Orientation extended...

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Hi, all,

a friend of mine is really upset right now about a situation at work. She recently started at a hospital unit after being away from acute care for several years (having done outpt in the meantime); her manager told her that orientation would be determined on an individual basis; however, standard is 12 weeks. A new grad started at the same time, therefore my friend did not get the usual unit preceptor. The one she got was absolutely dreadful and just left her to sink or swim. 5 weeks later one of the regular preceptors (who had finished training yet another new grad) became available and the manager assigned my friend to her. My friend was very grateful for that and got along well with her new preceptor. The new grad, meanwhile (who had barely passed nursing school and the NCLEX) got an excellent orientation but asked some pretty amazing questions when her preceptor wasn't around (e.g., while charting her assessment, "Is an NGT a head abnormality?" or when asking advice about giving a med, said she had no idea why this med was ordered).

Well, my friend was just told that she isn't ready to work on her own yet and needs more orientation (primary reason given was to improve time management); new grad, meanwhile - who started at the same time - supposedly is ready. Needless to say, my friend is crushed, being about 20 years older than this clueless new grad who stays late charting just about as much as she herself does (and probably would stay even later, but if you don't care why and how you give meds, you probably don't spend much time giving them).

My friend is concerned how this situation will be perceived (as we know, hospital units are the worst kind of gossip mills). What should she say when the inevitablle question will be asked, "Why are you still on orientation when New Grad is off?"

Any advice would be appreciated.

DeLana :)

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I don't know what to say about this one. Someone obviously has their wires crossed.

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Specializes in ER, education, mgmt.

"Inpatient nursing sure has changed in the last few years. Seems that I have not quite mastered the time management skills needed to function optimally. So they are giving me some more time to do that."

No shame in that whatsoever. Does not mean you are stupid or incompetent. If they ask you about the new nurse, the best reply is that you cannot speak of that- you can only speak for yourself. Best wishes to you.

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I have to say that in this situation, it doesn't really seem fair to throw the new grad under the bus. I graduated in May of 2009 and started working in the hospital in September. Orientation for us was 16 weeks long, and I had never had a job in the hospital before (I was bartendering up until about 2 weeks before I started my job as an RN). Just because the new grad asked "stupid" questions doesn't mean she's not really ready to be on her own, in my opinion. Every single day I go to work and ask a million and one questions about charting, what something stands for, even after 4 months of being there I see abbreviations and other things I have NO idea at all what they mean. And they are sometimes pretty "stupid". One example is when someone had a diet ordered and it said NCS, I had no idea what that was, and they had to explain that abbreviation means no concentrated sugars. There's also a bunch of meds I'm still not always sure why they are ordered for my patient. And I don't think I'm a bad or incompetent nurse at all, there is just no way that someone who has never worked in a hospital is going to know every single abbreviation in the charting or every single med and why it's ordered, being a new nurse, these things come with the territory. Everyday is a new learning experience for me and I have learned a great deal from my preceptor....

I think my point is you may not have the full story about your friend who has more experience. The hospital obviously does not feel she is ready for a reason, and she shouldn't take offense to it. You're never too old to keep learning, so hopefully she just uses this as a learning experience and keeps on going. Good luck to her.

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Specializes in ED. ICU, PICU, infection prevention, aeromedical e.

I think that each case is individual. Don't compare that new grad to your friend. Each has strengths and weakness. We older folks seem sooo much slower than the younger ones, often simply because we process and speak different. It may simply be a perception.

But I think your friend should concentrate on the positive. She has a job. They value what she has enough to extend an expensive orientation period rather than letting her go. They value her! Tell her that.

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Thanks for the replies. Just a couple of comments.

nygirl1986, the new grad is asking some questions that indicate that she has a serious lack of knowledge (and I'm not talking about hospital procedures, P&P, abbreviations etc). I won't be too specific here since this is, after all, a very popular nursing board. Trust me, it's not just typical new grad questions (I was one once, and so was my friend, and were certainly understand). In my friend's opinion, this particular new grad is the one who should get an extended orientation. But, perhaps she isn't because they're having a serious staffing crisis on the night shift where she's going. BTW, the new grad thinks she's ready and does not want any additional orientation.

Likewise, my friend - by staying on orientation - could possibly help alleviate a short-staffing problem on the day shift (by taking her perceptor's pts while the perceptor acts as the interim charge nurse). Of course, management wouldn't ever have such thoughts when deciding who "needs more orientation"? :rolleyes:

Anyway, thanks for the feedback, I'll pass these replies on to my friend (who is certainly thankful to have a job!)

DeLana

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Specializes in ER, education, mgmt.

DeLana- just wanted to say sorry for replying to your message as if you were the one with the issue. Sometimes my brain forgets pertinent info from the time I read the post until the time I get to the reply board. Please extend my best wishes to your friend.

And I have to add, if they told me tomorrow that I had to take a full patient load I would be very nervous, as I have only done charge for the better part of 2 years now. Time management is so different when you are doing patient care. so I can certainly empathize with how she feels!!

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Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.

Because your friend has time management issues and needs to swallow her pride.

She's been out of the clinical pic for awhile. It's to be expected. Why so hurt?

Besides, why does she worry about the new grad? The new grad has to worry about the new grad.

Your friend has to worry about herself and how she can become better at time management.

Period.

Who cares what others have to say?

It's a waste of time.

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Your friend and the new grad are two completely different people. It really isn't fair to compare one to the other. Your friend sounds threatened by the new grad for some reason. Just because she asks "stupid questions" doesn't mean she is a bad nurse. Maybe she didn't get an extensive education in the area in which she is working. And at least she is asking the questions instead of guessing. When I started on an ortho unit as a new grad, I started with 2 other new grads. I had 6 years of ortho experience in a clinic so I picked up on some things quicker then the other 2 did. It didn't mean that they were bad nurses. They just had different education backgrounds. Having orientation extended isn't a bad thing either. At least she still has a job.

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Specializes in OB/GYN, Peds, School Nurse, DD.

Your friend needs to stop worrying about the new grad and pay more attention to her own work. They are two different situations.

I had something similar happen to me when I worked in a very big, very busy NICU in Florida. I had some NICU experience, but nothing like this Level 3 center. I was overwhelmed with what I *didn't* know. And I didn't have a good sense of organization that this unit required. To top it off, I had the world's worst preceptor. She was a technically good nurse, one of the best. But she was a crappy teacher. She made it clear from Day 1 that she didn't want to teach me anything and she set me up several times to look stupid. Her main method of education was criticism, with a hefty dose of sarcasm. You can imagine how I reacted to all this. :uhoh3:

Thankfully, the preceptor had vacation scheduled about 5 weeks into orientation and they put me with another nurse. This nurse was everything the other one wasn't--calm, patient, friendly, engaging. I learned so much more from her and I felt enabled to ask questions about how and why things were done certain ways. However, the lack of teaching during my first 5 weeks was evident and they decided to extend my orientation for another 3-4 weeks. There were new grads in there that were off orientation before i was, but I just had to remember that they had had good preceptors from the start. i didn't. I just bucked up and took the extended orientation. What else could I do? If you're not ready, you're just not ready.

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Specializes in Medical Surgical Orthopedic.

How does one "barely pass" NCLEX? Isn't it just pass/fail?

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Tell her to laugh it off.Why worry about what people would say? Hard as it may be/ The length of time is not neccessarily the determinant of knowledge and ability.

Let her take it in good faith...if she can.

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