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orientation issues!!

Posted

hello everyone.. so i am a new grad.. graduated may from nursing school and got a job at a hospital.. started orientation and i have no nursing experience before graduating except clinical experience and this is my second career. at first i was excited to start at the hospital since classroom orientation was so fun... it lasted for 2 weeks..... and made me feel i was going to learn so much since it is considered a "teaching hospital". i got hired for a medsurg unit where ratio is 1:7 or 1:8.. my first day, i observed and was trying to orient my self to the unit and see where things are.... second day.. i got 3 patients and gave meds on my own without supervision... until it became a habit that i did things without supervision and had to go back and forth to find my preceptor if i didnt know how to do something.. my patient load had increased by week two.. and i got 4 patients. my manager was pushing me to do more patients but just couldnt do it since im not so confident. preceptors are saying im too slow with giving medications but im still learning and said i ask stupid questions. but how am i supposed to learn if i dont ask questions??? manager isnt supportive at all and wants me to have more patients.. i am going crazy in this place!! please give me your feedback :(

Been there,done that, ASN, RN

Has 33 years experience.

Your facility does not want to train you.They want to get you working ASAP. 1:8 is unsafe for an experienced nurse.

Demand your full orientation with weekly reports on your progress. You should have 12 weeks.

Best wishes, it's a jungle out here.

Personally I think a ratio of 1:7 or 1:8 is crazy on a Med-Surg unit and I wouldn't have taken the job, but I haven't worked Med-Surg as a nurse. Only a tech or a student. So maybe it's common in some areas. I haven' heard of any hospital units that are greater than 1:6 in my area.

thanks for your advice... yes 7-8 max is crazy...our orientation is 5-6 weeks.. i feel like its so unsafe.. few preceptors get annoyed since they are so busy with their patients but im taking a few of their patients too! they are always low on equipment... no wonder why people come and go on this floor

Dear God, guess I should be grateful for my 5 patients, I am on a Tele floor. I am too a new grad, about to go our on my own. I got 8.5 wks of orientation, you can get up to 12 weeks if needed. But I did have to sign a 3 year contract. And definitely was not trusted to do my own thing until a few shifts in and had proven at least baseline competence.

I would seek employment elsewhere honestly. I've struggled with 5, 8 is impossible. And this is coming from a former LTC LPN that had 25 patients. 5 pts in the hospital feels like 25 LTC pts.

Nurse SMS, MSN, RN

Specializes in Critical Care; Cardiac; Professional Development. Has 10 years experience.

Start looking for another job. Do the best you can, don't burn bridges, stand up for yourself and hang in there.

Been there,done that, ASN, RN

Has 33 years experience.

thanks for your advice... yes 7-8 max is crazy...our orientation is 5-6 weeks.. i feel like its so unsafe.. few preceptors get annoyed since they are so busy with their patients but im taking a few of their patients too! they are always low on equipment... no wonder why people come and go on this floor

Lack of equipment is a red flag. Continue your orientation, with a smile on your face.. and request 12 weeks. Start looking for other employment now. You have been set up for failure.

thanks for the advice. i did request to see lesser pts but manager said she doesnt want me to do more than 5 weeks extension and that 5 weeks is good. we were sharing one blood pressure machine at one point and a patient coded. im going to look elsewhere or at least try for another unit... i dont want to risk my license or my sanity.... when i ask other nurses for help... they say "ask your preceptor" but preceptor is never available

Sour Lemon

Has 9 years experience.

thanks for the advice. i did request to see lesser pts but manager said she doesnt want me to do more than 5 weeks extension and that 5 weeks is good. we were sharing one blood pressure machine at one point and a patient coded. im going to look elsewhere or at least try for another unit... i dont want to risk my license or my sanity.... when i ask other nurses for help... they say "ask your preceptor" but preceptor is never available

This sounds a lot like my first job as a new graduate in south texas. I had eight patients and an LVN to cover who also had eight patients. Nothing worked and everything was out of stock. We were lucky if the one or two CNAs on the 40 something bed unit didn't run off crying. I got a full 12-14 week orientation and still struggled to keep my head above water. And no one is ever available to help because they're all struggling just as much. You're going to have to cut corners in a major way, just make sure you don't cut the wrong ones.

