Low Censused while on Orientation

[missbutton]

Hi guys,

I'm orienting to the ICU (yay!). It's a rural and low acuity ICU and we're in the middle of a really bad summer slump. And both me and my 'dedicated' preceptor are getting low censused, but independently of each other, so as a result I've ended up passed from nurse to nurse, I've only had one acute patient, and I've been low censused so much that I've only worked 5 1/2 weeks of my seven weeks of orientation.

When I was oriented to med/surg ,at this hospital, my orientation was protected- no low census or call for me or my preceptor during my whole orientation.

Anyways, I'm pretty upset about the whole thing, but before I get too upset, I wanted to ask what your ICU orientation was like or how your ICU handles orienting new nurses...?

Thanks for the feedback

[IheartICUnursing]

I am orienting in ICU as well, I have 16-18 weeks of orientation and my preceptor and I are both safe from being cancelled or floated during that time.

[meandragonbrett]

They are cx'ing you on purpose! You are costing them valuable $ because you're in orientation so they have to pay two RNs when you are there. They can just cx you and only have to pay one RN. You shouldn't be thrown into the cx rotation until your orientation is complete.

[armyicurn]

Hey, don't be upset. Consider yourself lucky to not have been called off. No work = NO money.

Instead of letting it get to you, look at it this way: you are being exposed to working with other colleagues. Listen and watch how they do things and gather from them what you like and add it to your skill set. When you are done with your orientation, you will have a pretty good set of skills and knowledge when you get your first case all by yourself.

Enjoy the low tide because when it hits the fan, you will not be able to take a 2 minute walk to even go to the toilet. Trust me, I've been there.

Enjoy the time you have now and ensure you understand what you are doing for your patient.

Good luck and welcome to the big leagues!

[assidere]

At mine small-community based independent hospital, ICU preceptor and orientees are restricted from floating, though they can be called off for low-census. After orientation, the new hire can't be floated for at least six weeks...

[ICU-RN<3]

During my orientation, I had one main preceptor, but if she was out sick or on vacation, I would go with somebody else. I think it's great to be able to have some consistency, but it's also interesting to learn from other nurses, so you can "pick and choose" ideas from different people. I was also never floated or called off during orientation for low census.

[Sugarcoma, RN]

I have not been low censused at all during my orientation and from what I understand I cannot be. My orientation is 8 weeks and I have two main preceptors. They just removed one of them and are assigning a new one because they feel I need a stronger preceptor. I plan to ask them to extend my orientation because of this.

How are they handling these low census days for you? Are they going to add them back into your orientation? I would be concerned because once your orientation is up and your on your own...that is it. You will be held to the same standard as the rest of the nurses on your floor. I would speak with your manager and make sure that they plan to have you make up those orientation days. Those days represent lost learning opportunities and really should be made up in my opinion.

[montinurse, BSN]

Since you're being passed around, the nurses may not know your competency/comfort level. Communicate with them. Tell them first thing in the morning what you need to do, what your goals and expectations are. It's up to you to get the most out of your orientation. Even now is a good opportunity for you to practice being autonomous, a trait that you need to survive in ICU. Good luck :)

In my orientation, I asked for high acuity patients, if my preceptor did not. She was really great about making me take the sick ones. Even after orientation, I volunteered in morning report for the high acuities. Now that I've been in ICU for over a year, the new nurses and trainees get the high acuities. BUMMER for me. I guess it gives me time to work on my CCRN :) Though being stuck with low acuity/step-down floor patients can be busier than a vent!

[picurn1972, RN]

Don't you have a competency checklist of goals /skill that need to be acquired during orientation? Titrating drips, pressors sedation, bedside procedures? If you do tell them you need to focus on them, if not it wouldbe a great project for the future. Our orientation is no call offs, time depends on nurse as individual.