So i graduated in May and took a job as a GN on a surgical floor. I was told low acuity pt.'s, great teamwork, lots of help around, and you will be eased in and not given anything you cannot handle..... BS! My fist day I shadowed my preceptor, my second day I was told here are your 7 patients have at it, and to top it all off my preceptor is charge so she is very busy also. The other nurses cannot help...they all have 7 patients to. The staffing is ridiculous. 3 nurses from 7-3 then at 3 one nurse leaves and the other 2 split her 6-7 patients until 7:30. If you lose a pt, you lose a pca. if you gain another pt, you do not get that pca back.
Most of the techs are great but twice now I have had pt.s with bad vitals and the tech did not tell me.. example =post op 1 day with bp of 196/94 no hx of HTN, c/o HA, u/o 75 ml in 4 hrs! I try really hard to stay on top of my pts vitals and output but it is almost impossible with 7 pts, teaching, talking w/docs etc. I just feel so inadequate and completely overwhelmed. They are very big on independant decision making which basically means, if you have a problem, figure it out yourself. Even little things like how do i page this doc? the response i get is always you have to figure this out yourself. okay well my patient is going south and all i really want you to tell me is which one of the 12 sheets of phone numbers posted behind the desk should i be looking at? sheets which still have the names of residents long since gone as contact people for certain docs.
It is so very frustrating. To top it all off I start midnights next week and just met my midnight preceptor and found out he graduated from nursing school
TWO months before I did!!!! It just seems like a bad situation to me, but other nurses I talk with tell me this is how it is, its the same everywhere.
The most patients I have ever had in clinical were 4. 7-9 is very difficult for me right now and I just do not feel like I am giving quality care. Yesterday my "low acuity" patients were 2 GSW's, 1 post pneumo with a CT, 2 very complicated wounds with vacs, 1 MVA, and 1 with DT's who was intent on ripping out his JP drains. It seemed like everyone had complications at 18:30 (critical lab values, abnormal vitals, iv infiltration etc.) I was late to report and my preceptor just kept coming up to me and saying can we go yet? arent you done yet? She never offered to help, it seems like the only thing she will do for me is pass my meds. I literally just came home and cried. I have to go back tomorrow and am dreading it. What I really want to do is get in my car and drive to my mothers house...lol. If my family was not depending on my income I really would do just that. Please, experienced RN's out there, tell me it gets better!
Thanks for letting me vent!