new nurse blues

neokabuki · Nov 19, 2001

To monica and all nurses who responded, thank you all so much for the support. I have a few interviews lined up and I am going to make sure that the orientation program will fit my needs. Will it be too much if I ask for part-time evening or night shift? My last job was in med-surg and I am applying for another med-surg unit. I consider myself to be a very thorough but slow-paced learner that has more exposure to theory and less on clinicals. What is a reasonable orientation period for this type of learner.

Thank you again for the support. :cool:

P_RN, ADN, RN · Nov 20, 2001

This sounds too too familiar. My first hospital job was as an operating room circulator. My "preceptor" would sit in the lounge while I stumbled around doing the best I could. I only saw her for a few minutes a day. She loved the tonsil room, but wanted NO ONE in there with her!

Anyway after about 3 months, I told myself..."self, this is NOT for you, and I bailed out."

For the next 22 years I worked at ONE place and was a preceptor for the last 14 of those years. I precepted approximately 65 new nurses in that periiod of time. NO ONE ever left while I was precepting....

Guess it WASN'T ME in the first job that had the problem.

This place is BAD for you and BAD for your well being. Break the link in that BAD chain and find another place. It's NOT you.

RNforLongTime · Nov 20, 2001

Hi there neokabucki,

Keep you head up! I know that is easier said than done but you gotta give yourself a chance! You have what it takes to make a great nurse---you actually care and that says a lot.

The book that wrkout girl recommended--by Donna Wilk Cardillo is an EXCELLENT book! I have been an RN for 4 1/2 years now and believe me --there is still plenty that I do not know! But, I recommend picking up that book. It offers wonderful tips!

Good Luck!

Kelly

spudflake · Nov 20, 2001

I am so disappointed to see how many of you had such horrible experiences when you first started working. What a shame that nurses can not help each other. I have been a nurse for more years than I care to talk about and I am always astonished when I hear about how the newbies are treated. Even with all my years in nursing:p I still learn something new everyday. I do not know it all and NEVER will.

That fact that you wrote to this post gives me the feeling that you do enjoy nursing and you want to be the best you can be. Find the right hospital with the right preceptor program. If you don't like your preceptor - get another one. Stand firm - be polite but assertive. I have been a manager for several years and I always tell the new nurses - if you don't like or get along with your preceptor - let me know. Certain personalities just don't mix and it's no shame to change preceptors. I also tell my preceptors that it's no shame if the newbie wants some one different. We are each individuals with different learning styles. The fit is very important.

Good luck. Don't give up. Any help I can give you, let me know

psnurse · Nov 21, 2001

I thought it might be helpful to post my best and worst orientation experience to illustrate the variety for Neokabuki.

Worst: 1st job (that appears to be a theme). Went to work in the same CCU where I had been a tech. Got 2 days with a resource (no preceptor). The first day, I showed up and heard these words, "We really hate to do this to you, but we are shorted staffed. You will have those two patients and ________ will be your resource. By the way, do you know how to pull a Swan?" I do remember the nurse's name, and she was nice to me, but the whole idea of virtually NO orientation was a little bizarre. I did survive that job for a year, learned a lot (by asking tons of questions) and went on to another CCU (with a lengthy orientation which seemed a little late) I did leave that job after about a year (got excellent eval, by the way) because some of the nurses were having difficulty with my no longer being a tech. Every morning I had to remind someone that bathing all the patients in the unit was no longer possible for me because I had patients of my own now.

The best: Went to ED on a float. Was told I would only have to take chest pain patients (since I was coming from CCU). Before the end of the shift, I was taking respiratory failure patients. Then they asked for me to float again. Decided asthma was like COPD so I could do it. Added those to my list. Also could do codes. But then they brought me a chart on a patient who had injured their arm.... said "NO WAY!! I don't know anything about broken arms." They said ok.The regular ED nurses loved it when I came down, because if the patient was ICU material I would take it and they were free to do the easier stuff (learned this later). I did add those lacerations and extremity injuries to my list, as I was comfortable with them and with the idea that the staff would help and answer my questions. After 4 months, I transferred to the ED (loved it), when we got out the orientation packet, I had completed orientation during my many floats, on my own terms and at my own pace. It was a beautiful thing.

