New Nurses

mysticalwaters1 · Aug 10, 2005

So i just received my lpn license and got a job at what seems like a great LTC facility. I just started orientation on Monday. Today, I was given several forms, which were all sort of like a checklist as to what you know and dont know in terms of patient care,equipment,dressings etc. I felt like I didnt know anything. My question is... what was orientation like for you, did you feel comfortable with what was expected of you. .or is there at least ONE person out there who like me truly has no hands on expierience and feels quite incompetent

I had a checklist also when I first started and barely new anything. Barely any hands on except in nursing school. I don't work in LTC but I work at a community hospital on a respitory floor and can only go by that. They started their new nurses in my hospital with a 1-2 month orientation about the hospital then all the different deparments, and nurse educator teaching us the pumps, medical equipment reviewing picc dressing changes, secretary work, computers to put in order, practicing flow sheets, and practicing iv sticks on dummy arms. Then we moved to the floor with a preceptor and learned so much. I just asked bunch of quesions all the time and still today. I never did anything before asking someone more experience or looking up policy or calling supervisors with things. It gets better and it does take time but the more experience you gain more comfortable and time efficient your shift goes.

I'm learning from my position the preceptor helps a lot and the ones that try to get you to do more on your own and acting as a resource although very difficult allows you to handle your assisngment. I don't mean a preceptor who does not check on you and lets you do all the work I'm speaking of preceptors who follow and supervise what you do but tries not to interfer or help you out to get out on time. At my job now I'm noticing our coworkers because the load is so high trying to help them out they feel at the time by helping with charting and medications. What's happening is the nurses keep helping and not geting the orientee to work on their own. Then the orientee gets off orientation and I'm finding they are really struggling. So I'd talk to the manager about finding a detailed preceptor. Ask the preceptor how they do orientation and express the need for what I mentioned above.

But it is nerve wrecking the first year and I know all my classmates through school many did not have any experience and felt clueless at first. It's just getting used to the facility, coworkers, and management. You have the knowledge, now you have to apply it to various settings.

Also, you may never feel ready when you come off orientation but you have to make sure management does not push you off orientation too soon to fill in staffing. From others I've talked to it seems orientation on various med surg floors for new grads took a good 9-12 weeks.

Just hang in there!

Chel · Aug 13, 2005

Welcome to long term care, Sue. You'll be surprised how attached you become to some of little old people. Don't be discouraged by that list. You'll find you know more than you think you do. You'll also find that it'll be a good three to six months before you're actually comfortable and confident in what you're doing....that's how it was for me, anyway. There's always someone there you can go to and ask questions...and of course you have this board. There's a lot of experience here.

Brightest Blessings

Chel

Daytonite, BSN, RN · Aug 13, 2005

This is routine practice in LTC and acute care facilites. It is the facility's way to document your competence. You were, I'm sure, given a number of weeks, or even months to complete the checklist. It is also meant to be a guideline to help focus your learning on the facility's policy and procedures. If there is a procedure on the list that you haven't done, look it up in their procedure manual. Take note of what their procedures and notice that they may differ from what you saw when you were in school. As an employee you are obligated to follow the facility's way of doing procedures and charting them. It will be perfectly OK when you are ready to turn the list in that you will be marking some procedures as not being done or demonstrated back. Welcome to the world of red tape.

We all started out inexperienced and feeling incompetent. What nursing school prepared you for was to at least be introduced to some procedures and where to go when you need help finding information on one you haven't done. Use your good judgement and don't "try" anything new unless you are confident that you know what you're doing. Instead of your instructors to back you up, you now have co-workers to help you out.

LTCs are highly regulated and strapped with legal requirements that they must meet. A good part of them is the documentation. Make sure you understand very clearly when you are supposed to notify physicians and families of changes in a patient's condition or incidents that happen. Make sure they, in particular, talk with you about the care and documentation of Medicare patients. They should also be showing you the proper procedure for taking telephone orders from doctors and following up on them. Know what you are supposed to do in case of a fire or code blue. Give us all an update in a few months on how you are doing.

dinkymouse · Aug 13, 2005

See my post *orientation not enough*. LTC's are notorious for starting their nurses without much orientation. Because you are a new grad you will get more but tell them if you feel you aren't ready to be completely on your own. Take time and read the p & p of your facility. Orientate with different nurses because I found that some did things their way and some did them the way they were supposed to be done. Ask questions, ask questions and ask questions. If someone tells you that you ask to many questions tell them you only want to get it straight. Sometimes if they get impatient with you I have found they melt if I tell them, "but your so competent. I feel I can ask you anything."

krob0729 · Aug 13, 2005

my first job is at a pedi LTC and I started 3 months ago. My rotation consisted of one night on each section (there were 3) on one wing, and one night each on each section of the other wing (three also). On my 4th night of orientation...first time to this section....my CNurse had to leave on a family emergency.I took over, but there were 2 other nurses there beside me incase I needed them. I said, sure I can handle it..it's last med pass, i can read a mar, and i'll just take my time....YEAH RIGHT!!! 5 minutes after she leaves..one of my kids start seizing....I thought...oh God, not now....please...I just hollered out the door for the other nurse and she came in there and showed me exactly what to do, how to tell when he was through seizing and what to document and everything. Now, I can work any wing in that building, any section and know that I finally feel cometent because i utilized the other nurses there this whole time and asked a 100 questions. I still have to ask things. We never know it all. We just keep learning...You will do just fine. I promise