am I beyond hope?

gizelda196 · May 4, 2005

I have suffered from depression for years.(I posted on this some where else). Take care of you. If you need to work to live, find a easy job out of nursing. I waited tables and I loved it.It was hard work but sooooooo much fun!!!!!! When you get to a point that you feel stronger and your clear of that dark tumbling sinking into a endless black hole feeling .Start Your search.Find a place that will have a new grad program .INSIST ON A SINGLE PRECEPTOR.BE STRONG. Refuse to go on your own and document every instance that this was attempted.There are facilities out there that offer very good new grad programs. They are outlined and even have courses.Take a deep breath and hold your head up high. give your self a break. Forget about your awful first experience .They set you up for their own failure and blamed you. good luck

LaShell · May 4, 2005

I feel for you! I graduated with LPN 1 1/2 years ago with honors too, and after working in an ICU as an NA during schooling and seeing and learning so much from great coworkers, I felt pretty knowledgeable. My goal was always to work in a hospital but none was hiring LPN's at the time. I thought my closest bet was a sub-acute unit in a nursing home. My first two jobs were terrible, unsupportive coworkers including a DON who I know was dipping into the patients' darvocet, no support, no supplies, dangerous environment, 6 hours of orientation at one of the jobs..... I felt like I was back to square zero, I lost my knowledge, my self-confidence, etc. Now I'm in RN mobility program and am trying to regroup. I work pt at an Urgent Care clinic which is much easier and am trying to relearn what I lost and start over. When I choose my next job, I will be much pickier and look at orientation programs much closer and ask more questions.

It sounds like you jumped into a super hard job. It's sooo tough to be a new grad. It's hard to believe how green we are, especially when we graduated with good grades and thinking we knew so much. Hang in there, you'll find your niche. Maybe the hospital environment isn't where you'll fit best, if you love OB, maybe a clinic would be a good fit for you. It's less stressful but you still provide an incredible service and will learn and gain experience. Then if you still wanted to try a hospital you could. It really just sounds like you got in over your head temporarily and that your job didn't provide a nurturing environment for a new grad.

hollyster · May 4, 2005

6 weeks new grad ob 7 diffrent preceptors (right there is a set up for failure)
I don't care what meds your on. chop this up to learning experience and fight for your orientation if you don't feel like you've had enough ask for more.

Exactly. You are nervous scared and playing musical preceptors. A no-win situation. Take care of yourself and then look for a job. Start in an area not as stressful, hone your skills and build a comfort level.

Let your new employer know that your that your orientation was erratic but tactfully so. Best wishes.

BETSRN · May 4, 2005

hi everyone, I posted last week that I was worried about losing my job, and sure enough I did lose my job today. My boss said that I was not a safe nurse, and that I needed a refresher course on medication administration. I am a brand new grad, and i graduated with honors. This is not like me at all. I have been taking an antidepressant that I think may be contributing to my lack of organization. Since I've started taking it, I've had a lot of difficulty concentrating, and I feel apathetic when I should be taking something seriously. This is not like me at all. I can't get a doctor's appointment for at least a week.
I have never felt this low in my life. I felt like I did not get adequate orientation and supervision while I was there. I didn't even get my full 12 weeks in. I was off by myself a lot, and passed to several different preceptors during the six weeks I was there, at least seven different preceptors. My boss said I shouldn't work anywhere until I take a refresher course.
I have never been so ashamed, or just totally surprised at myself. This was a coveted job in OB that I got as a new grad. I feel like I will not be any good in the next place I go to.
Do you guys have any advice about keeping yourself organized during your shift, and keeping up with charting, and med administration? How will I know if I should not be a nurse anymore? Should I just take the hint here?
Thanks

First I am sorry for the problems you have encountered. You need to get your health (physical and emotional) in check first. That may take a while.

I am sorry that you did not have an adequate orientation. You should ahve had at least 12 weeks MINIMUM!! Your employer dropped the ball on that one for sure. It sounds as if you were bounced around and given many different prceptors and that never works.

