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Setting my orientee up for failure?

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Specializes in Med-surg/tele. Has 7 years experience.

SmilingBluEyes

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis. Has 24 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, BSN, RN

Specializes in Med-surg/tele. Has 7 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

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

speedynurse, ADN, RN, EMT-P

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

Specializes in Womens health. Has 31 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

Specializes in RN BN PG Dip. Has 21 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.

Edited by maryellen12
grammar

maryellen12

Specializes in RN BN PG Dip. Has 21 years experience.



Being unkind will not help at all. 

All this would do would be to create more stress for the learner.

My guess is that there is enough stress already and stress is not conducive to learning.

cgw5364

Has 33 years experience.

I loved precepting new grads and new hires. I had a new grad very similar to what you are describing very sweet and tons of book knowledge. However, she just could not function on her own. She never could develop a system of organization for herself. She actually had 6 weeks orientation on days and then 6 weeks on nights with me. She was able to go into a patient's room alone and do assessments though. But anymore than that and she would completely shut down. She could not do a patient's assessment and give meds all in one go. She ended up transferring into home care where she could just focus on one patient at a time and this was better for her. I always wondered if she had a learning disability. My high functioning autistic daughter shuts down if I tell her to do more than one thing at a time and that new grad was very similar. 

SmilingBluEyes

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis. Has 24 years experience.

I was far from "useless" as a PRN nurse. I picked up weekend nights for 14 years. EVERY weekend. And I had the nerve to have two kids.

NightNerd, BSN, RN

Specializes in Med-surg/tele. Has 7 years experience.

Thank you all for continuing to share your thoughts and stories - it is super helpful! I was definitely able to use a lot of your suggestions for our last week together. She was a little better with taking initiative on some tasks, and we got a chance to review some topics we previously had no time to cover.

There were some improvements, but I still have some significant concerns, as she seems to feel she is making more progress than I'm seeing from my side. Unfortunately she is off to night shift now, so we'll see if maybe the new shift will help her get a better grasp on things. If not, I'm hoping my manager can help her get some share time on a less acute floor; I do think she's coming along, just not far enough for this unit at this time.

Sounds like a tough situation for everyone involved. Hope you find a solution that works for everyone.

sleepwalker, MSN, NP

Specializes in Occupational Health. Has 17 years experience.

"I do think she will be a great nurse someday, but this is a smaller, weirdly fast-paced unit where she will not have the kind of support she will probably need"

You answered your own question...she has a place in nursing just not the one where's she currently located

Hannahbanana, BSN, MSN

Specializes in Physiology, CM, consulting, nsg edu, LNC, COB. Has 51 years experience.

My initial impression after your description is that she’s still operating at the student level- needs constant reinforcement, afraid to take initiative, can’t enter a room s the instructor, doesn’t trust herself, imposter syndrome. There’s a middle ground between handholding and sink or swim/drowning. You got one really good script on specific feedback to get her focused, and there’s a time where “Get in there and do this yourself” is going to have to occur. 

One of the most memorable comments made by a nursing instructor... "Before the NCLEX and results were available online, we had a nice, long time on orientation". They spent months waiting to see if they passed the exam and worked alongside their experienced peers while waiting. I feel sad that new grads are denied the time necessary to earn their wings. It's not your fault.