My termination story, any new grad success advice appreciated!

VANurse2010 · Feb 5, 2015

6 weeks orientation for a new grad in any hospital unit is bull. Move on.

dinah77, ADN · Feb 5, 2015

Don't feel too bad. You were not set up for success

As a new grad you should have a minimum of 12 weeks orientation on a med-surg floor. Do not accept anything less.

And six is a slightly high pt load on med-sug anyhow IMO. As far as how to proceed, is there anyone on your previous unit who would be a reference for you?

caliotter3 · Feb 5, 2015

Give yourself a certain amount of time to feel upset, then set that aside, and get to working on getting your next job. Do not neglect to sit down and figure out what you learned and what you can do to improve. Think about how you are going to address this in interviews. And do not beat up on yourself or engage in obsessing on how they treated you, you've already been told that many new nurses bite the dust on their first job. You just have to keep on getting up, dusting off, and trying again. You will make it,

Pediatric Critical Care Columnist · Feb 5, 2015

Many employers have a probationary period (not to be confused with orientation period) during which either party can "walk away" from the employment relationship without cause. The period may be defined by hours, days, weeks or months of employment. There are a lot of people who aren't aware of this probationary period, either because they weren't told, or because they didn't read all the fine print in their offer letter. The probationary period is there to protect both parties; when it's obvious a new hire isn't going to be able to handle the job, the employer has no obligation to continue to employ the new hire. Conversely, if the new hire finds the workload too onerous, the culture too unfriendly, the policies too restrictive, they have no obligation to continue to work for the employer. Perhaps this is the situation with your (former) employer. By the same token, 6 weeks of orientation should be enough, since the purpose of orientation is to provide familiarity with the physical space and typical patient population, charting expectations, availability of supplies and equipment, policies and procedures and culture on the unit. It's not intended to teach a person HOW to do the job - the expectation is that a new hire knows how to be a nurse, just not how to be a nurse on THAT unit. I personally have never had an orientation longer than 4 weeks, even as a new grad. Having said that, I also was supernumerary for those 4 weeks, meaning that my preceptor and I were essentially 1 person. I gradually took more responsibility for the assignment we shared until I was taking the whole load under her supervision and with her providing me with a resource. That doesn't sound like the case for you.

This is just an observation so take it for what it's worth. You mentioned in your post at least twice that you were quizzed by your manager after your 4th night shift ended. While that may sound like a good reason for not doing well, would that be an adequate response if something untoward had happened to one of your patients at the end of your 4th night shift? Of course you were tired. Of course you weren't prepared for a quiz. But in this profession, nothing is predictable. Patients, even the ones who look the most stable, do arrest just before shift change. There is no "appropriate" time for a code. We can't just say, "Well, I was really tired so I didn't..."

Islaleigh · Feb 5, 2015

Many employers have a probationary period (not to be confused with orientation period) during which either party can "walk away" from the employment relationship without cause. The period may be defined by hours, days, weeks or months of employment. There are a lot of people who aren't aware of this probationary period, either because they weren't told, or because they didn't read all the fine print in their offer letter. The probationary period is there to protect both parties; when it's obvious a new hire isn't going to be able to handle the job, the employer has no obligation to continue to employ the new hire. Conversely, if the new hire finds the workload too onerous, the culture too unfriendly, the policies too restrictive, they have no obligation to continue to work for the employer. Perhaps this is the situation with your (former) employer. By the same token, 6 weeks of orientation should be enough, since the purpose of orientation is to provide familiarity with the physical space and typical patient population, charting expectations, availability of supplies and equipment, policies and procedures and culture on the unit. It's not intended to teach a person HOW to do the job - the expectation is that a new hire knows how to be a nurse, just not how to be a nurse on THAT unit. I personally have never had an orientation longer than 4 weeks, even as a new grad. Having said that, I also was supernumerary for those 4 weeks, meaning that my preceptor and I were essentially 1 person. I gradually took more responsibility for the assignment we shared until I was taking the whole load under her supervision and with her providing me with a resource. That doesn't sound like the case for you.
This is just an observation so take it for what it's worth. You mentioned in your post at least twice that you were quizzed by your manager after your 4th night shift ended. While that may sound like a good reason for not doing well, would that be an adequate response if something untoward had happened to one of your patients at the end of your 4th night shift? Of course you were tired. Of course you weren't prepared for a quiz. But in this profession, nothing is predictable. Patients, even the ones who look the most stable, do arrest just before shift change. There is no "appropriate" time for a code. We can't just say, "Well, I was really tired so I didn't..."

Thank you for your response and being honest, that is just what I needed to hear. I do admit that I did have problems, which is why I've accepted the condition of my termination. And I realize now my approach to orientation was not correct. I had imagined that the format would the same as the format of my nursing clinicals. And a big part of that was being naive. And no one had really told me what you just have. I take full responsibility, and will definitely take your advice and information about orientation being a probationary period that can be taken away just like that, its a one time chance. I know you mentioned how you approached orientation, is there anything else you did, study after work? what were your strategies and tools to being successful? in more detail, I really would like to hear your feedback. Once again thank you.