You do need to look at your boss' overall perception of you and figure out what went wrong. Why did you have so many different preceptors? Did people find it difficult working with you? What skills are/were you lacking? What, exactly, was wrong with your performance. Make sure you understand the reasons so you can improve next time.

I agree with letting your next employer know about what happened. You are STILL a new grad and should be precepted as one.

I know you graduated with honors. That's wonderful! You did well academically, but how were you CLINICALLY during school? Were you organized and were you able to concentrate then? if you were then maybe it is your medications and all the more important that you get a medical evaluation.

Were you given your antidepressant by a psychiatrist? I think that is so important. There are too many general practitioners out there who give out meds like they are candy and never require the person taking them to have a full phychiatric evaluation. I think that is very unfair to the person taking the medication.

Take the time to get squared away so that you feel better. Otherwise, your license and your patients are on the line and that's not a good feeling at all.

What kind of OB position was it? I am just curious?

Good luck.

BandEmom · May 4, 2005

The reason I had so many preceptors is because the hospital I worked at was quite rural, and there were only three nurses working together on a shift at any one time. Rather than having me just follow a nurse's schedule, my boss had me working five 8's monday thru friday, so whatever nurse working at the time who had been trained as a preceptor would take me. I was with one for seven shifts, that is the most I had been with any one person. Over the course of the six weeks I was there, we would have periods of low census where there would be just one mom and one baby, and we were getting canceled, and then a week later, we would get slammed with 6 labors in one shift, (keep in mind this is a place that does about 60 births a month). So when we would get slammed, I'd be working on my own for the shift, which happened at least 4 or five times. The staff working would always be supportive and ask if I'm doing ok, but they were all taking labors, so I'd be getting by, getting my charting done, and my assessments and things, and my patients were always stable with no problems, but if I was doing things wrong, I didn't really know about it at the time. Plus, with four moms and four babies all for me to handle, if something did go wrong, like a baby hasn't nursed for hours, and this first-time mom can't get the baby latched, I could not spend the time with her, and if I did then everything else fell apart. I started out my orientation learning labor and postpartum at the same time, so the time I could have spent slowly learning just to be a nurse, was spent in this intense environment where I felt totally overwhelmed. So the total number of precepted shifts I had in postpartum was probably around 10 or 15.

My boss takes offense to the fact that I was dissatisfied with the precepted experience that I had. Some of the things I did wrong were not documenting some medication-related incidences such as dropping a pill on the floor and pulling a new one out of the accudose, (which happened while I was running around on my own), pulling a med from accudose at 11:10, documenting on the recovery flow at 11:15 that I gave it, and writing 11:20 on the mar. (No one ever told me that all the minutes had to be the same, something I could have learned if someone had told me). Another example is a pt I transfered without having had her fill out the birth certificate worksheet. No one was with me when I was doing the transfer. The baby had been transfered to a tertiary care facility earlier in the day, she was only 8 hours old. The birth certificate worksheet is something we kind of check off last as the pt is being discharged. This was a strange situation and to make it even worse, another nurse was "helping" me by putting all the transfer paperwork together for me, which was helpful, but by having had someone else do it, it didn't occur to me that there was missing paperwork. My boss was FURIOUS about this happening because she was the one who found it the next day, and had to call the pt in the other hospital to fill in the worksheet.

In hindsight, I wish I had recognized that I just wasn't mentally all there. I went home crying so many times, and I felt lonely all the time even though there were some very nice nurses there. In fact they were all very nice, but the orientation program was disorganized. And there was no one person who knew me, and what my learning needs were, or where I was strong and doing well. I never got much positive feedback from my boss, because she never saw me with a pt, and she only knew about things that went wrong.

I believe in my heart that I am a great nurse, and I love being a nurse, and I want to do my best. I think I need help with staying organized, and I think I need clear consistent instructions to follow until I feel confident. I think my boss interpreted this as a lack of critical thinking skills, which she told me I needed to improve. In school, I was always told that I had excellent critical thinking skills by clinical and theory instructors, and I always scored the highest in the class on the tests that measure this.

