Grad Nurse Stress

[juicyfruit06]

I'm a new grad nurse and I now have a job on a busy surgical floor. There is team nursing on days/evenings with 10 pts for 1 RN (responsible for all the charting, vitals, Dr.'s Orders) and the other RN (that assists with all the skills, meds...) I'm still trying to get comfortable working on day shifts with all the new skills, types of surgeries but now my problem is that I am suppose to work nights alone with these 10 patients. I've only received 2 wks of orientation on this floor and my manager failed to tell me that as a grad nurse I'm not suppose to be applying for night shift position b/c of the responsibility it entails. I think the manager found out I knew about this then he started offering me more orientation shifts. The manager tried to reassure me by telling me that the only other nurse on the other unit that also has 10 pts is suppose to be there to assist me (but I know this won't always be possible). I'm thinking of leaving this place if nights becomes too much for me. What do you all think?

[badtz143]

that is a lot of pts for 1 new grad RN. I am also a new grad on a very busy med/oncology unit. On weekdays the RNs get 8 pts each, on weekends, it is 12 each because there's only 2 RNs. But there's always LPNs to pass PO meds, 2 usually but people call in sick all the time that we're left with 1 so the other nurse have to do their own meds and everything else.

The nursing profession is set up for burnouts and unrealistic expectations. Everyday I realize more and more how much work we do as nurses and how little respect we get from everyone, the MDs, the patients...and sometimes our nurse managers forget what it's like to have a huge pt load. We are still expected to remember every little details and to work as quickly but as efficiently. Oh and we're not supposed to feel hungry either because it's not an excuse to have to leave an order you're supposed to carry out.

This sounds like I'm just venting but that's just part of it. What I mean to say is that I hear you and understand your pain. I'm right there with you.

Good luck to both of us. I'm sure you are doing the best job you can just as all other new grad nurses out there.

[Cristina_NS_RUM]

Hi, I’m almost new graduated too and it’s been a while since I don’t post here. (And I don’t understand very well how to post new threads) Anyways I wanted to write and tell someone not from my country about the experiences that I have had because I feel I am very incompetent (or that is how most of my ex co-workers had made me feel)..

The thing is, my first job experience in a hospital:

3 months of probation period (first 2 was all read manuals read manuals) -but not actually read because we were a group of new nurses and were getting to know each other and one of the nurses Talked A Lot! :smackingf About Anything! There was no way to shut her up! Anyway ...those 2 months passed and they started giving us patients (it was a post surgery floor, with 52 beds and 3-4 nurses on first shift, on last shift it would sometimes be 2 nurses... (Sometimes) Anyway we were 7 new young graduated nurses... (so things were supposed to get better with us...) anyway //I get lost in my own stories, I know// the thing is, 3rd month started, we started to get patients for ourselves, to give total care (medicine administration, taking blood samples, taking orders, all that would be related to our assigned patient care) it started 2 patients one day(I think I did ok)... next day 4 patients(some difficulty in documentation..) next day-6 pts. (Stress), next day on a 7-3 shift 10 patients, total care plus admissions (I had 3 and no one informed me until 3pm)... That Became Too Much Stress! It was a mess that day, near evaluation of the 3 months probation period! I had not find time to make all that I was supposed to do, most of my patients had pain and there was a mess with narcotics and guessing who had the key! Most of them had High Blood Sugar and when I’m going to get them insulin they had been taken to some study no one told me some came from studies and had their IVF's damage ...A Mess! :chair: Well it was 12pm already it had been a BAD Day I was feeling so bad + stress from evaluation, I’m preparing medications for next round, suddenly I’m called to Supervisor's office and they say 'don’t worry about medications while you are here, some one else will take care of it'' well I spent there like an hour, they said I was to get better in a Lot Of Things, I was feeling very bad, and -ahem..was on my days-- and I usually get a little depressed and easy to cry about anything around those days... so I start to cry and tell here the day has been a mess, and the thing ended out in they telling me they were going to refer me to a psychologist and well then I went outside to keep work and a nurse says 'here are your med's served, go give them to your patients :smiley_ab and I say 'are you not supposed to give them?' and she say 'no that is your job now' and goes away

it was 1:30pm I remember, starting to give medications of 12pm, I go to first room, I was so stressed could not think, very nervous about how evaluation went and all the day I was having, first patient had IV med's and did not have IV patent... aaah!! I keep because I’m told to finish medications first I go to second patient.. not in room... keep on keep on served medicines where some wrong I was so stressed and nervous and dizzy of hungry because I had have no time to get something and I ask for help cause I suddenly could not see well and could not think well I get called to supervisors office again and she ask what is wrong and I tell it all and I suddenly say 'I can not take this anymore, I don’t feel I can put up with the work here I quit, I’m sorry I made you lose your time' and they say 'Ok, I think that is a very wise decision you have made, bring me your resignation tomorrow'

