When I graduated from Nursing school, I was so excited to start working as a nurse. I got hired as a Graduate Nurse on a general Med-Surg Unit. First week -- typical orientation in classroom setting; goals and mission of the hospital, infection control, IV insertion, restraints, meditech training, etc... On my second week (on the floor), my enthusiasm starts fading. On my 2nd day with my preceptor, I was assigned to take care of 2 patients -- did everything on my own (preceptor never worked alongside with me): one very unstable (w/ trach and G-tube, aphasic, immobile), the other kept yelling and screaming due to excruciating pain. One doctor even commented to me that they shouldn't have assigned me to the pt with trach and G-tube. The educator never said anything about the assignment, so does the nurse manager. Although my preceptor answered all my questions, I still feel that I could have felt differently had she given me easier cases first, so I could familiaze myself to the system -- and she never entered the pt's rooms. This is my 2nd day on the floor and I still get confused with telephone orders, transcribing meds, paging the doctor, faxing new orders.
Now, I'm planning of quitting the job and look for another hospital with better preceptorship. During our first week of orientation, we, the new grads, were promised that we will progress gradually. I don't think the preceptors were given guidelines or were oriented about preceptorship. I just passed my board and I don't want to risk my license.
I agree with Shammy. Go through the appropriate motions first, even if it means changing preceptors. It is not unusual for new grads to switch preceptors when they are concerned that they are not getting the attention they need. It's possible you preceptor never had a preceptor class and is unaware of your preceptions. With any career, go throught the appropriate motions first, than move on if you can't work things out.
The grass will probably not be greener anywhere else you go. From what I can gather from scores of others in the nursing field, everyone is promised good orientation and training, but few ever get it. A lot of the time the units are so hectic/short-staffed/overworked, they aren't even able to give you the orientation you were promised. Even if their intentions start out good.
It's just the nature of the business, I'm afraid.
:yeahthat:
One of the biggiest complaints at the HHA I have worked at (and am going to resign from on Monday) is their lack of orientation. I discovered just last Wednesday after being on this job for 3-1/2 months that if data from a patient's file which has been uploaded to your laptop is not refreshed on a daily basis, that information is basically lost. I found this out the hard way, after being confronted by my Team Leader that she had not received a vital communication on two of her patients which I had sent the week before. Of course I get dinged on this foopah WHICH WAS NOT MY FAULT. The Director reassigns my patients I am scheduled to see the following day in order that I get "properly" oriented to their computer system by the Systems Manager and tells me to come in at 9:00 AM. I report as instructed, but the SM does not show up until 10:00, in which she proceeds to tell me that she has a doctor's appointment and and spends a grand total of 15 minutes with me before she disappears into the woodwork...again. Once more I wound up being on the short end of the stick, and losing 5 hours off the clock to boot. I decided right then and there that I had had enough of this lousy place, went home and found myself a job in Workman's Comp Case Management which I start on August 7. I REFUSE to be held accountable for something that I am not even REMOTELY aware of! :angryfire
I agree with most of the replys talk to your nurse manager and your preceptor. my first preceptor did a similar thing to me, she handed me the keys and said let me know if you need any help, I was mortified but when we were through orientation I felt comfortable on my own where as some of the girls who only had two or three patients didn't. I asked her many questions and she had to come to my aide a few times. but still to this day 14 years later I have no problem asking for help when I need it or asking questions if I don't know something and I don't mind offering my help either.
I am really sorry that you are yet another victim of the nursing profession. People will make light of it and make all kinds of excuses for it: my favorite is when they call it "trial by fire." Even an animal has the sense to run from fire.
I was not left alone with a patient for nearly a week. I had to have a special competency to deal with trach patients.Preceptorship was a great experience and I will never forget how great it was. Being a new nurse is stressing and sometimes unpleasant, but does not need to be hell on earth.
Talk to your manager. Be frank and honest. Tell him/her that you will quit if circumstances do not change. Remind them that your first obligation is to you and maintaining a safe practice in an environment that will not put your license or reputation at risk.
Do not risk your registration, sanity or self-respect for any job. It is not worth it. If you quit this job now, nobobdy ever needs to know that you ever worked there. I don't know your circumstances or where you life, but large university-affiliated hospitals can be much more supportive. Especially if they have a reputation to uphold.
Best of luck to you. I am ashamed to say that your experiece is all too common. Just always remember -- it is not you and it is not your fault.
