You may be in orientation for the facility for several weeks or months and that may be split with time on your unit. In any case, you will also have an orientation to your own unit. Pay close attention to all orientations you have and take notes. Review your notes and any handouts you were given each day.

Your orientation will most likely be during the day shift, whether or not that is the shift you were hired for. You may be mixed with new hires from all disciplines or separated into only nurses. This might even be just new grads or a mix with all newly hired nurses.

Get to know as many of your fellow new hires as you can. The medical world is very small and you'll never know when and where you may be working with someone again in the future. You are all new and nervous and a friendly gesture will be remembered and appreciated.

You will also be instructed in the documentation policies. If the facility uses a different format for charting than you have been exposed to, be sure you ask for additional help as you go along. Never assume that you'll catch on later. Documentation is too important to let slide. Depending on the extent that computers are used in your facility, you will be oriented to their use as well. Not all computer programs are created equal, so if you need additional instruction, be sure to ask for it now.

Orientation is the time to work out as many kinks and bugs as you can. The nurse educators are there just for this purpose. If you wait and think you'll learn it later, you may regret it. When you're working on the floor, you should never do something you are unsure of without asking for help. However, if this was something you should have learned in orientation, your coworkers may not be too happy with you. If you just need a little reassurance, that's one thing, but if you fail to utilize orientation to learn all that you can, your coworkers will resent it.

One of the most difficult aspects for nurses working with new staff is needing to take time away from their own duties to show the new staff the ropes. In most instances, your preceptor will also have to care for her own patients as well as show you around the unit. You might get a quick tour from the nurse educator, so pay close attention and when your preceptor needs you to get something, surprise him by knowing where to find it.

Make note of where things such as the crash cart, fire extinguishers, central supplies, and linens are located. Then explore these further so you can grab a pile of washcloths without even looking.

Learn how your medication cart is laid out and how it works. Even if you aren't allowed to dispense medications or controlled substances, know how it is done. You should know how to access the meds if it's all computerized and how to get a newly prescribed medication from the pharmacy. You should also learn how to get STAT meds when the doctor is screaming for them now.

Know how to obtain procedure trays and central supplies. How do you charge the patient for the supplies you use? What happens if you or someone else contaminates a sterile tray and you need to get another one? Is there a charge off procedure? How do you order the lab work, x-rays, or other tests the doctor has just requested for her patient? How do you access the lab and test results? What about IVs? Is there an IV team? Do the interns and residents start new IVs? Where are the IV sets kept?

During orientation, you will be introduced to the policies and procedures for your facility. You will also be shown how to use the various pieces of equipment and pumps used within the facility. You will spend time on clinical issues and you may at this time begin being checked off on procedures. This is the time to ask lots of questions and to speak up if there is something you are not comfortable with or have not done before.

Some of the most important items you need to locate are your reference manuals. These will be your policy and procedure manual (often referred to as the P&P) and your standards of care manual. Learn the specific protocols your facility has regarding things such as central line care. And are there any doctors who have their own specific protocol that differs from facility protocols? Watch and learn. Ask questions. Don't ever assume. Use your time wisely. Make yourself an asset to your unit.