The good news is that every other job will seem "easy" if you can survive there.

wow so we both experienced this type of setting. the aides on my unit... are another story. they want to sit all day and when you ask them for help, they say they are unavailable. so i have to do everything myself. its hard enough to handle 4 patients on my own.. imagine double! trying to find another job but job market isnt that great for new grads since all want experience. i dont think i can stay here and do my one year experience

This sounds a lot like my first job as a new graduate in south texas. I had eight patients and an LVN to cover who also had eight patients. Nothing worked and everything was out of stock. We were lucky if the one or two CNAs on the 40 something bed unit didn't run off crying. I got a full 12-14 week orientation and still struggled to keep my head above water. And no one is ever available to help because they're all struggling just as much. You're going to have to cut corners in a major way, just make sure you don't cut the wrong ones.

The good news is that every other job will seem "easy" if you can survive there.

how long did you stay there?

Sour Lemon

Has 9 years experience.

how long did you stay there?

I stayed for a little over two years because I knew I was moving out of state and wanted a stable-looking work history when I moved on.

wow... yeah i dont think i can even stay another week!! lol but il look for other places in the meantime.. dont want to quit without having backup.. thanks for ur advice

Been there,done that, ASN, RN

Has 33 years experience.

wow so we both experienced this type of setting. the aides on my unit... are another story. they want to sit all day and when you ask them for help, they say they are unavailable. so i have to do everything myself. its hard enough to handle 4 patients on my own.. imagine double! trying to find another job but job market isnt that great for new grads since all want experience. i dont think i can stay here and do my one year experience

Directing lazy aids is another thread. Write them up; each and every time; when they do not follow your direction. YOU are the boss.

caffeinatednurse, BSN, RN

Specializes in Med-surg, telemetry, oncology, rehab, LTC, ALF. Has 5 years experience.

My first medical-surgical RN job was 1:9 when I started, then it dropped to 1:8 when I came off orientation. My first night on orientation, my preceptor handed me 4 patient summaries and a pager and wished me the best of luck. From there on, it continued to go down hill. It sounds like you're on a similar unit.

There's better units out there. I'm currently working on a medical-surgical unit at a smaller community hospital. The ratio is 1:6 with the very slim possibility for 1:7. Usually it's 1:6. I'm used to crazy ratios, though - like 1:16 with 1 CNA. Or 1:20, or 1:27.

Hang in there. Don't quit without giving a notice, and try not to leave without having another job lined up. It's true when people say that it's easier to get a job when you already have one. If you can stick it out for 6 months, you'll be in an even better position.

Oh yeah, and ask for the rest of your orientation. Are there any other new grads on your unit? Talk to them and ask them what they're doing to manage the workload.

Edited by caffeinatednurse

wow sounds so similar...yes i am still looking for a job and wont quit until i have one secured - thanks for the advice.. iam the only orientee on that specific floor but another orientee on another MS unit observed the first week, second week had 1 patient, and is slowly increasing her patient load while learning. thats what i wish i had. not to be bombarded first week with patients and its much harder to learn. i ask questions and sometimes they dont want to be bothered but I am taking care of their patient! sigh... how long did you stay at that job? the one where u started off with 9 patients... again thanks for the advice

caffeinatednurse, BSN, RN

Specializes in Med-surg, telemetry, oncology, rehab, LTC, ALF. Has 5 years experience.

Four months. I was utterly exhausted, fed up, and wondering why I even became a nurse by the end of those 4 months.

In my humble opinion, there's short-staffed with high ratios, and then there's short-staffed with high ratios and no help. I can handle the first. I can even handle the second for a short duration...but as a new grad nurse, you shouldn't be expected to. It takes time to acclimate to the heavy workload of nursing and particularly med-surg. I would ask to be backed down to 1 or 2 patients and then work your way up from there. Your manager or supervisor should be able to help you create a game plan for the rest of your orientation.

thanks. i did ask for a back down of 1 to 2 patients and manager told me no :grumpy: that i need to be faster too but i keep reminding them im a new grad and they just dont care