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- Jan 3 by canigraduateAs far as the abx infusion goes, it depends on your order set. I always run concurrent for a rate of 75 or less if the patient has maintenance fluids running. I may slow down the primary rate to keep the IV site from infiltrating, though.
If a patient has a small catheter like a #24, then I may not run them concurrently so as to keep the site. This is part of nursing judgment, which you may not have much of yet. It builds with experience.
- Jan 3 by BostonTerrierLoverRNHi, you have received some good advice, and I am here to say how you "feel" is important to some extent. If you feel totally isolated from the other staff, dread going to work, are a nervous wreck the whole 12hrs,.....I say run!!!! Sometimes thing are just a bad fit, but if this continues- please seek some help, I suffered General Anxiety- and now I am at the top of my game- and don't sweat a few "hushed secrets."
- Jan 4 by InfirmiereJolieOMG you are not stupid, you've only been on the job for 3 weeks. If everyone could be perfect 100% their fist day we would have a utopia society.
I say work EXTRA hard, like push off breaks and ALWAYS look busy. Never stand around and if there's nothing to do... clean or talk to/serve the patients. Probably though, there is ALWAYS going to be something to do. I heard that the best work is work which is not noticed, meaning, you do it without being asked once you've learned how to do it under supervision. If you see it needing to be done and you've already learned how to do it, do it, without the co-workers supervision. Keep doing this until you are nearly 100% on your own. Your boss will LOVE not having to watch you and you'll change your rep from being "new" to "hard worker and best of all, GOOD worker."
I say work way up to down in terms of getting along with co-workers. The boss/ your preceptor director is the PRIORITY. Win their love first and you will win the other's loves too. In a conversation take their side... but try not to alienate the co-worker either. It's about balance and being friendly, but usually, "the boss is always right" . Co-workers like, actually, the co-workers which get along great with the boss because they want to get on their good side too. good luck! (and ignore the people who say it is your problem, psych ect., this doesn't really help at all guys... being the perfect worker and figuring out everything takes time )
Hope this helps!!!!
Quote from nikkole318I 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 thought everything would go smoothly once I got off orientation, but I've been wrong so far. During orientation, I managed to make a lot of really stupid mistakes that I should have known better than to make, had numerous personality clashes with a couple of my preceptors, and got on my nurse educator's bad side. I know that people at work talk about me. I have heard it first hand and get the sense that people do not like me. Although some of it is unwarranted bullying, I realize that some of it is my fault as well. I take the blame because my problems with coworkers seem to follow me wherever I go. I have never had an easy time making friends at work and have always gotten the reputation for being stupid, lazy, etc... I guess what I am asking for is help. I realize that I can control how I present to other people. I am tired of being "that person." I need some tips on how to better my reputation and gain friends at work. I also need some words of encouragement. There is a girl at work who I know has spoke poorly about me to various people and I feel like as a result, these people now have a very negative opinion of me. I can tell by the knowing looks, sideways glances, and hushed whispers in the hall. I realize that I cannot control what other adults do, but these things have really put a beating on my self esteem. Any advice on how to not **** other nurses off, how not to look stupid, and how to overcome a bad reputation? Thanks!
- Jan 4 by chevyvKnowing you accept some of the blame regarding not getting along well with some people is a really good start! I normally get along well with people but have had a couple of run-ins with some staff on the unit I currently work on but on a different shift. Now, I have both of them talking all kinds of garbage to other people who may work with me on a particular day from another unit. I can tell because I too get the side glances. By the middle of the shift however, those staff are telling me outright that I'm wonderful to work with. Because I know there are a few who talk the talk, I just keep on walkin my walk and let others decide for themselves if I'm that nasty to work with. I don't say anything, I let my practice speak for itself and I'm confident in what I do to let them decide about me. So far, the ones talking are looking like sour grapes.
I guess what I'm saying is be yourself but watch how you act or even your body language. It takes some time to find your niche within a unit. You are not alone!
- Jan 4 by samadams8There are actually several ways to run antibiotics, depending upon what the actual antibiotic is. I have run them via piggy-backs. I have given them in solu-sets.I have given them in ports, adapters, and other lines, and I have given them byinfusion pumps. It depends on the system and what is going on with the patient,the particular antibiotic, and then of course the access/accesses you have. Ifa person needs continuous intravenous fluids, another line, port, and or aninfusion pump delivery system will work. If the antibiotic cannot be run withthe other fluids or infusions, then you have to take that into consideration aswell.
Dear OP. We always have to ask ourselves the following:
What amI giving?
How andI giving it?
Why andI giving it this way--as well as perhaps—
Whereshould it go--i.e., which port, etc?
Different things have to be given different ways depending on those and perhaps other factors. This is another reason why nursing isn’t a job “any monkey can do.”
Another example is say you have a patient or kid on a particular infusion, but you don't want to bolus, say, a particular inotrope, that is another consideration, even if pharmacy considers it compatible.
About the personality stuff... Look, in my many years, I have seen a very high percentage (sorry fellow nurses, just one person's humble opinion here) of nurses that don't have the true gift, ability, and insight to be adult teacher/preceptors. Some of them may be fine with teaching little children, butnot adults. At the same time, too many may even NOT want to precept, or they may have inadequate instruction, and they themselves have received little or inadequate observation in appropriate models, and/or they aren't working with a system that promotes or allows for good precepting.
