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I think I'm going to be let go from Orientation :((

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by AmIDumb AmIDumb (New) New Nurse

361 Profile Views; 18 Posts

The title says it all...

As a background, I am 22 years old and graduated in May from a top-tier BSN program. I got a job at one of the best hospitals in the country and graduated from school with a GPA > 3.5. The point is, I sound awesome on paper. Everyone keeps telling me "how smart i must be" to have accomplished this much at such a young age. 

On the other hand, in real life, I am an extremely slow hands-on learner. Parts of nursing school were rough for me because I was more anxious (I have an anxiety disorder that gets exacerbated by anything nursing related) and because I'm more book smart than hands-on smart. Clinicals were rough for me, but I somehow made it through. 

At this hospital I'm at, I'm on my 6th week of orientation on a very fast paced med-surg, tele floor. 2 of the 6 weeks I was in a sit-down style orientation (almost like nursing school) with the other new grads. So, I really have been on the floor for 4 weeks although I'm technically 6 weeks into my orientation. The thing is, I'm expected to be able to handle 5 patients on day shift and 6 patients on night shift. I'm currently at 4 patients but struggling. 

My last shift, my manager said "hi ______!" in the morning all enthusiastically, but then later on in the day he saw me and avoided me/looked down at the floor. At the time, I didn't even think twice. He is the manager after all, and I assumed he wasn't even thinking about me and was just busy. 

Towards the end of the day, my preceptor tells me we have to extend my orientation and that he told my manager about it. I asked him what happens if I'm still struggling after this extra week, and he made a face and was like "we'll take it one day at a time." 

I then have a flashback to my manager looking down at the floor and avoiding me and I realized...he's probably avoiding me bc he knows he's going to have to let me go if I don't improve. Idk what to do since I moved out of state for this job. If I get fired I have no idea how I'll pay for rent or any of my student loans. I have no idea who's gonna hire me with 1 month's experience. I'm devastated and I feel like a giant idiot/failure. 

Has anyone else been terminated from orientation and if so how did you recover?? Please let me know, thanks. Also, do you think I should bring up that I'm cognizant of being on the slower end?? Should I quit before they fire me? I really hope if they let me go that I'll be able to at least just switch to a different floor or even outpatient. I just have no idea what to do!

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559 Posts; 7,794 Profile Views

Congrats on graduation and landing a job. Earning your RN doesn't mean you know everything you are supposed to know to take care of your patients. Its a start, a base of knowledge. Companies are aware of that and that is why they do offer such long orientations and preceptors. It sounds like they notice you are struggling and are trying to help you.  How is your preceptor? Do you take half the patients as your own and build up to the full load? i would make sure your manager is aware of your concerns and can give you feedback.

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18 Posts; 361 Profile Views

4 minutes ago, litbitblack said:

Congrats on graduation and landing a job. Earning your RN doesn't mean you know everything you are supposed to know to take care of your patients. Its a start, a base of knowledge. Companies are aware of that and that is why they do offer such long orientations and preceptors. It sounds like they notice you are struggling and are trying to help you.  How is your preceptor? Do you take half the patients as your own and build up to the full load? i would make sure your manager is aware of your concerns and can give you feedback.

The orientation is 10 weeks. My preceptor told me I am expected to be at 5 patients before I can switch to night shift. Though, I am currently struggling with 4 which means I can't move on. If i don't fix it by this week, I think they're going to let me go bc they can't afford to have me take this long...

I am taking the majority of the patients right now (4), while my preceptor has 1. The thing is, most of the doctors end up calling him bc they're more comfortable with him and know him. Then he goes to tell me he was doing my work bc he was taking the calls for my patients. But the docs weren't calling me directly so I don't see how that would be my fault. We are both running around the unit all the time and I'm not following him around. I'm doing my own thing

This hospital is notorious for low nurse satisfaction and high turnover rates. Though, since they're so high ranked they get away with it 

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Nurse SMS has 8 years experience as a MSN, RN and specializes in Critical Care; Cardiac; Professional Development.

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I can almost promise you 100% that manager wasn't even thinking about you. Your orientation is your whole world right now and your performance is obviously causing you no small amount of angst. However, your orientation is suuuper duper small on the scale of everyone else involved with your unit. Your manager in particular has a billion other things with far greater impacts on the patients, the unit, his/her career than your orientation. Nobody is worrying about it like you are. To assume because he looked at the floor that means you are going to be fired is taking some serious leaps that defy logic.

Your biggest risk at this point is your own anxiety. Get some help with that, as it is the thing most likely to cause you to lose your job, far more than anything else.

If you don't have a good brain sheet, get one pronto. Time management is the key to what you need to accomplish here. Get that down and the rest will follow.

