Help me, I'm falling...

  1. I'm a relatively new nurse, graduated with my BSN in June 2001. Went straight to the ICU of a 900 bed hospital on midnights. Did ok, midnights darned near killed me, though. Stayed a year, took some time off to take care of my Dad and after my Dad passed away in Sept., went to the ICU of a very small community hospital. Thought I was doing ok except when it came time to be pulled to stepdown...Jesus, 6 patients?!? It happened last week, except this was a disaster!!!!!!!!!!!!! I couldn't focus!!! My assignment changed halfway through the shift and I couldn't keep anything straight!!!!!! Result? Not one, not two, but four patients with meds not given!!!! Asked to come in to work the next day to talk...not good. At the end of the talk, I'm in tears. My manager put me off work for the weekend, says someone will contact me...told her I had some thinking to do. Am I really nurse material??? I try to be as careful and diligent as I possibly can, but when I can't find the chart, I can't get into the computer cause my password won't work, I have to go to a pixis to get EVERYTHING, including gauze and kleenex...tried explaining this to manager, she simply says, "you didn't ask for help, did you?" "No, you didn't" She's right, I didn't.
    Am I alone when I say it drives me absolutely crazy to work in a place that doesn't even have a copy machine on the floor? There are no medical supplies at all kept in any patient room, the break room has no spoons, no forks, usually no coffee, no wastebasket....ya see? I am totally hung up the the organizational aspects of this place. I just feel to discombobulated!!!!!!!!!!!!!! Hence, I fell apart!
    What the hell is wrong with me that I can't keep 6 stepdown patients straight?
    Ok, I've said all that, now I am seriously thinking about homecare (am I even qualified?). It seems like I may have some degree of control over my environment...maybe? What about surgery? Now that has always appealed to me...any surgical nurses out there with any advice?
    I am a very hard worker, usually get way too involved helping out my co-workers, but that's usually ok. I do like people, but I really crave order!!!!!!!!!!!!!!
    Ya know what? Maybe the Hallmark store down the street is hiring...oh, yes, I don't have to work full-time, even though I'm not married and don't have children, I do live pretty cheaply...
    Any advice from anyone is so appreciated
    Signed,
    The lil nurse who could...or used to think so, anyway....
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  2. 20 Comments

  3. by   renerian
    Wow sounds like you had the night from hell! I know six stepdown patients can be really ill. I know nurses who say stepdown in one half a step from ICU.

    Home care is less stressful. You have more control over your schedule but not in the patients home. Since it is their turf they can pretty much do what they want sometimes to their harm. Sometimes they won't do anything you tell them, won't take their meds right either. Some are great though. You definately are more in tune with the cost of their care as I am sure any clinical director will tell you. A fine line between loss and profit. I have worked in home health 11 years and just left.

    Do you have some specific home health questions I can help you with?

    renerian
  4. by   Coco48170
    Thanks for writing!!! Am I qualified for homecare? I have only 1 year of nursing, only ICU. I mean, you are on your own out there! It seems like an employer would need someone with top-notch assessment skills. Do any homecare agencies hire new nurses?
    Thanks again
  5. by   NurseWeasel
    How about going back to a larger, more organized hospital? Someplace you just have to come in, do your job, and leave... without all the chasing down of supplies, etc.

    I'm overly organized myself, so I can sympathize. ((hugs))

    Maybe you're having some post-traumatic problems since your dad died. Symptoms like you're describing, dealing with "simple" daily issues that at one time prior to the death were no problem at all suddenly seem overwhelming... Lots of change in your life this past year... think about it, maybe see a counselor???
    Last edit by NurseWeasel on Jan 19, '03
  6. by   Coco48170
    Ya know, in between the chewing out, she did hand me the card for employee assistance. i am going to call them tomorrow. You may be right about too many changes. And also about working somewhere where I don't spend 10 minutes putting together the syringe to flush an IV line! You've been an angel, thank you so much. Talk to you soon
  7. by   2banurse
    That definitely sounds like a scary scenario. I can see why some of the more established nurses suggest that you start with med/surg if you want to go into ICU. Because you start with a higher census, you, I think IMO, can get more experience with assessing and caring for a larger number of patients. Usually for ICU, you cover only 1 or 2 patients depending.

