When they're giving out assignments . . .

tampaflrn6 · Jun 4, 2008

I had that happen to me this week. On other floors that I been by myself I was able to handle the stressful patients. But this particular floor that I got off of orientation a week ago was not. They gave me 5 patients on a weekend (always short staff on the weekends). These patients were needy, had PCAs, small complaints like nausea, Nurse aides not helping you out, changes in patient's status, and one thing after another. I was able to pass out all my meds, but could not get caught up with my charting. My charting sucked that day. I was so so ****** off in my mind. The other nurses had less than 4 patients and chating at the nurses station. I got so ****** off... I cried. It was embarrassing, but the anger and stress overwhelmed me.

So i understand what you are going through. I think they are testing the newbies if we can handle a patient load by ourselves.

JRD2002 · Jun 4, 2008

Honestly on our assignments we don't even look at who they are or what they are in with. We divide the floor into small blocks and randomly assign them. Every other Monday we rotate with each other. That being said if one of us has a particularly bad group of people we are always quick to help each other out.

SoundofMusic · Jun 4, 2008

I think I'm just going to ask my preceptor to clarify it. I just want to know the policy, if there is one.

I also want to know what we can get written up for. Seems they don't seem to cover that in orientation, but you sure hear a lot about it on the floor.

Sometimes the expectations are SO vague and they assume as a new person, that you know all of these subleties -- but you don't.

Morettia2, BSN, RN · Jun 4, 2008

I have been waiting for a post like this for a while. I have been at my hosp. for almost 1 year. And I have up and down nights. I am no longer the new girl on night shift.

I was given all of the WORST pt. assignemnts, to the point I felt like quitting. My girlfriend who started 2 months before me also had the same problem until I came along.

Now I see them doing it to the new girl on my floor. She graduated last year, same as I, but worked in a pain management clinic untill she was hired at my hosp.

She finished orientation about 1.5 weeks ago. So she is on her own on night shift with me. I see the assignments the day shift charge nurse gives her for the night, so when she starts her shift at night, the day charge is already gone and the night time charge won't change it, It's AWFUL I had the same problem. I still get the AWFUL assignemnts when ever she isn;t there and my girlfriend gets the AWFUL assignments when ever I am not there, but we learned how to deal and manage, which takes time.

I ALWAYS reach out to the new girl on my floor and ask if she needs help. I say to her, "I know how this feels, I will help you with what ever you need." She always say she's fine. But I see her running round like crazy,like I still do.

I pulled her aside and said, "What can I do to make some of this madness better for you." She always says to me, "I don;t know how you do it." I said, "It took a very long time, and I still have problems, but when ever, which is rare on this floor, someone offers me help I take it, as long as I can reciprocate it in the long run for someone else, it just makes team work possible."

She gets all of the critical pt's. on top of admissions. I get the same load, but when ever she is working I see how the nurses treat her. Not offering help, or just giving a little bit of advice, ignoring her ect..I went through the same EXACT THING and it still happens to me.

I can;t let the RN's I work with at night with make her as crazy as they made me. It's in my nature to help her out. She's younger then me by 4 years and I am already starting to see how much she is hating our floor. I always offer to switch pt.s with her so maybe i can take a load off of her back. I try to give her tips and tricks, tips how to handle the other nurses, and how to deal with some of the crazy situations on our floor. I always do her admission orders, if i can. I show her what to do, b/c on my floor orientaion is a joke.

I also told her if she is overwhelmed speak up. It took me months to learn how to do this. Mostly b/c I was the new nurse on night shift, so I didn;t want to be a pain to anyone or "that nurse", but I realized when I have WAY TOO much going on I need to speak up.

I also told her that it takes a while to get to know the different personalities on the floor. Being new it takes a while to find out who will help you when you need it and ACTUALLY help you, who will say they will help you but when you ask they have every excuse in the book not to help you, and there are the ones that just ignore you and don;t want anything to do with you.

I also said get to know the CNA's, they are my bestfriends and I love both of the 11p-7a CNA's. If you are nice and say please and thank you, it goes a long way, and if you can help them out when they need it, they remember that, don't bark orders at them and make them feel like they are beneath you.

My CNA's told me that there are 3 nurses that they have respect for that work night shift and I am one of them. Reason being, I never talk down to them, I always say I will help and I always say please and thank you for what a great job they did before they go home in the morning.

