New Staff Orientation

[Bluem67]

For the first time I am not sure how to deal with this situation therefore I need your advice. I have been an RN for 13 years. My background include Cardiology/Telemetry, ER and last 7 months-the Staffing Resource Team (Float Pool).

Our float pool just hired 20 new employees in preparation for our new hospital (moving day Oct 18, 2015). As one of their more experienced employees, this is my second orientee within the last 7 weeks. I really don't mind being a mentor but this new person that started with me last Monday has brought on a tremendous amount of stress and frustration. I am just having a really difficult time with her.

First, I want to say that I am an immigrant therefore I don't want to seem like I am discriminating. This new orientee started with me last Monday and stated that she was a nurse in her country for 7 years. She recently migrated to this country 2 years ago but was not able to do any foreign training because she gave birth twice within the 2 years. She wrote the board exam and applied directly to the hospital of which she was a successful candidate. I am just appalled at the huge learning gap for someone who claimed to be a nurse for 7 years and for some things that I would consider nursing 101. She did not know how to apply the blood pressure cuff, how to check a temperature, how to put on a diaper, shocked that I am crushing meds, that I am putting morphine in a minibag, did not know how to cut a pill in half, asking if she needed to check the blood sugar before she gave the insulin. We work from floor to floor and the last few days have left me feeling very frustrated. I know it is my duty to help with orientation. We were all there. I was thinking of calling the manager/educator in the morning. What should I do?

[AJJKRN]

Your concerns need to be brought to your supervisors attention ASAP. Do you know another colleague that this orientee has worked with to compare notes with? Of course not to throw them under the bus (or to start rumors) but I would validate your concerns with a peer if at all possible.

[icuRNmaggie, BSN, RN]

Nursing practice can be different in third world countries. A float pool position might be setting her up to fail.

I know this may sound a bit preachy, but instead of looking for the worst in her, try to see what is good.

She could be very suited to work in a particular area such as psych or geriatrics or an outpatient setting.

It is very stressful to be tasked with orienting someone who doesn't have the basic skills that the position requires. It takes a lot a tact and patience to steer her toward a position where she will be happier (and you will be too).

[Pangea Reunited, ASN, RN]

At the very least, I would communicate that she will need a LOT of support and a VERY lengthy orientation. I would also give specifics with regard to the types of tasks she is unfamiliar with. If her judgement is poor and she's unsafe, that definitely needs to be discussed, as well.

[angieperry]

Am not a nurse yet, am in nursing school. This is what I think, you should notify your supervisor. Being a nurse for 7 years and do not know these basic stuff, it's quite strange. Let's consider our patients first. Seriously, are not safe with someone like this. I would tell my supervisor ASAP. Our patients come first.

[Bluem67]

Thanks for your feedback. I really don't mind being a mentor/supporting someone on their journey, I had just finished orientating someone the week prior. I would never be ONLY "looking for the worst in her". That's not my personality plus someone helped me when I was a new nurse also. I was just seeking advice as to how to approach this situation orientating someone without the basic nursing skills in a float pool situation. I apologize if that's how it was interpreted that I was only "looking for the worst in her".

[BeachFNP]

I would definitely bring up your concerns to the supervisor. She is probably going to need a much longer orientation then they thought. I used to orient all the time so I get the frustration. My main thing was to keep the supervisor informed with specific examples of why a felt a person needed more orientation or if I honestly felt they were unfit to practice. All you can do is make your concerns known. I would also be up front with the orientee as well. She should know if she's not making huge progress or if she needs more orientation. That way she's not blindsided.