I think a trached patient and a patient with a g-tube is the perfect patient for a new grad nurse with only two patients. It's a great learning experience. If you'd had too walkie talkies your post would read "I'm not learning anything and I'm bored........" :)
HOWEVER, big HOWEVER.......with the preceptor's help, teaching etc. The patients is the preceptors assignment, not the new grads.
I would hope before you quit, even if you've made up your mind to quit, you talk to the preceptor.
Too many times we always run to the manager and bypass the source of our frustrations? Why is that? And 80% of the time the nothing changes when you go to the manager anyway.
Go to the manager for sure, but you and the preceptor should have a face to face talk as well about how she/he let you down. It might help out the next new grad.
So sorry about your awful shift NurseMike. I all too readily remember when in the ER I've had the naked patient in the hall (with the staff laughing), one of my other patients pulling at their 4-point restraints and my third patient came out of her room and hit me in the face! Gee whiz! I can say this all with a smile on my face nowadays - lol.
There have been plenty of times since then that things have gotten hectic, or scary, or both. Still have moments when I'd like to just go hide somewhere. But they do build character, and many of them are pretty funny, after the fact. Like, after another nurse and I got my naked 90 yr old lady into a gown, I was encouraging her back to bed when she informed me, "Sir, I am a Christian lady, and I'm sorry but I don't want to have sex with you." Eeek!
My own orientation was a bit disorganized. At one point I was sure they were going to extend it so everyone on the floor could mentor me (I had, like, 14 different preceptors...). In many respects, it no more prepared me for working on my own than nursing school prepared me for nursing, but it seems like both prepared me enough to get by, and more than I realized, at the time.
It sounds like the OP could use more hand-holding. I don't mean that offensively. I had my hand held a lot, and still do, from time to time. There's a good reason a lot of nurses don't last beyond the first year or two--it's really, really hard! But I hope the OP will find, as I have, that it's worth it. Anyway, as others have noted, there are a lot of things to try before quitting.
It sounds like the OP could use more hand-holding. I don't mean that offensively. I had my hand held a lot, and still do, from time to time. There's a good reason a lot of nurses don't last beyond the first year or two--it's really, really hard! But I hope the OP will find, as I have, that it's worth it. Anyway, as others have noted, there are a lot of things to try before quitting.
I agree. New grads those first few weeks don't need to have assignments of two patients and be ignored. We have a preceptor like that here, they only use when the regular guys are on vacation or call in. She essentially is a "this my patients and these are yours" and ignores the new grad.
The first day I don't even give the new grad an assignment. She/he just shadows and gets used to how I do things, and can take what she/he needs from that. Then I start giving the nurse their own patients to by week 12 to take the entire load. However, I never forget the patient load is mine, I supervise, teach, jump in when I have to. The new grad should never once feel like they are drowning or can't handle their assignment while on orientation. (We save that for the day they are off orientation. :)) j/k
Every day should be a learning experience. Eventually they should know what the real world of nursing is really like, but on week three they definately should not be left alone.
Then I start giving the nurse their own patients to by week 12 to take the entire load. However, I never forget the patient load is mine, I supervise, teach, jump in when I have to. The new grad should never once feel like they are drowning or can't handle their assignment while on orientation. (We save that for the day they are off orientation. :)) j/k
Drowning was exactly the right word for me that day. Thanks to everyone who has given me his/her advice. I decided that I will quit the job. There was another incident on my third day that pushed me to the limits.
Oh, crap! Had my first orientee, last night. His intended preceptor called off. I think I was probably too easy--he only has two weeks left. On the other hand, we all need an easy shift, now and then. Anyway, he was able to handle his three pts with minimal oversight. CN pointed out he had a little too much downtime, though. I should have given him at least one of the new admissions--that would have kept him busier. Maybe both, and come to his rescue if he needed it. Drowning is no good, but you have to get out of the kiddie pool sooner or later. Then again, I was a substitute, so the big thing is I didn't do any harm that can't be fixed when he's back Monday night.
Sorry things aren't working out, Firefox. Sometimes bailing is the only good solution, and it isn't like there aren't other jobs. Best of luck in the next.
An Update: I have found my "home." It really makes a BIG difference if the preceptor you're working with is very supportive and helpful. Gradually, I am learning the routine and I love my job. :roll
debbyed
566 Posts
I agree with Shammy. Go through the appropriate motions first, even if it means changing preceptors. It is not unusual for new grads to switch preceptors when they are concerned that they are not getting the attention they need. It's possible you preceptor never had a preceptor class and is unaware of your preceptions. With any career, go throught the appropriate motions first, than move on if you can't work things out.