To those of you who precept, where are your preceptees in their nursing practice before you turn them loose? On my floor, new nurses are oriented for 4 weeks on days and 2 weeks on nights. I'm the day portion and am expected to get the newbies able to handle 4 patients. (I'm on a neuro tele floor). My last one has time management issues and can do 2 patients with help. 3 and she has major trouble. Forget about admissions. She never got to those. She was always too busy to do IV's and ... she just has issues. Today was my last day with her and she's going to nights. Are 2 more weeks enough? I've already talked w/ my manager about her and she's bound and determined that she go to nights. I don't feel like she's safe and don't want to clean up her mess on days when she does go on her own.
Long story short, how long is the orientation period on your floor if you have someone with issues.
Thanks for any stories. Jokes and funny stories are going to be appreciated. I need a good laugh after this day.
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 God after reading your post I have to think about all of the dumb questions I've asked. I sure hope that you taught her a lesson that she needs to NOT ask dumb questions, after all as new grads we should know everything, right? What happened to the old saying "There are no dumb questions?" To be honest I would have doubled checked the insulin/blood because of the dangers stressed in school surrounding giving blood. I guess I buffer all my questions with "I know this is stupid but.." I hope you tore her a new one in the breakroom with all of the experienced nurses so her credibilty could be rightfully shot, that always does wonders for us new grads...Thanks!
Sounds like some personal growth needs to be done on both sides of the fence.
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.
In defense of new grads, a lot of us came out of nursing school with VERY LITTLE experience in skills such as IVs, dressing changes, etc. I never started an IV in nursing school, and one of my classmates never put in a Foley. I even brought the issue to the curriculum committee, who brushed it off saying, "Well, they learn that on the job". Maybe your new nurse avoids starting IVs because she doesn't know how, or she's scared, or someone has criticized her for her IV skills.
It took me 45 minutes to draw my first blood culture. (Don't ask). But it all came together.
In terms of the "dumb questions", be glad they are asking questions.
It's hard to be a new nurse when nobody taught you basic skills and you are being thrown in. At my hospital, there is about a 40% attrition rate of first year nurses. Until the schools step up and give better training, the hospitals and preceptors are going to have to carry the burden, and these newbies should be given enough time to get acclimated. Geez, it can take up to 6 months just trying to figure out where everything is!
Thanks for the replies. I realize that 4 weeks is not a lot. This nurse has already been extended. She started around 4th of July and ended with me yesterday. She will be orienting on nights after this for 2 weeks.
I agree with everyone that nursing school doesn't prepare you for actual nursing. Like another nurse, I had never started an IV or even put a foley in but I made darn sure I took every opportunity when I was precepting. I always felt wiped out at the end of the day but it gave me great experience. Unfortunately for me, my orientation was cut short b/c my preceptor left and they stuck me on the floor. I had to learn quick!
So... I'm at a loss when I hear someone say that she's too busy to put an IV in or pull out a central line. These are things that she needs to know how to do. And talking w/ an educator will not make her proficient.
To the Original Poster..... I am a new grad that just started in an 8 bed ICU that takes anything from drips to vents to ETOH to AAAs. I am going into week 2 of night orientation, and I too started on the floor the beginning of July. On days I was spoon fed at first, until I gained enough confidence and time management skills... my preceptor did less and less each week. It was week 6 on days and I realized that I was functioning independently, (albeit SLOW with some things, like admissions or discharges...) I will orient for 4 more weeks, for a total of 12. Our institution also employs the skill checklists and weekly face to face meetings for strength and weakness evaluation. I dont feel that I will need it, but I know that an extension is available if necessary. ~cheers, Ivanna
I have been reading about other's orientations and have to share my first day experience as an LPN and see if there is more that I need to be asking for. I basically had 2 hrs of computer training, a very high level as the trainer said you will learn everything on the floor. Then day two after my calculation test I was given a binder and a "study guide", left alone in a room to complete the study guide using the binder, that basically had the policies and procedures of the hospital. Then yesterday was my first day on the floor when I was supposed to shadow another nurse. I followed her for the day, observed helped with meds, changed IV bags, but I still don't know how to answer the phones on the floor, don't know where barely anything is etc. I am working two 12's a week and dont have a set person, it will changed every shift. I feel so lost and overwhelmed. This is a very small 44 bed county hospital and this may be how a small hospital works. Any suggestions?
nurseby07
338 Posts
Good God after reading your post I have to think about all of the dumb questions I've asked. I sure hope that you taught her a lesson that she needs to NOT ask dumb questions, after all as new grads we should know everything, right? What happened to the old saying "There are no dumb questions?" To be honest I would have doubled checked the insulin/blood because of the dangers stressed in school surrounding giving blood. I guess I buffer all my questions with "I know this is stupid but.." I hope you tore her a new one in the breakroom with all of the experienced nurses so her credibilty could be rightfully shot, that always does wonders for us new grads...Thanks!
Sounds like some personal growth needs to be done on both sides of the fence.