graduated I KNEW felt confident being on a unit and having a grasp of most nursing procedures. My program was 36 months, with two weeks off each year for 'vacation'. We didn't have summers off for 'externships', we had clinical at least 2 if not 3 days per week beginning at the end of our first year....8 hour shifts. By the third year, we had clinical every day, with one hour off on Fridays to meet with the instructors for a 'conference'. We worked 2 weeks of 3-11, and 2 weeks of 11-7
Orientation was a laugh back then!!! I graduated from a small school in the sticks and went to the big city to begin a job in Pediatrics. The first weekend I was scheduled to work....I was the only RN [actually a GN] and I was in charge and had to give all the meds, my 'staff' was two LPN's !!!!
Students today need much more clinical experience, and less time writing extensive care plans. Honestly , in 34 years of practice, I have never felt the need to refer to such a document!!! Writing a five page care plan but not knowing how to use it is a total waste of time!!
I don't know what the answers are and I apologize if this is rambling on . My co-workers and I have had this discussion so many times.
Sounds just like my 3-year diploma program that I graduated from in 2006. Still educating students and believe me, we're welll prepared. In fact, there's now a waiting list for this school.
wow, I just read thru this whole thread and I found it fascinating. The differences in nursing schools across the country is just mind-boggling. We just started an accelerated program at our university, and many of the "traditional" students (BSN) agree already that there is no way to get the needed clinical time in one year.
I'm looking heavily myself into a program that has a year long orientation, just to get more experience, and that is after I do a summer internship this year.
My question is -- why did nursing education change. If it was working, what happened?
The world got more complicated. The health care industry got more complicated -- and nursing wanted to keep up with the developments. So, a lot of things were added to nursing curricula (mostly on the "academic side" of nursing.)
It wasn't a bad thing that those academic aspects of nursing were developed. That side of nursing is vital to our continued growth and development. Unfortunately, people were unwilling to lengthen the time and expense it took to become a nurse. So, to make room for the new stuff, the clinical time was shortened.
Also, many people have been unwilling to acknowledge that the development of nursing as an academic discipline meant that there would probably be the development of "different kinds" of nurses -- some that focused on the performance of direct care tasks and others who focused more on the academic side. People continued to labor under the misconception that all nurses should do both equally. "Everybody should take the same NCLEX and be the same." That lead to development of programs that provide a "watered down" education on both dimensions of nursing -- programs that try to squeeze a little bit of everything into a brief time period that hasn't changed in decades. To make room for the "new stuff," the "old stuff" got compressed or eliminated.
Then, with today's nursing shortage, there has been increasing pressure to graduate new nurses at a quicker pace by shortening the programs even more -- resulting in graduates who are even less prepared than before.
The solution is NOT to go back to the education of 20-30 years ago. We need to build programs anew -- taking the best ideas from all types of programs -- incorporating the best of what the old diploma programs offered as well as the best of what is offered by the leading university programs. Perhaps we need to STOP assuming that all nurses should graduate alike, but rather adopt a new model that allows for pre-licensure specialization with more indepth clinical in that area. etc. And yes, it might mean eliminating the accelerated programs etc. and lengthening even the average program -- or requiring an indepth clinical practicum prior to licensure, etc.
Tough choices need to be made.... And there will be losers as well as winners as the system evolves.
After being in nursing for 34 years here is my take ......
Orientation is not there to teach basic skills. That should have been done in school.
The purpose of orientation is to orient the new nurse to the policies/routines etc of the specific unit/hospital where they are employed.
It is frightening to me to have seen how much these 'new' nurses do not know!!! I have worked with BSN's who have said "I would like to see a delivery, because I never saw on in school" YIKES!!!!
Although my diploma program was back in the dark ages......when I graduated I KNEW felt confident being on a unit and having a grasp of most nursing procedures. My program was 36 months, with two weeks off each year for 'vacation'. We didn't have summers off for 'externships', we had clinical at least 2 if not 3 days per week beginning at the end of our first year....8 hour shifts. By the third year, we had clinical every day, with one hour off on Fridays to meet with the instructors for a 'conference'. We worked 2 weeks of 3-11, and 2 weeks of 11-7
Orientation was a laugh back then!!! I graduated from a small school in the sticks and went to the big city to begin a job in Pediatrics. The first weekend I was scheduled to work....I was the only RN [actually a GN] and I was in charge and had to give all the meds, my 'staff' was two LPN's !!!!
Students today need much more clinical experience, and less time writing extensive care plans. Honestly , in 34 years of practice, I have never felt the need to refer to such a document!!! Writing a five page care plan but not knowing how to use it is a total waste of time!!
I don't know what the answers are and I apologize if this is rambling on . My co-workers and I have had this discussion so many times.
