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INTERNATIONAL RN MAY REQUIRE MORE THAN 4WEEKS ORIENTATION.As an international RN, your agency packages and tags you for the price of an experienced registered nurse,referred to as a traveler RN. Travel nurses unlike international RN are experienced RNs who travel around the country to fill up RN positions in hospitals with RN shortages. These nurses are paid big with good compensation packages. This is the envy of some regular RNs and so will ill treat the traveler RNs. Regardless of conditions in their job offer, they are usually floated most, given difficult patients and are called off first. It was with these same eyes that some hospitals look at foreign trained nurses who are brought in by the travel companies. They expect you to immediately show you are worth whatever money is being paid on you. And if you came from a developing world with virtually no experience about the technology and pace of western nursing, they would refuse to understand your background and weakness. Most hospitals will make no provisions to teach you the advanced and western nursing skills that you had no previous knowledge of. The best you can get is a binder about protocols and policies. And so within the first few days into your orientation, you should be able to tell if you are making any good headway and will be ableto have your own patients after 4weeks. You should also be able to tell if your preceptor, colleagues, manager and the unit environment are supportive. It is good news for you when you find your unit very supportive, and you are on top of the orientation. You can even ask for an extension of orientation period if necessary. In my orientation story, by week 2 I was supposed to be caring for 3 patients with little supervision. By week 3, care for 5 patients with some supervision; then at end of week 4 should be caring for required the 5 patients with no supervision. But if by week 2 you still have problem adjusting and cannot set a mode on the pca or you don’t even know where the ON button of a dinamap is, let your agency know immediately. Your agency can arrange support programs for you. The orientation skills lab is not a place to train. It is just to introduce the difference in the brands of equipment and kits to you. The facility will usually have a clinical supervisor/manager who goes round to learn of your performance and sometimes continue with an extension of the skills lab. You may ask questions bothering on the hospital policies and he/she will be very much willing to assist you. But asking for his or her help to learn how a nursing skill is performed is just helping him to write an appraisal about you. You make the day’s report so easy for him. Their work is to monitor and give daily reports on the performance of each newly hired international RN. Don’t trust everyone at this time, and don't go the extra length of letting them know of your shortcomings. People are sometimes planted around you. Oh yes! They got to protect their facility and patients. These “spies” feed the managers with regular updates on you. So don’t just give them an easy clue to write you up. Just try to do the right thing always. Let your clinical assignment manager at your employer/agency know about your weakness. If you have any difficulty about some procedures and nursing skills, communicate that to the appropriate office at your agency. But if the help from your agency failed and at week 3 of the 4 weeks scheduled orientation you still can’t find your feet, ask to be moved to a less acute unit or a change of facility. That is a difficult decision to make. But moving to a new unit or hospital will be to your advantage. You are going to start the orientation all over again,as in most cases. And having had a taste of the US system from your previous orientation, you stand to gain more.
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