Nurse Residency Program: The First Eight Weeks
I am now in week #7 of the program, almost halfway through the orientation process, and it has been everything I wanted from nursing school and so much more. The time and talent that is being invested in me and my cohort is immeasurable. There are days where we feel like we’re back in school with lectures, PowerPoints, and exams. Then when we are on our various units—not as students or helpers, but as the actual nurse giving patient care and putting our critical thinking to work—all the sacrifices, the long hours studying, the lack of sleep, and the chaos of interviewing is worth it.
No week is exactly identical, which is good since no day on the unit will be an exact carbon copy of the previous day. Each clinical experience takes us from novice and advanced beginner to competent and proficient on our journey to expert.
The program lasts a year but is divided into two portions. The first 16 weeks are orientation. We are assigned one acute care unit and one critical care unit. My cohort of 13 was given five acute areas and four critical areas to choose from. We are each assigned preceptors. Under the guidance of clinical nurse specialists (CNS) and the managers we prep for final placement, which will come at the end of week 15 to 16.
So if you think the interviewing is done, it’s not. The units we transfer to will hold interviews and we will be officially and permanently placed by the end of orientation. I 90% love it, 10% hate it. I love it in that I am getting multiple experiences on various floors and working with many different nurses. I am gaining a well-rounded history that will forever play a role in my role as a nurse. I hate it in that I have to decide which one unit to make my home. I wasn’t one of those students that only had their eye on one specialty and closed the door to all others.
So here is how my weeks have been going so far.
Week One: Getting to know you
During this week our cohort met each other for the first time. We spent this week expressing relief to be in the program and excitement about unit placement and giving patient care. Each eight-hour day, our minds are filled with policies, procedures, maps of the facility, and training on computers and equipment. We are shown the online learning center that contains all the learning modules we must complete in 60 days. By the end of the week, we are mentally exhausted from the large quantity of information but eager to put our new licenses to work.
Week Two: Getting to know your unit
During this week we spent four glorious days on our assigned units and worked as nurses for the first time. Under the supervision of a preceptor, we actively engaged in patient care, getting to know the unit and becoming comfortable with our new positions. We call the physician, the pharmacy, or the family. We spend this week getting comfortable with the fact that we are the nurse and all that being a nurse truly means.
Week Three: Getting to know the fundamentals, again
This week is split into clinical days on the unit and classrooms days. Clinical nurse specialists speak to us on topics from patient safety and satisfaction to palliative care and medication safety. Patient and family-centered care along with the professional role and practice model are reviewed constantly. On the unit the preceptors are allowing us to care for 1-2 patients independently using them as resources as we practice time management and delegation.
Week Four: Building on the foundations
We are now a fourth of the way through orientation and this week is divided into more classes with a couple of days on the unit. The topics this time around cover vascular access, infection prevention, and isolation practices to pressure ulcer prevention, ostomy care, and glycemic standards. Some of the cohort will work their first weekend and others will loop or have a day visit to a different unit, such as the operating room or the emergency department.
Week Five: Practice makes perfect
This week is full of nothing but clinical days. We are thankful for the break from class time and are glad to get back to patient care. As we are getting to know the interdisciplinary team and our unique patient populations, we are also being evaluated by the CNS assigned to our units along with our managers and preceptors. We’re starting to feel the crunch of wanting to take on more (3-4) patients, being confident when using SBAR, and completing those ever-present learning modules.
Week Six: More certifications, more practice, more of more
It is back to two clinical days and two classroom days. ECG, stroke, bariatric patients, trauma, and more medication safety are on the agenda. We are notified that we will have to take an ECG exam in a few weeks and it would behoove us to do as many practice problems as possible. We are also encouraged to get our NIH stroke certifications, sooner versus later, and be prepared to move through all phases of the certification process.
Week Seven: Back to school
More ECG, looping experiences, learning modules, and clinical days. Time has passed quickly and after week eight we will transition to the next unit assignment. While preparing to say “see ya later” to our first unit stop, we are given study time to prepare the approaching ECG exam that requires 80% or better. We are all feeling the pressure of wanting to do well on everything and be perfectionists. We’re using our Reflective Learning time to process, decompress, and recess from our growing schedules and learning experiences.
Week Eight: Preparation for the next phase
This week will entail three clinical days and a classroom day. The ECG exam will be administered at the end of the day. The expectation is that we are consistently caring for 3-4 patients and growing in confidence in our skills and nursing judgment.
When I post again, I will have transitioned to my new unit, passed my ECG exam, and finished all my learning modules. Hopefully, I will have decided just where this new grad wants to make her first stop on her nursing journey.