Second Hospital Experience - I started with patients from week one, this time no patients are assigned! They are all mine, and yours and of everyone! In this one last hospital the organization was different, one nurse was to work only in giving medications to all patients, and the other one (the one in charge of the floor) was to give rounds and make sure Doctor's orders are performed -- and then start Documenting! Ah here the priority was documentation...

Well all was mostly well, I think, until near 3rd month evaluation time (I was always in rounds and in charge of the floor) 27 patients all just for me! :w00t: that was meant to be sarcastic... and well they gave me orientation on medicine administration, 2 days in orientation, 3rd day by myself (most medicines I don’t know what the hell are they for!) so well the thing I think is wrong about me is that I’m a perfectionist, I spend sometimes too much time making sure I did things right :/ and so everyone was always saying 'you must do it faster' 'faster! Faster! faster!' they had me crazy over this because (in rounds) the times I tried to do things fast I did not feel happy about how I did things, and when I was to do things to make sure all was right it would take me too long, and I once spent 3 hours giving a Good Round and they made me a Report! the supervisor said that a good round was to be made in 1/2 hour to max 1 hour! (27 patients) well anyways back to medicine administration, (I’m not sure if it was some trauma from first job experience that went bad while I was giving medication the time I quit) but giving medications was for me VERRY STRESSFULL! Everyone taking kardex away, patients discharged home and no one told me, admissions no one would tell me about and no one would give me their kardex yet, some medicines that were not there and I was to call to ask for them, changes not reported to pharmacy, any Terrible Disorganization! You Imagine It! It Was Happening There! Well there was always something happen that made me take too much time to serve medications and most of the times when I finish giving them to the patients it was near time to start next round of medications

This one last time, I started a 3-11 shift, they were starting to bring medicines for night and next day, I finished receiving medications from pharmacy at 4:45pm (I watched the time) so I started preparing medications when I was supposed to be giving them to patients, there were LOTS of medicines that had changed and where not there so I was to call every time, patients asking for this and asking for that, people taking kardex away, blah blah blah the thing is I’m so stressed, time keeps passing, I’m not finished, don’t know what to do I’m serving them one patient at a time, doing it as perfect as I can to not make errors and at same time as fast as I could, when I’m in last patient, the General Supervisor enters and says she will write me a Report!

It was Almost 9pm! Medicines for 5 and 6pm where already TOO LATE! I did not know what to do, I was now anxious, nervous, disoriented, I started on first patient and she start asking why are you giving me those, I took all my medicines this morning, what is that? what is it for? and well I got nervous, went back to check if I had made a mistake, no, I was right, it was new order but that patient kind made me lose it, I not sure if it was stress or that I had not eaten nothing since 1pm (or both) but I did not feel well I could not think right I went to General Supervisor who was on the counter with the nurse in charge talking... and I asked her if there was any way I could take a little break of at least 10 minutes or so because I could not feel well, she say 'You Can't take a Break Now! You Have Not Even Given your First Med's Round!' and I said 'please, I really not feel well' and she say ok, go eat now' and I go tell some specific instructions to the person who will do my work for me while I eat and she say 'just go eat, we'll manage' ok.. I go! I go to the kitchen.. there was no food for me, I got to my purse get a dollar, I go to a machine in the waiting room, I could not breath well, I try to get something to drink and I kind of can not make my hands work to put the money in the machine... and I feel I’m going to fall and I try to hold and all go blank and wake up when the LPN's nurses are sitting me in a chair and taking my BP and some one else on the other side is testing my blood sugar (all was ok) they send me to ER ........... anyway next day (What a long Story, are any of you still reading this) well next day I called in sick because at my house everyone got freaked out because that had never happened to me before and they said I was getting sick and that I should go see a doctor so I went... so Next day, I’m in charge of Rounds (yey! 27 patients all for me again, this time, strange… they left one of the new girls who was on orientation and one of the old who was to be promoted soon but I was not sure why they left her there (maybe so if I fell again someone to take charge) anyway I’m in charge, I was feeling kind of weird that day, like I was floating or something, and so they call me to supervisors office, she says I have had too many problems in medicine administration, that I am taking too much time, she say about rounds when I’m in charge I take too much time also and she say something about changing me to another floor maybe to some other place less stressing (I was in Telemetry, yeah Young Graduates at Telemetry) anyway she tell me to get prepared because in a few minutes she will call me to go to the Director of Nursing Department to get interviewed because I had gotten too many reports (for taking too much time to get job done) well I keep on working, suddenly there is a Code! one family member of a patient come and say the patient is blue and does not respond, I go see him because 2 times had pass that as false alarm, the patient start to cough and family get scared, I go to the room, patient lies still, eyes open, no response, and -- I had not seen Code before-- I was kind of in shock... suddenly one nurse enters and start compressions, fast the room was full everyone was doing something and me and another new nurse were just watching in shock and family members creaming outside 'it was because that room is too hot!' well I still kind of feel like when I was floating earlier but slow... the patient dies, they finish, everyone gets back to work

