Questions to ask during orientation?

icuRNmaggie, BSN, RN · May 12, 2015

A few basic things that I would need to know and would ask during the unit orientation are :

The exact policies for transfusion of platelets, FFP, cryo, PRBCs.

How much heparin to lock a medport and do you need a special order for cathflo.

How much blood do they waste when drawing blood?

The sepsis protocol and the policy for drawing blood cultures.

How are Neutropenia Precautions and the chemo precautions implemented on this unit.

Do they use chlorhexidine bath wipes and curos caps etc. to prevent CLABSI.

These nursing skills and interventions can all vary greatly from one hospital to another.

Good luck with your new adventure!

NedRN · May 12, 2015

Why not see what the orientation consists of? Ideally a good orientation will cover all the basics and include reading P&P. You shouldn't need to design your own orientation.

DatMurse · May 12, 2015

Why not see what the orientation consists of? Ideally a good orientation will cover all the basics and include reading P&P. You shouldn't need to design your own orientation.

just wanted to make sure I covered everything :)

AnthonyD · May 13, 2015

From my perspective, the most important thing to ask is where to go for resources. Where are the site's nursing policies listed (online, in a binder on the unit, etc), and who do you ask when you have a question about policy/practice/procedure specific to the facility. Is there a nurse educator, CRN, CNS, etc?

Pretty much every question you have about your practice in a new facility can be funneled down to the above.

Soliloquy, MSN, APRN, NP · May 13, 2015

A few basic things that I would need to know and would ask during the unit orientation are :
The exact policies for transfusion of platelets, FFP, cryo, PRBCs.
How much heparin to lock a medport and do you need a special order for cathflo.
How much blood do they waste when drawing blood?
The sepsis protocol and the policy for drawing blood cultures.
How are Neutropenia Precautions and the chemo precautions implemented on this unit.
Do they use chlorhexidine bath wipes and curos caps etc. to prevent CLABSI.
These nursing skills and interventions can all vary greatly from one hospital to another.
Good luck with your new adventure!

I like this list a lot. I didn't really get any training into policy and procedure for any of this stuff but I remembered it from my old job and fortunately, on my random "shadow day" the nurse was giving blood so I got to see how it was done. Whew!

DatMurse · May 13, 2015

I like this list a lot. I didn't really get any training into policy and procedure for any of this stuff but I remembered it from my old job and fortunately, on my random "shadow day" the nurse was giving blood so I got to see how it was done. Whew!

I think I am just overthinking it and trying to make sure I dont mess up. I will have remote access to P&P so I will be reading up on it when I get home.

Double-Helix, BSN, RN · May 14, 2015

Ask where to find the staff/hospital directory. Make a list of what numbers you find yourself calling most frequently (on-call pager, lab, nutrition services, environmental services, x-ray, etc.). You'll save yourself a lot of time and questions if you don't need to look up/ask for a phone number.

icuRNmaggie, BSN, RN · May 14, 2015

Just to be safe, I would review the Nurse Practice Act for Ca. and find out if RNs can insert LMAs, IOs, EJs, Dobhoffs, concious sedation and what types especially propofol, or do an arterial puncture for an ABG. Some states allow an RN do some or all of these skills and some don't.

sharroon7892 · May 20, 2015

Wow i didn't even realize some states dont allow nurses to do those things. Sometimes my day is full of just doing ABGs, inserting dobhoffs and adjusting propofol (and other sedation). Does anyone know if these things are allowed in cali (i know policies are hospital to hospital)

I would add to the list of things during orientation;

general protocol stuff on heparin flow sheets (adjusting doses) as well as vanco documentation sheets for troughs and being on an ICU floor in NY, we have strict turning and positioning guidlines. no hospital aquired P.U.'s here! I'm sure i'll start writing a list myself as i will be starting a travel position in june :)

TheNGTKingRN · May 20, 2015

Wow i didn't even realize some states dont allow nurses to do those things. Sometimes my day is full of just doing ABGs, inserting dobhoffs and adjusting propofol (and other sedation). Does anyone know if these things are allowed in cali (i know policies are hospital to hospital)
I would add to the list of things during orientation;
general protocol stuff on heparin flow sheets (adjusting doses) as well as vanco documentation sheets for troughs and being on an ICU floor in NY, we have strict turning and positioning guidlines. no hospital aquired P.U.'s here! I'm sure i'll start writing a list myself as i will be starting a travel position in june :)

My understanding is that hospitals can train both theoretically and technically, providing there is documentation of your learning... you can perform skills such as ABGs or adjusting propofol. The NPAs may not list it as a skill, but this doesn't mean it can't be learned and documented.

There are many hospitals training RNs to do IOs and intubation (esp in smaller suburban or rural hospitals) larger hospitals and teaching hospital usually leave those sorts of tasks for residents.

DatMurse · May 23, 2015

Wow i didn't even realize some states dont allow nurses to do those things. Sometimes my day is full of just doing ABGs, inserting dobhoffs and adjusting propofol (and other sedation). Does anyone know if these things are allowed in cali (i know policies are hospital to hospital)
I would add to the list of things during orientation;
general protocol stuff on heparin flow sheets (adjusting doses) as well as vanco documentation sheets for troughs and being on an ICU floor in NY, we have strict turning and positioning guidlines. no hospital aquired P.U.'s here! I'm sure i'll start writing a list myself as i will be starting a travel position in june :)

I am on the floor now. It literally is hit the ground running. I have electronic access to policies and procedures which is nice. I asked about IVs and what not. Need doctors order(I had no idea). We have standing orders for electrolyte replacement. Sepsis protocols q12. Possible Labs q12 or urine q8. People here have been awesome