bad ending of second night on my own, advice needed

[hollyberry678]

Hello, I finished my second night shift alone, off orientation. I work on a unit with high acuity patients. I had three patients, with one fairly heavy-- lots of q2 hours checks, ect, and who was up all night, many requests, pain,ect.

We have a TON of charting to do. Between cares, assessmens, charting, meds, ect I was busy- np break. (sorry for being disjointed/typos in advance- I am really tired).

The heavy pt had a catheter in her neck with tPA and heparin running, and a new nephrostome tube d/t a blockage/tumer to a ureter. It developed beeling. resident consulted, she ordered q 2hr irrigation (she didnt want to turn off hep for venogram in morning).

All 3 pts had procedures in am. I filled out conc. sedation forms on other two- was told that venograms didnt require this.

Morning nurse for this pt didnt come to get report from me. I stayed late to finish chart checks. She came finaly bursting in room asking me if I ordered new bag of tPA, as present one "almost dry" (it is run at fast rate- freq bags). I said yes, tried to give her report, she said not now, pt on bedpan. Asked me if I filled conc. sedation form. I said no...should I? she said yes. she came back, asked me what labs I was putting on there. I said last labs...she checked with me, then asked why no 0400 fibingen was done (it is a q4hour lab). We checked and the contnioous scheduled order had stopped at the midnight one, and I forgot to check the 0400 one. she said, oh thats really bad, I am going to have to fill out an icare (report error, ect) form. She left. I went to desk to ask secretary to reorder this continously, and get a stat one now. I heard her at the dsk ludly talking about this. Then she yelled down the hall 'oh, what was the midnight one? then, is the heparin running at a fixed rate?"

I asked her to come talk to me. I said I didnt like the way she was talking to me, she is here and there, and barking questions at me. she said, oh are you worrried about the lab or if youre a good nurse? youre a good nurse, dont be so sensitive. I just stared at her, then she babbled at a igh rate, i just stared, and then she said, oh now I am getting offended. I said do you want to know anything or have any questions about the pt? "no" ok I need to go, I am tired, and I am now, and I left.

I feel awful.... I alomost feel like quitting. Can anyone offer opinions/advice so I can understand this better (both good and bad-- whatever you think) thanks.

[SuesquatchRN, BSN, RN]

I worked with someone like that. If she had questions about anything she always made sure to do it loudly, with an audience. That asking you why you were getting annoyed is a new twist, though. She doesn't like to be called out on her nastiness, does she?

Simple. She's a rhymes-with-rich. And it isn't you.

[Diary/Dairy, RN]

Holly - you did the best you could in the time you had - she is being tooo particular...... and she needs to realize that nursing is a 24 hour job - let it go - do better next time (when the load is not too high.)

[caliotter3]

Just continue learning and doing your job the best you can. When she comes on, attempt to give her report at the proper time. If she comes off on you, then tell her when she is ready to be civil to you and take report you will be glad to do so and continue on until you finish. Or alternatively, give report to the oncoming nurse in charge. Tell her that you don't have time for the belligerent attitude of the other nurse. You can't be wroing as long as you give report to the oncoming charge nurse. Then, technically, you are off the clock to finish your charting or anything else that you have to get done. Don't take any bs from this nurse. When she talks to you like that, stop her every time, and tell her you will not tolerate being talked to in that manner. Sooner or later, she will learn that you refuse to be pushed around by her.

[QuestGAV]

It sounds like you're starting off on a tough floor. There are quite a few things you're going to need to adjust to. That will take time, you can't expect it to happen all at once. Colleagues sometimes (always?) forget that they were new too once and expect you to do everything just as they would do it.

Also - just because you don't have a preceptor anymore doesn't mean you have to feel like you're off on an island. You might have some luck running through what you've done and what you expect to do with the other nurses you're working with throughout the night. They might be able to fill in the gaps for things that didn't come to mind immediately for you. Obviously everybody is busy but I think they'll respect you for wanting to be thorough and get things right.

[Piki]

I'm sorry you are dealing with this. I'm only a few weeks off orientation myself. The others are right. My question is tho - why on earth would this nurse be going into patient's rooms (ie. noting the tpa bag almost empty, and getting someone on a bedpan) WITHOUT getting report first! To me, that is just crazy. *shaking my head* I don't see how you were at fault. Hang in there.

[Chloe'sinNYNow]

HollyBerry,

hang in there. I wish I did. I quit yesterday morn after a wrenching 3 mos day-to-night of hell "orientation" that was more twisted than the wicked witch of the west.

Now I'm scared b/c instead of developing a thicker skin towards nurses who constantly criticized me, I stood straight up, acted on my last orders, and went to my locker, curled into a ball and cried for an hour, then marched into the Charge's office to quit.

I'm proud of you for handling that case load. Sounds like you are already a pro.

Chloe

[caliotter3]

Choe

Don't let this get you down. Take some time to analyze what happened and make a pact with yourself to not let it repeat at your next job. Good luck finding a good job with good co-workers.

[Chloe'sinNYNow]

Choe

Don't let this get you down. Take some time to analyze what happened and make a pact with yourself to not let it repeat at your next job. Good luck finding a good job with good co-workers.

Not down so much Cali, just scared of where to turn next. I don't know how to go about it first.

I want to relocate to the NE, but don' t know how to get ahold of anyone recruiting new grads. How do i do this? It's been so long since I relocated and I've never done it for nursing.

Do I just Google hospitals up the Eastern Seaboard? Or are there agencies that will take on a new grad? That sure doesn't seem smart. I'd likely go fr the heat to the frying pan there! So it's December, surely there are hospitals that are hiring new grads again??????

How do I find them and set up interviews and then relocate? Zowie, this is overwhelming. I should have sucked up the criticism and just done my job. Even tho' just last Friday I was peeing straight blood, went to ER for 2 hours midshift and returned to continue job, lifting and all. Then had heaves 2 nights later fr the abx!! Did anyone ask me if I needed help?????? NO! Hence part of my decision to vacate!

(sorry to extra vent here)

Chloe