Length of orientation for new grads

[Brooke..RN]

Ok, I am new to this site...so I am hoping to get some feedback!

I am a new grad (RN) and just obtained my license in August. I was an LPN prior to becoming an RN. My past experiences include LTC and some geropsych. Recently (3/2011) I was offered a job in the ER at a local hospital. THRILLED, I immediately accepted!! I loved it!! The pace, the variety and not knowing what to expect from minute to minute. All that aside, I feel cheated, let down, failed!!

First day of orientation started out just like any other! "Here is where we keep this, here is how the rooms are set up, this is how the ER flows, here is the bathroom...etc" For the first 2 hours, that is. Then the ER got swamped and it turned into "just follow me and watch what I do." Which quickly turned into every day's routine. Then my preceptor started pulling away and letting me do assessments and some triage.

Then before I knew it, it was my first day on my own...still in "orientation," but on my own. NO ACLS, NO PALS, NO TNCC, NO EKG COURSE!!! I had....literally....16 days of orientation (6 weeks of 12 hr shifts, minus the last weekend). All my fellow nurses were cheering me on, telling me I was doing a great job and to keep up the good work. They all liked my positive attitude and made sure I kept it. Most nurses were right there if I had questions or needed help with anything.

Last week my boss called me at home and asked if we could get together within the next couple days and talk....I KNEW WHAT WAS ABOUT TO HAPPEN, I FELT IT.

She told me that some of the nurses were concerned that I "wasn't getting it," and that I probably wouldn't "get it." And that she had to terminate my employment.....WHAT???? They all told me I was doing well.....I was so confused. I asked for examples. She gave me an example of a situation in which the nurse telling her the events did not tell the truth, and gave me another situation in which there was absolutely NO WAY I would have/could have known the answer to...had never even heard of the possibility before.

I was the primary nurse for Coreg/Plavix OD, insulin/Metformin OD, and numerous other life threatening situations....WITH NO EXPERIENCE other than BLS!!

I feel cheated! Failed! I cried for 2 days! I am so upset! Talk about feeling STUPID. So my question is, is 6 weeks of orientation enough for a new grad? In the ER?

[jennifers]

no. I would say at least 12

[SpecialK38, ASN, RN]

Hi Brooke- I am SO SORRY this happened to you! I just graduated in Dec 2010 and was hired to a IN LTAC. My orientation was 12 weeks with classes for even the experienced nurses- EKG, etc. We also had a very good preceptor program. Unfortunately, it sounds like next time you need to be a advocate for your education on the job. I am also worried that other nurses were concerned about your performance and did not come to you first with their concerns. Obviously we can't learn if we aren't being told what we were doing wrong. My opinion: Yes, you were cheated!!! The best thing you can do is learn from this experience and move on. You are NOT stupid! You got into nursing school, passed and passed the boards. Try not to dwell on what you could have done different, but instead learn from it. For you next interviews ask specifically about orientation for new grads, preceptorship and support. Obviously you got good feedback from many nurses- you are going to do GREAT!! You just need to be nurtured. Good luck!!!

[CCRNDiva, BSN, RN]

Unfortunately, many departments live by this sink or swim mentality. There was a time when it was unheard of to land a job in the ED as a new grad unless you did an externship or worked as a tech prior to graduation. In this current economy, many hospitals do not want to spend the money on orientations despite a plethora of research that validates the use of a structured orientation/residency for new grads.

Please don't beat yourself up. ER nursing isn't for anyone and it certainly isn't an ideal place for a new grad. I act as a preceptor on my unit and I've had to tell an orientee that he wasn't ready to get off of orientation. Our director wanted to cut him loose and let him sink or swim (it was costing $$ plus we were short staffed) but I refused because I thought he needed more time. He was very good at the tasks of nursing but at that time, he couldn't grasp the rationales of critical care nursing. He and I had a long talk and he acknowledged that he wasn't ready to work alone in the unit. I didn't want him to risk losing his license or making a fatal error and he agreed. I didn't think he was ready for the ICU at that time but left the door open for him to return after getting some nursing experience. Our director then helped him secure a job on a telemetry floor. A few yrs later he came back to our unit to train as a float and he did quite well. I told him that I was glad that he didn't let his initial experience deter him from returning the ICU. He actually thanked me for looking out for him and he's now studying to be a FNP.

This is just a bump in the road. I personally feel that your manager did you a favor. Making a mistake there could have cost you your nursing license and even a patient's life. Those nurses should have used those events as teaching moments instead of a method of or a means to keep score against you. It doesn't sound like a supportive environment that would nurture a new grad. Give it some time and find a department that provides a supportive and structured orientation. It does not mean that you will never be a good ER nurse it just means that particular department wasn't the one for you. You can always try ER nursing again after getting some experience or you may find your own niche in nursing and thrive in another department. That's the beauty of nursing, there's something for all of us :clown:

[Soriano43]

12 weeks for tele