JustMeToo · Feb 5, 2015

I'm in a similar situation. New Nurse and very overwhelmed, which seems to show on my face, unfortunately. My preceptor has been concern that I'm too task oriented and I'm going to miss something important. I was called into a meeting to discuss whether I'm a good fit for the floor I work on. I won't go into details, but I did cry. I tend to wear my heart on my sleeve. I have 3 more shifts to prove myself and I'm so stressed about the outcome, I'm not sure if I'm up for the task. Any word from my preceptor and I'm out the door. Being a new nurse I am already struggling with confidence. This experience has been really hard. This was suppose to be my dream job and after only 2 months, it may have already ended. So, I really do feel for you. Hang in there. They say when one door closes another opens.

Pediatric Critical Care Columnist · Feb 5, 2015

Your comment about thinking orientation would be like an extension of your school clinicals is an important one. Many new grads are absolutely shocked to find out they're The Nurse now and have all the responsibilities that go along with that. It's not the new grad's fault, it's the school's, and the clinical instructor's fault for not giving the student a real-world experience. Too many faculty members haven't been real-world nurses for too many years and the poor student is left thinking they're the ones who're failing. I was lucky to attend a good school where my clinical instructors were only a year or two away from the bedside and to have a very down-to-earth head nurse on the unit where I did my senior practicum. She ensured that I got the whole real-world experience, right down to taking 4 peds medicine patients all by myself at the end.

Let me tell you about my very first nursing job. It was with a home health agency that also provided staff relief for hospitals and nursing homes. My orientation was a 4 hour session in their office with the manager going over how to fill out the paperwork. My very first assignment was the same evening, 4 hours in a home with an 11 year old severely handicapped child under the watchful eye of her mother. Next I did a 4 hour relief shift on a burn unit. Then an 8 hour night on a surgical unit... it was a baptism by fire and I had no one I could go to for support. I lasted 8 months.

In each of my other jobs since then, my orientations were 4 weeks tops. The orientation process included some classroom time where I learned about the specialty area I was now working in (neonatal intermediate care, followed by PICU and then PCVICU) plus buddy shifts where I got used to the unit, the patients, the charting and the pecking order. I understand that being supernumerary isn't the norm on many units but it makes a big difference in how well a person is able to integrate into the workplace. But I always made notes to myself during my shifts when there was something new to me - a diagnosis, a complication, an event, a new treatment or med... that I researched when I had time. Usually after I got home. My first night shift on my own in the nursery, one of my babies kicked out his IV right around the same time one of my other babies crumped. 5:30 in the morning I was helping to resus her and get her ready to transfer back to NICU. 5:30 in the morning is the WORST time of the whole night for me, even still.

Every experience will be a learning opportunity. When you take the time to do the research afterward so you can understand what happened, why it happened and whatever warning signs might have presented, you'll get more and more confident in your assessment skills. You should feel comfortable asking those with more experience to explain things to you, not only things that happen to your patients but to others as well. What I suggest is that when you start your next job, spend some time watching the other nurses so that you can identify the ones you can approach for help. Realize that it may not be your preceptor... not everyone is cut out to be supportive. Med-surg is hard. Heck, NURSING is hard. The workload can be staggering. Knowing who you can turn to is vital. You can turn this all into something good; sometimes things have to fall apart so that you can build something better.

Anna S, RN · Feb 6, 2015

OP,

I think you have a lot of good insight into yourself, and a great attitude. It is really hard being a new nurse- hell, it's really hard being an old nurse- it's just hard, period!

I think you have what it takes to make it- hang in there, and the right opportunity will come along.

Good luck!

whofan, ADN, BSN, RN · Feb 6, 2015

The hospital system I work for only has 5 weeks for new grads on the med-surg floors, and unfortunately it is the only one in 100 mile radius that hires new grads. We have many people coming from the surrounding areas to get trained her and they leave after their year contract. The management at her hospital seems a bit harsh, but 12 weeks would have been awesome.

calivianya, BSN, RN · Feb 6, 2015

Wow, it sounds like some of you have really bad orientations. Mine was 12 weeks at my first job - the new grads at my current job get six months. In fact, they tend to give the full six months to anyone with less than a year of experience. Heck, I got 12 weeks as an nurse with a year of experience in that exact same type of unit. I have never worked med/surg, though. I couldn't tell you what med/surg orientation looks like.

cat1235 · Feb 6, 2015

Girl no sweat!! That kind was an ******* move .... You JUST came off orientation and are still a new nurse... if the NM wanted an experienced nurse she shouldn't have hired you. And I understand a lot is expected of nurses but for her to pose scenario questions at the end of a shift like that really put you at an unfair disadvantage and was practically setting you up for failure. You don't wanna work somewhere like that anyway. Reminds me of an instructor I had once that unjustly failed me out of clinical. .. point is, there are some people like that who try to play God and think they know who's bound to succeed and who's bound to crash and burn. They don't know. I think you will find much better luck on so many other units. I hope you won't let this serve as a basis for what new nursing is like because I truly don't think most units are like this. You are better than that. Also, so many experienced nurses have said it took AL EAST a year if not longer to feel comfortable and get the hang. I also think it's important next go around to assess the people you will be working with on the unit as well as the NM. Maybe ask if you can shadow for a day to get a feel for the staff. I really don't think you'll experience that same kind of thing again though.