How does your unit handle new graduates?

Cewens · Jul 31, 2004

I thought I would tell you how our unit handles new grads. I am a new grad, been on the job 4 months on a 50-bed Renal Unit. My experience is that I was the only new grad on my shift for these past 4 months.There was another newbie on another shift who was 2 months ahead of me. We just hired another new grad who is starting on my shift in a couple weeks. So we were never overloaded with lots of new nurses at the same time. I Precepted for 6 weeks, then continued my Residency for 3 months, then they started me Team Leading (1 RN, 1 LPN, 1/2 NAC). I have a VERY supportive Core Nursing Team who are always there for my questions, but we have been short of Core staff (due to injuries, illness and new-babies)and it is harder when I have unfamiliar Floats who aren't as receptive to my questions. Two nights in a row there was only 2 RNs, 1 LPN on the floor when our census was low. That was pretty scary for me as a newbie, because we had a CODE, and we were stretched way too thin..even by the experienced nurse's standards! During that experience, the 2 more experienced nurses dealt with the CODE while I had to hold down the fort with the rest of the floor. That was a scary position for me and I am lucky nothing else went wrong!

Every one has been very patient while I continue to make really stupid mistakes, fortunately harmless ones, and I seem to manage to get through every night amd say "Pheww, another night, another 10 new experiences." :rolleyes:

RNPATL, DNP, RN · Jul 31, 2004

I thought I would tell you how our unit handles new grads. I am a new grad, been on the job 4 months on a 50-bed Renal Unit. My experience is that I was the only new grad on my shift for these past 4 months.There was another newbie on another shift who was 2 months ahead of me. We just hired another new grad who is starting on my shift in a couple weeks. So we were never overloaded with lots of new nurses at the same time. I Precepted for 6 weeks, then continued my Residency for 3 months, then they started me Team Leading (1 RN, 1 LPN, 1/2 NAC). I have a VERY supportive Core Nursing Team who are always there for my questions, but we have been short of Core staff (due to injuries, illness and new-babies)and it is harder when I have unfamiliar Floats who aren't as receptive to my questions. Two nights in a row there was only 2 RNs, 1 LPN on the floor when our census was low. That was pretty scary for me as a newbie, because we had a CODE, and we were stretched way too thin..even by the experienced nurse's standards! During that experience, the 2 more experienced nurses dealt with the CODE while I had to hold down the fort with the rest of the floor. That was a scary position for me and I am lucky nothing else went wrong!
Every one has been very patient while I continue to make really stupid mistakes, fortunately harmless ones, and I seem to manage to get through every night amd say "Pheww, another night, another 10 new experiences."

Carol - thank you for your response. Your post illustrates my point. Not that we are not appreicative of new nurses, just that there are not enough experienced nurses to make sure that the newer nurses have the resources they need to safely do their jobs. I am glad that you get the support you need and that you are growing in your position. I think that is great. The same holds true for most of the newer nurses on my floor also. But, like you, we have instances where the new nurse (who has been off orientation for maybe 6-8 weeks) and she/he finds themself on a shift with maybe only one other RN that is experienced and then a host of ancillary staff and maybe an experienced LPN. It can be a frieghtening experience for the new grad as well as for the experienced nurse.

As we move more into the nursing shortage, I am thinking that this will become the rule rather than the exception. I think hospitals need to address this increasing problem, but I am not sure what the answer is. Perhaps other posters might have some suggestions or thoughts to share. Good luck with your new nursing career. Sounds like you have a real supportive working environment and that is great! :balloons:

calimarinewife · Aug 7, 2004

I can't say that I can give you any info on this matter as I am still in school, and will be graduating in Sept for LVN/LPN. However all of our instructors highly recommend that we go straight into Med/Surg for atleast 2 years, so that we're exposed to a variety of different things and we won't lose skills we have learned through out school. From what I have read it's a little scary to think that I may be put in a situation where there isn't a strong "core team" of experienced nurses. Is there anything I can do now to better prepare myself to be a med/surg nurse. I know hands on experience is the best way to learn, but are there any med/surg specific books you could recommend or any other learning materials. Thanks!

RNPATL, DNP, RN · Aug 7, 2004

I can't say that I can give you any info on this matter as I am still in school, and will be graduating in Sept for LVN/LPN. However all of our instructors highly recommend that we go sraight into Med/Surg for atleast 2 years, so that we're exposed to a variety of different things and we won't looses skiils we have learned throughout school. From what I have read it's a little scary to think that I may be put in a situation where there isn't a strong "core team" of experienced nurses. Is there anything I can do now to better prepare myself to be a med/surg nurse. I know hands on experience is the best way to learn, but are there any med/surg specific books you could recommend or any other learning materials. Thanks!

First thing I want to say is BRAVO! to you for even asking such a question. I think the best way to prepare for practice (regardless of what area of nursing you work) is to seek out clinical experiences while you are still a student. Sometimes, in the clinical area, students do not seek out experiences (i.e putting in catheters, starting IV's, monitoring fluid administration, etc.). Once they graduate, they have been exposed to very little.

