I know most new nurses ask questions similar to this so I apologize in advance. I tried talking to my Charge Nurse but she didn't want to talk to me any of my last 3 shifts and I have no idea how to dig myself out of this rut.
-I seem to be declining in performance. I was fine the first month on my own, but now 5 months into my Med/Surg position (3 months w/preceptor, 2 months solo) I am barely keeping my head above water.
For example: I've now had 3 patients in the last 2 weeks "fire" me as their nurse, today alone there were 2 of them and they complained about me to the doctor so they were reassigned supposedly so they wouldn't "make the rest of my shift miserable" (according to Charge RN). In addtion, the CNAs and UC all feel free to criticize how slow they think I am and complain about me asking them for anything at all so I have to total care all my patients because apparently "I don't do enough" during the shift. And finally, no matter what I try for time management the plan does not survive anywhere near intact for more than the first hour of shift. By mid 8 am med pass I am behind, running like a headless chicken, and unable to prioritize because I am constantly told that "everything is important so you need to hurry up and multi-task and get everything done in the next 15 minutes so you aren't any later."
I end up crying in my car everyday at lunch time and sometimes in the restroom during shift. We have no DON right now so I can't even go to anyone else to ask to change to night shift, or split my schedule (who knows if they'll give me my schedule request so I can have more than 1 day off in a row), or even change floors even though I'm supposed to stay for 1 year due to New Grad contract. It's so bad I even contemplated turning in my license and going back to working at Wal-Mart.
Sorry to unload I just don't know what to think. I've probably burned all my bridges already but I'd at least like to know that so I could quit instead of being fired.
How many patients do you have per shift? What types of patients?
If you are doing total care on 5-6 high acuity patients, it's no wonder
you are behind all of the time. You shouldn't be afraid to ask the
CNA's and UC to help you do things that is their job.
Of course, I know from my own unfortunate experience.. there are
CNA's that will gladly bite your head off for asking them to do
things that you likely could have done yourself... especially if
the CNA is busy doing something else. But if a CNA is sitting
at the desk charting, they can help you with those tasks.
How many pt total. Why do you have to do total care? That's what CNA's are for? You should be doing only meds and tx, then if something is urgent then you can do care, otherwise the CNA should be doing care??
Why are the patients "firing you" that's the issue. Is it your bedside manner? Are you being rude? Rude to family? Are you not giving them their pain meds when they are "begging for it?"
---- If a pt is asking for pain meds- give THAT med only and finish your sequence, whatever path you were already on and tell them "i'll be back later for the rest of your AM meds, I'm at the other end right now" and walk away.
Are y ou forgetting pt preferences? Like crushes with applesauce? Whole with cold water, not warm? Things like that? Think about what it is that is making these people mad and see what you can change.
This just might not be the facility for you, maybe LTC, clinic, anything else? If you have to stay there another 6 months just work on what you need to so that patients aren't unhappy.
We are nurses so our patients are happy and can get healthy again, you need to find a way to make them happy and they will BEG to have you as their nurse not the other way around.
I have 6 patients of various acuity. I believe today there were three 3's and three 4's (5 is where we draw the line and refuse to take a patient). I had 2 that were pain management though one only asked for pain meds twice. The reason one patient fired me was because I didn't spend enough time in his room. Now I was told he was difficult to everyone when I took report, so I don't feel quite as bad about him as I do the other patient who's mother was upset that I took 10 minutes too long to give her daughter pain medication. The patient and I had a good rapport until her mother showed up and then I was the root of all evil somehow.
I do total care because I'm tired of being ignored when I do ask the CNA to do something while I pass meds. I have to pick my battles and honestly I just don't have the energy to argue anymore. No one gives a damn if my day is spiraling out of control as long as they don't have to listen to me.
As much as I'd like to just up and quit I know I probably won't get another nursing position. I'm already on job number 2 in just under a year (5 months in each job). At the same time though, I'm not overly confident that I have many more chances left to show improvement.
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