Looking for an opinion....

[DGNurse10]

I am a new grad who's new to allnurses.com (I've often read things on here, but never posted anything until now!) I need the opinion of some experienced PICU nurses right now and am hoping you can help me out!

I started working in a PICU in July, in (what I thought) was a 10 week orientation program--meaning I have 3 weeks left. I found out yesterday that it's actually a 12 week orientation, although my manager told me that since I'm doing so well I can come off after the 10 weeks if I want. Some days are better than others with my comfort on the floor, but I generally take full responsibility for a 2:1 assignment, with only the occasional question for my preceptor. Part of me feels like I'm ready to be on my own--and making my own schedule and finally getting differential pay, but at the same time I feel like ending my orientation early will be cheating myself out of 2 weeks of learning that could be really valuable.

I have two preceptors, the one told me that she thinks I can end it early if I want, but that she wants me to stay on orientation so she can keep having less work to do. The other told me all I really needed before I was ready to leave orientation was a really sick admission, and then later that night I'd admitted a kid who coded within 10 minutes of coming in the unit.

I met again with my manager and preceptor in 2 weeks to decide if I will do the full 12 weeks or end my orientation early, and I just can't decide which will be better for me (and my patients) long term. I know ya'll have great advice on here, so I'm hoping you can help me out!

Thanks in advance!

[kessadawn, BSN, RN]

i have two preceptors, the one told me that she thinks i can end it early if i want, but that she wants me to stay on orientation so she can keep having less work to do.

holy pickles i hope she was joking.

the other told me all i really needed before i was ready to leave orientation was a really sick admission, and then later that night i'd admitted a kid who coded within 10 minutes of coming in the unit.

how did you feel about your performance during this code? remember, nobody expects a new grad fresh off from orientation to run a code alone, that's why picu works as a team. being nervous to go on your own is completely normal, and it should be. anyone who has no fear, well, they're not ready. discuss your specific worries with your preceptor and educator, get their feedback on the situation. remember, those preceptors will still be working with you when you are on your own, and you can continue to go to them for guidance. good luck, and welcome to picu!

[NotReady4PrimeTime, RN]

That purely selfish (and wholly inappropriate) statement about a lighter workload aside, your preceptors know (or should know) where your level of function fits into the assignments you're likely to receive over the coming months. Your learning isn't going to stop when you come off orientation. As you build on past experience you'll be given more and more complex patients and develop your skills on the fly. If they think you're ready and you're feeling you're ready, then there's no reason to extend your orientation past the 10 weeks. The best workplaces have flexibility in these things and tailor their orientations to the needs of the new staffer. And of course that goes both ways... there should be NO reluctance to extend an orientation if the new staffer is struggling. My advice? Get a couple more sicker admissions under your belt, and transfer a couple of kids to the ward - you know that you'll be doing that a fair bit initially - then make the leap. Best wishes and please don't hesitate to come back and chat.

[llg, PhD, RN]

My expertise is NICU orientation rather than PICU, but ... I don't think you should be in a big rush to get off orientation. It's a luxury to have the extra learning time and I suggest you take advantage of it.

If you really feel ready and/or you feel they want you to come off early ...

Why not suggest a compromise of 11 weeks? Tell them that you feel comfortable with routing care, but that you would appreciate 1 more week to focus on a few specific things, such as really sick admissions, etc. That suggests that you are not "hanging on too long" in orientation and are prepared to move forward ... but that you are conscientious enough to want to be sure to get everything you need first.

For many issues in life, people assume it's an "either - or" situation, when in fact, there is a 3rd option. In this case, I think the 3rd option (the compromise) sounds like the best solution. Everybody wins.

[DGNurse10]

Thank you everyone for your advice. I decided to do the last 2 weeks of my orientation, because I ended up taking a lot of sick 1 to 1 patients in the weeks in between---which was definitely a good experience, but not the typical 2 to 1 assignment I will have when I'm off orientation. So I'll spend my last 2 weeks getting used to a 2 to 1 assignment :)

And yes, my Preceptor was definitely kidding when she told me that she wanted me to stay on so she doesn't have to work--she is the go to resource person for pretty much everyone on the unit because of her amount of experience, and has made it perfectly clear that even when I'm off orientation I should never hesitate to ask her for help or an opinion.

Thanks again for your input!

[NotReady4PrimeTime, RN]

It sounds like you're feeling a lot more comfortable now and that you've established a great relationship with your preceptor. She'll be a good resource for you for life now. By all means use this time to figure out your organization skills so that you can handle those 2 to 1's. And don't forget to have fun.