New Grads Assigned Without Orientation

BCNU has received reports from several hospitals across BC that newly graduated nurses are being assigned shifts on units where they have not received orientation. Deploying new grads without orienting them to their unit is poor management practice, given orientation's role in helping new nurses consolidate their skills and deliver safe patient care.

Many hospitals across the province are currently working short while running over-capacity due to seasonal demand spikes. Such pressures should not lead to routine assignment of new grads to units they are unfamiliar with.

Article 18.04 of the NBA Provincial Collective Agreement (PCA) obliges the employer to provide orientation when a nurse is "new to the worksite or new to the unit/ward". Orientation should include knowledge of the physical layout of the worksite, relevant policies and procedures, as well as an understanding of the principal duties specific to the unit.

All nurses have a professional obligation to deliver "safe, competent and ethical care" as set out in their practice standards. Asking nurses to provide care without giving them adequate knowledge and supports may place an "unreasonable burden" on them.

Some new grads have been assigned shifts on new units where they have sole responsibility for five or six patients with a complex mix. A new grad in this position should ask the in-charge nurse for a reasonable orientation and inform her of any reservations about meeting professional practice standards.

BCNU has also heard of new grads being redeployed into specialty areas like Critical Care, ICU or Emergency, for which they lack both orientation and education. Nurses in this situation should ensure they only practice within their scope. If issues arise, nurses should approach a steward about documenting the situation on a professional responsibility form (PRF) or filing a grievance.

If staffing insists and proceeds to assign you to a unit that you lack orientation to and have safety concerns about, please document the situation and contact your steward or your local chair as soon as possible afterwards for advice.

It's important that new grads communicate such orientation concerns to their stewards and their local chair. This way any ongoing lack of appropriate orientations will become clear and BCNU can intervene more effectively.

Inappropriate assignments for new grads can be highly stressful and greatly increase the potential for errors that impact patient safety. It can also undermine a smooth transition from new graduate to confident practitioner, compounding recruitment and retention challenges. Together we need to stand up for proper orientations and for safe patient care.