So a good orientation is possible with the right group. I love precepting new grads. I always try to remember that you don't have to know everything on your first day, and when you are comfortable with what you have gotten so far, the rest will start falling into place.

thisnurse · Nov 21, 2001

there is a huge difference between incompetence and inexperience. nurses seem to get them confused.

RNKitty · Nov 21, 2001

I think part of the problem is that nursing schools themselves have changed. It sounds like 30 years ago, they offered way more clinical experience. I have heard stories that the first year they did aide work on the floors (part to full time in addition to class work), the next year, more responsibility, then the last year some were running charge on the night shift.

The current trend in nursing schools seems to be that they will give you the theory and you will learn the skills on the job. Unfortunately, no-one has told the preceptors this! Plus, they started nursing when patients stayed longer and were less critical on the general floors than they are now. Now, new grads jump into very sick acute patient care, sometimes with very little experience or supervision.

Only later do some of us develop our salt to stand up for ourselves and our patients and demand better training/precepting.

It is sad to see so many experienced nurses retiring or leaving the nursing field, because with them goes a wealth of knowledge. If you can find one to gently mentor you into your chosen field, bless you AND your mentor.

askater · Nov 21, 2001

One nurses perception of you is not the same as another.

My 1st R.N. position our unit supervisor disliked certain nurses especially new grads. I was one on her "hit" list. I could tell you horrible stories how she treated me. I stayed on that unit for a short time.

Next hospital the nurse supervisor loved me...and still does.

I would stick with nursing. Get a new job elsewhere. Continue to study and learn. Everyday is a learning experience. You will not know all. Walk with confidence even if you don't feel confident. And if you have questions ALWAYS ask someone for an answer. As you're on a unit you learn who....has the knowledge and loves to share there knowledge. No one know's all answer's.

wrkoutgirl · Nov 21, 2001

:eek: Hi Neokabuki and everyone who has replied to this topic. This is Monica again. This is the third time that I reply to this one. Therefore you may know by now that I started my new job two weeks ago after resigning from my very first job of less than 2 months. After reading your replies and after having a new preceptor for a few days I came to the conclusion that there are all types of preceptors. There are a FEW angels who want to teach you everything they know. I had this one for one day. She was from another floor and did my boss a favor to help me out the first day. I had a second one who will only help me for a few times b/c my steady preceptor was "imported" for me as he used to work in this floor. This person will be w/ me for the rest of my orientation. Then there are other ok preceptors who give you very valuable info but at the same time put you down in front of the patients and or treat you like a child. This person told me that I am too eager and too independent. "Don't worry you will get there, don't think that you have to go home and read and study for the entire weekend. You'll get there, come down!! She said. I am confused! The evil one constantly told me that I needed to think on my own and take initiative and this one want for me to depend on her more.

To answer your question dear neokabuki I want to tell you that I wish I could convince you that with the shortage of nurses, with your qualities, qualifications and great disposition you are the one driving the boat. You interview that interviewer and ask millions of questions about orientation, everything that went wrong in your previous job, you must make sure does not happen again. After I asked those millions of questions I apologize to my interviewer and I explained how important a good orientation was for me. She told me that she totally understood and that these were great questions that I must clarify before I commit for a job. About how long your orientation should be, my actual job is giving me 12 weeks. When I took this job I had to decide between four weeks or orientation, 2000 dollars bonus and two and a half dollars per hour more, versus no bonus, less salary and 12 weeks of orientation. Who can guess what I chose? Go for it and remember that it is your call.

monica

KatWright · Nov 22, 2001

WOW, this brings back memories!! My first job was on a 48 bed orthopedic unit in a military hospital and my orientation was directions to the unit :eek: :eek: :eek:

So I guess the good part of that kind of orientation was that I didn't have to deal with a preceptor:rolleyes:

But over the years I have precepted MANY and I have seen alot of new grads being precepted. Everyone teaches differently and everyone learns differently.

Try to figure out which learning style is yours and let your preceptor know....do you like to "one , do one"? Do you prefer to look it up in a book? Do you like to have a picture drawn? ( I tend to draw alot of pictures which one orientee used to laugh at, actually she would often be found darn near rolling on the floor ;-)) So I had to stop it because I thought that I would have to do CPR since she couldn't catch her breath!!!

Last year we had a new grad that had a great nurse for her preceptor, however it was an awful "fit" They just didn't match well. And there was a time or two when everyone (including the new grad) wondered if this was the right place for her.

