8 weeks of orientation as a new grad and let go

[Magsrnursing]

I was hired, over the phone, as a new grad in the NICU in my home town. I accepted and moved from a large city back to a smaller city to take the position. After 8 weeks, they told me I was not learning fast enough and could not extend my training. I did not have a structured training and was paired up with several preceptors. Each shift was completely different, from critical care 2lb'ers to c-section admits. I had no idea about equipment, scheduling feedings, etc. I did make mistakes but not meds just charting and two mistakes with formula mixing and lab labeling. I was great with drawing labs, starting IV and made it through my shifts on time but never took a break. From week three I could tell my preceptorship were "irritated" with my inexperience and questions. They would discuss me behind my back and not to me. When I asked for feedback I was told I needed to be more organized and faster. I left like I was a outsider trying to stay a float without guidance. My mistake was not talking to the manager early on. Now I was told they will not extend my training and they will try to find another unit for me. Any advice?

[brithoover]

It doesn't sound like a new grad friendly kind of place. If they are not willing to work with you, it's not where you want to be. If NICU is where you want, apply to other NICUs or take a job on another unit and get some experience

[catlover314]

Agree with above that your current unit doesn't sound new grad focused, but a word of caution as you look for a new place...there is also some unspoken sense that you were doing them a favor...'moving from a large town to a small town' to take their job, along with a minimizing of the errors you made along the way. You'll want to avoid that kind of stuff as you move forward as it can come off as lacking accountability. When explaining why you are looking for something else let the new interviewer know that you learned a lot about what kind of structure you need to learn effectively. You don't have to even hint that you need SOME/ANY structure (like it sounds was missing!) but just emphasize what you have learned already and that you want to build on that foundation in a more structured new grad situation. File away those errors you mention in your memory bank...each of them can have just as serious an outcome as a med error (and none should have made it past a good preceptor!). In many places mislabeling meds once gets a written warning and doing it twice gets you shown the door; it can harm the original patient and whoever's name got put on the lab tube. Mistakes in mixing formula can be devastating, depending on the error and who got the wrong stuff and a breast milk error can be a huge mistake. Mistakes in charting can lead to changes in treatment or additional testing. While moving forward, don't minimize those errors, but learn from them and think about what you can do to avoid them in the future. Those are some substantial errors, but again an actively involved preceptor should have intervened. When interviewing, have a list of questions ready for them...are there didactic classes, will you have an assigned preceptor, will you be meeting with the unit educator or manager on a regular basis during orientation...that kind of thing.

[Magsrnursing]

Thanks for the response. By no means was I saying moving from a large city to my hometown of a lesser size meant I was doing them a favor. I was trying to say I relocated for this position. I also realize the mistakes I made were not minor. I just feel I was doing what any new nurse would encounter and learn from these mistakes. I do know the environment of this unit was a malignant one; not new grad friendly. I believe I was not able to fully excel from a lack of structured training as the nurses did not want to train someone without experience. I also know I was thrown into a position that was way over my head as a new grad. But I also now I was hired with them knowing my position of having 0 experience. Today I stand back up, tall and strong and move on. I have learned any valuable lessons. Thanks for your words of wisdom.

[catlover314]

Another idea: check the facility's educational classes section on their web site when considering your options. Do they have preceptor classes for their nurses? And do they have unit based educators? It might signal that they know every nurse doesn't know automatically how to be a preceptor. If they recognize that you would probably find a place that meets your needs better than your first place. Best wishes to you!

[Jory, MSN, APRN, CNM]

RED FLAG: THEY HIRED YOU OVER THE PHONE.

That is just screaming with problems, especially if you lived within a reasonable driving distance.