As for my meds, I have switched brands three times. I started on prozac, which gave me awful head aches, zoloft which didn't help at all, and now celexa which I just started right before I started at this hospital. The celexa has not helped me at all, so basically, I've been at zero trying to transition from student to rn. Plus I have a one and three year old, and a husband who has been traveling. I feel like my life is this constant disaster!

I appreciate being able to communicate with you guys, the advice i've heard is great and I will use it all!

NurseFirst · May 5, 2005

the reason i had so many preceptors is because the hospital i worked at was quite rural,
and there were only three nurses working together on a shift at any one time. rather than having me just follow a nurse's schedule, my boss had me working five 8's monday thru friday, so whatever nurse working at the time who had been trained as a preceptor would take me. i was with one for seven shifts, that is the most i had been with any one person. over the course of the six weeks i was there, we would have periods of low census where there would be just one mom and one baby, and we were getting canceled, and then a week later, we would get slammed with 6 labors in one shift, (keep in mind this is a place that does about 60 births a month). so when we would get slammed, i'd be working on my own for the shift, which happened at least 4 or five times. the staff working would always be supportive and ask if i'm doing ok, but they were all taking labors, so i'd be getting by, getting my charting done, and my assessments and things, and my patients were always stable with no problems, but if i was doing things
all really good reasons to choose a larger hospital next time
wrong, i didn't really know about it at the time. plus, with four moms and four babies all for me to handle, if something did go wrong, like a baby hasn't nursed for hours, and this first-time mom can't get the baby latched, i could not spend the time with her, and if i did then everything else fell apart. i started out my orientation learning labor and postpartum at the same time, so the time i could have spent slowly learning just to be a nurse, was spent in this intense environment where i felt totally overwhelmed. so the total number of precepted shifts i had in postpartum was probably around 10 or 15.
my boss takes offense to the fact that i was dissatisfied with the precepted experience that i had.
your boss and you clearly had different expectations about what you should have in your preceptorship. do your research--i'm sure you can get a lot of feedback here--about what you should expect in your preceptorship. you may also want to look at some negotation training and/or read some books on negotiations--it will serve you well in many arenas. "getting to yes" by the the harvard negotiations project is a particularly good one. you may also be assisted by some assertiveness training--read "when i say no i feel guilty"--it is the seminal book in that arena.
some of the things i did wrong were not documenting some medication-related incidences such as dropping a pill on the floor and pulling a new one out of the accudose, (which happened while i was running around on my own), pulling a med from accudose at 11:10, documenting on the recovery flow at 11:15 that i gave it, and writing 11:20 on the mar. (no one ever told me that all the minutes had to be the same, something i could have learned if someone had told me). another example is a pt i transfered without having had her fill out the birth certificate worksheet. no one was with me when i was doing the transfer. the baby had been transfered to a tertiary care facility earlier in the day, she was only 8 hours old. the birth certificate worksheet is something we kind of check off last as the pt is being discharged. this was a strange situation and to make it even worse, another nurse was "helping" me by putting all the transfer paperwork together for me, which was helpful, but by having had someone else do it, it didn't occur to me that there was missing paperwork. my boss was furious about this happening because she was the one who found it the next day, and had to call the pt in the other hospital to fill in the worksheet.
in hindsight, i wish i had recognized that i just wasn't mentally all there. i went home crying so many times, and i felt lonely all the time even though there were some very nice nurses there. in fact they were all very nice, but the orientation program was disorganized. and there was no one person who knew me, and what my learning needs were, or where i was strong and doing well. i never got much positive feedback from my boss, because she never saw me with a pt, and she only knew about things that went wrong.
i believe in my heart that i am a great nurse, and i love being a nurse, and i want to do my best. i think i need help with staying organized, and i think i need clear consistent instructions to follow until i feel confident. i think my boss interpreted this as a lack of critical thinking skills, which she told me i needed to improve. in school, i was always told that i had excellent critical thinking skills by clinical and theory instructors, and i always scored the highest in the class on the tests that measure this.
as for my meds, i have switched brands three times. i started on prozac, which gave me awful head aches, zoloft which didn't help at all, and now celexa which i just started right before i started at this hospital. the celexa has not helped me at all, so basically, i've been at zero trying to transition from student to rn. plus i have a one and three year old, and a husband who has been traveling. i feel like my life is this constant disaster!
i appreciate being able to communicate with you guys, the advice i've heard is great and i will use it all!

