Setting my orientee up for failure?

Updated:   Published

You are reading page 2 of Setting my orientee up for failure?

LibraSunCNM, MSN

1,616 Posts

Specializes in OB. Has 10 years experience.
4 hours ago, NightNerd said:

Honestly I feel like this hospital in general is a little insensitive to the needs of new grads, just based on observations of others' orientations. The words "sink or swim" and "let her drown" have been used to describe management's ideal approach to this particular nurse's orientation at this point, which seems very unhelpful and cruel. 

How sad!  It sounds like management would rather let patient care suffer or be outright unsafe, in order to avoid doing the work of supporting the new grad and/or having difficult conversations with them.  You sound like you're doing an awesome job, I honestly can't see from your posts what more you can do with the situation you've been handed.

NightNerd, MSN, RN

1,129 Posts

Specializes in CMSRN, hospice. Has 9 years experience.

@NurseBlaq yeah, this is a med-surg/telemetry unit, ratio 1:4. We are up to four patients in week 8 per our educator's grid, and I asked if I could bring her back down to three or even two for a little while, but no dice. I also asked if there was any room to extend her orientation and was told there is not.

Thank you everyone for your feedback! I will do my best with the little bit of time I have left before she moves to nights. I took some of your suggestions and shamelessly stole your wording when we debriefed from our shift tonight. We'll see what the rest of the week brings!

NurseBlaq

1,756 Posts

Well, you tried. It's up to her to pick it up if she wants to be there.

Has 18 years experience.
13 hours ago, NightNerd said:

We are up to four patients in week 8 per our educator's grid, and I asked if I could bring her back down to three or even two for a little while, but no dice. I also asked if there was any room to extend her orientation and was told there is not.

Based on this, and previously dismissing the concerns you and your peer have shared, I feel like your manager and educator will likely push this lady through just to have a warm body. Staffing problems solved! That's really disappointing.

If that ends up being the case, don't add fuel to the gossip fire when people bash her poor performance by telling them your concerns from orientation. Just continue being kind and encouraging when you see her at shift change.  She's definitely facing an uphill battle. 

RNNPICU, BSN, RN

1,261 Posts

Specializes in PICU. Has 17 years experience.

I wonder ishowing her a progession time line would also be helpful.

It sounds like you have taken all of the right steps to ensure your orientee's success.  I wonder if this is something where this orientee might need to be told that during a specific shift they need to do everything and you are available but for assessments, meds, balacing patient load is on them.  Obviously you will be following behind the scenes but to let them not check with you for everything.

 

Maybe have a lunchtime check-in that shift and see where they are at.

I think being very clear on the expectations for the shift is helpful and the orientee understands that they are the RN responsible for managing time. 

 

Jedrnurse, BSN, RN

2,776 Posts

Specializes in school nurse. Has 31 years experience.

Not everyone who passes the boards should be a nurse, nor is everyone who passes the boards able to be a nurse.

It sounds like you've gone above and beyond- why do you think you've failed?

SmilingBluEyes

20,964 Posts

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis. Has 26 years experience.

I have a bit different perspective as the "orientee." Hang tight, I am trying to help here.

I am far from a new grad and about 2 years ago, I applied for, and got, a new job in outpatient infusion. I was super excited as this was what I wanted for a long time. I just knew this was the last job I would do before I finally retired.

Well, about 8 weeks into my orientation,  it just seemed I was not getting it as fast/well as expected. I just did not seem to learn/move fast enough. It was hard to swallow, having been a nurse for 22 years at the time, that I was a poor fit for this unit;   I had to admit to myself I was not meeting expectations.

I did wind up ending the orientation, and resigning, no harm, no foul. I left on good terms with everyone, manager included.

Some people are just not a good fit for many reasons. In another unit, same specialty, I may have done better. Who can say? Sometimes, personalities don't jive. Sometimes, expectations are more than we can meet.

