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Orientation

Jennifer, a new nurse living in Michigan, found her first months on the job a refreshing change from the waiting period between school and taking the boards. Like most of the new nurses we talked to, Jennifer was going through an orientation program at her hospital. She said she was disappointed that her orientation was not for new grads only, but that the nurses on the NICU unit she was working with were helpful and encouraging.

"The nurses on the unit are very welcoming and answer my questions. I have received a great deal of advice from many of them," she said.

The wait after she graduated was nerve-racking for Katie from Ohio as well. When it came time for orientation at her new job, she was relieved. "I felt as though my whole life was on hold," she said. Once there, she had nothing but good things to say about her hospital.

"The biggest thing that has surprised me is the overall positive and uplifting attitude throughout the whole hospital. It seems like the hospital has done everything it can to make life easier on the nurses," she said.

Katie is also on an internship at her hospital, with a six-month orientation.

Rebekah, a new nurse working at a small hospital in Illinois, has had to make the transition from training at a fast-paced medical center in Chicago to a smaller hospital in the suburbs.

"What surprised me the most was the day I saw my first metal bedpan," the new nurse said. "I thought it was a joke."

But she also was surprised at how the small hospital manages to keep up with medical technology where it counts.

"The small hospital does a wonderful job staying up with medical advances, while keeping what works for them," she said.

Bait and switch

Most new nurses we talked to appreciated the opportunity to be a part of longer orientations geared toward new grads, but some were not as happy with their programs. Orientation, when it involved mostly classroom activities, was boring and disheartening. The new grads came out of school excited about being nurses and ready to care for patients, only to end up in a classroom for weeks.

When asked what they wished they had learned in school, their wish list ranged from how to communicate with physicians to simple tasks such as how to tie restraints or administer IV push drugs.

"I wish so many of our tests had not been multiple choice," one new nurse said. "I think I would have had a better concept of how to care for a patient with a certain disease if the answer wasn't sitting directly in front of me because in real life, there are no multiple choices."

Other new graduates said they did not feel well prepared by their new employers either.

"I was told that, during my orientation, my preceptor would have a smaller patient load to allow time for [my] orientation to policies and procedures," said Erin, a disillusioned new nurse from Colorado.

Erin found it frustrating that she was left on her own while her preceptor was admitting new patients.

"There have been only a few days where we have discharged several of our patients and been left with three or four patients. My preceptor has had to take on one or more admissions every day," she said.

With nine weeks on the floor under her belt, Erin told us she did not feel ready to take on patients on her own. "I have seen a new nurse who graduated in December having to give blood to three of her five patients. To me, that is very scary. I am very nervous to start working on my own," she said.

Erin said that even though she is told that as a new nurse she won't have to take on a patient load on her own, she doesn't believe it.