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How are all other experienced nurses coping with orienting new nurses

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snowfreeze has 16 years experience as a BSN, RN and specializes in ICU, CCU, Trauma, neuro, Geriatrics.

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The unit I am working on has currently 3 new nurses off orientation and we have 7 more coming on in the next 3 months. It is wonderful that there are nurses to fill the slots, but a lot of new nurses in a short period of time. I like all of the new nurses so far. A bit anxious about the new group though, we never know what is coming in.

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I am a new nurse, and I will be orienting for 16 weeks starting in July. As an experienced nurse, do you have any suggestions for the new nurses? I'm sure we are just as anxious as you are.

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ArwenEvenstar specializes in med-surg, teaching, cardiac, priv. duty.

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Hi Snowfreeze! I understand your concerns. I left the hospital (burned out!) about 2 and 1/2 years ago, but worked as a hospital staff nurse for about 14 years before that. In the last couple years that I was at the hospital, there was a huge influx of new (just out of nursing school) nurses being hired. Yes, it is so great to have empty positions filled. I am very supportive of new nurses, and whenever I oriented one I tried to be as helpful and supportive as possible.

But, things were out-of-balance between the number of new nurses and experienced nurses. Especially on some units. On the last unit I worked on, sometimes on any given shift the staffing was about 80 to 90% new nurses working (less than 6 months to a year experience) and 10 to 20% more experienced nurses. It was scary! (Please do not mis-understand me - I am not saying new nurses are scary!!!) But some things are only learned through time and experience. Until you actually experience some types of situations, you don't know how to handle them. Nursing "intuition" takes time to develop. This is normal. And when you have such an unbalanced ratio between new and experinced staff, it is not a good thing.

I remember several times when I worked, that I was actually the only experienced nurse on. I constantly had 3 or 4 other newer nurses coming to me for help or to ask questions. I tried my best to be helpful, but I had my own heavy load of 8 patients to care for. (AND I also felt nervous - what if I needed the opinion or help of another experienced nurse? I was it!)

Or I remember another time one of the newer nurses came and told me that one of my patients looked funny. She said that she put oxygen back on the patient because she thought maybe that was the problem. I immediatly went to check on the patient, and knew instantly what was wrong -the patient looked like a classic very low blood sugar. I checked the BS right away, and had to push an amp of D50. Could give several other similar examples....Until you have seen and experienced certain things, you just don't know what it is or what to do. There needs to be a better balance between new and more experienced nurses.

Well, this may not have been what your concern was... But there were my rambles...

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jill48 is a ASN, RN and specializes in Med/Surg, Geri, Ortho, Telemetry, Psych.

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i don't mind doing it at all. ;)

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Mommy TeleRN has 3 years experience as a RN and specializes in Float.

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I am a new (graduate) nurse. This is one of the main reasons I bypass several small hospitals for a long commute to a big hospital. My floor has over 40 beds. Many small hospitals only HAVE 40 beds in the whole place. I didn't want it to be me and one or two other nurses on a floor. I need the help of experienced nurses. They need the help of other experienced nurses. I feel there is a better mix and more experience to draw from when you have 6-8 nurses working on the floor. Plus I have the eyes and ears of the nursing assistants to in a bigger facility. While they can't assess my patients, their input can be very helpful if they notice problems with a patient and alert me to it.

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jill48 is a ASN, RN and specializes in Med/Surg, Geri, Ortho, Telemetry, Psych.

612 Posts; 4,448 Profile Views

but i do have a problem when training new rn's who think they are too special to be trained by an experienced lpn. that is when i get p'd off. :angryfire :trout:

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snowfreeze has 16 years experience as a BSN, RN and specializes in ICU, CCU, Trauma, neuro, Geriatrics.

948 Posts; 6,516 Profile Views

Yes there are multiple personalities in the new nurses also. Being THE experienced nurse or one of 2 out of 6 can be very stressful. On a busy unit this can be stressful, on a quiet unit this is stressful. I started working overtime one week out of 4 and then taking one short week in that 4 also to do something for ME. I buy a new book once a month, I take myself out to lunch or try a new recipe, I am going to afternoon matinee of new release movies. What is everyone else doing for themselves?

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but i do have a problem when training new rn's who think they are too special to be trained by an experienced lpn. that is when i get p'd off. :angryfire :trout:

with all due respect, i mean no offense....

i don't think it is right for a new rn to feel they are "too special" to be trained by an lpn however...an rn and an lpn's scope of practice are different. maybe they want to be trained by someone with the same scope of practice?

i wouldn't be happy if i was never trained in key elements of my job during my orientation because my preceptor had a different scope of practice. it isn't fair to the lpn or the rn.

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With all due respect, I mean no offense....

I don't think it is right for a new RN to feel they are "too special" to be trained by an LPN however...an RN and an LPN's scope of practice are different. Maybe they want to be trained by someone with the same scope of practice?

I wouldn't be happy if I was never trained in key elements of my job during my orientation because my preceptor had a different scope of practice. It isn't fair to the LPN or the RN.

That depends on the state you live in. A LPN can do everything that a RN can do here, except for the initial assessment. I do understand what you are saying though, in some states LPNs do far less than RNs.

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jill48 is a ASN, RN and specializes in Med/Surg, Geri, Ortho, Telemetry, Psych.

612 Posts; 4,448 Profile Views

With all due respect, I mean no offense....

I don't think it is right for a new RN to feel they are "too special" to be trained by an LPN however...an RN and an LPN's scope of practice are different. Maybe they want to be trained by someone with the same scope of practice?

I wouldn't be happy if I was never trained in key elements of my job during my orientation because my preceptor had a different scope of practice. It isn't fair to the LPN or the RN.

VegRN, don't worry, no offense taken. I totally understand what you are saying. But I'm in (or was in, i'm going to home health now) an LTC. In my state their are only two things that an LPN cannot do that an RN needs to do, that is spike the blood (I would say hang blood but I do everything but spike it) and give IV pushes. In LTC's where I live, it is not out of the ordinary for LPN's to be the supervisors, or even the DON. Just had an interview to be DON at an LTC last week. I think for the most part, in my case anyway, it comes down to experience. Considering there are only two things I cannot train another nurse to do (as mentioned above) and since I have been doing this for twelve years, I have alot to teach. Now if it was a specialty floor like ER, ICU, OB - then that would be inappropriate. Do you see what I mean?;)

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303 Posts; 4,416 Profile Views

VegRN, don't worry, no offense taken. I totally understand what you are saying. But I'm in (or was in, i'm going to home health now) an LTC. In my state their are only two things that an LPN cannot do that an RN needs to do, that is spike the blood (I would say hang blood but I do everything but spike it) and give IV pushes. In LTC's where I live, it is not out of the ordinary for LPN's to be the supervisors, or even the DON. Just had an interview to be DON at an LTC last week. I think for the most part, in my case anyway, it comes down to experience. Considering there are only two things I cannot train another nurse to do (as mentioned above) and since I have been doing this for twelve years, I have alot to teach. Now if it was a specialty floor like ER, ICU, OB - then that would be inappropriate. Do you see what I mean?;)

Yes, in my acute care facility, LPNs cannot do initial assessments, place dobhoff's (guide wire), give IVP, check off new med orders, triage patients and do many other things than an RN would typically do.

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Jules Anne specializes in Cardiac Stepdown.

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but i do have a problem when training new rn's who think they are too special to be trained by an experienced lpn. that is when i get p'd off. :angryfire :trout:

i'm still in rn school but i remember that the most helpful person in my peds rotation was an lpn with 20+ years of experience. i was so happy to have her direction. i'm sorry that you aren't given the respect you deserve.

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