How much orientation time for a new grad?

Cuddleswithpuddles · Mar 11, 2012

Hello,

There is no magic number for length of orientation. In my experience, it does help to have a formal set of criteria a new hire has to fulfill before working independently. Does your hospital have such a checklist? Does your policy and procedure manual outline the expected job duties and competencies for a staff RN on your floor?

If your hospital does not have a formal list, sit down and make your own. What are the everyday nursing duties that need to be done? What sort of major skills a nurse needs to have in order to hold his/her own on your floor ex. IV insertion, basic EKG knowledge, ACLS etc.?

See how your performance matches up to these lists. You may find that you have hit on all the major points. There can be a huge, huge gulf between competency and confidence level. Your managers may have deemed you competent enough to go on your own even if you are still nervous about doing things.

If you do see areas where you have zero experience on and urgently need training on, bring that up with your managers or educators. I think it is far more helpful to be specific on what you need as it relates to being an active member of a team instead of simply asking for more time.

I hope that helps and please do update us :)

~PedsRN~, BSN, RN · Mar 11, 2012

I'm currently orienting right now! :)

At my hospital, the standard time spent in orientation is six weeks. This is with a preceptor. I love it, I am having a blast and learning so much. Basically, you start off just shadowing and jumping in when you can and learning - then the next week you start taking on more responsibilities... but you have a preceptor as a resource. The goal is by the end of your six weeks you are rolling with 5 patients.

I know you can end orientation early if your preceptor thinks you are up for it - or you can have longer if you think you need it.

diligent-trooper · Mar 11, 2012

At the beginning, and through the interviewing process, what made you decide that this job was a right fit for you. Many would try to convince you that 2 months is very generous and sufficient. I am one who would differ in that opinion. These patients are on a telemetry floor for a reason: They need to be monitored. They may have a medical history, acute medical condition, or exacerbation of a chronic condition that would make them more prone to "whacked out heart rhythms", and therefore "code". A code is something that is the end result of not catching something in the earlier stages, specially on a medical-surgical floor. Codes should never occur on a med-surg. floor. There are many that quote: "It is a hospital, crap happens!" No, crap happens for a reason. If you do not understand my reasoning, then get with one of the best MD at your hospital and have a talk.

I believe the hospital owes its patients, as well as the nurses who work on these floors the tools for success. Its staff should know what, why, and when to things need to occur. The hospital should see the nurse as an investment and properly orientate, and that takes time and money. Two dirty words for the powers-that-may-be. It is appalling and inexcusable to do less. It is also quite frankly immoral. For a system that presents the image of caring, this smacks right in the face of grandma.

Enough of my soap box. Go have a talk with your unit manager with your concerns. If the hospital is worth-its-salt, then they will most likely give what ever time and resources you need. If not, you do not want to work for this place- period.

Sugarcoma, RN · Mar 11, 2012

At the beginning, and through the interviewing process, what made you decide that this job was a right fit for you. Many would try to convince you that 2 months is very generous and sufficient. I am one who would differ in that opinion. These patients are on a telemetry floor for a reason: They need to be monitored. They may have a medical history, acute medical condition, or exacerbation of a chronic condition that would make them more prone to "whacked out heart rhythms", and therefore "code". A code is something that is the end result of not catching something in the earlier stages, specially on a medical-surgical floor. Codes should never occur on a med-surg. floor. There are many that quote: "It is a hospital, crap happens!" No, crap happens for a reason. If you do not understand my reasoning, then get with one of the best MD at your hospital and have a talk.
I believe the hospital owes its patients, as well as the nurses who work on these floors the tools for success. Its staff should know what, why, and when to things need to occur. The hospital should see the nurse as an investment and properly orientate, and that takes time and money. Two dirty words for the powers-that-may-be. It is appalling and inexcusable to do less. It is also quite frankly immoral. For a system that presents the image of caring, this smacks right in the face of grandma.
Enough of my soap box. Go have a talk with your unit manager with your concerns. If the hospital is worth-its-salt, then they will most likely give what ever time and resources you need. If not, you do not want to work for this place- period.

:redbeathe:yeah::kiss:yelclap::bowingpur:cheers::heartbeat:up:..........because like is just not enough for this post!

Sugarcoma, RN · Mar 11, 2012

OP, I had 6 wks on tele and 10 in ICU, neither of which felt adequate. Talk to your employer and see if they will extend but do not be surprised if they balk at the suggestion. Unfortunately it has been my experience that employers do not like the idea of extending orientation. If only people like diligent-trooper were in control..................................

GitanoRN, BSN, MSN, RN · Mar 11, 2012

Unquestionably, the length of the orientation will vary with each individual and facility. Furthermore, the most important factor in the future success of a new employee is an effective orientation process. Needless to say, a great preceptor that will guide the new employee will set the tone for a successful orientation. Therefore, your orientation program should meet your individual needs and concerns. Having said that, the facility that you been hired, should offer an evaluation form to new hires to fill out as they navigate through orientation. Wishing you the best always:cool:...Aloha~

0402 · Mar 11, 2012

Both my current unit, as well as my original floor, when I was a new grad (both m/s with tele monitoring, but different hospitals) were 12 weeks. Some would be done around 10 weeks and others weren't quite there yet, even at 12 weeks, but these were the exceptions, and for the vast majority, 12 weeks was an adequate amount of time (this did include some classroom time, as well, during those 12 weeks).

sistasoul · Mar 11, 2012

I had 3 weeks of floor orientation as a new grad. That was not enough time and neither is 6 weeks enough time. If the hospital refuses you more time a suportive unit will help you succeed. The nurses I worked with were very supportive and that is the only thing that saved me from quitting. If it was now I would insist on more orientation but as a new nurse I was timid.

Epic_RN · Mar 11, 2012

I am a new grad also, in a Versant RN Residency program. It consists of 2 12 hour shifts on the floor and two 8 hour classroom days per week and lasts 18-22 weeks, depending on specialty. We have 3 preceptors (one for each 6 week period) with increasing responsibility. We also "loop" into other departments that are associated with our floor (example being that an ED new grad will do shifts in OR, ICU, and cath lab). I love this program and have had friends tell me that they felt so much better prepared after completing it. I cannot imagine getting only 6-10 weeks of orientation, that would really scare me! Ask for more time and be specific in what you feel you are lacking -- that is your best bet.

tots24 · Mar 11, 2012

I was just going to post a similar question! I'm starting as a new grad in private duty peds nursing (not by choice; no peds hospitals are hiring right now) and I don't feel prepared at all. The children we care for are all a high acuity level: vent dependent and have trachs/gtubes/central lines, etc. We had a week of orientation learning company policies/scheduling/HR stuff and 3 classes on trach care, peds assessment, and breath sounds. Next week I'll have 2-3 SHIFTS with a preceptor, then I'm on my own. I'm terrified. Is this normal for home care? I know that I've only got the one patient that I spend all my time with, but I'll be alone with this child for 8-12 hours a day. They say that we're never really alone because someone is always on call to answer phone calls if we have any questions, but that is not at all similar to having another nurse next to you at the hospital. I'm still searching for hospital jobs, but what should I do in the meantime?

Not Your Nurse · Apr 14, 2013

I am also a little confused about this process when being hired as a New Grad. I applied for the night shift, I know my classes won't be during the night (I think classes last 2 weeks) but is orientation held during the job shift (for me at night)?