And then some people are just way too insecure to be in a position of guidance or even one-on-one leadership, which is part of what precepting/teaching is. These folks have made it more about them--they don't understanding that part of the role of teaching and preceptingis about having a giving, tolerant, spirit. Sure, they may have to get you through guidelines and competencies, and so they have to stick to those and the deadlines, but there is a weakness in how this is done from what I have seen overall.
Finally, as I have said a zillion times, nursing education systems in hospitals and otherwise, need to develop way more objective systems of measurement of progress and evaluation.
Regarding one of your preceptors you mentioned: It is in NO WAY professional for a nurse(preceptor) to stand gossiping about her or his preceptee with such subjective comments as "She is clueless." I mean,OK, he may be in some areas, and in other she may not be, and then again, he or she may not be at all clueless, the preceptor may not have keyed into what’s going on with the individual. Either way, it was counter productive and grossly unprofessional. That preceptor should be given some counseling and taken out of the role until she is re-evaluated for the role of preceptor. As a manager or nurse educator, I would NOT tolerate that--even if it seemed quite apparent that a said nurse does seem grossly ignorant or incompetent--NOT at all implying that this is you OP.
The point is, there are professional and objective ways of handling this kind of thing. Maybe the nurse needs time and appropriate remediation, or maybe she needs to work in another area for a while,or maybe there is this problematic dynamic between the preceptor and the preceptee, or perhaps some other honest issue. Yes, there's a limited time in which to get someone up to novice-competency speed. But places are cutting their own throats by hiring inexperienced and unready GN/BSNs over experienced RNs, period. Again, not saying that is your situation OP.
The orientation-precepting situation is a two-way street. When parties aren't capable of or able to provide what it is needed, it's a waste of money and it is a lose-lose situation.
But you may well never know, OP, unless your nurse educator and hosptial/floor/unit has the value of objective systems of measurement and evaluation and prognostic indicators, and if these are fairly and consistently used, and then, if youhave someone that is able to evaluate both sides of things without bias. To this I say, Good Luck. Such a situation is VERY hard to find in nursing, I am very sorry to say.
Last edit by Esme12 on Jan 4 : Reason: formatting
- Jan 4 by Esme12Quote from nikkole318The first year after graduation is the hardest. School in NO WAY prepares you to be a nurse ....but I think you have already solved your own problem.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 thought everything would go smoothly once I got off orientation, but I've been wrong so far. During orientation, I managed to make a lot of really stupid mistakes that I should have known better than to make, had numerous personality clashes with a couple of my preceptors, and got on my nurse educator's bad side.
I know that people at work talk about me. I have heard it first hand and get the sense that people do not like me. Although some of it is unwarranted bullying, I realize that some of it is my fault as well. I take the blame because my problems with coworkers seem to follow me wherever I go. I have never had an easy time making friends at work and have always gotten the reputation for being stupid, lazy, etc... I guess what I am asking for is help. I realize that I can control how I present to other people.
I am tired of being "that person." I need some tips on how to better my reputation and gain friends at work. I also need some words of encouragement. There is a girl at work who I know has spoke poorly about me to various people and I feel like as a result, these people now have a very negative opinion of me. I can tell by the knowing looks, sideways glances, and hushed whispers in the hall. I realize that I cannot control what other adults do, but these things have really put a beating on my self esteem. Any advice on how to not **** other nurses off, how not to look stupid, and how to overcome a bad reputation? Thanks!problems with coworkers seem to follow me wherever I go. I have never had an easy time making friends at work and have always gotten the reputation for being stupid, lazy, etc...
You need to go to your manager/educator and tell them...you want to change. That you need a chance and guidance to become a better you and a better nurse for them. Set up an action plan....engege them in honest dialogue that you want to be better but need help. But do your part too!!! When you receive criticism or correction....you accept it with grace and poise and take the input gratefully and learn form it.
Maybe look into counseling.....go to your facilities EAP (employee assistance program) and ask to speak to someone. Change you. Take a good hard honest look at yourself....and move forward. Think before you act and ask questions.
One thing that may help you is to acknowledge that you don't know it all.......that you need help. Maybe you need some help with organization. I have several brain sheet that I share for AN members to use.......these may help. I wish you the best.
mtpmedsurg.doc 1 patient float.doc
5 pt. shift.doc
day sheet 2 doc.doc
critical thinking flow sheet for nursing students
student clinical report sheet for one patient
- Jan 4 by RNTCReading 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!
- Jan 4 by CrunchRNYou stated that in past jobs people have perceived you as "stupid and lazy". I think if you can gain more insight into why they perceived you that way you will know what behaviors you need to change.
Your a new nurse and mistakes will happen to a point. However, if they are the kind of mistakes that come from just not paying attention then you will have people feeling negatively about you.
Maybe sit down with your preceptors and tell them you need their help to know what things you need to change. They may surprise you. Of course hearing what they say will be tough and you will need to gird yourself to take the information in without letting it devastate your self esteem. And you must not be defensive. Once you go down that road they will not be willing to help at all. Not all the things they bring up will be your fault, but you will have to take a little of that to get to the heart of the matter.
I hope you will be able to do that as I fear if not the pattern will just repeat elsewhere. You seem to have good insight and the desire to change and i wish you well.
- Jan 4 by M/B-RNIf 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.