Very Confused about first job-cont. of very nervous first job. HELP!

Published

Hi Everyone,

Here I am again. Thanks so much for the words of encouragement last night, now another possible road block and please be honest with me about this, especially the seasoned nurses out there.

I called to clarify some things regarding orientation and preceptor time. She tells me that the orientation would be a 2 day unit orientation and then 2 to 3 days orientation and preceptor with a nurse. I could ask for an extra 2 days if I didn't feel comfortable after 3. I asked her if she realistically thought that was enough orientation time for a new grad. She said yes in most cases, but then went on to describe that it was fast paced like an ER. I knew it was fast paced because the DON discussed that with me, but 2 to 3 days, I don't know about that.

I fortunately did not put all my eggs in one basket and interviewed with a drug rehab facility today and got offered a job per diem. There are two of same facilities and I offered to float between the two and be "on call" also. The pay is the same. Orientation is 2 weeks, but the nurses role is not as in depth. We mainly do assessments, pass meds, hang IV meds and start IVs when needed. I know psych is not such a great place to start but that is what I did prior to getting into nursing and I need a job. I figured I could also search per diem at the local hospitals which may be easier to get than full time. Help me out here. What is the reality of the situation. Please, feed back quick as I have to decide by tomorrow.

Up Vote Up Vote ×

WOW! Only 2-3 days of orientation!?! As a new grad I had 12 weeks, with the oppurtunity to lengthen that if I needed. That seems frightening to be on your only after such a short "orientation". By orienation they do mean shadowing a nurse, right?

Up Vote Up Vote ×

My first thought is that it may be hard to find per diem in a hospital as a new grad. Per diem usually offers a quick orientation to the specific hospital policies and they expect you to hit the ground running as far as skills.

As for the job you are considering backing out of . . . I'd like to hear what nurses who are working in those environments say and I apologize for not being able to offer you much help. When I did hospital/LTC, we did primary nursing, and really did most of the care. From what I can gather, most of that care is now delegated to CNA's and LPN's with the RN overseeing things. If that's the case, you will need good delegation skills and can improve your hands on skills by working alongside the staff.

You mentioned that you want to stay in a job for a least a year. While that is a good thought, some jobs just don't work out. While "job hopping" does not look great on a resume, starting a position and then leaving because it just wasn't the right one for you isn't teh worse thing.

So, what decision do you make? The orientation they are offering you isn't great, especially for a new grad who usually comes in with minimal supervisory skills. If you can manage financially in the drug rehab, it may be a better start to gain your confidence. Just don't expect to supplement with hospital per diem work as a new grad.

And if I am wrong about all this, someone let me know . . . I have not been in a hospital/LTC setting in a long time. The loss of primary nursing makes me a little sad . . . . . . .

Up Vote Up Vote ×

O.K. so I've been thinking. Drug rehab drop wants me to meet with HR tomorrow to get the paper work rolling. Facility orientation for SNF is on Wed and Thurs.

Actual floor orientation with the nurse would be Mon, Tue, and Wed, and the extra 2 days if needed. I am thinking of trying out the first week at SNF and see how I do. If it doesn't go well I can leave and still have the per diem at drug rehab. I will just tell them that I can't start being on call until the 1st of June. At least it will be a fall back and in one way or another bring me in a paycheck which I desperately need. It will also give me time to look into some other psych facilities for extra per diem or tech work. Does that sound like a decent game plan? The 2 to 3 day orientation just blows my mind ---- WOW they must expect us new grads to be the next greatest thing, huh. I think I can handle the supervising and delegation o.k. It is just time management with admissions and discharges. Also maybe I should speak with the ADON in greater detail about what exactly my job description is a registered nurse. Any comments, suggestions?

Up Vote Up Vote ×
Specializes in Psych, Informatics, Biostatistics.

Orientation sounds too short. At Temple we have one month's orientation on the Psych unit. I can't imagine what it would be like for a new grad to go to an SNF or Med/Surg unit with three days orientation. It seems like they are setting you up for failure.

Your plan seems pragmatic. Advice: do it.

Spending a week at the place then telling them you feel uncomfortable is just fine. Please don' t feel guilty about getting the orientation then leaving. You won't be the first.

Up Vote Up Vote ×

Hello, OneLoneNurse,

I feel the same way about the setting up for failure thing. I think my orientation may have been shortened at the rehab (drug) because I have worked in drug rehab in another capacity an am familiar with the charting and dealing with detox patients. Basically it is meds and assessment. I do feel comfortable with that orientation time, plus at least there will be other RN's there if I need anything. At SNF I will be the only RN on duty - me, myself and I as a RN, after 3 days of training. You know what, that is down right freaking scarey! I may have book knowledge and some clinical experience but I do not consider myself competant to be handling patients lives on my own. These places really scare me. Imagine being a family member of a patient finding out that the nurse treating your loved one just graduated nursing school and has only recieved 3 days on the job training. I don't know whether to laugh or cry.

