What's a good length for orientation for an IMC?

shoegalRN, RN · Oct 8, 2010

Seems to me your NM is telling you in so many words that your current unit is not a good fit for you at this point. Maybe she was given written reports by your preceptor or co-workers about your "mistakes" and you were not made aware of this.

So instead of firing you, she wants to place you in another unit that is less critical to learn your basic skills. I see nothing wrong with this. Build your foundation and if critical care is something you want to do, go back when a year of experience under your belt. However, I would do critical care at another hospital.

Good luck!

Kitty Hawk, ADN, RN · Oct 8, 2010

Hi and thanks...

I really don't think it was sabatouged however my husband does Everything was discussed on the up and up. Things I should have caught, what I've needed to work on etc...and they know I'm a hard worker. I agree I was given an uphill battle to fight coming from LTC, everyone told me that...but everyone said they all felt like that. She told me just Tuesre day that I was were I should be, that I'm expecting more than they are of me. That surprised me. But no doubt I was stressed and it's a high anxiety floor. Honestly I knew I would leave after x amount of time I just wanted that experience and I loved learning the specialized info although there wasn't much time to really dwell on it there...that was at home studying.

My husband is ticked and quite funny, he thinks I should just quit...go back to my previous career. I don't know, I'm not making any hasty decisions. I do know bedside ultmately isn't for me but you have to do your time I suppose.

Sort of ironic too, b/c I was told most new nurses have tunnel vision in regards to the alarms and to retrain myself. I was getting much better with this, in fact I caught another nurses pt who was desatting in the 70's b/c they took their face mask off....the nurse was at the station having a b!tch session about something personal...I guess that can happen, but I was being taught there's no room for that sort of error.

I just really don't feel like it was a fair amount of orientation. Our ER people get 6mos. New or not. I'm just hoping it's for the best for now. I am really upset about the days/hours. That's not what I agreed to...I may have stayed at my other place longer to get a better situation. Hours and time w/my family were/are very important. I feel betrayed, maybe I shouldn't but I do.

I agree, I won't work for that hospital's critical care. In fact she's not the NM that hired me, she left to greener pastures at another hospital. I would definitely consider working for her in the future. I have a hard time with people w/forked tongues.

tyvin, BSN, RN · Oct 8, 2010

It is nursing politics as usual and I must concur with afrocentricRN. It sounds like they are attempting to do you a favor in so many words. In short you didn't cut it and I believe from what you wrote she's giving you another option. Take the ortho floor position and try it for awhile. The fact that they have invested so much time and effort into you is something I would be thankful for.

Your writing style reveals to me that you are very detailed oriented and take things personally but not necessarily being able to keep to the facts in a succinct manner. Critical thinking skills can be developed on an ortho floor and then when you are ready perhaps you can transfer to the position you wanted originally. Take this as a learning opportunity.

As far as people with forked tongues; you better gear up; this is nursing and is very competitive. Yes I know we're all suppose to be rosy and smiley etc...world peace and so on lol. As far as a "fair" amount of orientation time; there is no such beast. If you're not getting it after 2 weeks and then expelling forward very quickly you will be left in the dust IMO.

Kitty Hawk, ADN, RN · Oct 8, 2010

It is nursing politics as usual and I must concur with afrocentricRN. It sounds like they are attempting to do you a favor in so many words. In short you didn't cut it and I believe from what you wrote she's giving you another option. Take the ortho floor position and try it for awhile. The fact that they have invested so much time and effort into you is something I would be thankful for.
Your writing style reveals to me that you are very detailed oriented and take things personally but not necessarily being able to keep to the facts in a succinct manner. Critical thinking skills can be developed on an ortho floor and then when you are ready perhaps you can transfer to the position you wanted originally. Take this as a learning opportunity.
As far as people with forked tongues; you better gear up; this is nursing and is very competitive. Yes I know we're all suppose to be rosy and smiley etc...world peace and so on lol. As far as a "fair" amount of orientation time; there is no such beast. If you're not getting it after 2 weeks and then expelling forward very quickly you will be left in the dust IMO.