I am not sure there is anything more that you can do to prepare other what you are doing. However, one thing to remember, when you graduate and you are licensed and looking for a job, make sure your future employer will offer you a decent transition and orientation program. By decent, I mean a mixture of dydatic and clinical as well as at least 8-10 weeks under the guidance of a preceptor. This assurance from the hospital prior to accepting an offer will go a long way in securing your transition from student to "core" experienced nurse.

Good luck to you and with your attitude, I am certain you will be a great, and successful nurse.

caroladybelle, BSN, RN · Aug 8, 2004

Perhaps the question should be is why?

Why are experienced nurses not applying/being hired?

Why are experienced nurses leaving the unit in such numbers?

Until those questions are answered and situation fixed, the trend will continue.

RNPATL, DNP, RN · Aug 9, 2004

Perhaps the question should be is why?
Why are experienced nurses not applying/being hired?
Why are experienced nurses leaving the unit in such numbers?
Until those questions are answered and situation fixed, the trend will continue.

I think you make some very real and valid points..... from my experience, I think less and less experienced nurses are applying for jobs simply because there are less experienced nurses actually looking for jobs. I know we hire experienced nurses if they apply.

Most of the nurses that have left our unit, have transferred to move into critical care (ICU, CCU, etc) .... med-surg is still a stepping stone for other units unfortuantely. Still, other experienced nurses are leaving due to retirement, relocation or simply due to the fact that they are burned out on hospital nursing.

I don't know what the answer is .... but I do know that staffing and patient ratios are only one part of the retention equation .....

Do others have an opinion?

jackieliz · Aug 10, 2004

The day shift on my unit is really struggling due to a lack of experienced nurses. After the Dec.03 nursing classes graduated, our director hired left and right. The problem is that we only had one opening! Because of the overstaffing on days, nurses were getting census managed about once every pay peroid, causing the EXCELLENT experienced team we had to look for work else where. This left days with about 6 new nurses to 1 or 2 experienced per shift. Unfortunately, errors are now being made-scary ones-because there is no one to guide the new nurses!! A frustrating situation for everyone involved.

barefootlady, ADN, RN · Aug 14, 2004

Many facilities here look at my experience as a curse. It costs more to hire me, and I don't have that starry eyed attitude that everyone can get well. I treat patients, doctors and other staff members with respect as long as they treat me that way. I think some of the new grads today are awsome, but some are just plain awful. I worked with one this week who was trying to "fix a feeding pump", I asked if she needed help, she said no, I stuck around just in case she did not get it running. Finally after 30 minutes she asked me to fix it, I attempted to show her what the problems was, she looked at me as if I was nuts (too much feeding in drip chamber) and practically said I was wrong. But when I started the feeding, it ran fine. She did not thank me, she just said well, I never had one of those before and walked off. Next time she is on her own. If that sounds mean so be it. That is the fifth time I have stopped my busy schedule to help her without so much as a thank-you. I have told the CN about her attitude with me and stated she needs to help her more, seems like I and my help are not wanted. I was told by the CN the newbie, was afraid of me, I have done too much and she feels threatened and foolish. I asked her if she felt like I had done something to offend her, the CN said No, I had just worked too long. If Uncle Sam would let me I would retire tomorrow. but he said 66 or old, so off to work I go.

live4today, RN · Aug 14, 2004

perhaps the question should be is why?
why are experienced nurses not applying/being hired?
why are experienced nurses leaving the unit in such numbers?
until those questions are answered and situation fixed, the trend will continue.

well....i am an experienced nurse who overheard the "younger less experienced nurses" on the unit make the following statement about "the older nurses"...and i quote:

"....prefer to work with nurses in our own age group than work with the older nurses. we (meaning the young nurses) know more and have fresher newer perspectives...yaddy yaddy yaddy...." :rolleyes:

they had no idea i was that much older than they, so when they finished yacking, i told them i was an older nurse who had no problem learning from them and no problem teaching them -- that we should all be open to learning from each other.

that's just a taste of the drama i overheard, so i've chosen not to work on that particular unit since those nurses are not "older nurse friendly". :lol2:

RNPATL, DNP, RN · Aug 14, 2004

I agree that the new and younger nurses have a great new perspective. And, this newer perspective is wonderful for the team and ultimately benefits the patients. But, the same holds true for nurses that are experienced and sometimes wiser. I think it is all in the approach and how we treat each other. I know for me, when a nurse comes to me with a complaint about a new nurse, I will frequently ask for patience and tolerance. On the other hand, I will meet with the new nurse to address what her/his needs may be, in order to help them gorw and become a part of our core team.

But, there is more than enough room for all in nursing .... infact.... these days .... there is room for everyone! :) :uhoh21:

Schweetnsazzy · Aug 15, 2004

I'm a new grad and will be starting on the floor tomorrow with a preceptor. I believe on the med/surg floor I will be working, has a wide range of experienced nurses, from 1 year to 15 and 20 and I am looking forward to learning from all. It's sad to see that some of the older nurses are feeling like they are not needed by the newer nurses in some areas.

If it's any consolation at all, please don't view all new nurses like that, because many of us appreciate and value your experience and advice more than you know!!