i'm sorry you've had such a tough time--i'm sure your family issues haven't made it any easier. it also sounds like you need someone to be able to let off steam with; a therapist may be a start--but you may want to find others as time goes on. you absolutely need to have someone you can safely let off steam with. i'm pretty sure that some exposure to cognitive therapy would help you as well (one of my favorite books on that is called "feeling good" by david burns, ph.d.--he also has a depression inventory therein which is helpful in keeping track of how your depression is doing.)

whatever, and whoever may or may not be responsible--remember these two things:

1) you can't change the world--you can only change yourself.

2) you can't change events -- but you can change how you react to them.

(if you are not familiar with the technique of re-framing--look it up on the 'net--it is an extremely useful perceptual "tool".)

good luck,

nursefirst

lady_jezebel · May 5, 2005

I was spaced out in school while on Paxil. I switched to Prozac, which worked really well. It's interesting how the SSRIs can really differ in their effects. Maybe you could ask the doc to switch your rx this Friday?

As for your job, it sounds like that place wasn't at all supportive. They did not provide a proper orientation, for 7 preceptors is really way too many. Additionally, suggesting a "refresher" course may have been rude & way off the mark -- for maybe THEY are the one's with the deficiency? Maybe they didn't provide the type of support that you & many other new grads would need? Maybe they just didn't have the time/staff? Don't worry about it. Let it go. This time when you interview, discuss your need for a proper orientation. This first job simply wasn't a good fit.

Your life sounds stressful right now -- two young kids & an absent husband! I bet you're sleep deprived. Can anyone help you out? Do you have family in town?

Nurseprotect · May 5, 2005

Debi,

WELCOME! to this nasty trade.

Debi, any nurse with half a brain cell can see that YOU are NOT the problem here.

>>

YOUR BOSS is the problem - NOT you!

Do I need to repeat this?

>>

This is RIDICULOUS! It speaks for itself. YOUR BOSS is the problem - and a sad *** excuse for a nurse leader if I have ever heard of one.

>>

Who is your boss? - I would love to tell them to their face what a sorry excuse for leadership they represent.

>>

Recognize that your INCOMPETENT BOSS was doing their best to make you believe that you were not mentally all there. This is a sickening tactic used by incompetent nurse managers.

>>

Your BOSS is a dangerous, incompetent, and oh so typical of management.

>>

YOU are not the problem.

>>

Your boss doesn't know the first thing about critical thinking skills.

>>

This is SO TYPICAL - you are a THREAT to your incompetent boss.

Re: the nurse who recommended the book "Getting to Yes" - AVOID nurses like this at all costs - they think like your manager - I learned the hard way.

The book should be titled "Getting Toyes" as it reflects the ridiculous mindset necessary to become a manager - and if you have this SELLOUT mindset, you get bonuses, higher salary, and all of the token rewards and relative protection that comes with being a manager in any industry. You have the disposable income to buy "Toys."

The difference from this trade to several others is that you have human life DIRECTLY in YOUR hands.

Welcome to this nasty trade Debi.

YOU are NOT the problem - this nasty trade is the problem.

Take care.

