Orienting Help

Altra, BSN, RN · Aug 24, 2006

A one-year program ... is she an LPN?

I went directly to the ER as a brand-new GN w/no prior EMS background.

What is she having trouble with? Skills? Assessment? Patient flow? It's probably too early to expect much in the way of efficient flow.

We can probably help if you let us know more specifically where she's struggling.

ER-RN2 · Aug 25, 2006

Pretty much having trouble with everything!!!

Ruthiegal · Aug 25, 2006

Hi. Just need some advice from you all..... I have oriented a lot of nurses to the ER-all of them having background from another unit, etc. Now I have a brand new fresh new grad nurse...with little to no background or much clinical experience (went to a 1 year program that didn't really require much-plus the program isn't known for the best). So any suggestions on the best way to start?? She isn't really picking up on stuff very well so anything that could help would be wonderful! Thanks

I would say to talk to your supervisors to find out how they want you to handle this orientee, I believe with some patience and understanding and some time to talk with this new person about her fears, and concerns may help you make better decisions about how to bring her up to speed. Making cracks about her school is not helping her, and that attitude should not even be a factor. She is your peer, treat her with the same respect you wanted as a new nurse and teach her how to be a good ER nurse! As her preceptor/mentor that is now your job.

Mydnightnurse

AKA Ruthiegal

:balloons:

Trauma Columnist · Aug 25, 2006

I have used the ENA orientation modules in the past with great success. Plus, starting with simple patients to teach the flow and routine and protocols helps. Then...go for the more complex. Also - leave traumas and arrests for the end when they hopefully have organizational skills under better control. Also - it is important that orientation for new grads be lengthy and with a consistent preceptor. In our level one trauma center - orientation for new grads was 12-16 weeks. However, we didn't hold the new grads to the same standard as experienced RNs until about one year into it. And to feel really comfortable, you need several years of experience.

Huachuca · Aug 26, 2006

Here is some advise from a new grad, in an ED(total of 8 months now), who has been on my own for 3 months now. My hospital has a great education/orientation program. We are put through EKG, Critical Care Classes, ED classes, ACLS, PALS, etc. This program takes 6 months. The days we are not in class, we work with our preceptor..it works out to 1- 2 shifts a week on top of classes. Even with having gone through a traditional program, and with all the training...most everyday I am doing something I have never done before. Remember, the first two weeks new people are still trying to figure out where the bathrooms are!! I had a pretty strict, smart preceptor. For the first week I shadowed her, then took on an average of one patient each week. She jumped in when needed, and would put me in with other nurses if there was something I could learn from it. Starting out, one of the things I was most nervous about was starting IV's... one nurse gave me some great advice....Take the IV kit in with me when I first meet the patient, if there is any indication I might need to start an IV (at my hospital, we have standing orders to cover us with putting in a saline lock and drawing labs to send on hold to the lab).....that way, I had everything I needed, and could talk to the patient while I was doing my IV, part of my assessment.

I have to agree that the ENA modules are great, especially if you don't have a set training program. Our program was based around the ENA.

Finally, I was required to have a daily goal as well as a weekly goal. This kept me from falling in a rut and not taking on new tasks.

Remember, having a new grad is like teaching your 4 year old to cook....they are going to make a hideous mess, but will never forget the help you give them..