ONLY 6 week orientation for New Grad?

Dolce, RN · Jul 20, 2008

Well, as a nurse who has never worked in the ER I can't really answer that question from an ER nurse's perspective. But, as a former new grad myself I can tell you that it took me a full year before I began to feel competent. ER requires quick critical thinking and sharp, astute assessment skills. I am not sure those can be developed in 6 weeks.

northshore08 · Jul 20, 2008

Sounds like you have a great background to work from, and I think you will do well with six weeks. That being said, I believe you will find that six weeks will just touch on the basics, and probably not cover them all. It would be interesting to see what level of competency your manager expects after six weeks for a new grad--it might be helpful to see some type of schedule of what your employer's expectations are.

It sounds like the majority of your "orientation" will occur after that six weeks--it's called OJT (on-the-job training.)

In nursing school, they cover "the basics," then send you out to test for your license, then off to whatever specialty you are headed for. Then the real learning starts.

Gotta start somewhere, then be self-guided after that.

Good luck to you; be patient with yourself, and know when to ask questions. :nurse:

william4930 · Jul 20, 2008

Wow. That seems short. Is that class and clinicals? County USC's ER program has a longer training program.

locolorenzo22, BSN, RN · Jul 20, 2008

see...ours is 6-10 weeks, but only 6 class days...then we go to floor. They probably just expect you to go basics, then take patients as you are able...but you gotta learn somehow....that's all you can do...

clairebearrn · Jul 20, 2008

Thanks for everyones replies. The 6 weeks include a 5 day hospital orientation and the rest is on the floor. We don't have any class orientation. I guess everything will be on the job training. Hopefully, I will see a lot so I can learn as much as possible. :)

northshore08 · Jul 20, 2008

So it's really a 5 week ED orientation. The hospital orientation is usually not geared for the ED--more for floor nurses, computer stuff, etc.

Do you get a chance to ask for more orientation if you feel you need it? If not, I would ask for that chance before management publishes a firm schedule with you as one of the staff nurses. A gentle reminder that you are a new grad RN wouldn't hurt.

Try not to be forced onto the schedule with a full assignment before you think you can safely do it. It sounds like you will have some idea by week 3-4. And do your best to stay out of triage until you have a good year of ED nursing under your belt. From what you are saying, sounds like they will have you doing triage very soon. :nuke:

jncRN · Jul 20, 2008

Hi,

I am also a new grad (May 2008) who will be starting in the ER in a busy urban setting. However, in my ER we are required to take a 4 month ER course through the local RN Professional Development Center before we start in the ER. I came straight to a busy medicine floor in May, will have worked there 4 months when I start the ER training at the end of August, and then this training consists of 4 weeks of classroom then 12 weeks of clinical in the ER.

Then when I actually start in the ER in December, I will have 8 shifts of orientation -- but this is after having had 12 weeks during the ER course (you are preceptored in the ER where you will be working).

Good luck with your orientation -- and don't be afraid to ask for more orientation if you need it.

PM me if you like, to let me know how it goes and trade notes...as another new grad in the ER, I think we will need the support of someone who knows what we are going through. :)

------------------------------------------------------------------------

NurseScarlett RN...ER Newbie :nurse:

kmoonshine, RN · Jul 20, 2008

Were you a tech in the ER?

I personally feel that 6 weeks is WAY too short for ER orientation. The ENA recommends at least 3-6 months of orientation for new grads. There is so much to learn, and you won't even get the basics in 6 weeks.

http://www.ena.org/careercenter/SoYouWantToBeNurse.pdf

Your assessment skills will make the difference between life and death for some of your patiets, and its my opinion that 6 weeks isn't enough time to learn how to make accurate decisions and act on them. I've seen so many new nurses do terrible assessments - not because they are bad nurses, but because they weren't given enough time on orientation to learn.

For example: One new nurse I was working with did an assessment on a 50 year-old male who came in via ambulance after a fall at home; the nurse states there is no leg deformity, no meds, no medical history. I took over caring for this patient and I'm thinking "so why did a 50 year-old healthy guy fall at home?" I went into the pt's room and I noticed he had petechiae all over his body, c/o a severe headache, and had decreased grip strength on his dominant side. So I'm thinking he's having a stroke and get a doc ASAP, and he goes off to CT. I get a call from the lab, and they said his CBC is screwed up and they were re-running it. Turns out that he had tumors in his brain and a hgb of 2.4, white cell count of 250,000, and platelets less than 10,000. He was also going into acute renal failure. I believe he was diagnosed with an agressive form of leukemia and didn't even know it.

You could totally tell that something was wrong with the patient just by looking at him; and why the new nurse didnt pick up on this is beyond me - so I'll chalk it up to inexperience.

Even our ED interns that work as a staff nurse (once they graduate) get 3-4 months of orientation.

LeesieBug · Jul 20, 2008

Six weeks is not enough. I would I have serious concerns about taking a job in a department that felt a new grad could be adequately prepared in 6 weeks.

As a new grad in ER, my orientation was a minimum of 12 weeks with the opportunity for more time as needed. Once off orientation we were also assigned a designated resource person for several weeks to help in the transition. Even with that it was a stressful transition to say the least, with a hell of a lot to learn in little time.

I feel that ER is fine for new grads if the orientation is strong and the unit is supportive and has realistic expectations. No way is six weeks realistic.

These short orientation periods are the result of management wanting to cut corners and get their staffing up quickly at the expense of both nurses and patients.

I wish you the best of luck, and encourage you to be firm and assert yourself if you feel you need more orientation time. Congratulations on launching into your nursing career! :yeah:

LilgirlRN, ADN, RN · Jul 20, 2008

I think it all depends on the person. You've been a tech for two years while you were in nursing school, you have to have learned something by doing that. In our ER, no question is a dumb question, if you need help or don't know what you're doing you can always ask someone for help. The ER I work in is one of the busiest in the state, we're #2. We've hired new grads before that had been techs, sometimes in our own ER sometimes not and they've done fine. Plus iwht new grads you don't have to unteach them bad habits, we can raise 'em right! You do have to be a quick study, be a natural at it or the ER will chew you up and spit you out. Good luck!

littleRNthatcould · Jul 20, 2008

As a rule, I'd say 6 weeks for a new grad is not nearly enough. Your previous tech experience (depending on where you worked and what was expected of you) will give you an advantage over other brand new nurses, but it may not be enough.

If you have your heart set on ER nursing and all they are willing to offer is 5 weeks of orientation, then it is up to you to make the best of it. Ask questions, lots of questions. Observe everything. There are some excellent reference books available and as I've seen some posters say here they've "assigned themselves homework" on off shifts.

Also check with your hospital's education department. Some hospitals like mine offer 12 week classes on critical care nursing (i.e. EKG interpretation, ABG's, signs and symptoms, procedures etc.)

Best of luck to you, I have no doubt that you'll do fine. Believe it or not taking the time to post here asking whether or not you'll do a good job lets most season nurses know that you care enough to make it happen.

And that my dear is half the battle :nurse: