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Discussion

How much training is fair...

Hi. I am a Center Director at a dialysis clinic. Our typical RN training is 8 weeks. I have a nurse who is at 10 weeks currently and is not even close to being competent on the floor. Assuming adequate training was provided, even if she is motivated, would you extend the training or not? This is a very experienced nurse, not in dialysis, but many years on the floor. Just want to hear your ideas.

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    I spent several years coordinating orientation for intensive care nurseries. Here's how I always handled that situation (and I was usually in the situation a few times each year).

    If the orientee wass making definite progress, I would let the orientation be extended a few weeks (from about 16 weeks to 22 weeks if necessary for my NICU). But if her learning has "plateaued," then it is time to stop. Set concrete goals for each week and make her continue employment depended on achieving those goals each week.

    If she is already past the usual orientation time and "no where near" ready, then it's probably time to let her go. However, the setting of concrete goals and follow-up to see if those goals were met should have been done several weeks ago.

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    • Author

    Thanks. Those were very helpful observations. I have taken the steps you suggested of setting attainable goals for a set time period and evaluating with her and the trainer the progress that was made (or mostly not made in this case). Thanks again, any more opinions are appreciated.

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    I totally agree with PP. I've been a nurse educator since the earth's crust was still cooling and there is one absolute truth in staff development: don't invest too much time in an experienced nurse. Unlike new grads, who are little knowledge sponges and can have unlimited capacity for rapid growth under the right circumstances, experienced nurses definitely have their limits.

    Basic competencies carry over from one specialty area to another. She may not have experience in dialysis, but she should understand fluids & electrolytes & be able to assess the patient, critically think & solve problems in that area. Likewise with shunt access; basic IV & sterile access skills should transfer. Sadly, if she doesn't have it by now, it may mean she never had those basics and she isn't gonna get it now, no matter how much effort you put into it. Kudos to you for trying.

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    • Expert

    I'm an APN in the renal world and I've noticed that there is a very set criteria for orientation for the big companies: usually 10-12-16 weeks. All RNs must learn the tech role first, then the RN role, so that is why the extended orientation.

    Is this the way your orientation is organized also?

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