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Discussion

How Much Orientation is Normal?

I recently started working at an LTC. The first shift, I just observed the preceptor. The second shift, she handed me the keys and told me to get started. The medication pass took me about two hours, which the preceptor says is normal. When I started to do treatments, the preceptor was frustrated because I wanted to check the TAR. She told me not to bother and that I needed to memorize the treatments instead of checking them every day. I KNOW this is not normal. I am not a new nurse, but it has been a few years since I did LTC. I go in for my third shift today and have already been told I am on my own. The preceptor will be there, but she is not going to help. I am off for two days and after that I am on my own. Just feeling a little frustrated and overwhelmed. The facility has been in a bit of trouble with the state. They "cleaned house" recently and most of the staff is quite new.

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    Where to begin? Never do anything from memory. Things change rapidly so you can't rely on what you did yesterday. That certainly doesn't sound like a proper orientation even for a not so new nurse. Our orientation is continually being tweaked. Two days in a classroom. Day 3 and 4 are spent with the nurse manager or resource nurse learning where things are, the 'paperwork' which we do on computers, how to call the docs...some like to be faxed, some like to be paged. Day 5 you're with your preceptor watching the whole day. Day 6 you'll do the morning meds with the preceptor's help and then help with the treatments and charting. Day 7 you'll most likely do all the meds, treatments and charting with the preceptor there. Over the next 5 days, you do more and more with distant supervision. If you need more time we give it to you. I check in with all the new nurses on a daily basis to make sure they are getting what they need.

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    I take the treatment book on the treatment cart with me....just like if I was passing meds but only I am doing treatments.

    Start doing things right. I do things the proper way and got faster doing things the proper way. If your preceptor doesn't like it, oh well. You can learn short cuts as you go buy please keep integrity with your practice. You can and should do it.

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    I've worked in a couple of LTC facilities like that and got out as soon as I could find another job. They are setting the staff up for trouble with state. Of course if state comes in on a complaint and finds wrong doing, it's the staff who will be saddled with all the blame. By the sounds of it, I'd be looking for another job if I were you.

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    Sounds like they didn't learn anything from their last visit from the state folks. I, too always had the TAR on my cart with me; and so did all the other nurses I worked with.

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