Haha. YES! you nailed it for me. I am DO. It was a must in my previous job so I guess 20+ years of practice.

Honestly I'm not sure why I was killing myself to fit. TBH I loved the people, many of the job aspects. Many more, not so much...that's why I say no matter what I know bedside isn't for me. Seriously, why are hospitals over run w/obese people? I mean we had 2 that weighed over 400lbs. I have no idea what to expect on ortho, I can't imagine being able to to help someone really obese to the BR, I'm built slight and no lie it's hard for me to turn people like that etc...all by myself.

I wonder if down the line you can go from something less critical to a NICU or PACU or if ICU is pre-req for that as well. If not I may rethink my need to have critical care on my resume. Maybe you can move onto non hospital nursing jobs w/o ever worked critical care. Then again, I'm actually back to rethinking my nursing career and am thinking on my husband's suggestion...I know nursing can be competitive, but no wonder there's such dis satisfaction anymore...and life's too short for that.

Oh and wow! 2 weeks? that's insane for a new nurse. I graduated last year and pretty much a lot of my info is all being re-remembered.

opensesame · Oct 9, 2010

I can't really speak for your job performance but IMO you didn't get enough orientation to an area like that. Not sure what type of setting you came from or if you are a new grad, but regardless, one month on the floor if you haven't been in a setting where you need to read monitors or run gtts is not much. I do not think it was fair for a manager to put you through two weeks of classes and then give you 4 weeks on the floor and that is the end of it. I don't know if this is standard or not, but that seems awfully short to me. I am thinking like ~2 months on the floor or more seems a little more reasonable.

However --- I don't know if your NM decided based on your initial performance that you weren't going to be able to get up to speed, or perhaps she has a "little bird" somewhere on the unit backstabbing you. It's extremely hard to discover those types of politics in your first few weeks on the job -- they are usually covered up pretty well, at least at first. If that is the case, you probably don't want to work there anyway.

It's just hard to say. I'm sorry you are going through this. Hopefully the ortho position will work out for you. Best of luck --

Diane

DeLana_RN, BSN, RN · Oct 9, 2010

First, :hug: This is a tough experience, but unfortunately not unusual in nursing. I have had a similar experience, on a similar floor (very poor orientation, told I was doing fine, then encouraged to transfer with no good explanation). Like you, I'm very detail oriented, and I guess that wasn't appreciated since it resulted in some OT charting after shift end...

In your case, you orientation was (a) too short, especially coming from LTC; 12 weeks on the floor would be more realistic; (b) a bad preceptor is no better (or worse) than no preceptor at all; © there is definitely more going on than they're telling you (backstabbing? Spying? Reporting to NM? Better believe it). Summary: Good riddance to a bad job/unit (but I know this doesn't make you feel any better right now).

As for the transfer: The only reason why I would advise you to take it is that it can be difficult to explain to a prospective employer why you are no longer working in this hospital (assuming you didn't take the transfer); they said you didn't work out... but since they have a transfer already arranged, they are clearly expecting you to take it. Of course, you're not an indentured servant, and don't think you owe them anything for your "training". However - there is always the problem of what kind of a reference they would give you if you decided to leave.

An ortho floor is probably not easy either, you will have a lot more patients than on stepdown. If you decide to transfer, I would work there just long enough to have it look good on my resume and then quit. On the other hand, it's not really necessary to work in acute care to get work outside of a hospital.

Best of luck to you, let us know what you decide to do.

