The Newly Off Orientation Blues

[Work in Progress]

I just finished my first week off of orientation and I am slightly frustrated with the way things are going (nothing new for a new grad, right?) I just wanted to vent some of my frustration to people who most likely understand.

Because we are a hospital that is the "safety net" for our area and a lot of our patients are uninsured or underinsured, we have a lot of patients on the floor right now that are placement issues and need to find nursing homes that will accept them and get their Medicaid/Medicare applications finished before we can transfer them. These are a lot of people who have no real acute medical needs and just need supervision and assistance with ADLs.

On our 20 bed floor, there are 7 patients who are placement issues. During orientation and my first two shifts as an RN, every day at least 2-3 of my 5 patient load were placement patients. I don't mind caring for them in the least, but I think it severely hindered my orientation. None of them have IVs, none of them need wound care, etc. I am also a night shifter and these patients tend to sleep all through the night. The only problem I had been having was boredom. Then, because we are short staffed on days, I got put on some random day shifts.

Last Friday I went to work during the day, I had 5 patients who DID have acute medical needs. I was completely unprepared for this. I have to say I did pretty well considering, but I felt cheated by not being adequately prepared for this assignment. I discharged 3 patients and got 3 admits. They were all fairly complex d/cs and admits. I was running my tush off, had a disagreement with a PA that is fairly abusive to nurses (he is on probation for it) and he was a jerk. Not to mention that I had worked NOC on Wed and had to work a day on Fri. I was happy for the more intense pace, as I was starting to worry about how challenging this job would be. But I wish I had had a bit more training on the actually acutely ill patients, so that I was not completely thrown to the wolves.

This is already a novel, so I will post my other issues in another thread. Thanks for listening! I know it will get better, and maybe I can talk to the educator about the deficits in my orientation and help make some changes for the next people.

[mystic33]

First week off orientation with 5 pts already, wow! You must be a super nurse already for sounding so calm with 5 acute pts, kudos to you.

[Work in Progress]

Haha, maybe if super nurse spends her only 5 minute break on the shift crying in the bathroom. We are supposed to have 5 pts mostly independently (with supervision) by week 8 of a 12 week orientation. So, I had been having 5 for a while, but they had been 2-3 placement patients.