Steve Lee, RN

Judee Smudee, ADN, RN · May 5, 2005

I totally agree with Tweety! I am also a new grad and going through orientation. I have the same preceptor and follow her schedule...this is my third week. It is all new and overwhelming!!! Knock on wood, but so far things have been going ok, and I seem to get plenty of support from my preceptor and other nurses on the unit. I really think you weren't given a good orientation for a new grad. The hospital system I am working at has a program entirely devoted to new grad nurses. We have three full days classes with topics related to a new grad, monthly round tables, and workshops twice a month--all paid. I would advise that you look for a position that offers you some support. My unit also has a unit educator that I meet with ever so often to discuss how my orientation is going. Don't be so hard on yourself--like Tweety wrote, you needed a more nurturing environment.
Karen

This sounds like the perfect orientation.

BETSRN · May 5, 2005

The reason I had so many preceptors is because the hospital I worked at was quite rural, and there were only three nurses working together on a shift at any one time. Rather than having me just follow a nurse's schedule, my boss had me working five 8's monday thru friday, so whatever nurse working at the time who had been trained as a preceptor would take me. I was with one for seven shifts, that is the most I had been with any one person. Over the course of the six weeks I was there, we would have periods of low census where there would be just one mom and one baby, and we were getting canceled, and then a week later, we would get slammed with 6 labors in one shift, (keep in mind this is a place that does about 60 births a month). So when we would get slammed, I'd be working on my own for the shift, which happened at least 4 or five times. The staff working would always be supportive and ask if I'm doing ok, but they were all taking labors, so I'd be getting by, getting my charting done, and my assessments and things, and my patients were always stable with no problems, but if I was doing things wrong, I didn't really know about it at the time. Plus, with four moms and four babies all for me to handle, if something did go wrong, like a baby hasn't nursed for hours, and this first-time mom can't get the baby latched, I could not spend the time with her, and if I did then everything else fell apart. I started out my orientation learning labor and postpartum at the same time, so the time I could have spent slowly learning just to be a nurse, was spent in this intense environment where I felt totally overwhelmed. So the total number of precepted shifts I had in postpartum was probably around 10 or 15.
My boss takes offense to the fact that I was dissatisfied with the precepted experience that I had. Some of the things I did wrong were not documenting some medication-related incidences such as dropping a pill on the floor and pulling a new one out of the accudose, (which happened while I was running around on my own), pulling a med from accudose at 11:10, documenting on the recovery flow at 11:15 that I gave it, and writing 11:20 on the mar. (No one ever told me that all the minutes had to be the same, something I could have learned if someone had told me). Another example is a pt I transfered without having had her fill out the birth certificate worksheet. No one was with me when I was doing the transfer. The baby had been transfered to a tertiary care facility earlier in the day, she was only 8 hours old. The birth certificate worksheet is something we kind of check off last as the pt is being discharged. This was a strange situation and to make it even worse, another nurse was "helping" me by putting all the transfer paperwork together for me, which was helpful, but by having had someone else do it, it didn't occur to me that there was missing paperwork. My boss was FURIOUS about this happening because she was the one who found it the next day, and had to call the pt in the other hospital to fill in the worksheet.
In hindsight, I wish I had recognized that I just wasn't mentally all there. I went home crying so many times, and I felt lonely all the time even though there were some very nice nurses there. In fact they were all very nice, but the orientation program was disorganized. And there was no one person who knew me, and what my learning needs were, or where I was strong and doing well. I never got much positive feedback from my boss, because she never saw me with a pt, and she only knew about things that went wrong.
I believe in my heart that I am a great nurse, and I love being a nurse, and I want to do my best. I think I need help with staying organized, and I think I need clear consistent instructions to follow until I feel confident. I think my boss interpreted this as a lack of critical thinking skills, which she told me I needed to improve. In school, I was always told that I had excellent critical thinking skills by clinical and theory instructors, and I always scored the highest in the class on the tests that measure this.
As for my meds, I have switched brands three times. I started on prozac, which gave me awful head aches, zoloft which didn't help at all, and now celexa which I just started right before I started at this hospital. The celexa has not helped me at all, so basically, I've been at zero trying to transition from student to rn. Plus I have a one and three year old, and a husband who has been traveling. I feel like my life is this constant disaster!
I appreciate being able to communicate with you guys, the advice i've heard is great and I will use it all!

