People think I am stupid - page 4
I am a new nurse who just got off orientation a few weeks ago. I have worked at the hospital where I am for more than a year and was hired from a tech position to a nurse once I passed my boards. I... Read More
Jan 4, '13If people think you are lazy, it could be because you are not helping others out and/or completing your work. I don't know what you do or don't do but here are some of the things that make me think someone I work with is lazy:
Someone who won't even answer a call light for you when you are very busy.
People who sit around and complain about all the work they have to do, and then fall behind because of all the time they spent complaining.
Nurses who use lame excuses: well I didn't do that b/c there was no order (okay...so call for one?), I wasn't sure if i was supposed to do that or not so I didn't want to mess it up (okay....ask someone or look up the policy)
Just some ideas. We all make mistakes, I left tubing clamped and didn't give an antibiotic before. You are only human, but work very hard at not making mistakes, and don't take it lightly when you do make one, remember that it's people's health and well-being you are dealing with.
Jan 4, '13Who is it that thinks you are lazy? The nurses or the techs? I ask because I have been a tech and I'm now a nurse. When I was a tech, I thought a lot of the nurses were lazy (and many of them were) but now that I'm a nurse I've had at least one tech accuse me of being "stuck up and lazy" even though all the nurses praise me for doing a great job. I was mortified when I found out how the tech felt because I swore I would not ever be the "lazy nurse" and if you're like me then you take things like that to heart way more than other people do.
Instead of making a big deal about it and talking about it all the time or going out of my way to be helpful to that tech, I pretty much started distancing myself from her and actually helping her LESS than I did before! It's weird, but our "problems" disappeared. I know nurses who REFUSE to do certain tasks and they get along with the techs. Then, there was me who was always worried about what they were thinking about me if I was sitting at the computer charting for an hour, and go out of my way to do things like take out the trash or wipe down surfaces (tech jobs) and they would call ME lazy. I thought to myself, "What is the difference between me and the nurses who don't have this tension with the techs?" The ONLY difference I found was that the other nurses (even the ones who aren't helpful to the techs at all) didn't let comments bother them! I would be bothered by it, go around asking people what they thought about it/me, and basically obsess over it.
Since you are here posting about people thinking you are "lazy" and consider forgetting to put a sticker on a chart to be a "big mistake" it makes me think that you might worry too much about what people think of you. People actually spend a lot less time thinking about you than you think they do. Then, there are people who feed off drama. If someone sees that being called lazy really bothers you and causes you to do their job for them then they are going to keep calling you lazy. It doesn't matter if you actually are or not! This particular tech I have in mind actually just told me that I'm completely different than I was at first and that she loves me now! I haven't changed anything other than stop bothering to help and stop going around asking people if they thought I was lazy, stuck up, or whatever the dig of the day was. I don't know if that's the case or not...I'm just throwing some ideas out there based on my experience.
Another reason I asked who exactly was calling you lazy is because techs who become nurses often have a hard time transitioning in the role from tech to nurse. Are you focusing too much on things like making sure the room is clean and the ice pitcher is full when you should be paying closer attention when the nurse is hanging fluids or calling the doctor? It was hard for me even during clinicals to watch a tech struggling to keep patients bathed and toileted while I sat at a computer and charted. I was always tempted to jump up and help them even though it might mean I was missing an opportunity to insert a foley or do some other nursing skill/task. Once again, I was worried too much about what other people were thinking of me. Just some food for thought.
Jan 4, '13Lazy? I switched to agency the day after fulfilling my first year, and no matter where I worked thereafter, the implicit motto (social contract), as far as nurses, was, "No-one sits until everyone sits."
Jan 4, '13Stop making stupid mistakes (a COUPLE of times?? How do they know you'll never make that mistake again? You did it more than once already!), stop ******* people off, and think a lot less about your self-esteem than how damn dangerous they think you are, apparently with good reason.
Whoa. Stop right there, GrnTea.
Your first comment: very helpful. Informative, insightful, etc.
The vitriol of your second comment, however, completely undoes the good you did with the first. This new RN has come here, hat in hand, very honest and vulnerable, bravely asking for help and advice. What you offered is basically verbal and emotional abuse.
You know what? What you say MATTERS. The energy you put forth in the world with your intent and your words has an impact.
Seriously, you never made ANY mistakes? From your comments, I am guessing that you have, and that you were even harder on yourself about them than this new RN.
This is more a conduct issue for me than the use of the word *** in an earlier post that offended someone.
Just sayin'.Last edit by sirI on Jan 6, '13 : Reason: please do not attempt to circumvent TOS/profanity filter
Jan 4, '13Please help me figure this out. What antibiotic is run at 12.5 ml/hr? I have been doing this job for tons of years and have never seen this. I have never run anything at 12.5 ml/hr. Yes, we will titrate morphine drips for example but antibiotics? If it is 50ml of zozyn it is run in 30 minutes. If 100ml of Zozyn, it is run in one hour. Unless it is a specific special antibiotic which the pharmacist will decide upon rate, or if it is some special circumstance, then please tell me what is run at that odd rate?
