How to train a new nurse? all tips welcome!

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Specializes in LTC.

We have a new nurse with us now. Shes only worked in drs offices, no LTC experience at all. WE have all found alot of mistakes shes made and I have talked to her about them to no avail. She had 1 day and a half of training on the med carts. I had one night with her to just train her on the tons of paperwork we have. She didnt ask me one question the whole time. She seemed distracted and uninterested in anything I tried to show her

I got her to do some sample forms just so she would have some type of familiarness if she ever had to utilize them and gave her some blank copies to keep with her if she needed to refer back to them.

Several of my pts complained about her and said that she didnt know what she was doing and that they didnt get their meds.

Shes made a good bit of med errors already that I have found, mostly with narcotics, giving the wrong dose at the wrong time mostly.

I honestly dont think she knows how to read MARS. I also think shes halfway looking at them because one night I had a pt complain that she didnt get her lantus. So I went to the nurse and asked if she'd given the pt her insulin..she told me she didnt get insulin except weekly...yet before I confronted her I looked at the Mars..which she had signed for the insulin already. I told her we dont give lantus weekly, that her blood sugar checks had been changed to weekly. She looked and said "oh..you're right. I didnt give her sleeping pill yet so Ill take them both to her" which she did.

What methods have you guys used or had used on you to train you or other nurses? I dont like to throw anybody new to the wolves and let them sink or swim but at the same time I cant be with her the entire time either. I didnt get much training, I figured alot out for myself and made a notebook and used sticky notes...shes not interested in doing either of those. When she finishes her charts, she just sits around and reads a book. She doesnt do her chart checks or txs or skin audits even though we've all told her over and over to do them. I dont see this one lasting too long if things dont change.

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Her lack of interest indicates that she should not make it through her probationary period without a miracle change in attitude and behavior. There are too many people out there that are so hungry for a job that they are willing to show interest in their job. Have a talk with the supervisor and start providing the input needed so that management can take proper action. You can not single-handedly salvage this train wreck and you can't do her job for her as well as your own. Cut her loose.

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Specializes in LTC.

i totally agree. the boss was gone on vacation and told the asst boss to "hire anybody who looked halfway descent" to fill in 2 positions, this one and the weekend rn charge position. And, that was exactly what was done. Neither are experienced and both have made alot of errors.

When the boss checked in with me to ask about how it was going, I made her aware of the issues, she just said " well, everybodys gotta start somewhere", which is true but at the same time some effort needs to be put into it.

Most likely she will be like the rest of our prn/ pt staff.....a name on the schedule and a number on the phone list....they dont care who covers a shift as long as a body is there...sometimes.

its times like this I wish I was in the management field.

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Specializes in LTC.

ps, might I add also that they are so reluctant to thin out the ones who arent working out...they still have a prn nurse on our schedule list that hasnt worked in about 4 or more months....every time she was put on the schedule to work she called in....again...nothing done about that either. another one that was a ncns for 3 weekends in a row was on the schedule for over a month after the fact also..absolutely ridiculous.

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Specializes in Cardiac Care.

We just went through this and in the end major med errors can not be over looked and require terminiation. Mind you this decision was made knowing full well we would be scrambling for coverage until someone can be trained and hired. It just has to be. New Nurse or not med errors are med errors!

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Specializes in LTC.

True true. When I brought the insulin part to her attention she didnt even seem to be phased really...like it was nothing.

The problem with the training of the RN's to do "charge" is that they are so shabbily trained.....the one before this new one that just came on board was trained by a "prn" nurse whos never there.

She lasted less than a month.

This new LPN wouldnt have gotten that one night of orientation with me for paperwork had the DON not been out of town and the ADON not insisted on it because other nurses told the ADON about her mistakes.

it revolved around one thing....upper mgmt didnt want to have to pay for 3 nurses on night shift in order to give her more orientation. It supposedly put them over their "Nsg hours".....which I dont buy because they are alotted for 9 nurses total in a 24 hour period, we get a total of 6 per 24 hr period, 4 on day shift, 2 on nights for 12 hours. The 4th nurse on days is the charge nurse who only works 8 hours. That leaves 3 spots that could be utilized without going over the hours. Unless of course I cant do basic math lol.

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Specializes in LTC, Memory loss, PDN.

caliotter3 said it all

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Specializes in LTC.

Well, I went to work for a while last night and I couldnt believe all the mistakes I found from this new nurse. There was page after page of scheduled narcs she didnt give, holes all over the mars on every single one, insulins not signed for blood sugars werent wrote down, maybe not even done at all....

Not a good sign. The other nurse I worked with said that she had worked with this new one the night before and she was done way faster than any of us get done....I guess so if you havent give half the meds?

If I were new somewhere , Id be even more cautious of what I was doing. It seems like she just has no fear at all or concern about this stuff.

And I just dont see how a nurse can come and work for the first time ever in a Ltc facility straight from a dr office and get done with the heaviest hardest med pass on the hardest assignment an hour before the other nurse whos been there years and years and still cant go that fast?

It doesnt add up.

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Specializes in Pediatric Private Duty; Camp Nursing.

:eek:Woah, wait a sec... are you telling me she had less than TWO days training on the med pass? I can't account for her blase attitude, but I'm sure she's probably missed out on 90% of the finer points of doing a med pass. My facility is a hot mess, but at least our people get (theoretically) 10 days' training. I say theoretically because usually by day 8 or 9, we're short-staffed and the newbie gets a cart on his/her own. And I thought THAT was awful! We have a new guy now, he's sweet but quiet. Hard to figure out. He got about 8 days in when he got thrown in by himself. He's been at it for 4 weeks now, and he can do a pass ok, but he didn't get enough training for the horrible tide of paperwork and charting, calling docs, ordering labs, and also all the stuff that a unit clerk should be doing. (Our unit clerk is spread so thin, I see her on our floor maybe 25% of the time.) So needless to say the floor he's been working on is terrible. Meds aren't ordered right, labs aren't done, wound measurements are late, and it all fell on me the day after he worked a double, which I cannot believe they allowed him to do. But ya know what? I'm not blaming this guy at all. I feel terrible for him, because that was me a year ago. It took so long to iron out everything, because really, a new nurse should be a trainee and shadowing for at least a month. Of course that will never happen because it's a cheapskate corporate-owned chain facility.

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Specializes in Behavioral Health, ALF.

This is exactly why I don't apply for a TLC job. The work load is incredible. I went to LPN school very late in life and graduated in 2010. Then unfortunately had to deal with thyroid cancer. Cancer free now and working pt time at meth clinic. I am very impressed with the help you are willing to give this new nurse, but it sounds like she doesn't appreciate it. I have been a cna, and a med tech in the past, and don't understand why she wouldn't love working with you. Thank you for all the hard work you do in LTC !!!!

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Specializes in LTC.

I got about a wk of training as a new nurse but we had different mgmt then the med passes took me FOREVER to do. I worked 3-11 but never left before 1 am cuz I had to stay and chart. My med passes literally ran into each other because I was so slow. That's why I don't believe she can possibly be giving everything since she gets done so fast. It took me a year to really pick up my speed. I asked tons of questions and still do when I need to. I am paranoid and picky when it comes to my work. I was the same when I was an aide.

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