Rather than fight it, I moved on. I licked my wounds and found my way back to self-respect and happiness.

8 weeks in, a preceptor (and most of the nurses in a unit) can tell if a new orientee is "getting it" or not;  that is the moral of my story.

It is not all you and (rarely ever is). The orientee must be a self-starter and have initiative as well as be a good fit for their unit to succeed. Hang in there, keep trying but keep in touch with your manager about how it's going and let him/her help decide if this nurse is going to work out or not.

I hope this helps.

NightNerd, MSN, RN

1,129 Posts

Specializes in CMSRN, hospice. Has 9 years experience.
2 hours ago, Jedrnurse said:

Not everyone who passes the boards should be a nurse, nor is everyone who passes the boards is able to be a nurse.

It sounds like you've gone above and beyond- why do you think you've failed?

@Jedrnurse maybe "fail" is an excessively dramatic word choice, LOL. I've been trying my best and have put a lot of effort and thought into how to help this nurse. However, I'm also really glad I posted here and got all of these responses, because I'm seeing opportunities to do even better in the future. Hopefully it will be helpful for this orientee, and it will certainly be good for any other nurses I precept. I've also finally been able to sign up for a preceptor workshop at my hospital (have been trying for a while but it never jived with my work schedule).

I really do enjoy orienting new nurses, but this experience has me questioning my ability to do that. While I know that 10 or 12 weeks doesn't automatically turn new grads into full-fledged seasoned, confident nurses, I've never had an orientee I've worried about this much at this point in orientation. I just want to know I did everything I could to make this a successful learning experience for her. Based on the feedback here, I feel better about what I've tried to do as her preceptor; I just wish there had been more consistent involvement from our manager and educator from the beginning.

Ruby Vee, BSN

67 Articles; 14,022 Posts

Specializes in CCU, SICU, CVSICU, Precepting & Teaching. Has 40 years experience.

Sounds like you did a great job. The only thing I can think of is maybe meet with her at the end of every shift to go over what she did right and where she could improve. Are you meeting at the start of the shift to plan the day?  That might help some. And document!

If she has a night preceptor it might be a good  idea to meet with her to discuss strengths and weaknesses as well

Specializes in ER, Pre-Op, PACU.

This may sound bad but sometimes it’s important to be straightforward and honest with a preceptor and preceptee. I actually had a great preceptor when I was a new grad in the ER. She and I communicated well and for the most part, she did a lot to encourage me and help me prioritize. However, at a certain point in orientation, she was straightforward with me.....and honestly, it made me such a better nurse. I think our personalities meshed well enough together that we could be honest (sometimes to a fault) and this actually ended up helping both of us. I know I actually needed to hear my weaknesses and what I needed to work on to truly propel me forward. There is a thing as being too nice to the point of not being honest....however, some preceptors go the other way and end up crushing their new grad. It sounds like you are a really conscientious preceptor - I just wanted to chime in my two cents!

RN-90

3 Posts

Specializes in Womens health. Has 33 years experience.

I am curious to know the orientee's perception of how she is doing.

This is tough, but I agree with the others--clear expectations, lots of follow-up.  Which you are doing.  Another consideration--it would be nice if your hospital had a preceptor    class.

maryellen12

51 Posts

Specializes in RN BN PG Dip. Has 23 years experience.

You may have already tried this, but I am wondering if the new grad.  is a visual learner. They may be struggling to take new  information in through auditory processing.

This problem may be exaggerated through fear of making a mistake, an overall anxiety of working in a new environment, along with the anxiety around the expectations that need to be met. 

I would get the new grad. to write everything down in a time table with extra written points on the details that must be checked as part of her role.

Encouraging  her to follow the  documented notes of importance and a timetable may help the new grad to get past the auditory learning process. 

If the new grad. is too anxious to absorb and remember verbal instructions  the routines and prompts on paper may help them to get past their anxiety?

 They would need to speak with you when needing help but  visual learning aids may help them to learn.