Finally, a GOOD shift on a BAD floor!

psalm, RN · Jun 1, 2009

You used your critical thinking skills properly.

libbyjeanne · Jun 1, 2009

I am a new grad too, and I think you did the right thing. You are totally honest with your skill level and abilities, so it is obvious that you know what you are talking about. Obviously the floor you are on is tainted in a way and this is probably not going to be your only bad encounter while working there. Good luck to you and stick to your guns!

Mahage, LPN · Jun 1, 2009

i had a good shift last night. why? because i finally said, "no"!
a little background... i am the newest new grad on nights on a poorly run, very clicky, high paced m/s floor that no nurse in my hospital wishes to work or float (i know of travel nurses who decided to go home without pay and core nurses to use vacation time rather then float to this floor)! the last three weeks i have worked i had charge nurses give me the first admission of the night despite my acuities, the fact that i am a new nurse, and the fact that i am new to this floor!:angryfire
the first admissions on this floor usually occur between 5 minutes and 1 hour after the shift starts. therefore, not only am i trying to work on my time management but i have to make sure a new admit gets settled in, orders are implemented, and paper work is done before i can ever take care of the odds and ends for my current patients and in some cases meet and assess a current patients! not to mention being the first to get an admit usually means i am the one with the most patients by the end of the shift. on a slow shift i have 1 more then most and on a fast shift i have 2-3 more then most. thus, the last three weeks i have left my shift 2-3 hours after everyone else and not everything was done!
tell me... what charge nurse in his/her right mind assumes the newest new grad and new nurse on the floor can pull off having the first admissions of a night and the most patients with the highest acuity levels???? i used my mba and past managerial experience to figure out the answer to this problem. i am being sarcastic.. a ten year old can figure this one out!! i have determined that the charge nurses on this floor on nights are either crazy or they are out to sink me! so, rather then defer to their expertise on whether or not i can handle the first admission, last night i decided to defer to my own!
last night when i was approached with an admit slip 5 minutes after walking away from report and while trying to write down the numbers of my aids i decided to just say "no!" at the time, i needed to check labs on a patient who just received 1 unit of blood so i could call the doc, check results on a ct where i needed to call the doc, assess my current patients, give meds to one that called the patient advocate on days and fired his doctor, etc... i did not have time to look up information and admit a new patient!
my charge nurse freaked!!! she was very unprofessional! however, i did not sink to her level. i explained my situation to her calmly.... but her response was "so?"
do not get me wrong, i understand even while writing this that such a response is justified with the more experienced nurses. in fact, i have seen them give blood in 2.2 seconds, control a patient's pain in another room, and start an iv without blinking. however, my skill set is not there yet!!! i will miss something if i do not have a little more time! so, i told her "no" and kept my bearings (military lingo for not showing any emotions). i think it intimidated her because she backed off like i was going to punch her in the face and walked off like a miffed 8 year old child. in fact, the next time i got an admit she did not speak to me or look up any information on the patient. she dropped off the slip near my clipboard while i was in an isolation room and only made eye contact with me through my patient's window before walking away.
this is ok with me because i was able to get my current patients stable, my documentation in order, orders signed off and implemented quickly, and medications were passed on time much of which occurred before my new admit arrived to the floor! by the end of my shift, all of my work was done and i gave report without having to give any unfinished work to a day nurse or leave late!!!! in fact, i was able to attend church today even though i had trouble staying awake... i apologized to my pastor, but i'm a night nurse by choice.
-currently a medical surgical new grad nurse... future er army trauma nurse (if i can survive 1.5 more years of this garbage-the time needed to finish my bsn)

your situations sounded just like mine early on. only difference was i never knew i could say no! i just took it and ran with it. the particular charge nurse that pulled those stunts seemed determined to break me. the night charges don't make out our assignments, but they can change them if need be if we approach them at shift change. i didn't even consider that, just kept rolling. luckily no one died, including yours truely. i had some pretty good coworkers who helped me out a lot and a couple clued me in to the fact that they always give the new nurses the hard load. it is trial by fire. i started that floor in december and by june they had a new crop to pass the hardest load and highest acuity on to. i made it a point to help them out in any way that i could. i totally disagree with the fiery baptism method of initiation to "early post official orientation." there were a lot more of them than me as 11 hired in at the same time, and i was the only new hire when i came on board.

i rarely gripe about an assignment but if i need to i will. i love my job and i even love riding the tide of chaos that takes place on our floor. i have seen the best and the worst of my co workers. i wonder what it would be like to work on a unit that is not so tough, but i am making it on my floor and hope to help it become a little bit saner.

mahage

SummerGarden, BSN, MSN, RN · Jun 4, 2009

thank you for your responses! i think i read encouraging posts form all regarding one's survival of the first year in nursing. i have been a new grad for 6 months now so i am not exactly very new... just new to this floor.... i began working right after i graduated in december (literally one week later). i have been thrown on different floors not by my own choice but because re-organization occurred in the middle of my orientation. in any case, i think all of the stress of not doing right by my patients because of the work load thrown on my new nursing shoulders (that is what i care about... not what other nurses think of me) has finally gotten to me and has woke me up to grow-a-pair of nursing thingies (btw, i am female).

i was also finally fed up with the techs who ignore me to take care of something less important by another nurse (i have cardiac markers due now and some other nurse wants the tech to turn a patient... the patient gets turned and my cardiac makers get missed). so i have taken charge in that area as well. when a tech ignores me i go to another tech. if the other tech states "but that is so-and-sos patient" i let them know that that tech reports being busy. usually the tech i asked to do the job gets upset and goes straight to tech so-and-so and insists on having that person do his/her job. if push comes to shove and all techs blow me off (it has happened) i will go to the charge nurse. i will not play games with these people any more. i am a nurse that jumps in to help out others when i can and i am a nurse that wipes butts!! however i am not superwoman. i cannot do everything and i am not experienced enough to take on more then a new nurse can handle. i am still working on being efficient (safe and fast) and my time management. thank you for your support. :up: