Archive September 2019 XX, No. 9

Behind Closed Doors: Disorientation

Onboarding at a new hospital can be as tortuous as waterboarding.

Paula Watkins

Paula Watkins, RN, CNOR

BIO

DISORIENTING
DISORIENTING Tips on how to survive a really stressful week of orientation.

When I'm Queen of the World, new-job orientation will be department-specific. I don't know a thing about ICU or ER, nor do I need to, yet I just endured an incredibly stressful week of orientation at my latest hospital assignment learning about departments in which I'll never work.

Orientations weren't always so disorienting. Back in the day, you spent 2 to 3 days getting to know your particular department. Sometimes they'd show you a filmstrip (remember those?) or a video representing the services of care. You'd get a bunch of hole-punched handouts about your unit's policies. You were supposed to keep these papers in a binder, but they usually wound up creased, crumpled and crammed in a drawer or a locker. The hospital provided lunch. Then there'd be the requisite quiz — and you didn't have to guess 7 out of 10 right to pass.

Never-ending nesting dolls

Today, onboarding is more like waterboarding. You get 5 days of in-depth presentations and hands-on demonstrations about every hospital department. It's like Back-to-School Week. Everything starts at 0800, and if you're late, you might get to make it up or not. You get 30 minutes for lunch — and you're on your own. Those at the head of the class had the foresight to brown bag it. I think the No-Lunch Lunch is actually a cruel test to see if you consider variables or do you just function on gut reaction when you don't plan?

The quizzes are now major online competency exams. You can only miss 1 or 2 questions (so I've heard) if you expect to pass and advance to the next overwhelming module (the modules are like nesting dolls that never seem to end — the more you open, the more detailed they become). Some modules are pass-or-fail. The program will shut down once you've guessed wrong one too many times and instruct you to take the walk of shame so you can ask the educator to readmit you into that module. By the way, you don't retake the test you failed. They give you a new set of questions in case you took pictures of previous tests with your phone.

A quick aside: It's funny, they spend a whole day on the facility's mission statement, values and vision, and I still haven't found, in any hospital that I've worked in the last 35 years, that everyone walks the talk. Actions speak louder than buzzwords like "healing ministry," "care of the whole person — body, mind and spirit" and "not-for-profit healthcare system." Not for profit? Where is all that money going to? Check on who's making the 6- and 7-figure salaries. Oh, and it's not the staff.

You've been warned

On the last day of orientation, you get another free drug test, you smile pretty for your identification badge and you notice on the guided tour that the stretchers are older than you. Maybe this is why older nurses stay with one institution forever: to avoid going through orientation. OSM

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