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"nursy" has 40 years experience as a RN and specializes in ICU, ER, Home Health, Corrections, School Nurse.

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Some people are slow learners than others and that's OK.  I would make sure I was getting lots of feedback from the preceptor.  One thing confuses me, you say the docs keep calling her back, but if you initiate the call and leave your number, how are they calling her? Also, if the preceptor is getting the calls, she can transfer the call to you, so she doesn't have to do the "extra work".  

I would also talk to the nurse manager and look for constructive feedback, letting them  know that although you may be struggling, you are determined and will not let them down.  However...

I'm concerned that you are already mentioning that this hospital has low satisfaction and lots of turnover.  Before you talk to your manager and assure them that you will do whatever it takes, are you sure that's what you want.  Can you commit to a place when  you are already having this kind of negative perception.  Not every hospital is a good fit for every nurse, and also not every unit is a good fit.  If you are sure this unit is where you want to stay, then give it your all.  If you have doubts, talk to your manager about the possibility of someplace slower paced.   

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Kyla RN is a BSN and specializes in Research, Neurology.

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I'm sorry you're feeling so stressed. I can't tell you how many new grads I've known (including myself) who have felt overwhelmed and have struggled with the learning curve on the floor. It can be a very hard transition, good managers should know this. Sit your preceptor down when you both have a moment before or after shift, talk about your strengths/skills you could improve on. Ask him for tips, how does he handle 5+ patients? How does he manage his time/cluster his care? And encourage him to forward all calls to you. Please, do not assume you are getting fired, and please please do not jump the gun and quit because you think you will get fired. As all have said previously, managers have 500+ things on their mind (and some can be socially awkward and not give appropriate eye contact at times..). I think a sit down with your manager AND preceptor will also alleviate some anxieties and clear the air, so you have a better understanding of where you are in this orientation. It is expensive to train new grads, but its even more expensive to try to train new grads and let them go early/have them quit early on because they're overwhelmed and don't feel ready. It sounds like your employer is already trying to invest in and keep new grads with this classroom portion of the training (like a residency?) which is a huge plus- take advantage and reach out to those nursing educators who teach those classes- they are there to help you succeed! Best of luck and keep your head up, you got this and you will push through! We are all cheering for you 🙂

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33 Posts; 728 Profile Views

I’m sorry you’re feeling so stressed.  I could really appreciate what you were saying about longer orientation because I have always been slower at orientation also.  I have ADHD and an anxiety disorder.  Don’t beat yourself up!  Ask your preceptor what you need to focus on and relax!  Good luck!

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227 Posts; 5,852 Profile Views

MD Communication/Communication has been super tough for me during orientation as well. I have been working really hard to get over the idea that I shouldn't speak up or reach out to MDs because I'm new. That line of thinking is just not acceptable--its imperative that WE start that dialogue with the docs and not wait for them to communicate with us.

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bubblefishez1989 specializes in EMT/Medical Assistant.

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This is going to sound bad on here, but fake your confidence. Inside you maybe stressed, second guessing, freaking out and over whelmed, but no one needs to know that but you. This will make others around you feel more comfortable and wont question your abilities. In turn boosting your additute and actual confidence. Fall back on your training always. If you have questions ask even if you think they are stupid. Dont take ANYTHING personal. Kindly remind some that they were once in your shoes. Dont be afraid to ask for feed back or advice on how to do something better, more accurately or in a timelier manner. Make a list of what needs to be done for each pt. the routine stuff. Write out questions that need be asked etc. this may help you stay on track and more organized in your brain if you get into a habit of doing every patient in the same order every time it will be come second nature and routine. You're going to go home crying. You're going to be stressed, over whelmed, annoyed, pissed, irritated etc. Scream into your pillow, write the nasty letter to who ever you want in your journal (DONT EVER SEND!). More importantly write every reason why you wanted to spend the money and countless hours of studying to become a nurse. You may have struggled during practicals but something motivated you enough to pass and passing is passing remember that. Best of luck. You got this. 

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On 10/10/2019 at 12:46 AM, bubblefishez1989 said:

This is going to sound bad on here, but fake your confidence. Inside you maybe stressed, second guessing, freaking out and over whelmed, but no one needs to know that but you. This will make others around you feel more comfortable and wont question your abilities. In turn boosting your additute and actual confidence. Fall back on your training always. If you have questions ask even if you think they are stupid. Dont take ANYTHING personal. Kindly remind some that they were once in your shoes. Dont be afraid to ask for feed back or advice on how to do something better, more accurately or in a timelier manner. Make a list of what needs to be done for each pt. the routine stuff. Write out questions that need be asked etc. this may help you stay on track and more organized in your brain if you get into a habit of doing every patient in the same order every time it will be come second nature and routine. You're going to go home crying. You're going to be stressed, over whelmed, annoyed, pissed, irritated etc. Scream into your pillow, write the nasty letter to who ever you want in your journal (DONT EVER SEND!). More importantly write every reason why you wanted to spend the money and countless hours of studying to become a nurse. You may have struggled during practicals but something motivated you enough to pass and passing is passing remember that. Best of luck. You got this. 

