New grad no preceptor.

**canoehead, BSN, RN** · Jul 25, 2019

I think your best move is to repeatedly request a preceptor for your shifts, and do not take an assignment without one. They will figure it out.

I'd be looking for other jobs. If they don't immediately and strongly change things up, I'd move to another job as soon as you land one. In the interview, be up front that you need a strong orientation, the experience that you have is not one anyone should go through. (Frankly, I'd go for another job whether they change things or not. Just the fact that they didn't notice you drowning is concerning.)

caliotter3 · Jul 25, 2019

Excellent advice by canoehead. Become the squeaky wheel and they are liable to give you a preceptor just to get you to be quiet. And do look for that new job. The handwriting is definitely on the wall.

allnurses Guide · Jul 25, 2019

15 hours ago, NewGrad613 said:
At this point I'm starting to resent the hospital and most of my coworkers. I come home and feel like a failure because I know my patients did not get the best of me. I'm being pulled in 10 different directions and I honestly don't know what is best for the patients at times. It takes me a long time to get help doing things that I dont know how to do when the other nurses are busy. Armed with the information provided from the awesome people here, I agree that my best course of action at this time is to do some research and try to find a good facility with a program that is specifically designed for new grads. I don't think this facility is equipped train new nurses. I also don't want to just learn to get by, I want to learn the proper way to do things. I know I can be an amazing nurse, I just need to find a place that is willing to invest in me and teach me what I need to know. Its been an eye opener to have other nurses confirm that it's not just me and what's happening isn't the norm. As crazy as it sounds... I think I just needed some confirmation that this situation isn't right. I needed to know that the expectation wasn't for me to come out of nursing school and be able to flawlessly transition into the RN role without any additional training or support. I've been made to feel as if I'm not doing enough or pulling my weight as a team member. I'm just relieved to have support and have other people in my same profession tell me to do what my gut instinct has been telling me this whole time.

I want to commend you for this response. You have been tossed into the deep end of nursing right out of the gate, and by that I am not only referring to your current situation, but to the fact that you are being required to advocate for your patients' safety, uphold your license and do the right thing. Those are very difficult things to do, particularly for a new grad who is likely to have tons of self doubt going on as the natural course of things.

There is a thing in life called "grit". Sometimes it is referred to as resilience. Your ability to step back, evaluate this situation and start moving toward the solution, even though its hard, shows you have it. Keep this part of yourself in your nursing practice for as long as you practice. It will serve you well. Let us know how your manager meeting goes and where you wind up.

Rionoir, ADN, RN · Jul 25, 2019

Worry more about your license and less about what people think about you.

**LibraSunCNM, BSN, MSN, CNM** · Jul 25, 2019

I can't fathom even getting past the first day on the job without a preceptor. I would have sat at the nurse's station until they figured that nonsense out. No way would I have just agreed to take report by myself. You work at a s***hole. Who would want to work there, and (more importantly) who would want to be a PATIENT there? It's utterly unsafe, and I would walk, like, yesterday, before patient care is further compromised. If they would do this, who knows what other unsafe stuff is happening. Don't worry about others' feelings or future interviews---you can honestly say you left this job because you had NO orientation and it was unsafe. No one can really blame you for that, and if they do, you don't want to work for them anyway.

JKL33 · Jul 25, 2019

10 hours ago, canoehead said:
I think your best move is to repeatedly request a preceptor for your shifts, and do not take an assignment without one. They will figure it out.

I thought about this and included the whole "ask for a preceptor" thing in my response, too, but I'm pretty sure that these fools who have been unabashedly taking advantage of the OP are going to respond with a mixture of defensiveness, resentment, and vindictiveness no matter how professionally it is brought to their attention that this is not right. I will be shocked (but pleased, of course) if they don't turn this back onto the OP because that's just what terrible people do rather than ever admitting they did wrong.

I cannot believe that they have pretended to orient this person by essentially giving him/her a patient to care for as an RN while otherwise working the tech role. What the world. That's a new low I don't think I've read on here before. I could never respect these people unless it became clear that there was truly something that had fallen through the cracks and upon realization of it the proper people were visibly/believably regretful/remorseful and took correct action immediately without excuse.

I hope I am wrong about how they will react.

Closed Account 12345 · Jul 25, 2019

Oh my word.

Nurses do not learn to be nurses in nursing school; they learn at their first job. Nursing school gives you some basics to point you in the right direction once you get to your first unit. I say this as someone who teaches nursing school.

