Rantings of a young new ER nurse. - page 2

I am a new nurse. I graduated in May 2006 took my boards and started working in the ER soon after. I personally do not think working in the ER is rocket science. I don't know it all and I am not... Read More

  1. by   CritterLover
    so, how did things go on friday?

    i'm quite a bit like you, in that i don't like to delegate (i'm a bit of a control freek, and i'd rather do it myself). i'm also not all that assertive. it serves me well for my main job (inserting piccs), but does not serve me well at all when i work in the er.

    i probably do more of my own "stuff" in the er than the average ed nurse, but i have learned to assertivly/politely ask the techs/attendents/secretaries to do what i need them to do. i've learned not to ask, but to instead say something like "i need you to please insert this iv/ draw this blood/ do this ekg..."

    as for the secretary, if she were to tell me that i needed to put the order in myself because i needed to "learn" how to do it, my reply would be something along the lines of "i know how to enter the order. right now i need you to do it. dr. x wants it stat." if i were feeling b****y, i might say, "well, the lab needs to be drawn and the order needs to be entered into the computer. i can do either. which do you want to do?"

    good luck. learning to delegate appropriatly is an essential skill to learn as an er nurse. if you don't, you will burn out very quickly. trust me.
  2. by   appydfc
    Eating our young is not new to nursing, nor is in unique to the ED. Take the time to break this chain. This kind of behavior really has to stop.

    Horizontal violence (don't sugar coat it....that's what's going on here) occurs often because people feel powerless and hopeless to affect change in their work environments. Lousy way to impact things, I think.

    Standing up and verbally attacking back may be effective for the short term, but it lowers you to the same base level and really doesn't change things long term, does it?

    I had a very wise nurse tell me once (though I didn't think she was so wise at the time...) "Don't take things so personally....really, you're not that important". She was right.

    It's all about the patients. If we can keep that in mind and take care of what our patients need, we'll OK.....even if we're new grads.
  3. by   JessicRN
    First of all I feel for you, you are in a difficult situation. I had this happen and I an an old RN (greater then 25years experience) I was just the newbie to this hospital. Some nurses and staff are just mean nasty burned out misable people who take pleasure in making other peoples lives miserable. If the unit secretary is friends with these nurses and you make waves your carreeer will be in jeopardy because they will band together and make your life miserable. They say go to the unit manager and speak to her/him but in my personal opinion and experience all that does is widen the rift. If the charge nurse saw all the secretary being rude to you and did nothing the chance that she or anyone will support is nil to none. Trust me if nurses do not like you and want you out it is soooooo easy to to. I have seen it done many times in my carreer.
    This is the real world answer. I suggest you go to EAP talk to them about it and get their advise. At work watch and see who the secretary is friends with, if it is the charge nurse or the lazy nurses you talk about confronting is useless and will only backfire. Ask for help when the brass (not the charge nurse) is near if possible so if the secretary says no for no reason and is rude in the process, the brass is obligated to do something but she sounds like seasoned witch so she will not refuse with witnesses who she is not friends with. Do not be a pushover but telling her off is useless. Try to find an ally with the other staff if possible. I use to ask them to give the orders to the secretary. Keep a journal and write down anyone who might have heard your conversations with the secretary. Finish your year and then get out and get another job. On the rare occassion this staff member might get used to you and accept you but I would not bet on it.



    Quote from LizzieJ
    I am a new nurse. I graduated in May 2006 took my boards and started working in the ER soon after. I personally do not think working in the ER is rocket science. I don't know it all and I am not afraid to ask questions. I would rather ask questions than kill a patient.

    I just got off orientation like two to three weeks ago and I have to say it has been challenging. Not the work...the people. The work is hard and some days I want to cry but I just realized that even experienced nurses feel that way some days ( so they told me). It might not just be as bad as I would feel because I am a newbie. There is so much I don't know but I am so willing to learn. Some nurses are just big gossips....They sit around and want to discuss how that new nurse will never make it cos she is soooo slow and stupid or how this experienced nurse is sooo lazy and should not be an ER nurse. Some of these "gossip clicks" have only been nurses for like 2 years or at the most 5 years. I just act like I don't hear cos I'm sure the day I am not working, I will the new topic.

    People tell me that I have to learn to tell the techs and the secretaries to help me cos I cannot do it by myself and I am kind of trying to get used to that. I try so hard to prove myself that I can do stuff. I feel uncomfortable because I don't want them to think I am a lazy person and I'm always asking for help because I do not know how to do it. I have to admit that the times when I do ask the techs to help me do a work up with me for a chest pain or something else or so they are always willing to help. There is this particular secretary that just really ticks me off. While I was on orientation if the Doctor had additional orders my preceptor will tell me to tell the secretary to put the orders in while I go gave the meds. Each time I would ask her she would give me an attitude about how I need to "learn" how to do it and she was busy (reading a magazine or on her cell phone)...by the way I do know hot to put the orders in. I would be so frustrated that I would go put in the orders in and delay giving the meds and my preceptor will be mad at me. Other nurses told me that she does have an attitude regardless but she dare not disrespect them like that.