The new grad came to me several times in tears (we would sit in the lounge after work, she'd call her mom to tell her that she was going to be late....a few times she was sobbing so much that I would talk to the mom and tell her that I would make sure that she was OK enough to drive ;)

Anyhow, this new grad was chosen as new grad of the year for the WHOLE hospital !!! (This is a big 700 bed hospital!!!)

She has flourished, EVERYONE loves her and she tells anyone that will listen who her preceptor was !! And trust me, I would LOVE to have her take care of my family !!

So dear one, it is OK that the first hospital didn't work out. Everything happens for a reason.

I know that you are hurting and for that I am truly sorry, but have you ever seen such wonderful support!!!!

What a fantastic family of nurses!!!

YOU WILL DO JUST FINE !!!!

Everything that we do teaches us something.

The only thing that concerns me is the question about night shift. Evenings OK, but it is hard enough to adjust to this demanding profession. Night shift is hard on the body and often the mind. UNLESS you know for sure that you would be able to sleep because sleep deprivation is HORRIBLE. So, I would either do days or evenings.

And you want to be able to interact with the patients and families and doctors while they are awake.

Look for an internship or fellowship that is geared for the new grad. Ask questions (write them down and bring the list with you when you go for your interview.)

Also when you interview, ask if you could shadow a nurse for a few hours (on your own time) this way you get to see how the nurses work together, the respect they show for each other and the patients....we have had several people do this and it works out really well.

Also a few of us mentor nursing students and they spend time on our unit to see what it is like.

I have been out of school for 28 years and I am still learning, so for a preceptor to expect you to know everything shows that she has the problem NOT YOU !!!!

GOOD LUCK, too bad you don't live in the DC area, I could tell you of lots of places that would welcome you.

Kat

Aerolizing · Nov 22, 2001

I had been hired as a new grad on my first unit with 6 weeks of orientation. After that, I still had my preceptor. She still worked with me and was my resource person whenever I had any questions. Everyone on my unit reported my every move to my preceptor (who missed her calling as a drill sgt.) For example, if I missed a question on an admission assessment, I got a written note to complete my work. I also had weekly meetings with a nurse CNS to answer any questions and to process interactions with psych patients. The other staff and I processed (gently criticised) events like acting out patients and if we ever had to put anyone in seclusion or restraints. I was not the only new grad my unit ever hired. I think there may have been one other. Five years into my job, my coworkers still thought that I needed to handle the challenging patients so I could gain more experience. I always had their support though. I never felt like I was alone. Sometimes I felt dumped on but I never felt abandoned.

Here is my dilemma. After 10 years, I started a new job doing the same thing. There is a new grad who has been there for a short while who is unsafe. This new nurse left me with a tech and a very assaultive patient when this nurse was coming in just behind us or so I thought. When we got back from fighting to get this patient back to her room, the new nurse gave a really stupid reply. Mind you, I wanted to do unkind things to the new nurse. I told my administrator of my very serious concerns for this new nurse. They want to fire the new nurse. They want me to give them the ammo. I have been thinking about this. When I started, I was given a whole lot of support and my coworkers had many years of experience. This new nurse did not have the same support as I did. This new nurse also has a much poorer attitude than I do though and I am not sure having a prolonged orientation would change anything. I don't believe I would have ever done things like this new nurse does. I was shown many unsafe practices and even what I would term abusive behavior. I was still being oriented (by the new nurse) to my job when this all happened. Sorry, but I do know a lot and I would love to share this info with everyone if they want to learn it. I will not be party to this type of nursing though. I have even thought of quitting. Administration has a very long way to go. The new nurse did not violate any policy or procedure because there are none. New ownership, new policies whenever they get around to it. I don't like this position they have put me in and I will voice that to them Friday.

Sorry, I know lengthy post. I just want to make sure that every new nurse feels the support and guidance I did. I don't want to be one of those nurses who eat their young.

wrkoutgirl · Dec 4, 2001

hi neokabuki . it is monica. i answered your post a few times. i wanted to get back to you b/c i wanted to know how things are going with you. are you working? is it better this time? i posted a thread called Im i asking to much from my preceptor? you may want to take a look at it. it may also give you some ideas about how the sweet nurses who have replied to it feel about orientation, preceptors and orientees. hope all is well. monica