Believe me there have been manytimes I have been in a bind at 7am right before shift change and everything goes to poop literally. One example my 2 CNA's were ready to leave, bag in hands and walking out the door and saw me trying to ask the 7a-3p, CNA to help me with a pt. with an exploding ostomy bag that needed to be cleaned, it was everywhere. The 7-3 CNA told me she was busy and Ignored me. My Night CNA's dropped their bags, said "Ang, we are here to help you, not a problem." We had the whole mess cleaned up in 10 minuites. I gave them both a hug and said, "you have no Idea how much this means to me." They have even stayed late to help me take pt's for stat scans b/c the pt. went south at 6:45AM and knew I would have no help at all. I thank these ladies every night I work with them.

I also remember their birthdays b/c no one ever does, and just the fact that I said, "Happy Birthday" or got them a card goes a LONG way!!

I can't say it will get better, but from all of the BS we deal with as new nurses, we learn how to manage our time eventually, I am almost at my 1 year mark and still have problems.

I do know from getting the worst of the worst pt's I can identify things and handle situations alot better and with more skill then I was able to a fwe months ago. I am able to tell the MD's get up here NOW and evaluate this pt., and don;t tell me I will get there in a little bit. I see the new girl call the MD's at night and they ignore her or don't show up, like they used to do to me. I said you have to get aggressive, not witchy but aggressive. I have gained alot of MD's respect by being aggressive as to comming to evaluate a pt., ot just follow through with orders.

I also said to her, DO NOT let the day shift RN's give you a bad report, or just leave things out, b/c they will do it and leave you with a mess to clean up. Do a through chart check while getting report. She has the same problem I had. She was on Day Shift for 8 weeks and and since she is Night Shift now, she dosen;t want to point out things that should have been done during the day shift b/c she is afriad of what they will think. Worst of all the day shift RN's know how to push over the new night shift RN's, and it is awful. I told her don't let them do it to you b/c when you go to give report in the morning and are bombarded with 1 million questions, you end up scrambling to find the answers. I just got over that fear a few weeks ago and I am almost 1 year into my 1st year of nuring.

I gave her the new report sheet I use, which works like a charm. I made it out of frustration, b/c I was always left with a crap report at the start of my shift. I also said don;t let the day shift RN's that also graduated with us in 2007, give you crap, she said ,"I noticed they act like thy are better than me." I said it has to do with the fact they have been working on the floor longer. Just tell them if they have a problem with you, to tell you, and it usually diffuses the situation. I also said if the day shift nurse is short, ask them if they are ok, or if they got enough sleep, this always seems to do the trick, and the attitude usually goes away or at least you understand why they are being short with you.

Hope this helps, sorry it was so long but I had to get it out b/c I know EXACTLY how you feel. First year nurses, it's tough and you may hate every minuite, but you learn how to deal with situations, and manage people and problems from the experience you are getting. It took a long time for me and I still have problems.

But all I know, if my pt.s say to me at the end of my shift, thank you so much for everything you did for me, or I love when they ask If I will be back tonight, or they only ask for me to be their nurse tonight b/c I am the only one who actually took care of them, I know I did my job the RIGHT way.

Remember, we are here for the pt.'s, and I KNOW it's hard to remember that when we get the most horrible pt. assignments on a regular basis, deal with all the chaos and confusion, questioning why we became a nurse, or worse feeling like handing your badge in and quitting (which I have wanted to do more times than I can count) , I also remember it makes us grow into becomming excellent nurses, and giving our pt's the time and care they need.

When I feel like I want to just quit right then and there, I ALWAYS have one pt. that seems to remind me why I became a nurse, even if they didn't say it. It's a smile or just a thank you for all I did for them. That no matter how much I whine on the phone on my drive home to my mom, about how horrible my night was. About an hour after I get home I always remember that I got through the night, no matter how much I hated it, and I was able to provide the best care I possibly could for mt pt's. And if i made an impact on at least one of the 6 pt's I had that night, it seems that I am meant to be the RN I worked my but off trying to become.

REMEMEBR HANG IN THERE, AND WE ARE HERE FOR YOU!!! This is what this website is for!!!! I have been using it from my first day as an RN and every morning when I get home from work since. I have had more advice and support on this website, being a new RN, then from anyone I work with. Conrats for becomming an RN, you worked your butt off to be at this point if your life, I know I did!!! Have a drink, or just 5 min. to relax and think why you became an RN.

*wine:beercuphe

RainDreamer, BSN, RN · Jun 4, 2008

I just can't figure out for the life of me why I am always running around like a chicken with my head cut off when at many of the nurses on staff have half the day to sit in the nursing station and just shoot the breeze. What exactly IS their patient assignment?