    Considering the very thin line between telemetry patients and ICU patients in their care needs, I can definitely see where you feel overwhelmed even without all the other stuff you have to deal with. Have you considered other areas? Such as being an OR nurse or L&D where the census isn't too high. Or maybe just doing a year of med/surg if you want to stay with the hospital.

    Well, good luck!
    Kris
  8. by   bossynurse
    Sounds like they didn't even give you an orientation to your new floor. There is a big difference in nursing on the 2 different units. I thing it was unfair of them to put you on I new floor and not train you and THEN have the Big Talk. I agree with Kris that medsurg is a good place to get your experience.
  9. by   RNanne
    You did have the night from h-. It is really hard to work where there is no equipment and you can't organize anything. But listen, number 1 When you get floated like that, the facility sets you up to fail. Number 2 I used to work on a telemetry floor with 8-9 patients night shift. They used to float ICU nurses out and believe me they were a disaster. We would all be done with the first rounds, assessments etc. and be sitting down to chart. The poor ICU nurse would be on her third patient. And these were experienced, cracker jack nurses. We used to all pitch in and help them. We never let them fail. So you see, as far as I can see or tell, this is not a rare thing to happen. It is common, so don't beat yourself up. What doesn't kill you, makes you stronger. The lesson from this is to ask for help, admit you are drowning. Tell the other nurses, tell the supervisor. Don't ever do that to yourself again. I feel for you. Don't give up!!!!!
  10. by   oramar
    Sounds to me that managment is blaming you for a situation they largely created. I think as you get more experience in other places you are going to start getting very mad at the bosses that put you in this position. Right now you don't have enough experience to realize what is going on and you are blaming yourself. It sounds like you have no floor experience what so ever. That is the problem, not your inability to manage 6 patients. If they wanted to pull you they should have given you some orientation and worked you into it slowly. As for the equipment problems, that is the way small hospitals are run. If you come from a big hospital where everything is at hand it is a shock some of the things that are not available. The reason the managers don't realize they are putting you into a stressful situation is that in the old days all nurses went from med/surg to step down then to ICU. It is not that way nowdays and this is the kind of problems that result.
  11. by   BadBird
    Perhaps a transfer to med/surg floor will benefit you, it sounds like your nurse manager is offering you help so reach out and take whatever is offered. It takes a long time to master critical thinking skills and to deal with all sorts of stressful situations, this does not mean that you aren't a good nurse you just need time to learn to organize and prioritize. I know how frustrating it is to work with no supplies, no computer code, etc.. Please don't be afraid to ask for help, let the charge nurse get your supplies if you don't have a code, reach out and ask questions, ask for help, we must all learn to work together but no one can read a mind so speak up. Don't give up, even though you had a bad night you will also experience many great nights too.
  12. by   Carleigh
    You've had a lot of changes in your life between graduating, becoming an RN, changing jobs, your father's death, adjusting to a new facility, etc. My father died Thanksgiving and it is very hard for me to concentrate and manage things that I could before. Grief is a powerful thing and maybe this is affecting you more than you know. Good luck and I hope everything works out for you!
  13. by   cwazycwissyRN
    You mentioned the OR. One of the reasons I work the OR is the organizational thing. One patient at a time helps alot with that. Since it is a specialized area with lots of things to learn (just plain a different aspect of nursing) the type of orientation you recieve is pretty important. If you like organization you could really enjoy the OR. It's mandatory, Dr.'s do not like to stand around and wait for you --to find--anything.
  14. by   l.rae
    ICU nurses have a lower nurse/pt ratio, are very methodical in assessments, everything your need for a critical pt must/should be at hand....it is really not surprising that it is more difficult to multi-task, delegate and prioritize so many pts. Not anyones fault, just a "side effect" of being in a different nursing environment.......then not to mention all the life changes and stress.....we all adapt to our different nursing enviornments and being thrown into an unfamiliar situation is difficult...doesn;t mean you are inadequate...not at all!........LR

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