suddenly I’m called to upstairs to meet with Nursing Director, she asks me 'How do you feel working in Telemetry' and suddenly I lost my common sense! I start to cry saying I feel frustrated and insecure and incompetent and blah blah blah—well let just say I said all that YOU ARE NEVER to say at an Interview! so they fired me, saying that I was a risk to patients health, that I was self medicating myself(I once commented to a co-worker that I was taking natural tea for anxiety) and well, it ended, they told me to get my things and that I would be called to give back my ID and the Employers Manual.

So… if you are still reading this and have not passed out for reading this whole lot ...my question is- am I incompetent? I been feeling so bad, I love being a nurse, but here in my country most nurses try to do things faster than right! and I, trying to do things right, ended up being too slow :/ they even told me that I could try some other job places that were not of nursing (as if saying you are no good as a nurse) and most of the time I always wonder if maybe I do am Incompetent.

[All_Smiles_RN]

Cristina, I think it was a blessing that they let you go. That environment was not only unsafe for your patients, but also not good for you. No one deserves that kind of stress. I think you sound like a great new nurse. You realize that you can't just rush through things and that you need to take time to avoid mistakes. Don't give up on nursing. I know you can do it in an environment that is better suited for a new grad. Good luck!

[DolphinRN84, MSN, RN, APRN, NP]

Wow Christina...I noticed you're from Puerto Rico. I'm part Puerto Rican (from mother's side). Are all the hospitals in PR like that to nurses? My gosh...thats stressful, and I'm glad you're not working in that kind of environment. You definitely deserve better. Wishing you all the best and NO YOU ARE NOT INCOMPETENT!!

[Cristina_NS_RUM]

:roll Thank You Thank You Thank You!!!! I feel so happy that someone from outside this environment tells me that :)

And at least in 2 hospitals I have been at it is that way, all everyone here is up to do is to do things 'fast fast fast!!!' (They actually said to me that 'rapidito! rapidito! rapidito!-doing snap sound with their fingers) wanting to finish up rounds with patients as fast as possible to start documentation.

Well I wanted to tell someone: today I went to see some of my old university Professors! To ask for recommendations’ letters because I am going to start Master Degree Studies in Community Health Nursing on January!!! The professor who gave me the community class when I told her about what had happened to me she told me 'I had told you since you were a student! You are not meant for Hospital Work'

And well I think it is true, I love community health, health fairs, working with families and healthy people who won’t just suddenly die on me, and I can teach them how to take care of themselves to avoid having to go to a hospital!

Some people think and say that a Nurse is not a Nurse if she has not worked at a hospital for some years... but I think that (for those who like it and can take it -good, but for me, no thanks, Anything but a Hospital! unless things change in no time and people start doing things right I don’t want to be there!

Anyway Thank You Again for Your Comments :roll :monkeydance: jiji I feel happy! Take Care People!

[octopus]

I work with graduate nurses, providing clinical support to them as part of a graduate nurse development program.

A few issues here:

10 patients is way too many - but you can't control that!

With your level of experience you are probably outside of your scope of practice (buzz word in Australia at present!) - if you continue to work in this situation, knowing that you our outside of your scope, and don't refuse to take this load you are putting yourself in a very risky situation. Not to mention the patients! Thankfully you have control on this one! You can choose not to continue to work under these circumstances.

I recommend finding a hospital that offers a supported transitional program - the existence of a program suggests that they have a better learning culture and will give you the support they need.