First of all, it takes many weeks for any antidepressant to get a good blood level to help you. You have not had the Celexa long enough.

Secondly, you should NOT be learning any labor at all for at least 6 months. You need time to get it together in post partum before doing anything else at all!

The fact that your manager took offense says a lot right there. You had a poor experience and it was really HER responsibility to make sure things were better for you. It would have been better for you to follow one preceptor's schedule as much as possible.

You clearly were NOT ready to fly on your own and you should never have been counted (as a nurse) at all, whether it was slow or busy. You should NEVER have been cancelled. We never cancel our orientees. A slow time is a great time to learn and practice, read policies, go over whatever you need to do.

You clearly have not done your neonatal resuscitation either, I assume. That automatically right there says you should have NO part of labor or nursery really.

My point in mentioning these things is not to make you feel bad but to help you see that what happened set you up for your demise there. This was a poor expereince: no doubt about it.

Chalk it up and go on. Do not be afraid to tell your next interview what happened. They will appreciate your honesty. Make sure you are very clear about your needs related to an orientation. You are still a new grad. That's okay.

mtnmom · May 5, 2005

I am so sorry. You are not a bad nurse. you have just had a bad experience. Sounds like you were severely mishandled.

Is there a facility near you that has a dedicated postpartum or Mother/baby unit? This might be a really good place to start. Otherwise, dont just run out and take the first nursing job that will hire you just to get a job. Investigate several options.

You and I share many things in common. I feel your pain but I know you will truimph. I know because I have been there.

If you are honest about what happened and do not try to place blame, it should not hinder you from future success. Just say the position was not a good fit (which is an understatement).

Take a little time, some deep breaths, enjoy your family, get your medicine straightened out and pray. Where a door closes, a window soon opens.

Please keep us posted and email me if you need to :)

NurseFirst · May 6, 2005

re: the nurse who recommended the book "getting to yes" - avoid nurses like this at all costs - they think like your manager - i learned the hard way.
the book should be titled "getting toyes" as it reflects the ridiculous mindset necessary to become a manager - and if you have this sellout mindset, you get bonuses, higher salary, and all of the token rewards and relative protection that comes with being a manager in any industry. you have the disposable income to buy "toys."
sorry, steve--i had no idea that people shouldn't learn about negotiations. what do you suggest, besides placing the blame entirely on her boss? when a person blames other people for a situation they are in, they lose choices in how to deal with it--because everything then becomes how to change someone else or how to avoid that someone else. when starting out, it is easy for people in authority to influence the people under them as to how to feel about themselves. as i've gotten older, i realize that i have choices about how to feel about myself, using what people in authority say as feedback. i can accept and believe what they say, and agree with them (which they then call "able to handle constructive criticism"), i can listen to them and try to understand why they might think that--without agreeing or disagreeing. i can, in my own mind, decide which things they've told me have validity or not.
you see, i don't think that we think so differently. we both think the op should have autonomy in how she feels about herself, and should not be imprisoned by the beliefs her manager attempted to make her (the op) feel about herself.
i once had an instructor ask me what else i thought i could improve on. i gave her the answer i knew she was expecting, and then turned it around and gave her some additional information so that she would both realize that 1) i didn't agree; and 2) i had valid reasons for disagreeing (i.e., she didn't have all the information to make such a judgment correctly.) that's how i think negotation skills can help even non-management people.
me, a manager? ha ha ha ha ha ha. i'm sure my fellow classmates would find that very amusing. me think like a manager? only to the extent that it helps me to keep power for myself. what do they say? "know thine enemy." :)
as for toys--i have the only toy i want: my own house. since i bought it in the late '80s, i pay substantially less in mortgage than most people do on rent. i hate spending money, shopping, etc. and i'm definitely not management material.
the difference from this trade to several others is that you have human life directly in your hands.
welcome to this nasty trade debi.
you are not the problem - this nasty trade is the problem.
take care.
steve lee, rn

nursefirst -- a mere nursing student who has had several years of healthcare experience and is far more interested in her legacy than in "toys".