Jan 4, '13Quote from redhead_NURSE98!I guess Stargazer is the only other person besides me here who knows about Zosyn (practically) continuous infusions? They have apparently decided that you don't have to be on it for as long if you run it in this slow manner over 4 hours instead of 100/hr q6 hours. You hook it up to its own primary and Y- it in, like you would potassium.
If you have to run Zosyn at 25/hr for 4 hours, is that patient staying hydrated by that < 1 ounce an hour infusion while fluids are ordered to be running at 150? Yes most abx are piggybacked, but not always Zosyn.
I did, I said that too!
Jan 4, '13I piggy back as well, but I've noticed that is a pretty mixed reaction here on the boards. Either way, part of moving to new hostpails is adapting to new practices. You'll get the hang of it!
Jan 4, '13Quote from needshaldolNew guidelines are for Zozyn to run over 4 hours, it has been found to be more effective. We just recently started this timing.Please help me figure this out. What antibiotic is run at 12.5 ml/hr? I have been doing this job for tons of years and have never seen this. I have never run anything at 12.5 ml/hr. Yes, we will titrate morphine drips for example but antibiotics? If it is 50ml of zozyn it is run in 30 minutes. If 100ml of Zozyn, it is run in one hour. Unless it is a specific special antibiotic which the pharmacist will decide upon rate, or if it is some special circumstance, then please tell me what is run at that odd rate?
Jan 4, '13Hi OP,
I am not a nurse yet, so I cannot help you in the area of giving you advice about your mistakes. I'll leave that to the other nurses in here, even though, I do believe we're being a little -too- obsessive about the antibiotics. I think a few postings to help the OP along will suffice...
As for those who are attacking the OP based on their honesty. Tsk, tsk. Stop with the negativity already! The OP asked for advice, not to be scolded! As I told one person in an earlier forum way back, quit feeding the negativity in the culture of nursing. There is already plenty of that going around! Especially for this OP it seems...
Now, OP in regards to your problem with others, I can relate because of my own personal experience. I worked in a hospital setting as well. The pharmacy inside the hospital is a very small world. Everyone talks about everyone. No matter what. It is the nature of people inside settings such as these. When I first came on board as a Pharmacy Tech at one hospital, I was as green (new) as they come and I got a lot of pushback because of that. Those who I shadowed and taught me, were a mixture of both positive and negative feedback. Despite how social I can be, not EVERYONE liked me. Even those I got along with, still talked about me, nonetheless, because I was the 'newbie'.
It's hard to fit into any circle. However, I learned what I could from them, worked my buns off, and guess what? It paid off. Eventually I got gratitude and respect. Three years later, I had to leave that work, sadly enough to pursue nursing school and they were sad to see me go, even the people I did not get along with, were a little disheartened, because they knew I worked hard and did my job.
That's the key...do your job and work hard. You are there to be a nurse. Sure, you can mingle. But do it as needed. Meaning, be social enough to where you can professionally get along with everyone. And if you have questions...be as kind as you possibly can. You always get more with honey...
Also, if you really feel you need to work on yourself, go to group sessions or therapy. There really is nothing wrong with that. It actually helps to get it all out in the open and get another person's perspective and advice. You might even feel better after, knowing what you need to work on. Then practice on it!
I am sure you will be a good nurse if you really work at it and I wish you nothing but the best!Last edit by Beautiful Mind RN on Jan 4, '13
Jan 4, '13Interesting. I will wait to see if we do this. So what happens if they need more piggy backs during this 4 hour period? They are always coming up with something new that takes more time.
Jan 4, '13Quote from RNTCI hear what you are saying, and I have seen nurses do this, and also I have done this. In the places and units I am referring to, it is very easy for assignments to get changed--preceptor situation or not-- so unless the nurse on orientation wants to research all the patients in the unit at that time (also not knowing what's in the ED or what's moving in from emergent ORs or the like, and then who can be moved and who can't--information that the charge nurse and the supervisor know), well unless than an exercise in academics (which may not be without merit) is what he or she will likely encounter.Reading your original post, my advice is to not "be that person". You have developed a reputation and you need to improve your practice by being consistent and trustworthy. To do this as a new nurse especially, you need to come to work up to an hour prior to your shift and gather information regarding your assigned patients, i.e. hx, iv, tele, tests, labs, Dr notes, etc. Know your patients thoroughly before you step into the room. You may receive this info in report but with your reputation and being a new nurse you need to be prepare yourself accordingly. The goal is to strengthen your reputation by showing that you are putting in the time. Your coworkers will see improved effort and develop respect for you. If you are not prepared to leave your current position you need to develop an action plan. Being a new nurse is very difficult; you are learning so much information on the job and on the go. The first year is the most difficult you need to be proactive in your approach. Ask lots of questions, you will find your peers respect you for being thorough. Find the coworkers you can trust and develop a bond with them and they may be able to mentor you through this tough time. You can do it!
