New Grad RN: Should I hang in there or leave?

[Smnthvolger]

I’m a new grad nurse who finished school during the pandemic. I don’t have hospital experience and I was lucky enough to land a new grad position in the ER in a community hospital a month after licensure. Three people are in my new grad cohort and it’s a couple months of orientation. It’s a little community hospital ER with a lot of psych patients as well as medical, ratio 4-1... and they want to hold me back on orientation for a month, and if it doesn’t work out transfer to medsurg.

The experience has been difficult. My preceptor is very sweet but has been there for years and started as an LVN. Most people have been an RN longer than I have, even the other new grads. I’m assigned a different preceptor every shift and I feel like I’ve been thrown to the wolves for most of the orientation period - most people that works with me just let me make a bunch of mistakes all shift, don’t watch over me and notify me of my poor patient care at the end of the shift. Another new grad and myself made a med error because nobody was supervising either of us and trained us wrong in terms of co-signing high risk medications. I cried. I feel like they had too much confidence in me and threw me in without supervision too soon and now I’m left to be judged and perform poor patient care, while getting looks of disappointment and them stating that I should be ready to be on my own by now... but I’m not. Btw, there’s NO new grad classes to help brush up on nursing topics, policies and procedures. 

I feel like I’m drowning and the loser of the unit. I also feel like I should have started in home health or something to get my feet wet. 

Any advice? What should I do?

[turtlesRcool]

When people are kept on orientation longer, they often look at it as a sign they're doing poorly and get discouraged.  But on the flip side, what it really means is that they are doing well enough that their employer wants to give the support necessary to help them succeed.  Even the transfer to another department (in this case ED to Med-surg) is about helping the employee find the right department that will fit his/her strengths.  ED and Med-surg are different, but neither is better or worse than the other.

That said, it sounds like your orientation is really not doing much to actually orient you.  An extra month that is basically an extension of the months before it is not likely to yield much improvement. What's that saying about the definition of insanity?  Insanity is doing the same thing over and over and expecting different results.

So, embrace the extra month, but take the initiative.  If your preceptor hasn't been great, is there someone - anyone - else that seems like they might be a better fit?  Could you see about getting that person as your preceptor, and being really proactive about soliciting specific advice or feedback?  If you've been told that X is a problem, try stating that you're working on X, and appreciate any tips on X, and then ASK for feedback.  I'd do it at the end of the shift, but also probably about half way through, so s/he has the chance to steer you right if you're floundering in some way.  Some good nurses have NO CLUE how to be preceptors, and it seems like just another thing added to their plates, and one they're not comfortable with, too.  Some do not know how to give constructive criticism, so asking (and being obviously open to honest answers) might open the door for them to speak up.

Good luck!