Up Vote Up Vote ×

The one faciliity I thought was horrible would only orientate new grads for 2-3 shifts- that's IT. This place also had the most lawsuits and was ranked a 1 star facility.

The job were I learned HOW to be a nurse (my first LPN job) gave me 6 weeks, yes 6 weeks of orientation. The last 4 weeks I was on my "own" but the nurse was always behind me or in the corner making sure if I had a problem, she was there. She would ask all the other nurses if they had stuff that was unusual for me to see or do myself. I LOVED that facility but had to move on when I needed another work schedule for school.

I don't think 3 days is enough for any new grad- RN or LPN. What is this facility ranked from state? There is so much to learn. Yes passing pills is one thing but it is ALL the paperwork, doc orders, labs, when to call, who to call, appts, admits ect.. If you do decide to stay there, demand more time. Don't ever think you don't deserve more time. You only have 1 license and you worked hard for it.

Up Vote Up Vote ×

changeofpace,

I went online to see what the facility ranking is (I can't find it). I went on Fldoh and google. I did find a report and noticed that their pressure sore for long and short term patients were above the florida and national average.

My next question to anyone is how do I go through this 3 day orientation without putting my license at risk. Should I insist that someone is with me at all times and checking everything I do. If I am going to get only 3 days, I feel sorry for the person orienting me because they are gonna get pelted with questions. You are right I worked hard for my license and I am not willing to compromise it for a facility who is willing to compromise it's patients care by hiring new grads and throwing them out there with 3 days experience.

Up Vote Up Vote ×

Are you saying they hired you, as a new grad, to the the RN supervisor for the building? I'm sorry, no matter how much "book learning" you have, I think that's crazy and a dangerous situation for you, the LPNs and the patients. I think before you become a supervisor you should have a minimum, bare minimum of 1 year acute care experience, and ideally much more than that.

Up Vote Up Vote ×

Yes, I would be responsible for patient care and for supervision and delegation of assignments to the LPN/LVN and CNA's. The actual title is RN-Supervisor. I would be the only RN on the subacute end from 7p to 11p. The ADON is there til 4:00 so they say there is only a 3 hour window and that I can ask for help from one of the nurses from the residential end. I don't know, this is a bit scarey. It seemed like an awesome responsibility for a new grad, that is why I was suprised they hired me. Honestly my first concern is the patient. I don't want to put any one at risk because I am not trained properly and I don't want to lose my license either. I have decided to call ADON tomorrow can anyone offer me any suggestions for questions I should ask regarding this whole situation?

Up Vote Up Vote ×
Yes, I would be responsible for patient care and for supervision and delegation of assignments to the LPN/LVN and CNA's. The actual title is RN-Supervisor. I would be the only RN on the subacute end from 7p to 11p. The ADON is there til 4:00 so they say there is only a 3 hour window and that I can ask for help from one of the nurses from the residential end. I don't know, this is a bit scarey. It seemed like an awesome responsibility for a new grad, that is why I was suprised they hired me. Honestly my first concern is the patient. I don't want to put any one at risk because I am not trained properly and I don't want to lose my license either. I have decided to call ADON tomorrow can anyone offer me any suggestions for questions I should ask regarding this whole situation?

No WAY would I do a supervisory role as a new grad. All those workers work under your license. If an emergency happens the CNA's and LPN's will look to you for help ect.. Are you in the Tampa area? It almost sounds like a facility nearby:no:

Up Vote Up Vote ×
No WAY would I do a supervisory role as a new grad. All those workers work under your license. If an emergency happens the CNA's and LPN's will look to you for help ect.. Are you in the Tampa area? It almost sounds like a facility nearby:no:

I'm in West Palm Beach. You know what, since I am a new grad I haven't developed the foresight of what you mentioned which really has swayed me to make my final decision to not venture into this unless the ADON offers me a full 8 to 10 week preceptorship. I did not think about my license being on the line through my delegation of resposibilities. See I haven't even begun to see the ramifications of certain things yet. Thank goodness you nurses with the experience are here to help me protect myself from things I am not yet aware of. I will explain to her that I think it would be placing myself, the facility and the patients in a potentially dangerous position. If they will take me up on the extended time, I'll go, but if not, this IS DEFINATELY NOT A GOOD IDEA AT ALL!!

Thank you so much for shedding light on the situation. I just got my license, it took a lot of time, money and hard work and is the license that will ensure that I have future employment. I cannot and will not put it at risk. Bottom line --- they want a "body", I'm not even sure they want a brain to be honest with you.

Up Vote Up Vote ×
+ Join the Discussion