I know someone that is having a really hard time in orientation. She has been crYing constantly.
She is new grad to the ICU and was told the 1st day on the unit she needed to speed up. On her 4th day to the unit, her preceptor gave her one hour to assess 2 patients and to complete her charting. (Started shift at 0730, expected to complete ALL charting, head to toe, lines, wounds etc by 0830) This preceptor got upset because she took longer and told her she is too slow for the unit. The preceptor gave her another time limit of 30 minutes to administer medication. She took longer than 30 minutes (she wanted to look up the meds and triple check before giving). She overheard the preceptor talking bad about her at the nursing station. About 30 minutes later she was called into the office and asked how she was doing, she said everything was going well. The manager said that it's ok to tell the truth and that she has been getting complaints about her time management. At that point she broke down and cried for a good hour saying she feels overwhelmed and pressured to be expected to work at the pace of an expert ICU nurse.
The manager thought that it was inappropriate to give a timed deadline to complete tasks and was not aware that it was only her 4th shift on the unit (new manager).
During a staff meeting, a few nurses said that if she can't handle the pressure, this is not the unit for her. They are also upset that she complained rather than talking to her preceptor. Now there are a few nurses that do not speak to her.
I have also another friend on the same unit that was told she needed to speed it up also on the 1st day and was given 2 patients by the 3rd shift of orientation.
Now I don't understand this, aren't most people slow in the beginning? Is this just an expectation in the ICU??? Or could it be just this facility??? Is this a bad thing or a good thing to be rushed??
The preceptor's demands don't sound reasonable... but to be honest, I would have concerns too if said new hire needed a whole hour to cry.
At that point she broke down and cried for a good hour saying she feels overwhelmed and pressured to be expected to work at the pace of an expert ICU nurse.
Take 5, collect yourself, and then get back to work.
Regardless though, it is not reasonable to expect one to function so independantly, so quickly. My unit only gives the new orientees one pt initially. I want to say I was on the unit a good 2-3 weeks before I was taking 2 pts.
I went to CVR straight out of school but had a three month orientation or internship in the critical care education Dept specific to my new unit. Then I was precepted for 12 weeks. I worked my way u from 2nd and 3rd day post op open heart to a fresh heart over the course of a few months on my own. This is the best of the orientation world I know but I wouldn't have done it any other way. I found that I am cut out to be in critical care just needed the proper training as I didn't get any critical care training in my BSN program back in 91. If you are a new grad looking for a "graduate nurse internship" is a perfect way to start. Many hospitals offer this.
Tell your friend to keep her head high and keep at it to prove them wrong. I was a new grad in the icu and was pretty much told by the end of my first month that I would never make it as an icu nurse. I not only made it I was the charge nurse after 3 years, sat and passed my corn at 3.5 years and ended up preventing many new grads and students over the years. No one can tell if you can make it after just a few shifts!!
I am currently on orientation in the ICU as a new grad. I never had any time limits...Like obviously if im running late my preceptor may remind me that my 9 meds are due etc. But every facility is different.
I would suggest she first have a conversation with her preceptor. She should tell her preceptor she is struggling and ask:
what can be done?
What are some time management skills you use?
Can you show me how you do your assessment so i can better my own?
Is there any faster way to look up her meds? In our Mar we can hover over a med and get a reference manual for that med.
ICU is very intense. It is overwhelming but it truly does take a special type of mentality. Also all that being said, i agree this is unfair and unsafe. Sounds like a very cliquey and gossipy unit. Can she ask for another preceptor?
The expectations that the so-called "preceptor" is putting on this new grad are so grossly inappropriate that a conversation with the manager would be more appropriate than talking with the preceptor directly. This unit sounds like a cess pool.
While I agree that it sounds like they are being pretty harsh with her with the time limits, I also can understand the need for expressing how fast paced things can be in the ICU. I was a new grad who went right into ICU out of school last year. My preceptor pushed me and was pretty firm with me at first, and I did feel overwhelmed and cried a few times. BUT by the end of my orientation I felt really ready, and I feel like I was really well-prepared to be on my own. I also understood why my preceptor was the way she was, and she and I are friends now. I think it came down to me working to be less sensitive and opening myself up to the fact that this was all happening for a reason and trying to figure out what it was that I needed to get for it to not seem so overwhelming. It didn't happen in a week for sure, but by the end of orientation I got it.
Edited to add though that my unit was always really supportive from the beginning though- I felt ok to ask any nurse any question and receive help no questions asked. The hostility that the OP described sounds crappy to say the least.
Here.I.Stand, BSN, RN
5,047 Posts
The preceptor's demands don't sound reasonable... but to be honest, I would have concerns too if said new hire needed a whole hour to cry.
Take 5, collect yourself, and then get back to work.Regardless though, it is not reasonable to expect one to function so independantly, so quickly. My unit only gives the new orientees one pt initially. I want to say I was on the unit a good 2-3 weeks before I was taking 2 pts.