Help!

Specialties Cardiac

Published

I'm a brand new graduate (graduated on May 8th). I just started working at this hospital in June, and I haven't even had two weeks on the floor yet. Our floor has cardiac patients...such as fresh CABG patients, other med-surg patients, and anything else you could possibly think of. I oriented on day shift for a week and two days, and then went to nights (7p-7a). During all of this, I have had a different preceptor on every day. Last night the clinical coordinator (over all nurses on the shift), decided I should take 5 of my own patients. It was terrible. I had a pt with an epidural, TPN, lipids, IV antibiotics, and Narcan going on top of all of that because of the "itching" caused by the epidural. Oh, she also had an NG tube, Then another pt with an NG tube, PCA, and several IV antibiotics, a CABG pt with chest tubes still in place an an external pacer, a fresh heart cath patient, and a patient that was being monitored due to afib. The charge nurse was also running behind and asked me to do several pushes for her. It was just way too much and I can't believe I was stuck in that situation with less than two weeks on the floor. I think it was very unsafe to say the least and I was incredibly stressed. I didn't eat, or take any sort of break and ended up working about 15 hours total. I need some advice from experienced nurses on how to deal with this situation.

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Specializes in ICU.

I would demand more orientation! Personally, I think new grads need more than 2 weeks orientation. And then for them to expect you to handle that assignment being so new...not a good idea.

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Specializes in Float.

I would be meeting with the nurse manager immediately and explain this is extremely unacceptable. If they can't give you a better orientation I would resign.

I am on a cardiac tele floor and I have been working 2 months with my preceptor and I take 3 patients WITH my preceptor in a shared assignment. I do their total nursing care but she is available to help if I get overwhelmed. I will work up to 6 patients but I have until November to do that.

Sounds like some SERIOUS staffing issues if they are willing to do that to a brand new grad. :(

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Specializes in Cardiology.

Sounds like my first job as a new grad. A crazy tele floor... they tried to give me someone with an AICD misfiring and with orders to hang a lidocaine drip. Veryyyyy appropriate for a new grad... Anyways, best thing I ever did for myself was get a new job on a floor that was more supportive of a new grad. Bail out. That's my advice.

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Specializes in Cardiac Telemetry/PCU, SNF.

First, before you bail, talk to the NM. See if you can get more orientation. Two weeks is not nearly enough, especially on a high acuity floor. If they are unwilling, then you bail. At least you gave them the chance to correct a problem. If you should decide to stay, start every shift by prioritizing and getting a game plan. I know that our patients rarely let us stick to any sort of plan, but if you have an idea where you are going and when, it will go a bit smoother. Before I even see my patients I figure out what has to be done and when. That 15 minutes at the start of the shift makes all the difference in the world.

There are nights I feel like I'm drowning, others not so bad. Lean on your co-workers if you can. You are not in this alone. Ask for the help you need. I know that it is easier said than done to do that, but you'd be surprised how much a little extra help can take you.

Good luck,

Tom

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Hi,

I know your situation wery well, but by the times going these thing will give you load of confidence at work.I know you feel deep down and exhausted but beleieve me... it will worth later on...I was 17!!!! years olda when i was qualified and i was working on the medical ward... the sister put me into the night duty after 2 weeks and i was alone with 40!!!patient..that was the hardest time in my life but i had huge experience and confidence... just one thing...when you newly qualified you need to learn even more in your life than you did before!!!!I did in the same way and dont be affraid to ask...medical staff your collegues...and finally you going to have a whole picture...it`s so nice when you know why the things happens....Im working on the Cardiothoracic unit so don`t be affraid drop me line if you need any advise..

Best regards,

Monika

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Thank you all so much for your input. I had made up my mind before going back in to work that I would refuse to accept that type of assignment again. I was told that I would have at least 6-10 weeks with a preceptor, and that during that time I would have patients on my own, but they would serve as a resource...etc. Then, after the 6-10 weeks, I would receive 3 patients of my own...then gradually take more as I was ready. I'm going to hold them to that agreement. I know that my hospital is very short staffed, and will most likely try to get away with what they can...but I will not let them pull that with me again. The charge nurse probably should have told the coordinator that she would not give me that assignment, but in the end, I'm going to have to look out for myself. Again, thanks so much!!

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Definitely watch out for yourself, it is your license that you worked so hard to get.

And sorry, who ever did the schedule had no business whatso ever giving you a "new heart" that still had chest tubes in place and a temporary pacemaker as well. That is no type of patient that should be assigned to a new nurse. Were you ever trained or oriented to caring for a patient like that? If they still have the temporary pacer on, then it means the physician thinks that they could possibly need it. Would you know what to do with it? What if a CT gets disconnected? This is not fair to you, nor the way to keep a nurse.

Even a well-seasoned nurse would have issues trying to keep up with an assignment like that in many cases. You were dumped on, pure and simple. Does not matter that they thought that you could do it. That should not even be a part of it at all.

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Specializes in Emergency.

OMG!!!!

If I had had that kind of experience, I don't know what I would have done! I shudder to think that any hospital thinks that this is an acceptable way to "precept" a new grad!

I too just graduated in May, and I started working on a telly/med unit in June. Our preceptorship is AT LEAST 10 weeks long, and more if you or your educator think you need more time. I am on my 7th week, and just started taking 5 patients. I do have more than one preceptor I work with, but I also have a nurse educator I report to, and each new nurse has an education folder that has certain competencies that we are signed off on as we accomplish them. It's really very structured, but that is OK with me, because I do not want to ever be responsible for harming my patients due to my lack of experience. I do work pretty much independently at this point, but my preceptor is always available for me if I need her. I guess in some ways I am lucky because my unit is so welcoming to new staff and the experienced nurses are always willing to help us out.

I would definitely speak to someone about this, and demand proper orientation! If it doesn't happen, find another job. You have come too far. Protect yourself and your patients.

Amy

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