Hi everyone!! I have found myself in what seems to be a weird situation. I was hired on a med surg floor to work nights 7 p.m. to 7 a.m. Right now I am in orientation. My orientation is only 6 weeks. At nights patient load is 6 patients per RN... the one CNA that I have goes home at 11 p.m. So I have six patients with no CNA for the whole night. Right now they're working me up to get to having six patients. I had four patients yesterday... one which was a 300 pound lady. Who was incontinent and needed changing every couple of hours. And also she slid down in the bed and have mobility issues. Several times I have to call my preceptor to help me push her up...pulled her IV out, blood gushing everywhere.. another patient had uncontrollable pain.. My concern is once I'm off orientation the only other people on the unit are the other nurses who also have six patients..
During my break yesterday, I was talking to a float nurse who told me that the hospital has a huge turn over rate. Which I knew. Most of the nurses who work at my hospital are new grads. And it's been said that my Hospital likes to hire new grads because we are cheaper to pay...
My preceptor pulled me to the side and told me that tonight was a very easy night. And that it can get very crazy.
Nurses out there, does it sound like a lot to handle six patients plus no CNA as a new grad? Just would like your opinion... I am not a quiter but also want to be wise.... I dont want to disappointment my family... but I am starting to feel the depression and dread setting.... as a new grad I know I should be happy with basically whatever I can get. Ugh
Thank you for your advice! I agree that 6 weeks is short. My friends at other hospitals get 12 wks as a new grad. I had a meeting with my manager after my shift. And she basically told me i need to start keep track of what things i need practice with. She said bc its gonna be really bad when i have to do a procedure for the first time when im by myself... my question why ever let me do a involved procedure alone for the first time as a new grad... I dont know she just seemed really cold when she said that. A lot to think about.
Are you unionized? If so, what are your union agreements? Is there a legal safe staffing ratio in your home state?
Six patients was a common occurrence at my first job as a new grad on day shift. On evenings we had 6-8, and nights sometimes had as many as 9 or 10. Nursing, especially medsurg nursing, is a team sport. It will be hard but if you work together you can get through it.
Specializes in Geriatrics, med surg, telephone triage.
she basically told me i need to start keep track of what things i need practice with. She said bc its gonna be really bad when i have to do a procedure for the first time when im by myself.
Not ok. They don't have reams of papers with orientation tasks that you and your preceptor(s) must date and initial off on once you have completed them? And that shouldn't mean you can't ask for help after the orientation period is over either. I am in agreement that 6 weeks for a new grad is too short. Should be 12 or so.
If you are thinking of making decisions I would certainly be careful, as you are at a vulnerable point in your career. On one hand as a new grad, you don't know what you don't know. You are still learning how to prioritize, still learning how to set limits with some patients (that can be key when it comes to time management, some people will try to suck you dry), and you are largely dependent on a healthy working environment for success. That includes having coworkers you can count on and supportive management. Starting out in a toxic environment is not going to give you the confidence you need to grow.
On the other hand it is NORMAL and expected to have a rough time right now. It will take you a year before you feel comfortable in your role. As a new grad it can be hard enough to find a job in the first place. Quitting now might look sketchy on your resume, and managers are wary of staff that play the blame game (not saying you are, I'm just saying from a management perspective they don't like it). My official advice is give yourself a year to learn how to be a nurse, learn what is normal, and learn how supportive your manager and coworkers are. After a year your vision will be a bit more clear, and if you don't think it is a good fit you can move on. In the meantime network with other new grads for support and try to find an experienced nurse to be your friend, they can give you advice on the way. I hope that helps! Everyone has been there its just that the memory is a little foggier for some than others.
Six patients was a common occurrence at my first job as a new grad on day shift. On evenings we had 6-8, and nights sometimes had as many as 9 or 10.
I don't get the rationale for night shift having higher ratio than days. Just because of the business of daytime? This seems unsafe for a med-surg unit to have 1:10 ratios!! What is that like??
A nurse/patient ratio of 1:6 in med/surg during the night shift is normal in the hospital in the area where I live. You'll bust your butt working without a CNA or tech, but this patient load is not necessarily 'unsafe' or outside the realm of possibilities.
The unit in which I "grew up" had a similar staffing pattern on noc shift. Four RNs, no CNA. The other option was 3 RNs and a CNA and you can see that having the other RN would be better. The RN can do everything the CNA can do, but it does not work the other way around.
I had floated there as an aide and knew the patient population and the staff before taking the job as a new grad.
We had 6-8 pts apiece. It was busy, but we had good teamwork and it was doable.
To answer your question, OP, I'd take the job, but only after shadowing a full shift.
She said bc its gonna be really bad when i have to do a procedure for the first time when im by myself... my question why ever let me do a involved procedure alone for the first time as a new grad... I dont know she just seemed really cold when she said that.
But thats exactly why shes telling you to list them so that you can get those opportunities while still on orientation. It sounds like shes possibly trying to help you.
Although there will always be lots that you wont see till you are done orienting....and a first time for everything!
The med/surg nurses have eight patients each at my hospital, and sometimes they have no or inadequate numbers of CNAs. Six patients would be a good night.
Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
I don't get the rationale for night shift having higher ratio than days.
It is assumed that most of the patients will be sleeping during the overnight shift, thereby creating less work for nursing staff. Of course, any experienced night shift nurse knows that is often not the case.
It is assumed that most of the patients will be sleeping during the overnight shift, thereby creating less work for nursing staff. Of course, any experienced night shift nurse knows that is often not the case.
It's not just the assumption that the patients are sleeping, but the assumption that the workload is decreased because fewer diagnositic tests, surgeries, doctors' rounds and new orders are done during the night.
Specializes in med-surg, IMC, school nursing, NICU.
When I started out as a new grad on med-surg, my patient load went from anywhere between 5 and 8 patients a night. 6 was pretty standard and after an 8 patient night, I was thrilled to have 6!
After your (albeit very short) orientation, your status as a "new grad" isn't really supposed to have any bearing on your assignment. By completing your orientation period, it is expected that you can autonomously complete all the tasks expected of you in a safe manner. Most hospitals, at least all of the hospitals where I have worked, don't take how long you've been there into consideration. I'm not saying I agree with this; like many PPs have mentioned it takes at least a year to really feel confident in your skills. But it's an unfortunate truth.
Not having an aide can truly make a decent shift a nightmare. I can't believe they consistently staff you without one. Is this the policy on all units in your hospital? No wonder the turnover is so high!
I'm really sorry you're having this experience. This hospital doesn't sound at all like a good place for a brand new nurse to grow. If it were me, and I am a bad judge because my first unit was a great place for a new nurse, I would try and put your time in and start looking elsewhere once you've got some experience under your belt. The first year flies, trust me. Reassess how you feel then. In the meantime, ASK FOR HELP! And use good body mechanics. And ASK FOR HELP! Team work is the tool so nice, I listed it twice. Good luck.
new.grad.rn
31 Posts
Thank you for your advice! I agree that 6 weeks is short. My friends at other hospitals get 12 wks as a new grad. I had a meeting with my manager after my shift. And she basically told me i need to start keep track of what things i need practice with. She said bc its gonna be really bad when i have to do a procedure for the first time when im by myself... my question why ever let me do a involved procedure alone for the first time as a new grad... I dont know she just seemed really cold when she said that. A lot to think about.