Precepting?

al7139, ASN, RN · Sep 6, 2007

Hi,

I am a new grad nurse. I work on a telly/med floor. At our hospital, the preceptorship starts with two weeks in classes learning the computer system, pyxyis, ECG interpretation, point of care tests (BG, hemo/gastro cullt, ISTAT, etc.), policies & procedures, and general orientation. It's not until we complete those classes that we start on the floor. Then, we are with a preceptor, and monitored by a hospital educator. Our preceptorship can last anywhere from 10-12 weeks, during which our preceptors and us are meeting with the educator weekly to determine our progress. I started with a day of shadowing, and gradually worked up to 6 pts from there. We also have an education folder that has certain competencies that must be signed off on. We must have the basics to get off orientation, but have 6 months to complete them. We are told what we need to work on weekly. A preceptorship can be extended for a week or two if needed.

6 weeks does not seem like enough to me!

Amy

cardiacRN2006, ADN, RN · Sep 6, 2007

So after 4 weeks on days, she still can't handle more than 2 patients? Wow, she's in for some tough times ahead...

I don't think 2 more weeks will help. I think she needs some more time. Is is possible to extend her time?

USAstudent · Sep 6, 2007

I've been a RN for slightly over a year now. My 1st job on a tele/cardiac floor I had 2weeks of classroom orientation and 5weeks of floor orientation. This was pretty set in stone for that hospital-nobody got extended even if they needed it because they were always short-staffed (and they just didn't care that much). I recently started a new job in June (moved 2hrs away, plus the 1st was just a bad work environment-staffing and management issues) in the ER at a level 1 trauma center. I had 2weeks of classroom orientation and about 5weeks with a preceptor, but I've seen that time period extended according to the person and what their learning needs are. I think someone recently spent as long as 8weeks with a preceptor. I felt that my orientation was adaquate at both hospitals, but I wasn't having any issues during my orientation period either (eg. able to handle patient load that was expected of me, etc). Different people need different things.

I think sounds like yours needs some more time, but I think it depends on the hospital if they allow that. My current job is at a teaching/university hospital which also helped the process alot. 1st job was a private hospital-that might make a difference also. I would ask about getting her precepting time extended, it would do her a favor.

allele, LPN · Sep 6, 2007

Generally about 10-12 weeks on my progressive care cardiac/thoracic/vascular surgical tele floor. If the nurse is experienced they usually only need about 6 weeks, but it can be extended if needed....although no hospital will let extensions go on forever, of course! We have a pretty fair orientation program. :)

Tweety, BSN, RN · Sep 6, 2007

She actually might do better on nights because sometimes in the wee hours of the morning she might get her act together. Orientation should be individualized and often people need a little extra time, a week or two and they become good nurses.

**RosesrReder, BSN, MSN, RN** · Sep 6, 2007

Hi,
I am a new grad nurse. I work on a telly/med floor. At our hospital, the preceptorship starts with two weeks in classes learning the computer system, pyxyis, ECG interpretation, point of care tests (BG, hemo/gastro cullt, ISTAT, etc.), policies & procedures, and general orientation. It's not until we complete those classes that we start on the floor. Then, we are with a preceptor, and monitored by a hospital educator. Our preceptorship can last anywhere from 10-12 weeks, during which our preceptors and us are meeting with the educator weekly to determine our progress. I started with a day of shadowing, and gradually worked up to 6 pts from there. We also have an education folder that has certain competencies that must be signed off on. We must have the basics to get off orientation, but have 6 months to complete them. We are told what we need to work on weekly. A preceptorship can be extended for a week or two if needed.
6 weeks does not seem like enough to me!
Amy

This is exactly how it is at my hospital. I start in a classroom, then 8 weeks on the floor with the option of getting more time if needed. There are core competencies that we are checked off in etc.

I agree, 6 weeks doesn't sound like much.

SCRN1 · Sep 6, 2007

I don't think 4 weeks is long enough for a new grad either and 2 weeks at night is just scary!! I've worked nights myself for years and there have been many nights I was busier then than I've been on days.

