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New RN Grad Need Guidance Please :()

First Year   (3,837 Views 33 Comments)
by NewICUNurse93 NewICUNurse93 (New Member) New Member

241 Visitors; 6 Posts

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Newgradnurse17 has 2 years experience as a BSN.

2,871 Visitors; 254 Posts

But expect it to be any easier if you move.

DONT expect. Oops.

It won't be any easy.

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1,046 Visitors; 211 Posts

I'm in my first job as well. My training/orientation is 12 weeks. With my preceptor, feedback is immediate. I find this helpful as I can correct things immediately. I also thank him for his feedback. Day one my preceptor told me that he likes to train people and if people leave soon he takes it personal. Listen to what he says, just improve week after week and we're good. He'll look at my documentation and I'll have feedback by the next shift. Past few times I had to ask if there was any feedback on documentation and was told keep up the good work. We sit at the end of every day and discuss how I felt and his observances. As time has passed, I've gained confidence and the talk consists of what to work on next shift. Now it's gaining new skills as opposed to improving things learned. I only have a few weeks of orientation left at this point.

While I sympathize that having that many preceptors and no feedback is frustrating, you need to take a big dose of humble and never assume anything. Ask daily for things you can improve on. Training is a two way street. You also need to voice you want to learn an improve daily instead of just during weekly reviews. I'm in a different field but don't think the amount of orientation time is fair for all you need to learn. Maybe for someone with experience in a med/surg but certainly not a new graduate. My unit manager offered to extend training if the person feels they need it. I am the middle of 5 new people on the unit. It costs a lot to train you and am not sure why they'd invest the time in the first place if they didn't want you to succeed.

Best of luck to you

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Nurse Beth has 30 years experience as a MSN and works as a Nursing Professional Development Specialist.

13 Followers; 88 Articles; 226,025 Visitors; 1,746 Posts

We were all task-oriented before we got the big picture.

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CareerStudent10 has <1 years experience.

269 Visitors; 6 Posts

I too am a new grad nurse. I am working in a trauma one CVICU. This coming week will be my fourth week off of orientation. I completed a 12 week orientation and I was previously a nurse extern for one year on the unit while in nursing school. I have seen experienced nurses with several years of experience in med-surg, ER, and even other ICU's come to this unit and struggle. Even now I go to work every shift with the fear of God in me. These types of units are not for the faint of heart that's for sure. I agree with several of the previous respondents in that your first step now is to have a realistic discussion with your manager and educator. It is not impossible for them to offer a lengthened orientation for you if they/you feel it could be beneficial. In regards to feeling uncomfortable on the unit or with the patients (new admits, surgical pts, crashing pts etc.) you, as I do, will continue to feel that way for the foreseeable future. As far as the assessment issues go, as you feel more comfortable the processes will start to become second nature. You will begin assessing the whole room, situation, monitor, patient and even visitors/family without even realizing it. The only other advice I have is to be proactive in everything you do. If you have an issue/question and your preceptor is not available there are multiple other resources on unit. Pod charge, unit charge, senior nurses, NP/PA, resident, fellow, etc. One of my preceptors told me something early in my externship that I have thought of at least once per shift as a nurse. I asked him if he thought that I should let the Dr. know about a change in a patients status relating to vitals. He said, "It is always ok to ask and to inform the team, it is not ok to miss something". Hopefully you will be able to figure something out that will be beneficial for you and the unit as a whole. Lastly, I have never heard of only eight weeks as an orientation in the ICU. Did you complete a classroom based portion first? Critical care classes etc? Best of luck!

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amzyRN works as a RN-Emergency Services.

16,631 Visitors; 1,141 Posts

8 weeks isn't long enough for a new grad. Most new to specialty orientations for experienced RNs are 12 weeks long. You should have been given feedback after every shift and meetings every week with the NM. With that said, taking feedback, both positive and negative is an important skill to learn. It should involve a conversation on how to improve moving forward with specifics. It dosen't sound like that's what you are getting. I would have a frank discussion with your NM, tell her how much you appreciate the training you are getting and expain what you think you need moving forward or that you would like to transfer to a lower acuity unit.

I started on a cardiac step-down unit and now work in the ED. I was a very good student in nursing school but don't think I could have cut it in a critical care unit as a new grad. Now you know what you really love and have a goal in mind, to work in the ICU. Building your skills by going to med/surg for 1 or 2 years would only help you. You'd still learn a ton of stuff and gain more confidence too. Try not to take this experience personally, use it as a lerning experience to grow.

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1,550 Visitors; 114 Posts

Sounds like you're in a toxic environment, I'm sorry. I think your best bet is to figure out how to play the game and just survive through this training period. You should try to find out the policy if you "don't make it." I think our hospital would relocate you to a lower acuity unit if you didn't get through the training.

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1,550 Visitors; 114 Posts

All that is normal, I would have never been able to handle that on my orientation and you shouldn't have to either. I was a new grad into the ICU. I was a tech in a different ICU during nursing school and was a straight-A student with my full-time tech job, and that patient scenario is completely unrealistic for a trainee to handle. And the fact your preceptor gave a "whole bottle", whatever that means, like 2-5 mg Versed (not a ton of medication) makes it sound like she's an idiot for saying she "almost killed them." Patient would have went to sleep, that's about it.

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1,550 Visitors; 114 Posts

I will admit there was one day was not so go good was definitely a humbling day having two patients with no report from previous nurse one was bleeding out (new adm.) and the other is trying to actively extubate himself.. I was probably all over the place since my preceptor was the first one 1-4 weeks and he was like you got em let me know if you need help... but that was weeks ago and my really bad day (I felt overwhelmed by it and owned up to it later) that I was like woah I need to really learn from this.. otherwise I feel like I've been doing really well with Assessment, careplans, communicating with our team, helping neighbors, meds, and labs... I'm weak on admitting patients an hour and half before my shift ends (it freaks me out but not because I have to stay late but because I don't look like an employee running the clock) like it's soo much and I need help in that area but it seems they believe I should be making vast improvements when they said my first 4 weeks won't count because we have no idea where you actually are.. now 2 weeks later I'm being told by my preceptor you aren't ever doing stuff right.. yet my assessments/orders/meds/prodcedures are on time and I'm always asking questions and open to criticism, even though I've barely at all been praised for what I am doing right

All that is normal, I would have never been able to handle that on my orientation and you shouldn't have to either. I was a new grad into the ICU. I was a tech in a different ICU during nursing school and was a straight-A student with my full-time tech job, and that patient scenario is completely unrealistic for a trainee to handle. And the fact your preceptor gave a "whole bottle", whatever that means, like 2-5 mg Versed (not a ton of medication) makes it sound like she's an idiot for saying she "almost killed them." Patient would have went to sleep, that's about it.

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not.done.yet has 8 years experience as a MSN, RN and works as a Professional Development Specialist.

4 Followers; 43,007 Visitors; 5,240 Posts

Honestly? It is impossible by your posts to tell exactly what is going on other than that you aren't a good fit for this group of people. That could be them, could be you, probably a combination of the two.

Request to transfer to another floor. I understand you only want ICU, but presumably you also want to eat and pay your bills and continue to grow and develop. You won't always get to have what you want right out of the gate but that doesn't mean you won't get it in the long run.

Good luck and I am sorry you are hurting. I think it sounds like you have a lot of potential.

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