Shortened orientation for staffing needs

[Lf1995]

Is it appropriate/acceptable for a hospital to take a nurse off of orientation (newly-hired) simply to meet staffing necessities? Regardless if the nurse has prior experience or not. Seems to be a pattern for new-hires. If a nurse feels uncomfortable agreeing, should they speak up? What would you do?

[llg, PhD, RN]

It really depends on the details.   Sometimes, such things are necessary -- and might not be a big deal if the new nurse only being asked to do things that she is capable of doing.   That is the key.   

If the new nurse has been taught certain skills and can complete certain tasks safely, then it should be OK if she is asked to perform those tasks while still within the orientation period.   However, even a nurse who has been off orientation for a while should NOT be asked to take on responsibilities that she has not been prepared for.

People get too hung up on the phrases "on orientation" and "off orientation."   It's not clear cut.   There is a middle ground of being competent at many tasks and capable of being a huge help -- but not yet 100% finished with orientation.    My favorite system is one that counts people as 100% "out of the numbers" in the early phases of orientation, but then counts them as "partially in the staffing numbers" as  they progress through orientation and become capable of taking on some responsibilities.   The person who is going to be completely "off orientation" tomorrow should be capable of taking an assignment today -- with just a little backup help available if needed.    And someone who "just came off orientation" yesterday still needs some back-up help available.

Exactly what is appropriate and what is not appropriate depends on the specifics of the situation.

[Chickenlady]

Sometimes, things have to be flexible.  Certainly if the nurse doesn't feel ready, they need to speak up and keep a paper trail. 

[Sour Lemon]

As a new graduate, I've had my orientation extended. 

As an experienced nurse:

I've been taken off orientation early for short staffing while the rest of my group stayed on. I agreed to the change, and later found out the rest of my peers had refused.

I've been floated to my hospital's med/surg unit (from psych) with no med/surg orientation, but support staff was good and the nurses I worked with were friendly and helpful. It was a little bumpy, but mostly okay.

At the same hospital as above, I was scheduled to work alone on day two of my orientation in psych (which was a new specialty to me). The people I worked with in that unit were also friendly and helpful and it went fine.