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Orienting woes!

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by KeechieSan KeechieSan (New Member) New Member

KeechieSan has 8 years experience and works as a Clinical Nurse IIII.

2,626 Visitors; 93 Posts

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Five weeks ago I started orienting a new girl to my unit (IMC step-down). I have oriented 5-6 times before without many problems, but this girl takes the cake. I was already upset because I wasn't asked to orient her, she was just handed to me one day and they said "oh this is Megan, she'll be with you for EIGHT WEEKS". I like to be notified ahead of time so that I can get eduation stuff together and prepare myself for a few weeks of difficult shifts. But fine, whatever I've done it before, I'm sure I'll do it again.

Since she is a brand new grad who has never worked in a hospital I let her just shadow me for a few shifts, just to get the lay of the land. I started her off slow with one patient and me being with her every step of the way, and here we are five weeks into it and she's getting worse! She cannot handle one patient even with my help. I literally have to watch her every second of the shift, I'm terrified she is going to do something without asking me. She's a very nice girl who clearly wants to be a nurse, but I'm beginning to think she has a real inability to learn. I have always stressed the "ask questions! ask questions!" mentality but she's taking it to the extreme! Five weeks in and I'm getting questions like "Do I give this Tylenol pill IV or by mouth".. YES, she asked that last week. She turned off a Heparin gtt yesterday because "the patient said it was done". She makes the same mistakes over and over again! I must have told her at least 20 times that Lovenox sub-q does not go in the arm and that you need to check a BP when giving SL nitro, yet she cannot seem to remember those simple things. She and I have had numerous conversations about her performance and she always says she will improve but so far no luck. The nurse manager and I have had a few talks about her, but so far nothing has changed. I'm actually afraid for patients safety at this point. I've tried to be nice, I've tried to be stern....heck, I have tried every technique I know of! She is supposed to go to day shift this week for two weeks and then come back to nights on her own after that. I am actually sick to my stomach over the thought of this. My manager doesn't seem concerned, but all the floor nurses are terrified. Would it be inappropriate of me to go to Human Resources? Who else should I talk to about this?? :confused:

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kimmie4476 works as a Med-Surg/Tele.

3,323 Visitors; 107 Posts

Document, document, document! Is there someone above your manager that you can talk to? Like the DON? This girl obviously does not be on a step down unit, sounds like she has no common sense and needs to start somewhere with lesser acuity patients. Those examples you gave are extremely scary!

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3,324 Visitors; 103 Posts

Have you tried talking to her on a more personal level and asking her what SHE thinks she's struggling with and what's inhibiting her success? You might be very surprised. I don't think you should go to Human Resources and just report her like that. That's not gonna help her. Maybe set some time after your shift to really talk to her. Don't forget, she's a NEW GRAD. Even if it's been five weeks, all this is still brand new to her. Not everyone learns at the same pace. But you need to talk to her little bit more seriously and find out what the problem is. Good luck

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Florence NightinFAIL has 2 years experience and works as a RN.

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"Do I give this Tylenol pill IV or by mouth".. YES, she asked that last week. She turned off a Heparin gtt yesterday because "the patient said it was done". She makes the same mistakes over and over again!

These are NOT the regular mistakes that new grads make and that are "normal" - these mistakes reveal a serious lack of education.

This is 'deadly' serious and you need to think about the patients that she's going to put at risk. At least have a written report on file about your concerns and keep a copy - just in case something happens and the manager plays dumb.:uhoh3:

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~Mi Vida Loca~RN has 6 years experience and works as a Emergency Room Nurse.

1 Like; 30,805 Visitors; 5,259 Posts

How in the heck has this girl graduated school and passed NCLEX???

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FancypantsRN works as a RN.

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How in the heck has this girl graduated school and passed NCLEX???

That's what I was just wondering.

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FancypantsRN works as a RN.

7,290 Visitors; 299 Posts

"Do I give this Tylenol pill IV or by mouth".. YES, she asked that last week.

Just have to add that I have heard of nurses attempting to crush pills, dilute them in a saline flush and......... you guessed it. I have never witness this (thank God) but I have heard of it. Hopefully it was a silly urban legend. Perhaps your student heard the same one?

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Five&Two Will Do has 3 years experience and works as a RN MICU.

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Just have to add that I have heard of nurses attempting to crush pills, dilute them in a saline flush and......... you guessed it. I have never witness this (thank God) but I have heard of it. Hopefully it was a silly urban legend. Perhaps your student heard the same one?

One of my teachers in school had mentioned something like this to us. It is crazy to think of somebody carrying a nurse's license thinking that it would make sense to do such a thing. I think I would treat this new nurse like she was a student in clinical for a while and have her do medication pages and the like. Perhaps she is one of those folks who accel in the classroom aspect but not the clinical environment.

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himilayaneyes works as a ARNP.

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Her asking does she give tylenol IV or by mouth is dangerous? I fear for the patients' safety on your unit. You could definitely try talking to her on a more personal level like one of the previous posters suggested. However, remember that's its not your job to make sure that she suceeds, but to orient her to the best of your abilities and to protect the patients above all.

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roser13 has 17 years experience and works as a RN.

3 Likes; 50,461 Visitors; 6,504 Posts

Whoever said that NCLEX "weeds out" the inappropriate nursing students had obviously not met your orientee.

Your situation is frightening. First, because of the orientee's lack of knowledge, and secondly, because of your manager's apparent lack of concern.

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caryrey02 works as a LTAC-Med Surg Nurse.

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I wouldnt say it's OK to go to human resources. This is a person that graduated and has a lot to learn, probably needs the money and the benefits from a jod too. I understand patient safety is the main priority but there must be a way for this person to start getting the hand of being a nurse little by little. Fear to commit mistakes might be her first barrier to learning...talk to her but more like a co-worker than like a preceptor, it worked wondefully with me, in three weeks I was doing all of my preceptor's work, including documentation. Good luck

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1 Like; 1,485 Visitors; 31 Posts

As an older experienced person, but new grad nurse who is 2 months into a 4 month orientation, I would like to give you my perspective about preceptors. I have been working with 2 different nurses, mainly. Once in a while 2 others. I have gained a lot hearing things from different perspectives, some have ways of doing things that I can relate to better than others. One thing they all have in common is that when I asked a question about a drug or compatibility, etc, I am told to look it up. I don't ask anymore! Perhaps your new grad would benefit from another person's teaching methods. From your point of view, if you shared with another preceptor who had your same results, you have more documentation to do what you have to do!

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