You're running around like a chicken with your head cut off because you're new and you haven't totally mastered the art of time management. And that's ok ...... you're still learning.

I look back when I was just off of orientation and think of some of the assignments I had ..... some of them made me running like crazy, whereas an assignment like that now, 2 years later, would be a cake walk. Just thinking of the assignment I had last night ..... if I woulda had an assignment like that when I was a brand new nurse, I woulda been stressed out and running around like crazy, rather than reading my book and chit chatting like I did last night.

I work my butt off the first few hours of my shift, so I can get my ducks in a row and then will hopefully have smooth sailing for the rest of the shift. That's obviously not always going to happen with every assignment, as some assignments are busy no matter how well you manage your time. Those nurses that have time to sit at the nurses' station and shoot the breeze have been nurses longer than you have, therefore they've been able to effectively manage their time.

Now, if they're just giving you the grunt work and the crap assignments that no one else wants ..... that's not right. Giving a new nurse a more challenging assignment at times is just fine (you need to learn) .... as long as you have the support of your co-workers. If they're all chatting at the nurses' station while you're busting your butt with a critical patient ..... that's not an environment that's conducive to your learning.

racing-mom4, BSN, RN · Jun 4, 2008

I was given the hardest assignments --the sickest--the busiest and the most. But my boss let me know that right up front...and I am glad she did, that way I didnt feel like they were being "mean" to me, I knew they were doing it to help me...logic being, I had to learn it and in a short amount of time, best time to take on your 1st vented patient was when you had a preceptor you could turn to and ask for help...

We have a 6 bed ICU. 2 RNs that means technically we could each have 3 patients, there were nights when I was in training that there were 4 patients, I was given 3 of them and the teles to calibrate and chart on. While the other nurse had 1.

I am no longer the newest nurse on the unit. We just hired a nurse from the med surg floor to work in ICU, and guess what my boss told me Monday---"Make sure you give Amelia the hardest patient tomorrow, and make sure she takes more than 1." and ya know what----I felt kind of bummed...I like taking the sickest patient now....

SoundofMusic · Jun 4, 2008

I was given the hardest assignments --the sickest--the busiest and the most. But my boss let me know that right up front...and I am glad she did, that way I didnt feel like they were being "mean" to me, I knew they were doing it to help me...logic being, I had to learn it and in a short amount of time, best time to take on your 1st vented patient was when you had a preceptor you could turn to and ask for help...

Now this I could deal with -- if they were up front about it. I would even be grateful and would look at it as a learning experience. I think I just need to find out from my co-workers what the philosophy is for doing assignments. Maybe it's just luck of the draw.

*ac* · Jun 5, 2008

It was this way towards the end of my orientation. I had to take 5 pts no matter what, even if other nurses only took 2 or 3.

It's more even and fair now that I'm off. In fact the first week, they gave me the lighter load. (Only for one week though!)

I really hated those last couple weeks of orientation. I felt like everyone was looking for mistakes with a microscope they wouldn't dare use on each other... It was like having 10 or more bosses at one time.

Aren't you off soon??

Danish, MSN, APRN, NP · Jun 5, 2008

Same here. I hope it will make me a better nurse in the future. I had 7 pts with 2 d/c and 2 admits, while many of the seasoned nurses had 5. :confused:

RainDreamer, BSN, RN · Jun 5, 2008

If you guys ever feel overwhelmed or feel like they're giving you more than you can handle ..... then you need to speak up. There were a few times after I got off orientation that I was given an assignment that was just too heavy and I didn't feel comfortable taking ..... so I said something and they changed my assignment, with no problem whatsoever.

It's good to have a challenge, as you learn that way, but don't ever put your license in jeopardy by taking something that you don't feel comfortable with.

Danish, MSN, APRN, NP · Jun 5, 2008

If you guys ever feel overwhelmed or feel like they're giving you more than you can handle ..... then you need to speak up. There were a few times after I got off orientation that I was given an assignment that was just too heavy and I didn't feel comfortable taking ..... so I said something and they changed my assignment, with no problem whatsoever.
It's good to have a challenge, as you learn that way, but don't ever put your license in jeopardy by taking something that you don't feel comfortable with.

You're right. If I was given so much that I was compromising my pt care, I would absolutly speak up. So far, its just keeping me moving. Nothing wrong with that as long as I am keeping up. It just makes you wonder, when you see some of the assignments and know the other nurses are not given an equal share of the work.