DeLana

shoegalRN, RN · Oct 9, 2010

Hi and thanks...
I really don't think it was sabatouged however my husband does Everything was discussed on the up and up. Things I should have caught, what I've needed to work on etc...and they know I'm a hard worker. I agree I was given an uphill battle to fight coming from LTC, everyone told me that...but everyone said they all felt like that. She told me just Tuesre day that I was were I should be, that I'm expecting more than they are of me. That surprised me. But no doubt I was stressed and it's a high anxiety floor. Honestly I knew I would leave after x amount of time I just wanted that experience and I loved learning the specialized info although there wasn't much time to really dwell on it there...that was at home studying.
My husband is ticked and quite funny, he thinks I should just quit...go back to my previous career. I don't know, I'm not making any hasty decisions. I do know bedside ultmately isn't for me but you have to do your time I suppose.
Sort of ironic too, b/c I was told most new nurses have tunnel vision in regards to the alarms and to retrain myself. I was getting much better with this, in fact I caught another nurses pt who was desatting in the 70's b/c they took their face mask off....the nurse was at the station having a b!tch session about something personal...I guess that can happen, but I was being taught there's no room for that sort of error.
I just really don't feel like it was a fair amount of orientation. Our ER people get 6mos. New or not. I'm just hoping it's for the best for now. I am really upset about the days/hours. That's not what I agreed to...I may have stayed at my other place longer to get a better situation. Hours and time w/my family were/are very important. I feel betrayed, maybe I shouldn't but I do.
I agree, I won't work for that hospital's critical care. In fact she's not the NM that hired me, she left to greener pastures at another hospital. I would definitely consider working for her in the future. I have a hard time with people w/forked tongues.

I think it was a combination of the following:

-not enough orientation

-bad preceptor

-someone backstabbed you

I had the same experience when I started off as a new grad in the ICU. I had a "few" preceptors and two were really bad. Both of the bad ones sent emails to the nurse manager, the educator and the charge nurses about my "mistakes". I was told to my face "oh you are expecting too much of yourself, relax some", only to have it used against me as a reason why I missed important findings. I was told I should watch the monitor more, and when I started doing that, I was told I shouldnt run to the patient's room at every alarm on the monitor. I couldnt win for losing.

I transferred to the ER and couldnt have been happier.

That unit was full of cliques, gossiping and backstabbing. They would literally talk about each other all the time and all the mistakes that person has made and then when that person would come around, they would be like "hi, how's it going" blah, blah blah. I simply didnt "fit in" and no matter what I did, it was wrong simply because they just didnt "like me".

The last straw was when one of the preceptors wrote a long drawn out email to the director and she forgot to log off the computer. Another co-worker saw it, called me at home, and told me to ask for a transfer STAT because she is pretty sure they are gonna try to get rid of me. I beat them to the punch, applied for ER, met with HR and told the director I'm out of there. She was pretty suprised because I beat her at her own game. She tried to give me that spill about "I would love to hire you back after a year on the floor" and I told her I simply have no interest in working in critical care ever. If I did, it sure would be at another hospital.

Be grateful they are allowing you to transfer to another unit. Learn all you can on the floor and then apply for a critical care position at another hospital. Start fresh with new co-workers and you won't be so green by then. Things may work out in your favor.

Good luck!

Kitty Hawk, ADN, RN · Oct 9, 2010

Hi Diane and DeLana

What's a reasonable time? I'm thinking I need to try for at least a year, but is 6 mos still respectable? Diane, I came from LTC and not really a great learning tool. I'd have an occ. IV fluid. I had 1 peg tube, and one person with a sm. pca pump. Other than that, it was pretty much psych.

She claims if she had a spot, she would have hired me to the ICU b/c there are nurses there that have more experience, like my preceptor. But who knows.

The people really seemed wonderful. Although they'd make snarky comments about LTC and those nurses in general, so how nice is that? I can't stand when one speciality thinks they are so much better than another.

It probably has something to do with this not being my original hiring NM. And the fact the usual preceptor was still precepting someone else, so they set me up with someone who had 2 years herself and never precepted before. I think she was really great, I really have nothing bad to say about her, I just don't think she has the ability to tone it down to teaching level. I knew nothing coming in.

You're right though, nothing much is helping the feeling of failure right now. I have no idea how I'm going to walk into the hospital in different colored scrubs! I wish I never went through that if it couldn't pan out...y'know pride and all that but mostly I'm upset with the hours. At least I'll still have 2 weeks of daylight....but I seriously can't stand 3-11.