I agree with you completely. As a new grad RN, though, with little choice, what are WE to do? Most programs are set up with all the textbook stuff and not nearly as much clinical experience in comparison. There are some things I do NOT know how to do, even though I am working on my own now. This mean I would have to ask for help. The hospital that hired me KNEW THIS, however, and still took on this burden -- as do so many other hospitals. Unfortunately, my co-workers didn't agree to this arrangement. So... here I am, stuck in the middle of what management has agreed is acceptable and what (some, not all) staff nurses feel is just an added burden.
I agree with you completely. As a new grad RN, though, with little choice, what are WE to do? Most programs are set up with all the textbook stuff and not nearly as much clinical experience in comparison. There are some things I do NOT know how to do, even though I am working on my own now. This mean I would have to ask for help. The hospital that hired me KNEW THIS, however, and still took on this burden -- as do so many other hospitals. Unfortunately, my co-workers didn't agree to this arrangement. So... here I am, stuck in the middle of what management has agreed is acceptable and what (some, not all) staff nurses feel is just an added burden.
The best you can do is to not blame the staff or the unit educators for the situation. Realize that you are all in the mess together and they need your support as much as you need their patience and teaching.
Support them. Make friends with them. Be as helpful to them as you can be. Don't complain about every little thing that is not perfect about your job. Don't expect them to be perfect teachers. etc. etc. etc. As they get to know you and see that you are willing and able to learn (without being a big burden or a complainer), they will see you as someone they want to invest in. In time, you will become a respected and trusted member of the staff -- in other words, one of them.
I think also, not only can we just do our best to get along and get through it, and NOT BLAME ourselves, but we could also probably communicate with our schools of nursing and let them know how unprepared we were and how difficult orientation was not having gotten basic skills down before graduation and not having had enough clinical time.
Perhaps if enough new grads complained to their schools, they'd start to listen.
Pressure needs to be placed on the educators and the hospital administrators. Will it get done anytime soon -- sorry, but I'm really doubtful as many folks will just endure it and suffer through, never speaking up about it. Many, I also believe, tend to gloss over it and not admit how hard it was for them also, out of pride.
It's funny, as we've got through this thread, I remember one of my best instructors saying to me: "Anyone can learn the clinical stuff ...but we're teaching you to THINK, critically."
Yeah, ok, but that doesn't help me in the moment, when 3 IV's are beeping, someone needs an enema, my paperwork is piling up, I've got a new admission, and the shift is coming to an end. I need major time management skills -- and it only comes by DOING. If we're not doing that in clinicals, we're going to have to learn it on the floor -- the hard way.
Another point in regard to how nursing education might need to change for the future... I think we may have to lose some of the assumed flexibility of changing nursing specialties and instead have more explicit specialization to different types of patient care.
We could go back to training all acute care nurses for a general med-surg unit. After that, nurses could take 6mo-1yr specialization programs that would cover the unique physio, pathophys, pharmacology, nursing care etc of a particular area such as maternity, cardiology, oncology, pediatrics, etc. Perhaps hospitals wouldn't be allowed to hire just any nurse for any nursing position but could only hire a cardiology certified nurse to a cardiac step-down unit.
It would be a draw back for practicing nurses to not be able to so easily jump from one area to another and it would be a drawback if nurses had to invest extra time and money to get specialized training. But it would also protect nurses from being pressured to work in areas where they have no real experience and it would give nurses the resources to make a safe transition to a new area. And hospitals might be willing to pay for such training in areas where they can't find qualified staff. Though for popular areas (eg maternity) it might be up to the individual nurse to invest in the extra training.
For this type of training, though, there would have to be some kind of educational provider out there that offered post-graduate training and certification. There's very little of that available currently. It's usually that one works in a specialization for some time and THEN becomes certified.
And where does non-clinical nursing fit into nursing education? School nursing, occupational health nursing, public health nursing... should there be a whole other track for these types of nursing? There is still an assumption in much of the nursing community that acute care clinical nursing experience is a necessity for all other nursing roles. Most definitions of nursing includes these roles but is there enough time in training programs to include these along with acute care skills? Is it reasonable to try to cover it all? Lots of questions!!!
I KNEW felt confident being on a unit and having a grasp of most nursing procedures. My program was 36 months, with two weeks off each year for 'vacation'. We didn't have summers off for 'externships', we had clinical at least 2 if not 3 days per week beginning at the end of our first year....8 hour shifts. By the third year, we had clinical every day, with one hour off on Fridays to meet with the instructors for a 'conference'. We worked 2 weeks of 3-11, and 2 weeks of 11-7
lench1k
5 Posts
i see that you're in ny. what hospital did you have your orientation at?