paperwork aaaarrrrggghhhh!!

[MIA-RN1, RN]

hi all. I am just getting SO frustrated at work.

The new employee orientation was so disorganized, that all of us new employees (four, and all new RN's) are being met with individually by the nurse educator to review paperwork protocols. Everyone but me has met with her so far and each meeting has been pretty long (2 hours or more)

So my problem is that I am constantly being told I didn't do this, or I didn't do that with paperwork. Now, I have asked one nurse specifically to help me, because she has been there a while and she knows her stuff. But it seems like each afternoon I get to work and hear about more and more paperwork that I have not done. (not just by that nurse whom I asked to help me) I am so frustrated and paranoid. SOme of the stuff I never even knew I HAD to do. Which of course is why the meetings with the NE are happening.

But then, after the meetings, one of the other nurses will be auditing my charts (and those of the other new RN's) Which is great but totally singles us out. I know that not every one of the other nurses does every little thing. I feel singled out and nauseaus. Its almost 1am and I left work an hour ago and I am still sweating that I forgot to write down one of my 8pm checks. But I don't want to call and find out because the charge nurse tonight is one of the critical ones who gives me such grief when I have to give her report.

Our nurse manager has issued a new policy of hourly rounds on patients. This, coupled with all of this paperwork that I am finding out on a daily basis that I have to do, is just making me crazy. I am worried I am forgetting to document and I can't remember if I have done it all. At work, I obviously thought I did because I didn't think of it. But now I am so nervous about all the different forms, pathways, and various bits of paper I need to do that I am worried I forget stuff I've never forgotten before!

Plus I hate that it feels like all of us new RN's are lumped together as the new girls. I don't want to be compared to the others, I am an individual.

Most of the nurses I work with are very supportive but now I wonder if some of them are keeping notes or something because the notes and lists of things I haven't done seem to be multiplying. I know that some nurses are more lax than others, and its the ones that aren't lax that are paying attention and leaving notes. But I wonder now if there are things I haven't been doing that I didn't know to do and that now people are saying I am not doing my job because they are getting frustrated with me.

Arrrgh. I hope I can sleep tonight. I want this stress to go away. I provide great care to my patients but there are pathways to date, sign off on, and all sorts of educational things to sign and then I have to double check everything the tech does (because I found out last night the tech never took blood pressures on ANY of my patients and I didn't find that out til this morning) (and yes I know its my job to check but I just didn't because I was so busy with my hemorrhaging patient, which also made my 4 oclock checks two hours late for which I got a note that the nurse after me had to write a note in the chart that the 4pm check wasn't done because she said that its not documented. Well duh. I was late, what could I do?)

Its stuff like this that is starting to eat me up and make me want to take the pay cut and go to office nursing. WHy is there so much bs paperwork and why aren't other nurses just nicer and WHY didn't orientation get planned better?? The NE said that the next orientation will focus more on paperwork. Well great but damn, what about the orientees in my group?? I am so frustrated.

[youngatheart]

coopergirl,

After 12 week of orientation, I still don't have much of a clue what paper work needs to be done unless I didn't do it then they ask about it, If it was never shown to me I wouldn't know. During my orientation the day shift was so hectic the nurses didn't get a chance to show me half of what they needed, Now I am on night shift and find it a littler better, I have found out more in 3 days than 12 weeks on days. Keep persisting don't give up and don't get buried alive in paper work.

[RNKay31]

I too dread every moment of these paper work, wishing you the best

[truern]

Sigh...I feel your pain.

I've done so many discharges that I can do them in my sleep....I THOUGHT! Once I asked what was a FL2 form that was in a patient's chart with all the other discharge forms and was told that form was used only if they were going to rehab or a SNF. Ok. The first discharge I had going to rehab the FL2 was all filled out and ready for the patient to be picked up. I went to lunch and was happily munching away when my phone rang. All hell was breaking out on the floor because the transport came early AND MY PAPERWORK WASN'T COMPLETE!! You see, not only was the FL2 to be filled out, but also the other discharge forms which seemed redundant since they contained the exact same information.

And just about the time you have the paperwork down pat, they change the danged stuff!!

ARGH!!!!

Anyway, just wanted you to know you're not alone (((((CoopergrrlRN)))))

[MIA-RN1, RN]

thank you guys. I am getting to the point of dreading going into work to day and finding out what I didn't do right. I appreciate the support.

[RNsRWe, ASN, RN]

So much of what you said sounds like my life, too! I feel like I'm under the microscope as it is, and instead of encouraging me toward feeling competent the experienced nurses much prefer to make me feel like I'm dead weight. Yes, I'm taking 2/3 to 3/4 of one of their loads (orientation still) which frees that nurse up for helping others, and yet I'm still getting stared at and rolled eyes like I'm a bother. Perhaps they'd prefer to take ALL their patients back when I QUIT??

Yep, that paperwork is a sore spot. No matter what the heck I do, I'm still finding that I don't do it "right" according to the one nurse that is often in charge and is technically precepting me. I used to look forward to the day when, no longer on orientation, she doesn't scour over each of my charts. Except that seems to be her MO anyway....argh.

You are NOT alone!!

[Indy, LPN, LVN]

Coopergirl-

What kind of floor are you on? What's your typical patient load? Is it a 12 hour shift?

I'm asking because it's hard to comment without a little frame of reference. But at first reading your job sounds nightmarish. My load is 4 to 6 (six is absolute heck!) patients on a 12 hour shift and I tell ya. I can not do hourly checks. No. Not without more help, less patients and less paperwork.

[MIA-RN1, RN]

Coopergirl-

What kind of floor are you on? What's your typical patient load? Is it a 12 hour shift?

I'm asking because it's hard to comment without a little frame of reference. But at first reading your job sounds nightmarish. My load is 4 to 6 (six is absolute heck!) patients on a 12 hour shift and I tell ya. I can not do hourly checks. No. Not without more help, less patients and less paperwork.

I have usually four mother/baby couplets. Some are more involved. NSD's are q4hour checks, C-sects start at half hour intervals X2, then 1hX2 then 2hX2 then a4h X48h. It can be pretty involved. Then we get antepartums for stuff like kidney stones, htn with magnesium sulfate (hourly checks), and sometimes a postpartum. (Like recently, a postpartum hemorrhage that delivered 14 days ago. Yeah, I got her too.)

I am switching soon from five eight-hour shifts a week to three 12-hour shifts a week.

[JentheRN05, RN]

you need a change of pace. They need better orientation. They need more 1:1 on paperwork. Computer training that you could do at home would be ideal (that way you can not be constantly interrupted) - It should however be paid time. Maybe a set amount for training. Maybe a test at the end (competency). Just alot of changes that are obvious to you and I and we're powerless to personally make the changes, but it is within our means to point out suggestions. I think I would point these things out. Hold your head up and be strong, it's not easy being new, and even harder when everything you do seems to be wrong. But keep in mind this is a learning process. What you were taught in nursing school was only basics, after that it is a whole different ball game. Feel for ya :)

[RNKay31]

Guess what I also dread it to the point where I am totally fed up, why can't we just help our patients, and forget the paper work, LOL

[miss81, BSN, RN]

Do you work in Florida by any chance??? I could have wrote your post myself. I'm so frustrated that I want to quit!

[coffee4metech]

Well they are investing in you as a new employee and they want everything to be in place and run smoothly. Just step aside gather your thooughts and don't read to much into the paperwork just fillout what they ask and they will tell you if they have any problems or help you to get to the point you need to be .