    People must have noticed that I like to do things by myself because my preceptor actually made a week where all I have to learn how to do was delegate to people. Anyway four days ago I had to draw two set of blood cultures and hang Avelox for a patient with pneumonia .My hospital has a narrow window period (couple of hours) where the blood cultures needs to be drawn and the antibiotics need to be hung. I was going to draw the blood and I just stopped by to tell the secretary to pls help me put the orders in and she started with her attitude again telling me that I have to learn how to do it and that she was busy (doing nothing). I told her I was going to go draw blood and hang the antibiotic and I was really busy too. She just kept on going on and on and there were like three nurses there including the charge nurse. The secretary said that well she saw me hanging around doing nothing so I should have the time to put the orders in. I asked the charge nurse if she saw me standing around and the charge nurse said no. The secretary then said "Well You need to stop your yapping around and go do some work. Didn't I say I will put the orders in?" there were three nurses standing right there. I was in shock for a second....then I just walked away.
    I was trying hard not to cry at work... when I got to my car, I just had to cry. Maybe I'm just to sensitive..maybe I need to be way more assertive. I didn't know nursing would be like this...I didn't know at all.....
  4. by   BSNtobe2009
    The next time you ask the secretary to do something and she doesn't follow through, look her dead in the eye and say, "So what you are telling me is that you are refusing to put the orders in? Just let me know so I can inform the charge nurse, and I repeat the question back to her if she starts to give you any lip."
  5. by   mvsnurse2b
    Let's face it...orientation over...everyone expects you to act like an ER nurse. Wouldn't it be nice to have all of the experience required? I too am recently off orientation after graduating in May. I am not a kid, and have previously worked on the unit as a medical tech. I am facing several issues-people expect me to know everything because I am older-expectations are way too high! The other techs know me so I get-she can do that....ekg, istat, blood drawer, stocking of room, etc..., the secretaries give me I knew where you came from look, and some of the other nurses who don't believe newbies belong in the ER pile on the work, especially when they are charge without pity. I am not afraid to delegate and my "niceness" is wearing thin when tasks are not complete. The most important thing I can say is to request the task, and make sure the person doing it understands THEY MUST COME BACK WITH THE RESULT OF THE TASK ASSIGNED-NOW....NOT LATER. It is your time, and they must answer to you! Let people talk, your work will eventually speak for itself. Do what you need to do and at a rate that is comfortable for you. The day after Thanksgiving our ER was creamed! I didn't think I could take another second-the pressure was intense-too many assignments-too much to do, the charge (one of the ones I already mentioned) kept sending patient after patient. I was ready to crack! All of a sudden I was calm and I called the charge nurse telling her she could send as many patients as she wanted-however, they would sit until I had completed my critical work with my current patients. Guess what? My day turned around-the flow in my area slowed, and I was able to handle my assignment. The business didn't end-I had just controlled the situation. This past Friday I had a patient that was placed in my hallway-a young woman of 18....was a little dizzy at school-accompanied by a teacher. No information available-seemed easy enough. Diabetic. She was seen by our PA"s, DR., Charge nurse, triage nurse, and then finally myself. Unable to get a line and with minimal complaint she was not my priority-or so I thought. After several iv attempts and several nurses attempting-a line was established. Labs sent-bolus hung. For some reason I did an istat-the patient had perked up, was no longer dizzy and stated she felt fine but was thirsty. BG came back at 700-oh crap! Told physician-gave 10 units reg sq. Lab called with Critical result 1 hour later-BG actually 1149-13 units more given-NOW EVERYTHING IS AN EMERGENCY! NEED TO MOVE FROM HALL AFTER 2 HOURS. NOTHING HAPPENED FAST ENOUGH! I AM THE SUCKY NURSE-PT IS IN DKA! Now the charge is looking at me like can she handle it? I am thinking how could I miss pt's breath? Pt is finally moved to Acute care ER with insulin drip...by the end of my shift BG is 200. I felt sooooo bad, and here it is two days later and it is still in the forefront of my thoughts. However, after pondering all of this-I realized her acuity was misjudged by two veteran nurses, both our PA and ER physician didn't see anything other than a higher than average BG reading from a noncompliant diabetic, and that two other experienced critical care nurses also missed any signs that may have been present. I will never forget that this patient's outcome could have been horrendous! In some ways, I realized that her age was a sticking point for not only me, but for our other staff. If she had been 40 I would have been all over her. Here my inexperience shows....but I have learned. I guess the most important thing as a new nurse is to ask questions, never assume, don't judge, and be open to change. Good luck to you-you will find your rhythm..
    Peace and Happiness in 2007
  6. by   firefly86
    Wow! There is alot of common situations in all ER's I live in CA. We see the same problems. Believe in your self I was a secretaryand believe me I made it very easy for the nurses too tell me what I needed to do. Plus I offered my self to help or whatever. I was secretary/er tech. But anyways Yes the Secretaries do talk about nurses and gossip just like other people. But hey now that I am a nurse in the same department you have to stick up for yourself and just say these orders need to be put in and leave it on her desk and make sure she sees it and walk off to get your meds. Imagine I for example I have was a tech and secretary in the same department and now a nurse some days i do feel i am doing everything while others are on the cell phone in break room gossiping. But hey what ever its not only me who sees this. I just try not to take things personal. If they roll there eyes who cares. Dont take things personal. BUT NEVER FLAG YOUR BADGE TO THEM AND TELL THEM YOU ARE THE RN. No one should do that. I am a nurse and still youll will see me changing garbage bags and linen carts. SO WHAT!! If I can help so be it. Its hard though sometimes I dont like certain people I work with but hey I am there for patients not to make friends RIGHT! Hey good luck, Just stick with and dont just find do it be ASSERTIVE NOT RUDE.Congratulations for passing and getting a job in ER.
  7. by   Displaced
    When I worked as a tech, I told new nurses to stop asking me if I had enough time to do something, and just tell me to do it. I am also the same person that would defend them from the ICU nurse attacks....

