nursing school vs. new graduate RN

Pediatric Critical Care Columnist · May 21, 2008

There are a few threads that deal with similar questions, like this one... https://allnurses.com/forums/f224/hospitals-suck-orientation-289031.html Be warned, it's pretty blunt language over there!

bryndamor · May 22, 2008

that other post is not true of all hospital orientations and admin. where I'm at, mine was/is fine. orientation varies per hospital and it seems that the different unit managers have leeway on it. I was allowed 5 weeks of orientation on the floor of my unit, after 2 weeks of hospital/general RN orientation. We had an experienced nurse hired on that got only 2 weeks of floor orientation because she apparently didn't need more, but again, its the unit manager that dictates that kinda stuff, prob based on their budget and judgement. If I really needed it, I prob coulda asked and received another week or two of floor orientation.

Now, back to the core of the original Q. Nursing school will teach you the basics of a lot of stuff, but where it really sinks in is in actual practice. There is a lot to learn, a lot of variations, and getting the steps in the right order matter -- easier to work by memory of doing than memory of what you read in a book, imo. Nursing school clinicals is where I learned the bulk of stuff -- a real gem. No surprise tho. Back in my last career in college mode, there was a common saying that 1 week of intership is worth a semester of classroom theory. Nursing school clinicals are that supervised internship for you. Get the most out of it. Not just asking Q's from your instructor and classmates about what they saw and learned, but asking the nurses where you're working about things. Those nurses are usually somewhat entertained by the bright young eyes and curious, enthusiastic attitudes, and will answer your polite Q's. Be a sponge.

After nursing school, you should have a basic handle on a lot of basics. Find a hospital w/ a decent new-nurse orientation. Ask during interviews what the hospital's orientation is like PAST general employee orientation, which was for all departments -- Security, Housekeeping, Physical Plant, Home Health, etc. You want to know what kind of orientation you'll get on your unit. You'll have ideally interviewed w/ the unit manager where you'll be working. Be discriminating -- ask Q's. YOU don't want to be stuck at a job on a sucky unit. I noticed that there were 3 nightshift and 1 dayshift positions that were open on the unit where I settled. I asked the unit manager about that, where'd those employees go, and received a satisfactory answer. Had I not been satisfied w/ all the answers I received, I would've turned down the job offer at the end of the interview. Its a two-way street.

Now, let me say that after I graduated, I was told stories of past nursing school graduates from previous semesters who've still not found jobs. I dug into this cuz I wanted to know what kind of factors influence not finding jobs and how much labor supply in nursing that I was up against. Get this (important): a bunch of those previous grads HAD found jobs but for one reason or another, all QUIT, and thereafter were finding it hard to find other 'first' jobs. What that means is human resourses at another/other hospitals weren't willing to take the chance of investing into an individual's training and orientation if they are a risk factor for leaving -- money down the drain. I understand that. From my previous career, the #1 employee expense is TRAINING, which orientation falls under. Places (and units) hate training employees and they quit/transfer. So, the jist of all that is spend time finding a good fit for your first job. Doing clinicals at different hospitals at school is a good way to preview hospitals. Talking to classmates and finding out/sharing what you know is a big help too. Not all hospitals are equal. You could even pick a good hospital and pick a sucky unit w/ a sucky manager to work under. The unit mgr could be good but you have sucky co-workers. I have one co-worker RN that I absolutely hate to work w/ -- a young RN w/ a little ICU experience that must think that she was a queen in another lifetime. If I had to work w/ her, or was precepted under her, I would've quit. Instead, I probably got the best pick of employees to work under that answered all my Q's and helped me succeed. Most of what you will learn (assuming that you have a decent grasp on basics from school) as a new RN will come from your unit orientation, which will hopefully be at least 4 weeks w/ a good preceptor.

Last note, ask how preceptors are chosen. At the hospital I'm at, the preceptors volunteer to be a preceptor -- no one is 'saddled' w/ someone, AND the preceptors get some extra training to be a preceptor -- prob how to encourage Q's and learning, as well as preceptors getting a slight pay differential for precepting. I think it's like $.50/hr, but most aren't doing it for $, and the big time-savings is towards the end when you're taking a full load of pts and they're just mostly supervising/helping.

It sounds like you're worrying too much tho. The fact that you're concerned enough to wonder if you will have a good enough handle on skills signifies to me that you're trying to learn what you can. Nursing school will be enough, clinicals esp. Unit orientation is where its mostly at, to tie everything together. It sounds like you will do fine. =)

smk1, LPN · May 22, 2008

No. I am in a fairly sour mood, but still think as someone who has been orienting as a new grad RN for a few weeks, that "No" is the correct answer. However, that that doesn't kill me will make me stronger...