New grad on a neuro floor, need advice

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Hey all! I graduated a ADN program in December and secured a position on a "neurotrauma step down floor" at a fantastic, large hospital. I accepted the position before I graduated (October) and was really excited then as Neuro was something that always interested me.

However, my program does transitions/preceptorship the last 8 weeks of school where you shadow and work 1 on 1 with a nurse practically full time & and I got stuck on a labor and delivery floor. It was a 1:1 patient ratio with all the same meds, and that hospital did not let me pracrice skills as a student. I hated the preceptorship and felt like I was left behind my other classmates who got to practice prioritization & skills (Putting in ivs, ng tubes, dressing changes, foleys, etc) and feel as though I am behind.

I passed my NCLEX and I start orientation next week. All my teachers told me that the neurotrauma floor will be stressful and challenging and now I'm kinda worried that I am not competent to be taking care of such high acuity patients.

Any advice would be appreciated!

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Forget feeling worse because of your L&D preceptorship. It's too bad it did not really serve your purposes very well, but it's over--time to move on.

Yes neurotrauma is going to be stressful and challenging. What they didn't tell you is that it doesn't much matter; most new grads find whatever their first job is to be some degree of stressful and challenging! So tell yourself you don't have it any worse than anyone else and that will be pretty much the truth.

You are a new grad like innumerable other new grads. Believe in yourself (and those who will be helping you) and put your best foot forward.

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Specializes in PICU.

ANY unit will be stressful and challenging for a new grad. I repeat ANY unit will be stressful and challenging. Your preceptorship was just that, a class you needed to take for nursing school.

All that the others in your class learned were just a task, nothing special, nothing truly nursing, just tasks.

What you WILL learn once you start your NURSING job will be assessments, time management, medication administration and evaluation/assessment post administration. Every unit will have specific tasks and skills to learn that are essential to the unit. IV placement not always done by a nurse or even the bedside nurse, sometimes there is a team. Instead focus on IV site assessment, determining if the IV is still functional, did it infiltrate, should it be replaced... those are the nursing components. Foley placement, not truly a nursing skill. Peritoneal GI/GU assessment, Urine output quantity, color, etc - assessments - that part is nursing.

Don't feel bad because you did not learn a task in your preceptorship, again it was just a clinical you needed to graduate.

Be proud and excited that you are starting in neurotrauma. You will learn so much and it sounds like it would be a fascinating unit to start in. They would not hire a new grad RN if they did not think you would be successful.

Just think for a moment, what if you learned a task one way at a preceptorship. You start in your new unit and begin to perform the task and it is all wrong because the hospital does it a different way, or maybe the way you learned was incorrect. Now you have to relearn everything.

Be patient and excited about your next steps.

Sorry for the long post.

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Specializes in Community Health, Med/Surg, ICU Stepdown.

Agree with above posters, skills take time to learn and I doubt your fellow students are super ahead of you due to a few extra months of hands-on practice. But I do understand why you are frustrated that your preceptorship could be considered a waste of time. But I have learned all life experiences are worth something... at least you got to see some babies be born? LOL

Anyway, as stated above many new nurses focus on mastering skills but assessment is really the most important. It's great to get good at IVs for when your patient needs one urgently, but there is usually someone experienced to back you up in an emergency, and you can take time to learn when it's not urgent for a patient to have an IV. Foleys, same thing. You will get better with time and if it's a tricky one you may need back up! 3 people holding legs with a flash light perhaps... I hope you get to work with a great team! Teamwork and coworkers willing to teach and help are so important. Wishing you the best!

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Specializes in orthopedic/trauma, Informatics, diabetes.

regardless of unit, you can get an idea of the flow for the day, time management, navigating whatever charting system they have, policies that are system-wide.

You will get to learn whatever you need to know when you get to your "home" unit.

Congrats! I work ortho and our "sister" unit is ortho spine/neuro so we have a little neuro training.

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Thank you all for the thoughtful responses. Going to give it my all!

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