    Nurse: Hey [my name], if you have a enough time or a spare moment can you please do an EKG on the chest pain, SOB, diaphoretic and hx of MI in Room 2?
    Me: Yes, but next time please feel free to tell me to stop what I am doing and get my ass into room 2 now.
  8. by   sjt9721
    Quote from Displaced
    Me: Yes, but next time please feel free to tell me to stop what I am doing and get my ass into room 2 now.
    *LOL*
  9. by   MassED
    Quote from DaretoDreamRN
    I am a new nurse. I graduated in May 2006 took my boards and started working in the ER soon after. I personally do not think working in the ER is rocket science. I don't know it all and I am not afraid to ask questions. I would rather ask questions than kill a patient.

    I just got off orientation like two to three weeks ago and I have to say it has been challenging. Not the work...the people. The work is hard and some days I want to cry but I just realized that even experienced nurses feel that way some days ( so they told me). It might not just be as bad as I would feel because I am a newbie. There is so much I don't know but I am so willing to learn. Some nurses are just big gossips....They sit around and want to discuss how that new nurse will never make it cos she is soooo slow and stupid or how this experienced nurse is sooo lazy and should not be an ER nurse. Some of these "gossip clicks" have only been nurses for like 2 years or at the most 5 years. I just act like I don't hear cos I'm sure the day I am not working, I will the new topic.

    People tell me that I have to learn to tell the techs and the secretaries to help me cos I cannot do it by myself and I am kind of trying to get used to that. I try so hard to prove myself that I can do stuff. I feel uncomfortable because I don't want them to think I am a lazy person and I'm always asking for help because I do not know how to do it. I have to admit that the times when I do ask the techs to help me do a work up with me for a chest pain or something else or so they are always willing to help. There is this particular secretary that just really ticks me off. While I was on orientation if the Doctor had additional orders my preceptor will tell me to tell the secretary to put the orders in while I go gave the meds. Each time I would ask her she would give me an attitude about how I need to "learn" how to do it and she was busy (reading a magazine or on her cell phone)...by the way I do know hot to put the orders in. I would be so frustrated that I would go put in the orders in and delay giving the meds and my preceptor will be mad at me. Other nurses told me that she does have an attitude regardless but she dare not disrespect them like that.

