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Orientation: How long is enough?


I've been precepting several new orientees for the last eight months or so and the latest person I've been with has been on my service since the beginning of May. The orientee has been through General, two rounds of peripheral vascular, urology and is now with me in Gyne. After these few months this person just doesn't seem to catch on. His performance runs hot and cold. He shows no initiative, seems like he's spacing out when scrubbing, gives absolutely no feedback and when I press him for questions he states he has none. I have repeatedly gone to the educator and manager but they seem to take this lightly, making excuses, etc. He's been in the OR for going on a year in September. What are your thoughts? Thankfully he's moving on to another service next week.

I just graduated from nursing school this May and started in the OR in June. They expect me to begin working general cases on my own after 6 months - which will be around the first of the year. I'll then be expected to take call after 9 months of orientation - March of next year. I would hope that this person you have been training is able to acceptably perform general cases after one year of training.

I know that I won't know everything after six months. I've been told by other RN's that I won't FEEL like an OR nurse for at least a year, and won't be absolutely comfortable in all areas for at least 2 years. I LOVE my job and I can't wait until I can be on my own!!

Good Luck with your orientee.


TracyB,RN, RN

Specializes in jack of all trades, master of none. Has 14 years experience.

Hi Pam. I'm curious about this orientee. Has he performed well in the other services? I wonder if, being male, he is feeling uncomfortable in the gyne service. I know it shouldn't make a difference, but maybe his lack of enthusiasm is a mask for the discomfort he is feeling. Just a thought.

Pam, I agree with you. That has crossed my mind and definitely take that into consideration. The young woman that I precepted loves the Gyne service and I believe she will be apart of my service when her orientation concludes. But, for this guy, when he has gone back into General cases he seems to forget things there as well. He puzzles me. When I talked again with the educator about this she blew me off. It was until a preceptor from another service chimed in that the educator took a few minutes to talk with me seriously about it. We made an appointment to speak with this fellow and at the last minute she cancelled the meeting. So as far as I'm concerned, I'm done. He can start to take responsibility for his own career. I've done all I can do. If the people in charge of management and education don't want to help or show concern I can't force them.

KC Chick--I was born in KC and lived in Raytown by the Blue Ridge Mall. My family moved to Illinois in the early "70's when I was in first grade. I have great memories from there...:)

Sorry.....I meant to say Tracey!!:rolleyes:

TracyB,RN, RN

Specializes in jack of all trades, master of none. Has 14 years experience.

Hi again, Pam. It's interesting that he forgets things. Especially after almost a year. I just started in the OR a month ago & will start my service orientations on Monday. We generally do 4 weeks for each service. 2 weeks to circulate & 2 weeks as scrub. It is overwhelming at times, but I LOVE it, so far. I wish I had some suggestions for you, but until management sees for themselves that he has a problem, I guess nothing will be done. Did this guy come into the OR as a new grad or has he had any floor experience? Are the surgeons complaining about him yet? I bet once the docs are *****ing at the managers, things will change.

As the preceptor, do you have to sign off a checklist for your preceptee?


That's so neat that you're from KC. I'm up north and working at Liberty.

The other 'newbie' in the dept and I just found out Friday that we will be circulating our own room on Monday. We will be under the supervision of a preceptor, but together, the two of us will be responsible for the room. We will be able to 'bounce' ideas off each other. I was told that simple general cases such as breast biopsy, abd mass excision, ect. are scheduled in the room. I can't wait!!! It's going to be fun. Wish me luck. :D

KC chick--I remember when I first scrubbed a breast biopsy bymyself I was so nervous. My hands were shaking when I handed the light handles to the doctor! I always try to remember those feelings so I can relate to the orientee's anxiety. I had a dream when I was on orientation in general surgery that the doctor asked for a Kelley or something and I turned to get one from my instrument tray on the back table and it was filled with forks, spoons and knives!! Good luck with your orientation and remember that this should be fun as well as a challenge!

Tracey--Actually a doc did complain to me when I releived the orientee for lunch one day. The doctor said the orientee didn't seem to know his way around the tray of instruments very well and he had poor anticipatory skills. (Clamp-Cut-Tie). But, if management is unwilling to deal with it, I guess they get what they deserve. Poor attitude I know, but it's their choice.

Pam, I think I need to clarify a little.

The hospital I work for uses RN's to circulate only. Surgical Techs are used for scrubbing. It's not because of our Mgr......she wants all the RN's in the dept. to be trained for both scrubbing and circulating. You know, just in case there is a need. It's the administration's decision. ($$$$$$$$ talks.) Anyway, due to a shortage of techs, we may eventually be trained to scrub in. I would like to have that under my belt as well.

Just thought I needed to let you know - I'm circulating, not scrubbing. :cool:

Funny dream. At least the spoons, forks, and knives weren't chasing you!!

I am a Clinical Educator in the OR and you are right to be concerned. The one thing I emphasize to any new OR employee is the seriousness of the orientation process and the persons commitment to learning is essential! It is time that the strings are cut from the dept. unless he can show monumental improvement. It sounds like that he is just a warm body to fill an open position. Don't give up though and maybe you need to impress upon your managers how important this issue is and that well motivated staff makes or breaks the department and eventually effects the morale of all staff. I am sure that you strive for optimum patient care and this is impossible without the work of ALL staff.


Specializes in O.R., ED, M/S.

I agree with most of the responses. He is just a warm body! It seems to me that the nurse mgr wants him trained so he can just fill a position. I have 24 yrs in the OR and it took me almost 3 years to feel very comfortable, but I was able to function on my own after 1 year. If he doesn't show considerable improvement in the next month or so he should be told to find a different area. I personally would not want to be his call partner with this kind of attitude. I have the same problem with a new person that is on my shift. She has been here going on 1 year and still has problems remembering procedures. We have an all RN staff so all of us scrub and circulate and take our share of all types of cases. We have a very unusual situation here where we use NO techs at all. I think this guy needs to be talk to very frankly and told if there is no improvement he is gone. The nurse mgr should not allow this to continue for the safety of the patient, the weel-being of the staff and the sanity of the surgeons! It sounds like he has had plenty of time to learn and his lack of enthusiasm is too evident good luck with him, Mike.

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