In hospital areas, people are moved around quite a lot. Some charge nurses are not that supportive of newbies coming in early for the 411, when they haven't figured out how things are going to roll. Finally, some units have policy where the on-coming charge nurse makes the assignments. They may or may not come in early enough. I think coming in early to learn about the different players in the unit, is a good academic experience, but it may or may not help some poor newly hired nurse "precepting" in a particular unit. In fact, in just about every unit I have ever worked, patient assignments were very dynamic, whether there were people on orientation or not. You are expected to roll with it. So then this really comes down to the quality and effectiveness or the preceptor, nurse educator, and the manager.
I say your idea is a great one, but it doesn't always work in certain areas of units, b/c the flow of movement can be dynamic.
I have seen very few places that have worked diligently at developing comprehensive, objective systems for precepting. And too many times, being a preceptor is either thrusted upon a nurse, or he or she really is far from the best precepting material by progressively and objectively evaluated systems of measurement. By that I mean to say, X amount of newbies know how to play the right political games, and they give lip service to their preceptors, b/c they want to be accepted and not weeded out. IOW, the preceptors' and the systems' evaluations are not objective. So then preceptors are praised and past on by these standards rather than more truly objective ones. Same thing with the evaluation of the preceptee. The patience required to precept as well as the evaluations often comes down preceptor/nurse educator/other staff/and nurse manager biases. This is not right. So it way too often comes down to predominate likeability, which may be a factor, but is given way too much weight and isn't put together with the big picture, in balance. Nursing is often doing things just plain WRONG when it comes to the whole preceptor/preceptee process.
Of course the newbies should be open and accountable; but I am talking about a much bigger, more pervasive problem.
I don't know what the OP means by lazy or stupid. I wish she would expound upon these subjective terms. That doesn't help in any kind of solid evaluation process.
Jan 4, '13Quote from superVNew guidelines are for Zozyn to run over 4 hours, it has been found to be more effective. We just recently started this timing.
This > also:
In patients with renal insufficiency (Creatinine Clearance ≤ 40 mL/min), the intravenous dose of ZOSYN (piperacillin and tazobactam for injection, USP) should be adjusted to the degree of actual renal function impairment. In patients with nosocomial pneumonia receiving concomitant aminoglycoside therapy, the aminoglycoside dosage should be adjusted according to the recommendations of the manufacturer. The recommended daily doses of ZOSYN for patients with renal insufficiency are as follows:
Recommended Dosing of ZOSYN in Patients with Normal Renal Function and Renal Insufficiency (As total grams piperacillin/tazobactam)
For patients on hemodialysis, the maximum dose is 2.25 g every twelve hours for all indications other than nosocomial pneumonia and 2.25 g every eight hours for nosocomial pneumonia. Since hemodialysis removes 30% to 40% of the administered dose, an additional dose of 0.75 g ZOSYN should be administered following each dialysis period on hemodialysis days. No additional dosage of ZOSYN is necessary for CAPD patients.
Renal Function (Creatinine Clearance, mL/min) All Indications (except nosocomial pneumonia) Nosocomial Pneumonia > 40 mL/min 3.375 q 6 h 4.5 q 6 h 20-40 mL/min* 2.25 q 6 h 3.375 q 6 h < 20 mL/min* 2.25 q 8 h 2.25 q 6 h Hemodialysis** 2.25 q 12 h 2.25 q 8 h CAPD 2.25 q 12 h 2.25 q 8 h * Creatinine clearance for patients not receiving hemodialysis
** 0.75 g should be administered following each hemodialysis session on hemodialysis days
Zosyn (Piperacillin and Tazobactam Injection) Drug Information: Indications, Dosage and How Supplied - Prescribing Information at RxList
Jan 4, '13Sometimes when you've (general) been working at a particular place, you tend to gloss over P&Ps and figure you "know" a procedure since you've seen it done countless times.
I think you should forget about making freinds for now and just try to learn as much as possible. Even if you think you know, listen to your preceptors. Even if one of them shows you a different way, nod and pay attention. Never bad mouth another preceptor or co-worker.
At the end of every shift or during downtime, sincerely ask for criticism. Even if you don't agree, you probably will not change the preceptors opinion of you, so nod, apologize and never repeat that mistake again.
Unless the pt is CLEARLY in danger, let the preceptor do things her way, and once out of earshot of the pt, compliment her on her way and ask for rationale.
Come in early, go over charts, offer to help others.
It's easier to destroy someone's reputation than it is to restore it, so don't expect people to forget everything in a week.
*****You made it through nursing school, passed NCLEX and got hired at the same facility so you must be doing some things right.