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Discussion

Orientation for experienced RNs

I wanted to find out about other nurse's experiences with orientation after working as an RN for several years. Right now I'm in the middle of a very difficult orientation and wondering if I'm expecting too much from my new employer or if I'm right to be concerned about how things are being handled.

How long was your orientation to a new position? If it was a new specialty, was that orientation longer? Were you assigned patients immediately when you started orientation? Were you given a chance to shadow a preceptor before caring for patients?

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I had a year of experience in my specialty when moving to my current full-time job. They oriented me for 12 weeks with a preceptor anyway. They orient new grads/people new to ICU as a specialty for six months. They have recently cut it down to about 10 weeks/five months for cost purposes.

My current PRN job (in the same specialty) gave me 12 shifts since I'm only PRN. They orient full-time people for much longer.

All of those shifts at both jobs were with a preceptor.

Before I transferred to the ICU, I had about a year of med/surg, and got six weeks of training. New grads to the ICU get 12-14 weeks.

Currently, I work on a really busy (and almost always short staffed) surgical patient care unit. I precepted on that floor for my last semester of nursing school and when I was hired, I had 5 weeks (probably a week less because I already knew alot about the floor). I'm transitioning to a nights position with the SICU and the manager told me that my training will be 6 weeks. Even though I have a year under my belt I'm a bit nervous. I guess I'm just surprised because our hospital is a level one trauma center and we get all the major traumas. I was thinking thay our training would be longer (some people were suprised, others werent). But the nm did tell me that if i encounter a patient that i had never had before on orientation, they will place me back on orientation because of that special case. That was kinda reassuring.

Transferred from telemetry to ER. Got One 12 hour night shift. For orientation. For ER!

And it was Y2K night, yup.

Ok so had 8 years tele experience plus about 15 years med-surg/ortho/neuro/ & was in FNP school. Stayed in that ER for 2 years. Left after finished FNP.

  • Author
Transferred from telemetry to ER. Got One 12 hour night shift. For orientation. For ER!

And it was Y2K night, yup.

Ok so had 8 years tele experience plus about 15 years med-surg/ortho/neuro/ & was in FNP school. Stayed in that ER for 2 years. Left after finished FNP.

Yikes. That's definitely worse than my current orientation. I have almost 3 years Med-Surg experience and got a job in Oncology. I was given three weeks orientation with three patients assigned to me on my first night, two to my preceptor. When I asked to shadow the next night so I could ask questions, I was assigned three patients again and shadowed my preceptor with her one patient for less than an hour before I had to see to my other patients. It doesn't really feel like an orientation.

I got four shifts in the pediatric ICU. Not four weeks, four shifts.

I got two shifts in inpatient psych.

My first job was on a general peds floor; I got a full 12-week orientation with a preceptor. Overall, a good, thorough orientation and wonderful learning experience.

My second job, a little over a year later, was on a pedi sub-acute unit: 10 kids, most with trachs, and most of those on vents. I had only ever seen a ventilator about 3 times while on my ICU rotation in nursing school, and I was hardly allowed in the room--I never got anywhere near the vents. The facility allowed me to shadow the day nurse for one shift--the next day, I was on my own with a CNA and we had an RRT stop by a couple of times. I cannot believe I actually put up with that. I mean, I'm a quick study and all, but that was insanely dangerous.

I know of a former icu nurse who came to the float pool and she got two shifts of orientation, both shifts were icu.

I think orienting has changed on average and may be shorter or longer in certain areas. I, personally, would prefer a shorter orientation that allowed you to shadow someone for 3-4 12 hr shifts then BUILD your assignment. Some places just do NOT know how to orient the right way....and throwing people to the wolves is NOT safe for the patient. Stinks.

  • Author
I think orienting has changed on average and may be shorter or longer in certain areas. I, personally, would prefer a shorter orientation that allowed you to shadow someone for 3-4 12 hr shifts then BUILD your assignment. Some places just do NOT know how to orient the right way....and throwing people to the wolves is NOT safe for the patient. Stinks.

YES! I wouldn't mind a short and sweet orientation if I got the basics and could move from there. And no, not safe.

After 5 1/2 years as an RN (and all of it in pediatric critical care), I moved to a new city and took a job as a critical care float pool nurse for a childrens hospital. The job was to float as needed between PICU, CIVCU, NICU, and stable vent unit.

They oriented me for 12 weeks. Just for PICU. Then I was supposed to go and have full orientations in CVICU and NICU, and about a week on the stable vent unit.

I started out thinking "hey if thats what you want to pay me for....", but eventually my brain nearly exploded. I actually ended up quitting long before my orientation was ever complete.

(Now as a traveler, I get 1-3 shifts of orientation) :)

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