I am mid way through my orientation in ER. Prior to this, I worked in telemetry/med-surg for nine months. I am a new nurse - have just passed my 1 year mark.
I had an evening this week in ER that was absolutely nuts. I had two simultaneous discharges, another pt came in - with knee pain due to a fall... Doc ordered UA on this pt. Then two more patients came in - asthma for one and chest pain on the other. My knee pain pt couldn't urinate - so I left urinal with him. In the meantime, I checked my two pts in, ran back and turned the charts in, checked on my knee pain guy (still no urine), returned to my two pts (respectively) and did quick assessments and a blood draw on one - also explaining to that one that we needed a urine specimen (she couldn't "go", either).
By this time, slightly more than an hour had passed, I was getting ready to go into knee pain pt's room to cath him when the dr approached me at the nurses' station. He told me that he couldn't wait any longer for the UA, that UAs are "just as important" as blood tests and that I should have had the UA turned in long before. I nodded my head. I knew that already. Unfortunately, I didn't have techs immediately available to assist with the other pts, and I was busy trying to prioritize and get everything done... and it didn't happen. BTW, by the end of the evening, I'd seen 7 pts (in the acute hall) and felt that was a decent number to be seen given my level of experience. And the knee pain pt? As it eventually turned out, knee pain pt had a dx for SIRS and metabolic acidosis.
Now I am scheduled to go in and talk about my orientation. I don't know if it's a "good fit" or not. I think it "could be" given enough time... but all I ever hear at work is how I don't document thoroughly enough, that I'm not "self motivated", I am focused too much or not enough, and that I don't have any confidence. My work gets picked apart. I'm an intelligent person - what is wrong with me? It's obvious it's not "good fit" and there are hints from my preceptor that this is the case. I like the work, the busy-ness - but at the same time, how do I get all of it done with my level of experience (it's not much).
I had just begun establishing a decent level of confidence - now my confidence is quite low again. Yes, I know if it doesn't make me happy, I should do something else - however - there is this thing called the "economy" that compels me to stay - and my age. I am too old to fritter my time away going back to school and look for something else. The fact is, I don't want to look for anything else - but at the same time - I'm slamming my head against a wall with the gut instinct that I "am good at this" but the inference is that I am not - and - I know I'm not the only one.
So - if I'm not the only one and if there really is a shortage of nurses - how do I make this work? I am told that while it may not be a "good fit" in ER, that I am a very good nurse. I don't get it - at least not today - not after all the effort I've put forth.
I always write to Allnurses. This site has the most concise responses and they are much appreciated.