    People must have noticed that I like to do things by myself because my preceptor actually made a week where all I have to learn how to do was delegate to people. Anyway four days ago I had to draw two set of blood cultures and hang Avelox for a patient with pneumonia .My hospital has a narrow window period (couple of hours) where the blood cultures needs to be drawn and the antibiotics need to be hung. I was going to draw the blood and I just stopped by to tell the secretary to pls help me put the orders in and she started with her attitude again telling me that I have to learn how to do it and that she was busy (doing nothing). I told her I was going to go draw blood and hang the antibiotic and I was really busy too. She just kept on going on and on and there were like three nurses there including the charge nurse. The secretary said that well she saw me hanging around doing nothing so I should have the time to put the orders in. I asked the charge nurse if she saw me standing around and the charge nurse said no. The secretary then said "Well You need to stop your yapping around and go do some work. Didn't I say I will put the orders in?" there were three nurses standing right there. I was in shock for a second....then I just walked away.
    I was trying hard not to cry at work... when I got to my car, I just had to cry. Maybe I'm just to sensitive..maybe I need to be way more assertive. I didn't know nursing would be like this...I didn't know at all.....
    that secretary needs a slap. Seriously. ha!! I would so give that back to her, then tell her that you are busy doing your job and the patient would appreciate it, and the charge RN, if she would do her job. Walk away. Let her talk behind your back - you don't like her, so who cares. That's how I would roll.
  10. by   MassED
    Quote from UKRNinUSA
    I had a similar experience to you, both when I was new to ER and then when I transferred to the ER at a sister hospital. In the first instance I took a lot from one particular EMT (which I tried to ignore) who thought she was a better "RN" than me. One day, I finally had enough and stopped being polite. I lost my temper and stood up for myself, shouting-"I'm sick of this *%$#@ &%^$@! -- you're the tech, I'm the RN, I'll be the one giving the orders. Got it ?"
    She was really peeved, didn't talk to me for a while, but I was exhilirated and never had any more problems with her.
    The next instance I had the same kind of problem but this time with the unit secretary, who had been there forever. The situation was a bit more difficult because she was related to just about everyone who was anyone in the hospital. I talked (ranted) to the manager about that one along with my frustrations about always getting the crappy assignments. This too blew over - after a while they accepted me and began treating me better.
    Humans are more like animals than we care to admit - if we see a weakness we will jump all over it, if it can work to our advantage.
    My suggestions are: get a self-help book/take a class on assertiveness and mention to your manager that you are concerned about the lack of teamwork from this individual and it's impact on ..........(choose your manager's/ hospital's favorite cause). Good luck.
    I am sure we've all had experiences with either secretaries, CNA's, or fellow nurse's who are determine to push your buttons, if you allow it. It does suck. It's hard to make a change and force people to come along with you. Kill them with kindness. I hate doing it, esp. when a person is downright rude, but kill 'em with kindness. Please and thank you to DEATH. That's what I tell my kids too. At least you'll know you did your best to do the right thing, and in the right manner. They'll feel like an ass for knowingly putting you through the wringer and if they don't care, then stop being as nice to that person. I find I have more around me now that are nice, and far less that are nasty. You just learn that you are not going to take it anymore. It's not fair to be treated that way and it makes you feel bad. Don't react to their negativity or hostility!
  11. by   MassED
    Quote from nursebearfeet
    First let me say that most ER's are trial by fire. not that I agree with that, but your story is one of a million like it. I have my reservations about new grads in the ER. Not because you lack nursing skill but because it takes most people a while to gain confidence in themselves. When you're more confident you feel safer telling snotty secretaries and the like to kiss off.
    My advice, believe in your self. you cant be the nurse, the secretary, the tech, the cleaning crew, ect. next time you tell that slacker to go draw blood and hang your meds, when she informs you that she cant, remind her of what she can do ( your orders), she can like it or shut her trap!
    dont give up, just practice deep breathing exercises.
    best of luck
    that's a good point. If you do the secretary's work, she'll become obsolete.
  12. by   MassED
    Quote from JessicRN
    First of all I feel for you, you are in a difficult situation. I had this happen and I an an old RN (greater then 25years experience) I was just the newbie to this hospital. Some nurses and staff are just mean nasty burned out misable people who take pleasure in making other peoples lives miserable. If the unit secretary is friends with these nurses and you make waves your carreeer will be in jeopardy because they will band together and make your life miserable. They say go to the unit manager and speak to her/him but in my personal opinion and experience all that does is widen the rift. If the charge nurse saw all the secretary being rude to you and did nothing the chance that she or anyone will support is nil to none. Trust me if nurses do not like you and want you out it is soooooo easy to to. I have seen it done many times in my carreer.
    This is the real world answer. I suggest you go to EAP talk to them about it and get their advise. At work watch and see who the secretary is friends with, if it is the charge nurse or the lazy nurses you talk about confronting is useless and will only backfire. Ask for help when the brass (not the charge nurse) is near if possible so if the secretary says no for no reason and is rude in the process, the brass is obligated to do something but she sounds like seasoned witch so she will not refuse with witnesses who she is not friends with. Do not be a pushover but telling her off is useless. Try to find an ally with the other staff if possible. I use to ask them to give the orders to the secretary. Keep a journal and write down anyone who might have heard your conversations with the secretary. Finish your year and then get out and get another job. On the rare occassion this staff member might get used to you and accept you but I would not bet on it.
    great advice.
  13. by   MassED
    Quote from sjt9721
    *LOL*
    most nurses would say "Hey, (your name)" I need an EKG NOW on the CP, Diaphoretic, massive MI in room 2." I can't imagine saying "when you have time...." haaaaa!!! I'm cracking up right now. Has that been said to you? geeesh!

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