"By the way, everyone's first night off orientation is pure hell...."


This is what I was told last night by the nurse that was charging the night I came off of orientation 2 weeks ago. I've been working on a busy Ortho/Neuro floor for about 3.5 months now. My first night off orientation, there were 5 nurses working, giving us 4 patients apiece. Two of my 4 pts were total care and 2 were total joint replacements. Most of us were pretty busy that night except for the charge nurse and another nurse who had pretty easy pts. About midnight that night, we got a new admit which the charge nurse asked me to take. The new admit ended up being total care (giving me 3) and needed blood hung, stat labs, etc. In the midst of me admitting this pt, another one of my patients started having chest pain. So now, I'm running back and forth between my chest pain pt and the new admit. Thankfully the nurse who had the easier pts. stepped in and helped me out some, but the charge nurse basically just sat there and did nothing. I pretty much ran the whole night like a chicken with my head cut off. Word must have gotten out about the night I had, because the next night I worked there were several nurses that talked about how wrong the charge nurse was to give me that type of patient load my first night out. I didn't really make any comments about it, other than I had a bad night, and just let everyone else talk. I guess someone said something to her about it, which in turn made her make that comment to me. Now don't get me wrong, I never expected to have the easiest patients or a light patient load my first night off orientation. Our floor is hard and we are often short staffed so I'm more than willing to pull my own weight, but I guess I'm upset with how it all went down. I honestly believe that she could have taken the admit or assigned it to the other nurse who had easier pts, but gave it to me because I'm new. Has this happened to anyone else? Am I wrong for being upset?

Pediatric Critical Care Columnist

NotReady4PrimeTime, RN

16 Articles; 7,358 Posts

Specializes in NICU, PICU, PCVICU and peds oncology. Has 25 years experience.

My first night off orientation on my very first hospital job was nasty! I was working in an intermediate care nursery with babies who no longer required mechanical ventilation but still needed monitoring and semi-intensive care. I had 3 such babies, one a 24 weeker with multiple complications, another was a 32 weeker only a couple of days old and the third was on q2h gavage feeds. (We were not allowed to leave the OG in place between feeds...) So I had 14 sets of vitals, 14 diaper changes, 14 feeds, 3 baths, a handful of IV meds and another handful of oral meds, hourly charting on each of the babies and so on. I was doing okay until the 24 weeker decided at 4 am that she really enjoyed a heart rate of 40. I could stimulate her back up but she wouldn't stay there. Oh and did I mention that she didn't really like to breathe? I ended up having to transfer her to NICU. While she was up to her hijinx, my 32 weeker's IV tubing somehow became disconnected from the IV catheter and the kid was bleeding back into the bedding for who knows how long. So I had to deal with that issue. And then my other baby vomited up a bunch of bile so we had to do an abdominal x-ray and a sepsis workup... Those were the longest 3 1/2 hours! I've had lots of other shifts like it, but I've gotten to the point where I expect it, goes with the territory. I take advantage of the "good" shifts and survive the bad ones. So will you.


462 Posts

Has 6 years experience.

Yep...happened to me too. I must say though I have been on my own for about 7 weeks though. Only had 4 weeks of orientation and then I was thrown out there to sink or swim. My floor got closed to low census so they assigned me to a tele floor. Mind you, I have no experience with Tele patients. The charge nurse gave me 6 patient at the beginning of the shift; then an hour into it she assigned me the new admit. I had 3 total care patients. I get a phone call from someone (we have to carry phones on us at all times) saying my patient in 318B has a heart rate of 130. I said Ok and immediately looked for my charge nurse. Nowhere to be found. She did no assign herself any patients and the other 3 nurses had 6 patients themselves. So I found one of the other nurses and I asked her what do I do? She looked at me like I was stupid. She then said figure it out!! What the H***. Then I asked another nurse and she said who called me, I told her who. She called them back. In the meantime I went to the patient's room to check on her. Sound asleep. I checked the leads did vitals. Then the nurse told me to check the MAR and see if she has an order for anything. I did, but what was I looking for?? I did find parameters for elevated heart rate. I was to give it IV push (can't remember the med off the top of my head now)/ While I was getting the med, I found one of my fall risk patients out of bed walking around in her room. She had to go to the bathroom. I asked someone if they could sit with her while I gave this med. No one helped!!

What a night, what a night! I am loosing my sanity and praying that the year goes by fast. I am out of that hospital!!

Good luck with your carreer. There are some nurses that will help and some that wont. I haven't been able to find any support where I am. So sad... patient saftey is so important!! why do some not help new nurses?? they were once new themselves, they must know how we feel!!


52 Posts

I am a new nurse too, and from my limited experiences, I think you need to know that you need to start watching your back with that charge nurse. She knew that what she did to you wa snot only wrong but unsafe. And she enjoyed sitting down and watching you suffer. This is a classic example of young eating. This is how you do it: COMPLAIN!! (behind her back).

Start to connect with your fellow nurses, and make them feel your cause. Mobilize their support. Help them out, (only the ones that you know will help you when you need it. Some people are not worth it), and mobilize the support of the rest of the girls around you. That way, when she pulls that crap on you again, you have the support that you need to demonstrate that this B*tch is engaging in unsafe practices to your director.

I have been doing this for six months now, and I luv it!