How are all other experienced nurses coping with orienting new nurses

jackkat · Nov 17, 2008

The influx of new nurses can be stressful at hospitals and nursing care facilities too. I worked as a staff nurse on medsurg orienting new grad RN's and they were adamant that they did not want to work off shifts which surprised me because I finally could remember what I would do to get my foot in the door...Times have changed nurses want to have time with their families and not feel crazy switching back and forth on different shifts. Now on the other hand I have been a supervisor on 3-11 with 60% NEW GRAD LPNS these nurses need alot of support in critical reasoning skills and explanations on how to do things. And the reasons for becoming a nurse is not clear except there was a financial gain. For some not all. So now I am just a charge nurse in a real elderly setting. No gunshot wounds, ventilator pts, or generally people who are not geriatric. My daughter would have been a 4th generation nurse but she did nt want anything to do with the work I do. I was fascinated by my mother and grandmother's work. I love nursing but I have been at it too long I think. Burn out.

Ruby Vee, BSN · Nov 17, 2008

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.

there's a lot an inexperienced new nurse can learn from the experienced lpn -- and believe me, i know! the lpn was the only person who would teach me anything when i first started! yes, the scope of practice is different, and there are certain things an rn can learn only from another rn. but no not discount the value of the things an experienced lpn can teach!

Ruby Vee, BSN · Nov 17, 2008

in my icu, the new grads (those still on orientation) outnumber the experienced nurses by a fair margin. some preceptors have two orientees at different stages in their orientation! it's pretty overwhelming at times. even when i'm not precepting, i'm often the only experienced nurse (more than 1-2 year's experience) around. i love to teach and don't mind answering a few questions -- but i have my own assignment, too! when i'm in the ward with 6 patients and 5 new grads just off orientation, i spend most of my shift helping the others with critical thinking, trouble shooting, learning new skills, etc. and then i'm behind while they're all sitting in the break room gossiping! arrrrgh!

southernbeegirl, BSN, RN · Nov 17, 2008

When I started my first job after graduation, I oriented for a few weeks with an LPN that had been there since the place opened i think, lol. She taught me everything there is to know about working a floor in LTC. I often catch myself doing something and thinking that "martha would be so proud of me". It didnt matter one bit that I was an RN and she was an LPN. she was the experienced nurse, not me. I had no idea what I was doing. She was so patient with me and made sure I learned everything. When I orient people, i try to make Martha proud and show them every single little detail I can think of.

GoNightingale, BSN, RN · Nov 30, 2008

I'm a new nurse. Passed the NCLEX on 7/2/08. I've had terrible, terrible experiences with preceptors. I've tried to do some self-analysis, but I think it winds up that it's a matter of luck! Everyone perceives me differently. I'm going for an interview on Monday for the Med/Surg-Telemetry floor. Any suggestionns on what Nursing Managers want to know when they interview you? And....as a preceptor...what are things that preceptors like and don't like?

I'm feeling really anxious. I really don't know what a positive work environment looks or feels like.

Help!

Scrubby · Nov 30, 2008

I've only been an RN for 3 years but quite often I have to help with training new RN's in the OR. Now I accept this comes with being an RN, however I received no training on how to teach people whatsoever. I have found it harder teaching people in the OR than bedside nursing because everything has to be done NOW, you have so many people watching you and hurrying you up like surgeons, anaesthetists, and it's often it's pretty challening to get the list done on time, yet take the time to teach people to do things properly.

GoNightingale, BSN, RN · Dec 1, 2008

I feel ya Scrubby! I can imagine how difficult that must be for you! Especially since you have been given any training on how to train/teach others. This is precisely the point I tried to make to my ex-director. Preceptors first of all should have a calling to want to teach others and then be trained and even certified. This is an investment for the hospital, but I'm sure that in the long run they will have less RN turnovers of new nurses. The new nurses are very nervous as well. They are being observed not only by the patient, but by the preceptor and other members of the team.

Well, gotta go. I have an interview tomorrow on the other side of the state! Please pray for me and thanks for your input.

Happy Holidays to my fellow nurses in the land down-under! Did I write this right? Probably not but....Happy Holidays to our friends in Australia!

pagandeva2000, LPN · Dec 1, 2008

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.

i remember when i was a pca, we got two nurses that transferred from inpatient to the clinics, an lpn and rn. they were both oriented by an lpn. the rn told me that while she is grateful, the fact is that they work under two different scopes of practice and would have rather been oriented by a peer.

as a new grad lpn, i had to begin an orientation on med-surg for 6 weeks, even though i was hired to work in a clinic. i was supposed to be buddied with an rn, but really, i didn't have all of her responsibilities, so, she paired me with an lpn and it was a bit better. when i got back to the clinic, i was able to function independently quickly. rns at my job are paid to percept, not us. but, on occasion, they would assign new orientee rns or even rn students to me and many felt that they learned more from me on the basic survival skills than others. i did feel a bit conflicted orienting them because of the different scope of practice, however. i'm not trained as an rn, so, i don't really know for sure if they are benefiting from my training versus a peer of theirs. however, skills are basically the same, at least for a new grad with no experience. i am sure that they can gain from learning from lpns, but i don't think it should be every day.

pagandeva2000, LPN · Dec 1, 2008

One thing is that the perceptor should be a willing person, and that is hard pressed to find these days. At my hospital, perceptors (RNs) get paid $3.00 a day to orient nurses. I didn't get paid to orient anyone, even LPNs or aides.

I found that the pay does not give incentive, but the anticipation of getting help should. Many times, nurses leave because of being bullied and mistreated and the same nurses that bestowed the abuse whine about being short. If we take the time to teach we can obtain the assistance we need.

lpnflorida · Dec 2, 2008

Our hospital policy states we Lpn's cannot precept Rn's nor students. This is the first year in fact that the Lpn students had to be with RN's.

I am not quite sure what to think of this, as I have always precepted Lpn students, at times Rn students were buddied up with me. While I have on a rare day when the Rn Preceptor was sick and I was the most experienced person on the floor had an Rn orientee for the day, that was not the norm.

Do I mentor Rn's, yes, if they have any questions or need help I will give them what I know. I will let the new people know if they need anything or have questions I am willing, some are greatful, some well they want it from another RN.

GoNightingale, BSN, RN · Dec 2, 2008

Hey paganvenda! When I was a student nurse, I was paired with an RN (I am now an RN) during clinicals. The RN's were great when speaking about medication administration and overall assessment/evaluation skills and care planning (which is really what differentiates technically an RN from an LPN- but the LPN's were extremetly helpful to me when it came to hands on clinical skills. As an RN I strive to get just as good in clinical skills as assessment/evaluation skills. So to the LPN's out there THANK YOU, THANK YOU THANK YOU!

I have also seen LPN's that due a great job at patient assessment as well!

Happy Holidays! :yeah:

futrarmyCRNA · Dec 2, 2008

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 hear you. as one who went from tech to lpn to asn to bsn, experience in any capacity has its wisdom. some of the newer straight to bsn nurses seem to have disregard for our techs and lpn's when they (the lpn's, techs) probably know a whole lot more about patient care and little things than the new bsn's will know for some time. one of our techs had to set a brand new rn straight one night after she kept ordering her around like a redheaded step child, leaving her alone to clean up stool etc while the new nurse went out on a smoke break. what are they teaching now a days in school?