It sounds like you're precepting the same nurse I currently am. She dwaddles when she knows there's an IV to be started, a dressing to be changed, etc. Her excuse is, "I haven't started my charting yet and I need to get this done". No more letting her off that easy! I've told her the charting can wait, even if it means doing it after she reports off at the end of the shift, but the patient needs take priority. She didn't like that, of course. But, oh well, that's the way our job goes. Yesterday, when we were talking about a patient's dressing change that needed to be done on a Stage 4 decub, she asked me, "who's going to do it?". Without pause, I said, "you are". I heard her saying something about it later to our nurse manager. I laughed and said, "I wasn't gonna let you out of that one" but pointed out that we didn't push her out there on her own. (I stood right beside her assisting and giving her step by step instructions, while there were two other nurses also helping to hold the patient on his side and also assist.) She's been with us for over a month now...with me the past 3 weeks...and she's still not ready to take 4 all by herself. I don't think she even realizes all the things I'm doing for her that she will be expected to do alone once she's off orientation and I keep trying to remind her when she says, "I'm already doing something", that soon, she won't have a preceptor as a back up and now's the time to learn to handle a load by herself. She's only up to 4 patients at a time (with LOTS of help) and needs to get up to handling at least 6 because there could be days when she'll have 8.

BGgirl · Sep 6, 2007

Our nurses get about 10-12 weeks on dayshift and then when they come to nights they just get 2 weeks. Our new group of nurses is getting a month on nights instead of the usual 2 weeks. By that time they pretty much are ready to be on their own but just need to learn the nightshift routine.

We've have a few doozies with our new grads coming through. One nurse asked if she could send a stool for c-diff if the stool was loose, another one asked if it was okay to give the pt insulin because they were getting blood, one after being on her own for MONTHS asked one day what the difference between sq heparin and the heparin we use for picc line flushes. I could go on and on but my mind is going blank right now.

Good luck with your new grad. Sounds like you'll need it.

**RosesrReder, BSN, MSN, RN** · Sep 6, 2007

Our nurses get about 10-12 weeks on dayshift and then when they come to nights they just get 2 weeks. Our new group of nurses is getting a month on nights instead of the usual 2 weeks. By that time they pretty much are ready to be on their own but just need to learn the nightshift routine.
We've have a few doozies with our new grads coming through. One nurse asked if she could send a stool for c-diff if the stool was loose, another one asked if it was okay to give the pt insulin because they were getting blood, one after being on her own for MONTHS asked one day what the difference between sq heparin and the heparin we use for picc line flushes. I could go on and on but my mind is going blank right now.
Good luck with your new grad. Sounds like you'll need it.

Thank Goodness for those nurses who were born nurses and their first word was RN! :thankya: (tongue-in-cheek, btw).

Seriously though, I think 2 weeks is way to short (personally speaking of course). When I was job hunting, orientation was a big deal for me, so I made sure I asked plenty of questions and looked for a good program. 2 weeks would have scared me right off...........oh well.

cardiacRN2006, ADN, RN · Sep 6, 2007

I don't think she even realizes all the things I'm doing for her that she will be expected to do alone once she's off orientation ....

She probably doesn't.

I had 6 months of orientation offered to me. My preceptor was mostly off the floor by the end. I had to take the full load, and I would only ask for her advice when I felt that I needed it. I pulled myself off orientation more than a month early.

Man, my first few days without her there were horrible! I had no idea how much of my work she did behind the scenes! It was a reality shock for sure! Not to mention always being able to ask her opinion of for advice. I missed her!

teeituptom, BSN, RN · Sep 6, 2007

Our nurses get about 10-12 weeks on dayshift and then when they come to nights they just get 2 weeks. Our new group of nurses is getting a month on nights instead of the usual 2 weeks. By that time they pretty much are ready to be on their own but just need to learn the nightshift routine.
We've have a few doozies with our new grads coming through. One nurse asked if she could send a stool for c-diff if the stool was loose, another one asked if it was okay to give the pt insulin because they were getting blood, one after being on her own for MONTHS asked one day what the difference between sq heparin and the heparin we use for picc line flushes. I could go on and on but my mind is going blank right now.
Good luck with your new grad. Sounds like you'll need it.

Good lord, the way newbies are oriented nowadays, simply amazing.