Thank you so much for commenting! It really means a lot to me. This situation is something I'm so shocked to be going through honestly. Even after I wrote this post I was going to try to stay for a year, but since then I realized I cannot do this (for my own sake). 

I hate to define myself by my anxiety disorder, but I'm afraid it wins this time. My last shift, I broke down in the med room twice and by the time I left I had given myself a rash on my face from all the stress. I'm all for not giving up, but i think this has come to the point where i cannot jeopardize my own mental health...

I'm tired of crying and hating my life over this job. I hate to quit so early in the game, but I'm scared if I don't that I'll become even more insane. 😞 I think I'm going to talk to the nurse educators about this. Surely, I have to put myself first this time. I'm not used to that, but I think in this situation I really have to take care of myself and try to be happy again. I can't even remember the last time I was truly happy and I feel like I've lost myself through this whole process. 

Maybe I'll learn something from this, but right now I think I have to quit. Idk what I'll do, but life is unpredictable. I think I have to take this risk right now, although I feel really bad about it

 

P.S if anyone else who commented on this post is reading this, I tried to reply to your comment as well but it wouldn't let me. Thank you for your response!!

Edited by AmIDumb

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Leader25 has 35 years experience.

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On 10/6/2019 at 1:37 PM, AmIDumb said:

I think they're going to let me go bc they can't afford to have me take this long...

I am taking the majority of the patients right now (4), while my preceptor has 1. The thing is, most of the doctors end up calling him bc they're more comfortable with him and know him. Then he goes to tell me he was doing my work bc he was taking the calls for my patients.

You sound smart enough to have gotten this far,orientation is not what they say it is.It is part trial by fire and part dump it on the newbie.Some places have more leeway than others.Your preceptor is supposed to be there for you and they have a boss too,the doctors are supposed to call him because you are on "orientation" and are to be supervised safely.Go over your check off list and see where you might need more help,but if they are loading you down with difficult cases and insisting that you work faster ..then it is not you,they have failed to do their  job appropriately.Nursing education dept head is in charge of preceptors and you should be having weekly discussions with them on your progress.You can state your dissatisfaction.

As far as them letting you go because they cant afford the time it takes,stop your negativity  right now,none of your business what they can afford or not, you are there for a proper orientation,which should also continue when you are on the night shift.

Not all preceptors are created equal,and have seen the mean ones get reported,all that stuff goes on their yearly evaluation.

Hang in there,work hard,dont gossip,keep your nose clean.

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11 Followers; 3,606 Posts; 26,524 Profile Views

Hello--

A few comments:

 

On 10/6/2019 at 1:04 PM, AmIDumb said:

I then have a flashback to my manager looking down at the floor and avoiding me and I realized...he's probably avoiding me bc he knows he's going to have to let me go if I don't improve.

Agree w/ others that this is really a leap.

This is why positive thinking, although very difficult sometimes, is so important. It's sad how many of our limitations are self-imposed.

 

On 10/6/2019 at 1:04 PM, AmIDumb said:

Towards the end of the day, my preceptor tells me we have to extend my orientation and that he told my manager about it. I asked him what happens if I'm still struggling after this extra week, and he made a face and was like "we'll take it one day at a time." 

If that's the case (orientation is going to be extended) it should involve a sit-down meeting with you, your manager, your educator, your preceptor (or whomever else is involved in overseeing your orientation). Working this out should not be just between the preceptor and one of these other people.

I know what I would like to talk about if I were the preceptor in this situation: I would advocate for putting you back to three or even two patients and having you concentrate on doing everything as much as possible. This is (IMVHO) how it should have started from the beginning. I like people to be able to build; it just works better in my experience; it encourages people to be able to get a bit of a handle on something before adding more. Plus I think it is a better overall gauge of capability; if you can't take care of two, you can't take care of 5. I heartily disagree with pushing someone to the max ASAP.

So that is one suggestion they might be willing to consider. You would have to put that suggestion out there in an upbeat, can-do manner and then work your you-know-what- off if they allow you that opportunity.

If they basically only say that you need to do x, y, z and "if you don't, then ...." well, that is pretty negative.

What kind of feedback have you received so far, other than the fact that they will need to extend your orientation?

I hope they have given you some compliments as well as constructive criticisms...

 

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