Thankfully, to your knowledge you haven't caused patient harm yet. I agree with everyone else. If your manager doesn't assign a preceptor at your pre-shift meeting, you turn and leave. Do not take a single patient. Do not complete a single skill. Your competency has not been validated, so even things you think you're doing right may be wrong... And that's not your fault. That's because you're brand new and need guidance!

People tend to be more worried about losing their licenses than need be, but this is a case where you are jeopardizing yours. If a patient is harmed, there is no way to say you were advocating for safety or acting as a reasonably prudent nurse by walking into an ER as a nurse with 0 days of RN experience and accepting a patient load. You have got to stand up for yourself and your patients!

You deserve a preceptor who is explaining things from the moment your new patient comes through the doors. Here's how the triage nurse determined his acuity. With this chief complaint, we expect to see ABC orders and will be watching ABC labs because XYZ. We'll assess and monitor for XYZ because patients with this complaint can easily go downhill. Here's the policy where we can pull up the standing nursing orders to see what we can independently initiate before the doctor is at the bedside. Here's how we document XYZ. Here's where you will find these needed supplies; for this kind of procedure you always need ABC at bedside, etc.

Even if your manager assigns a preceptor at this point, I'd be hesitant to work at that kind of facility. If you have any other options, they're worth considering.

I'm so sorry you're going through this!

MiladyMalarkey, ASN, BSN · Jul 25, 2019

I'm a newbie and can't give you much great advice. Just that, I sat in a BON hearing, new nurse before them, made a rookie but serious mistake & facing board action. Point is, after seeing that, my only advice would be do what you have to to advocate for yourself and your license so you don't have to go through that. It's crappy that they put you in this situation and everyone seems okay with it. Protect yourself & your license first.

Display Name · Jul 25, 2019

On 7/23/2019 at 9:40 PM, Crash_Cart said:
Approach the individual who told you that information and have them fix and make good on it.

Display Name · Jul 25, 2019

Sounds like Hostile work environment due to the facility not following through on getting you a mentor. The same thing happened to me but I had to go two weeks. If another nurse was nasty to me for whatever reason, I would tell her to “kiss my ***” and find the answer another way. In your case, using protocol, file a Hostile Work Environment Grievance. Don’t mention the treatment until you mention you never received a mentor.

Kooky Korky, BSN, RN · Jul 27, 2019

On 7/23/2019 at 8:53 PM, Wuzzie said:
You need to talk to her and if not her then HR and I rarely recommend going to HR. This is untenable. Nobody should start working without orientation and certainly not a new grad much less a new grad in the ED! There are really very few situations where one’s license could be at risk. Your current situation is verging on that. Trust me, if something happens they are going to throw you under the bus.

DO NOT go to HR without having spoken to your Manager. Follow the chain of command.

You are not an outsider. you might not be in what you perceive as

The In Crowd, but you are on staff there, just as they are.

They can only do to you what you let them do. You need to speak up, nicely and calmly, at once. Do not put this off another day.

At this point, what do you need help with? Map out a list of things you need to learn about, a list of questions. Maybe your Manager is so far removed from the bedside or hasn't been there for a very long time, that she has forgotten how it is to be a brand new nurse. Help her remember by telling her the things you need and want.

How did it get to be the way it is? What happened on your very first shift?

Did you get a full assignment?

Was there no one showing you around and helping you to have the experiences you needed to have?

How many other RN's are there when you work?

You must speak up, to your Manager, and do it now.

Do it nicely but you have to mean business. Figure out what your response will be if she says you are doing great and you should not need more Orienting and Precepting after being in your role for a month now and having worked there as a tech prior to that.

Have you got a new orientee Checklist?

Believe it or not, your boss might not know you have no Preceptor. You say she is in and out and sees you working. And maybe she has assigned Nurse X or Nurse Y to precept you but that person, for whatever reason, isn't doing it. Get this clarified immediately.

"Boss, I need a few minutes. I don't have a Preceptor. I feel like I am in need of precepting so I can do my very best here in your ER. Who do you think would be a good Preceptor for me?"

Do this in private.

Wishing you well.

smini · Aug 3, 2019

A new nurse from nursing school should not be expected to work a full load and work at the pace of experienced nurses. To expect otherwise is messed up. Go to management and reiterate to them what they promised you at your interview: that you would be working side by side with a preceptor. If they don’t follow through, get outta there and find another job. It is not worth putting your license in jeopardy.