How long did you orient?

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I am a new grad, and just accepted a position on a Behavioral Health floor in an in-patient psyche unit. Patients generally come to us from the ER, and our avg patient load is 17-18 or so patients (2 nrgs & 2 health workers). So we are kind of like a crisis stabilization unit. We have an extreme amount of paper work and computer charting (no exasggeration here). We get a lot of admits and discharges around the clock (except no discharges at night obviously), so this floor is very busy. I had four days total of orientation. What do you all think? Is this enough, or is this the norm? Thanks for any posts.

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No, you should orient until you are comfortable being on your own. Do not let your units staffing problems put you in a position where you could make a mistake.

tricia

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Specializes in Psychiatry.

I had about the same time as a new grad and I've been slowly catching on since. I've been at this for about 6 months. I'm still shaky on running groups and get pretty flustered when I have 10 patients. I think your patient load is way too high for a new grad with too little orientation. You should have about 6 pts. On our committed acute side we have 3 nurses with 7 pts each max and our mood/geri side there are 2 nurses and 10-11 pts each.

But hang on, you'll make it!

Marc

I am a new grad, and just accepted a position on a Behavioral Health floor in an in-patient psyche unit. Patients generally come to us from the ER, and our avg patient load is 17-18 or so patients (2 nrgs & 2 health workers). So we are kind of like a crisis stabilization unit. We have an extreme amount of paper work and computer charting (no exasggeration here). We get a lot of admits and discharges around the clock (except no discharges at night obviously), so this floor is very busy. I had four days total of orientation. What do you all think? Is this enough, or is this the norm? Thanks for any posts.
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I've been on orientation for almost 8 months...Just went solo 2 days ago. It was good for me...mgr had to extend my orientation because I didn't pass PBDS test second time around.

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Specializes in Med onc, med, surg, now in ICU!.

Three. Days. On a medical oncology ward. On my first rotation as an RN, ever.

I was only supposed to have two, but those first two days were so busy that I didn't even get shown where things were kept at all, I was just seen as another pair of hands and thrown into the melee. At the end of the second day, I was SO stressed that I was in tears, and I am not a crier normally. I got a third day of orientation with a preceptor, and said to them, "I still don't know where X, Y and Z is, and I don't know what the plan is for this ward if there's a fire, and frankly, if I don't get some help today I am going to be no use to you whatsoever tomorrow."

I had two days where I had my own patient load on my own (only 4 patients, but still, I had been an RN for, er, 4 whole days by that point, so I needed help). After that, my 'buddy' (not exactly a preceptor; she had her patients, I had mine and we ran the ward between us) had to go home for a family emergency. On day 6, I had a casual who was an experienced, organised nurse, but who didn't know the ward, and on day 7, I had a nurse who had years of experience, but who had picked up a LOT of bad, lazy habits during her time. She was a disaster. I was trying to look after my patients, and she kept asking me things about hers and putting any phone calls to the ward through to me. I was FURIOUS, because the first thing I said to her, before I even introduced myself, was that I was a new grad and I needed support! To add to it, I was given a first year nursing student (yes, on my fifth and sixth days on the ward!). She was lovely, but I felt like I was failing her by being unable to provide a proper learning experience. She didn't want to go with the casual because she and I were horrified at some of the things she was doing - e.g., not washing her hands for an entire shift, despite having two contagious patients (one ?avian flu and one shingles!). I felt like I could, at least, do my things safely.

I have yet to work out what the process is in this hospital for admissions and discharges, ordering more drugs, gate leave for patients, how to transfer calls properly, and how to obtain more supplies if we run out. I need to try to learn more about medical oncology. I have four days off at the moment and then I leap in for seven days straight (all mornings).

I was SO stressed to begin with, and I really don't think I had a good experience. On the other hand, my disastrous day meant I had to stand on my own two feet, rely on myself and just learn to handle the big waves. On that day, I resited a subcut line and did two PICC dressings, both things I hadn't done before. I called a CNC and asked for help, and she talked me through. I feel good that I got through and was able to support my patients. One family told me I had a wonderful attitude to nursing and never to lose it.

Um, long post, but I wanted to get that out. It wasn't an experience I'd recommend. It was definitely sink-or-swim, and I think I managed to swim!

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Sounds like you handled it well. I don't know if I would have fared as well. I'm starting to think I'm too old for all of this...I don't have the patience for the hospitals unorganization, lack of supplies, etc. I'm really an organized person at home, to the point of being anal with it, but I just can't seem to get my organization skills together at the hospital.

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Four days total?!! That's simply insane. As a new grad on a geri-psych floor I got two weeks of unit orientation, three or so weeks of general nursing and hospital orientation. Even that didn't seem enough at the time. Luckily I had a full complement of support staff a great charge nurse and 2-3 very experienced nurses each shift. The first day I was nervous as hell but since I had such a great team to work with my nerves were more about me and my anxiety and not my competence level. As a traveler I've had hospitals give me a month,three weeks,one week and the last place was three days of orientation. The only way I could handle the three days of orientation is because of my experience level (psych-nurse/traveler for three years). I have no idea how they expect you to function as a new grad with four days of orientation on an acute unit. Demand a longer orientation. You're not asking for anything out of the norm and it's your license on the line. Be prepared to leave if they don't comply, you're a nurse now with a license to protect and in time of a great nursing shortage. Don't let them forget that!

Good Luck and let us know how it turned out!

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

I worked in the adult chemical dependency unit of a small psychiatric hospital as a PRN medication nurse. I only received 8 hours of orientation before being cut loose to work by myself. In addition, sometimes the census swells to 25-30 patients. Sometimes the situation got quite dangerous due to the lack of staff and protection.

However, the chief nursing officer and C.E.O. only cared about one thing: the bottom line. They were out to maximize profits.

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