Talk about feeling like you're life has been turned upside down. My husband still can't get over that they can hire you for one thing and move you to another....he thinks that's deception at it's finest....yeah well, welcome to the hospital.

Thank you for saying I didn't get a decent orientation time. I didn't think so either. I think I would have improved even further in another week....however the stress was getting to me, even hitting me in malls etc...so maybe it just not a good fit. They claim they all went through throwing up and crying before/after work...but still maybe the heart of it is you need to love being an adrenaline junkie...and that I don't.

Kitty Hawk, ADN, RN · Oct 9, 2010

I think it was a combination of the following:
-not enough orientation
-bad preceptor
-someone backstabbed you
I had the same experience when I started off as a new grad in the ICU. I had a "few" preceptors and two were really bad. Both of the bad ones sent emails to the nurse manager, the educator and the charge nurses about my "mistakes". I was told to my face "oh you are expecting too much of yourself, relax some", only to have it used against me as a reason why I missed important findings. I was told I should watch the monitor more, and when I started doing that, I was told I shouldnt run to the patient's room at every alarm on the monitor. I couldnt win for losing.
I transferred to the ER and couldnt have been happier.
That unit was full of cliques, gossiping and backstabbing. They would literally talk about each other all the time and all the mistakes that person has made and then when that person would come around, they would be like "hi, how's it going" blah, blah blah. I simply didnt "fit in" and no matter what I did, it was wrong simply because they just didnt "like me".
The last straw was when one of the preceptors wrote a long drawn out email to the director and she forgot to log off the computer. Another co-worker saw it, called me at home, and told me to ask for a transfer STAT because she is pretty sure they are gonna try to get rid of me. I beat them to the punch, applied for ER, met with HR and told the director I'm out of there. She was pretty suprised because I beat her at her own game. She tried to give me that spill about "I would love to hire you back after a year on the floor" and I told her I simply have no interest in working in critical care ever. If I did, it sure would be at another hospital.
Be grateful they are allowing you to transfer to another unit. Learn all you can on the floor and then apply for a critical care position at another hospital. Start fresh with new co-workers and you won't be so green by then. Things may work out in your favor.
Good luck!

WOW! I'm stunned at some of the politics. I can relate to a lot of that. I was told that anxiety is normal...but you know the rest! That's interesting you didn't experience that in the ER. So they may hire someone with a year or so of med/surg ortho?

I have that on the backburner of my mind. I'm not sure if you have to be a true adreneline junkie for that too or what. I thought maybe you'd have to graduate to a step down unit or something. But the get-'em-in-get-'em-out appeals to me. As does NICU or PACU...things that don't involve heavily turning q 2 H etc.... I know I'm going there...and that's why I'm not sure how long I'll last being I didn't sign on for that.

I know the one poster said to get used to the backstabbing etc....but no, I'd never work for this NM again. I don't think it's cool to be smiling and telling me we'll talk about my last precepting weeks plans and have my preceptor compliment me for the great job and quick thinking under pressure, obtaining the rush ABG etc...and then this. And if it was all lies and I suck...all the more reason to stay away. Thanks for showing me this happens all over. Maybe I won't feel so crappy soon.

opensesame · Oct 9, 2010

What I would do if I were you is stick it out on ortho for a year, or at least give yourself a solid 12 months in the hospital system total before you go somewhere else. Who knows, you might really like ortho, and I bet you don't make any less money, and sometimes you just have to remind yourself of that. I would also ask your current manager (of the ortho department) if you could transfer to days or day/evening or whatever your shift preference is when something comes available...even in this day and age with the job market the way it is, I bet something will change before the year is up.

I'm confused as to whether the manager of this IMC is also the manager of the ICU at this place you are talking about. If that is the case, nah, I wouldn't try to get back in there either. Once bitten, twice shy, as they say. Take this time to think about what you really want for yourself and where you want to go and how your current job can help you get there.

Diane

regularRN · Oct 9, 2010

What does IMC stand for?