Struggling

Specialties Emergency

Published

Guys, I got my dream job and have been loving it. Lo and behold, 45 day review wasn't so hot. I'm behind where they'd like me to believe. I don't know what to do. I want this so bad.

Thibgs like in a trauma not being sure what to do as opposed to seeing what is not being done and just doing it. Efficiency is an issue. Assessment issues. Etc.

Specializes in Emergency.

Are you still on orientation? If so, talk to your preceptor about what you can do to improve.

You're a new grad handling traumas? Nothing personal but unless you have relevant prehospital experience, that's not fair or good for you and the pt. Please tell me they sent you for tncc if you're a new grad seeing trauma.

Efficiency is speed i assume. And that comes with experience.

Assessment issues is different. Exactly what do they mean by that?

Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.

Did they give you a development plan or an improvement plan? It's not worth much to give someone feedback that they are behind, and then not tell them how to catch up!

Are you still on orientation? If so, talk to your preceptor about what you can do to improve.

You're a new grad handling traumas? Nothing personal but unless you have relevant prehospital experience, that's not fair or good for you and the pt. Please tell me they sent you for tncc if you're a new grad seeing trauma.

Efficiency is speed i assume. And that comes with experience.

Assessment issues is different. Exactly what do they mean by that?

Not new grad. By assessment they mean I'm used to doing full assessments like on the floor, whereas they want it more simple and focused.

Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.
Not new grad. By assessment they mean I'm used to doing full assessments like on the floor, whereas they want it more simple and focused.

I have worked with nurses in the ED who came from a floor, and this is a challenge for them — they always want to do a head to toe. There just isn't time for that in the ED, so keep your assessments focused on the triage complaint and anything relevant to it. Sure, if the patient is an admit hold in your ED for any length of time you might be on the hook for a comprehensive assessment based on unit policy, but that comes later.

Any more suggestions on how I can speed up my learning?

Specializes in Colorectal, emergency medicine.

Keep getting critical feedback and don't be so harsh on yourself buddy up with a suitable mentor and watch how they work and cater it for how you work you will get there I'm 2 months in to transferring from a surgical ward to emergency medicine and finding it a hard transition but enjoyable and lucky enough to have a very supportive team not expected to know everything ... always lots of people around and you can bring your speciality to them and utilise it. Stick in and good luck

Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.
Any more suggestions on how I can speed up my learning?

You really need to develop a plan with your preceptor and educator — they are in the best position to evaluate strengths and weaknesses and develop a plan for you. Their investment in your success is very important! Good luck!!

Specializes in Pediatrics, Emergency, Trauma.

I agree with Pixie on getting a developed plan, I also wonder if you have some self-studying? It seems as though you know your weaknesses, but how to you learn, prepare and use as resources when a situation arises?

I may not have the chance. We gonna revisit my progress at the 90 day mark. In a few weeks.

Specializes in Pediatrics, Emergency, Trauma.
I may not have the chance. We gonna revisit my progress at the 90 day mark. In a few weeks.

What do you mean?

I've been in the ED for over a year, and at least one of my days off I decompress, evaluate my own progress and self study.

I entered the ED with 10 years of nursing experience, all outside the hospital; I felt like a new grad all over again.

To compound the issue is that there was no staff educator on my unit (we have one now).

When I first got the position, I self studied prior, and along the way while incorporating what I was learning from my preceptors and peers and ironed out my own practice, it helped immensely...sometimes taking all the tips and working them out to your practice is beneficial.

Focus on what improvements you need to make; seek out clarification and keep plugging along.

Make your own weekly goals and work on achieving them, and maintain consistency. You also should seek out the resources on the unit as well, and keep showing that this is your dream specialty and you are in it to win it. :yes:

What do you mean?

I've been in the ED for over a year, and at least one of my days off I decompress, evaluate my own progress and self study.

I entered the ED with 10 years of nursing experience, all outside the hospital; I felt like a new grad all over again.

To compound the issue is that there was no staff educator on my unit (we have one now).

When I first got the position, I self studied prior, and along the way while incorporating what I was learning from my preceptors and peers and ironed out my own practice, it helped immensely...sometimes taking all the tips and working them out to your practice is beneficial.

Focus on what improvements you need to make; seek out clarification and keep plugging along.

Make your own weekly goals and work on achieving them, and maintain consistency. You also should seek out the resources on the unit as well, and keep showing that this is your dream specialty and you are in it to win it. :yes:

Truth is, at this point, I'm so lost I don't even know where to begin.

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