how many patients for a new grad on the first day on the floor?

Published

Specializes in Medical, Surgical.

i am going thru orientation and my manager said she is going to gradually build up my patient care load until i reach the max. we (me and my fellow co-horts) will start out with 1 then 2 and so on till we reach 5-6. but on another floor which is a med-surg floor also with 27 beds at the same hospital, the new grads stated they are getting 3-4 patients on the very first day (which was today) and they were doing "everything" with the preceptor just observing and being called as need (hmmm a bit scary, in my opinion). isnt that a bit much for the first day or should we also get that many pts on the first day????? these new grads on that particular floor says we are being "baby-ed" onto the job and we need more patients. its only the first week dude, i was like "did they really just state that, that was a slap in the face". probaly would seem a bit overwhelmed with that many to start out on the first day. i really love the way my mgr has it planned out. from last year my floor still has all of her new grads (9 total) and the other floor has no new grads from last year. i need some input from others about this.:confused:

Up Vote Up Vote ×
Specializes in Med/Surg, Telemetry.

:heartbeaton my first day, i basically "shadowed" my preceptor. i did what she did. i got a tour of the floor and learned her routine. on my second day, i took one patient and then gradually went up to 5. taking one or two patients at first allows you to really concentrate on all the aspects needed to give nursing care. as soon as you learn a routine, it is easier to provide care to more patients. taking 3 or 4 patients on your first day is horrible! you don't know anything yet! easing yourself into your position slowly is the best advice i can give! worked well for me! :yeah:

Up Vote Up Vote ×
Specializes in ER, Cardiac Tele/ICU Stepdown.

Hey, i'm a new grad also, started on the floor about 3 weeks ago. My hospital has an intern program where we're with a preceptor for 3 months and gradually work up to the full pt load with minimal assistance from our preceptor. Initially, I followed my preceptor and got a feel for how things worked on the floor. The next day I had one pt, and the next 2. Now I've got 3, planning to take 4 the next week (which is the max on my step down floor on day shift) It's really been nice to gradually work my way up to the full load, and not be dumped with all of them on the first day! And I have a preceptor there to help when I need it. Good luck!

Up Vote Up Vote ×
Specializes in Geriatrics, Cardiac, ICU.

I work in ICU with a six month time with a preceptor. The first day, I took one patient and did everything except checking charts, calling MD and the lab or any off floor procedures; I never shadowed because I had already worked on the floor as a nurse tech and I knew the routine. After about 2-3 weeks, I did total care on just the one patient and gave meds to both. After a month, my original preceptor left and I got another one. We picked up where the other had left off and all the way up to about the 5th month, I just did everything except call MD's. By the time I was in the second week of the 5th month, I was doing everything without a problem. I guess it was just a matter of the preceptor listening to my needs and feeling me out to see what I needed.

Up Vote Up Vote ×
Specializes in Med/Surg, Hospice.

For the first 3 weeks of my orientation I wasn't permitted to take patients on my own because I was not licensed. However, I did assess and chart on a progressively greater number of my preceptor's patients and followed her as she pulled meds and passed them. I also did as many procedures as I could while she talked me through them. I started with 3-4, then moved up to 5-6.

Once I was licensed, I started taking all of her patients. I was just really lucky that she only had 4-6 patients per shift for that first week. After that, it went up to 6-7 every day and has stayed there. I now take all of my preceptors patients and do everything myself with her still helping out as needed. When I had 6 patients to discharge, she did 1 of them, and she frequently checked my charts for orders for the first week, though she is trying to let me do those now too.

I have a little more than one week left of orientation, so it's good that I have been consistently taking the max number of patients for a couple of weeks now.

Up Vote Up Vote ×
Specializes in Med/Surg, ICU, ER, Peds ER-CPEN.

I had one my first night and 2 the next 2 nights, not sure how many I'll get tomorrow night, depends on the census a bit lol

Up Vote Up Vote ×
Specializes in Ortho, Neuro, Detox, Tele.

My first day...I did a lot of following with, but I did do assessment parts and after 2-3 patients, I felt comfortable enough to do a total assessment...I watched what we needed to chart, and we went from there....

Then I passed 1 patient's regular meds....and gave prn's as needed. It took a while to get the hang of it...and it was a really busy day! Sent people out, took 2 admits, by the 2nd admit I was able to get them in with preceptor assistance....so that was good.

today, I was able to assess completely, and get things in...give all regular meds(ZOINKS!)...chart everything, check on papers, verify orders, get things done...what? I can sign orders off now? what happened?

It's like NS all over again...they're hunting me down for IV's, Foley's, papers, orders, etc....wow! LOL.

I think that expecting you to do anything extra is tough.....you have to start with 1-2 and go from there.....but only after you know where things are and what to basically do on the floor for a stable "regular" patient....GL to you!

Up Vote Up Vote ×

after 3 weeks of orientation......new grads are given 5/6 patients we are not given any special treatment:uhoh21: after me and another new grad at the time (it's been six months now) made a suggestion that the orientation be longer....it was made longer and now is 5 weeks. Even though we had 5/6 patients right away we alway had help if we needed it. six months later....me and the other new grad are now promoted to RN II with a little raise and now we have to be trained for charge nurse.:no: not ready for that but it is mandatory:uhoh3:

Up Vote Up Vote ×
Specializes in Oncology.

I had no patients my first day, just shadowed and did skills I felt comfortable with. Second day I had 1 patient and shadowed my preceptor with her other two patients.

Up Vote Up Vote ×
Specializes in Oncology, Med-Surg, Nursery.

I've been in orientation where I was on the floor on my shift since June 16th and I am up to 2-3 patients by myself now. The first week I just shadowed my precepter.

Up Vote Up Vote ×
Specializes in Cardiac Telemetry/PCU, SNF.

It depends on so many factors. First, what kind of floor? How acute? What's atypical load? Second, the preceptee/new grad. Are they a "go-getter", or a little more timid? Did they work previously on the unit? What about their senior practicum?

When we get new grads, we try to factor these things into the equation to avoid overwhelming our new folks. When I started, over a year and a half ago, I took 2 my first day and went from there. Others shadow, get the flow and some jump right in. To expect a new grad to care for a full load from day one is setting people up for failure - not to say that it can't be done, but that it does not bode well for retention or quality care. We expect our new grads to be carrying full loads by the end of orientation (a total of 6 weeks), sooner if possible. The newer expectations is that new grads will take at least one patient on the first day, but like I said above, it is something that is worked out between preceptor and preceptee.

Hope this helps!

Tom

Up Vote Up Vote ×
Specializes in PeriOp, ICU, PICU, NICU.

I started with 2. The following week I was up to 7

Up Vote Up Vote ×
+ Join the Discussion