HELPP! New nurse to Med Surg but NOT a new nurse

Nurses General Nursing

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Hi all,

This is my first time writing a topic but I've been coming here for the past 2 years as a source of comfort and that feeling of I'm not alone in how I am feeling/doing. Sorry, this is going to be long...

So, I have been a nurse for a little over 2 years but, I started out as a new grad in postpartum. Our postpartum floor is very specialized where we never start IVs, hardly ever have to draw labs/tests/exams. Usually, the only labs we look for are H/H and WBCs. Sometimes we get med surg overflow but hardly ever. When I was a new grad, my education was mainly mother/baby with no med surg training, I had to learn on the fly how to take care of the med surg patients and ask a lot of questions to other nurses who did have a med surg background. I decided to leave postpartum b/c on the off chance that our floor did get a med surg patient, I would be the one to get them and of course something 'bad' would happen to them such as a cyst would burst after surgery, or a patient would become septic, or something would always happen to me. The other nurses, who have been on the floor for 15 years said that nothing has ever happened before. That scared me so much that I didn't know what to do in those situations so I decided that I needed to get med surg experience.

I was hired to a med surg floor! I was super excited but, it was the hardest surgical floor in the hospital.. It's a step-down ICU with emphasis on trauma, transplant, and GI. To say that I struggled is an understatement. B/c I was not technically a 'new grad' anymore, I was only given 4 weeks to train. When I encounter something new, I take some time in the beginning to learn things but once I get it, I'm really good.. so, my orientation was extended to another 4 weeks (8 weeks in total).

I was hired for day/night and while on days, my day preceptor was amazing. She was strict but never made me feel like I was dumb, she never belittled me, and was always open and honest. Once I passed days, I felt somewhat confident that I could handle this floor. But nights was something else...

Did I mention that my night preceptor was very, very unkind to me? She kind of shot what little confidence I had in myself (being new to med surg and new to the floor) by telling me "I wouldn't want you to be my nurse" b/c it took me, in her opinion too long to chart that I hung a fluid bag in the computer and she said this IN FRONT OF THE PATIENT or "Don't rely on your brain, you're looking at your brain too much"-and when she would ask me a question regarding the patient, I obviously can't remember everything and wouldn't know the answer, she would get upset. She would literally be 5inches away from my face whenever I charted anything and I would get super nervous and click the wrong thing and she would say things like "nope, that wrong, why are you charting that?" She is not approachable at all for questions, but I'm new and I have questions, so I would try to not ask but once I did muster up the courage to ask, she would say something like " I already told you this but..." with a lot of eye rolling. the list goes on and on..

Imagine being told every day that you're not a good nurse, that you're never going to make it, that I wouldn't want you to be my nurse, how would that make you feel? Every day I would make more mistakes b/c I was anxious and nervous..and every day it would be something else that I did wrong...

We would have weekly meetings with the manager and preceptor. After my second day training with her, she straight up told the manager and I, that she thinks I'm not a good fit for the floor. Which, is her opinion but I think she should have told me first instead of me being blind sided. She was very supportive of me in front of the manager but someone else when it was just her and I.. there were some other things but pretty much she failed me and rightfully so b/c I kept making mistakes..

I tried to go back to postpartum but there were no openings. The ladies on my floor made a petition for me to be able to come back without me knowing but if there's no money, then there can't be a position open for me. The fact that the nurses on postpartum wanted me to come back and worked so hard for me to be able to come back, I think speaks a lot about the kind of nurse I am. I am a good nurse, I work hard, I am a team player, the patients love me... but failing this has completely shot my confidence as a nurse.

Fast forward to present day, I am now on a new med surg floor, but b/c I am still not a 'new grad', I only get 3 days of training... and if I fail this orientation then I will be fired from the hopsital. So that is not an option. But I think I passed b/c according to the manager I am a safe nurse and that is all she is looking for. But, I still only have 2 months and 3 days of med surg experience and there is still so much I don't know. I over heard a few of the nurses talking about me saying, "she doesn't know how to do that?!" or "we can't have slow nurses on our floor!" or I would get yelled at b/c I didn't know what labs to look out for specific disease processes. I also know that this job that I got, was supposed to be for an aid on the floor so I am guessing that people are upset that I got this job via senority... I don't know what to do...

Study techniques/ patho on your days off. Make a learning plan about perceived deficiencies and how you will address them. Take every opportunity to try new skills and have the educator monitor the first time. Read Hospital policies. Ask questions. Help people out and try not to stress out. Easier said than done, I know.

Specializes in CCU, SICU, CVICU.

Sounds like you need a new preceptor for starters; she sounds awful. Is your hospital unionized? I find it shocking that they can fire you for just 3 orientation shifts. See if you can try a new preceptor? Not sure if that'll help on such short notice, but it's worth a shot. Good luck! I'm sure others will have better advice! =/

I hate to kick someone when they're down, but you would sound so much more intelligent if you spelled out the word "because". I want to gouge my eyes out after reading that.

Thank you for your advice :)

No, any advice is good. Thank you!! :)

I think you are focusing too much on not being a new grad anymore and what you don't know. You need to focus on what you do know. How do you know for sure the other nurses are saying those things about you? Did you personally hear it?

All jobs come with a learning curve. I didn't feel comfortable on my unit for a very long time. You are going to be slow at first. I guess I'm not getting though why the other nurses know how slow you are. Don't they have their own patients and you have yours? Nursing is a 24 hour job. You can't always get everything done. As much as I try to get it all done for the oncoming shift, I can't always do that.

You just need to relax and realize that each shift you are getting faster and better. Go in with a positive attitude and do your best. You will get there.

Study techniques/ patho on your days off. Make a learning plan about perceived deficiencies and how you will address them. Take every opportunity to try new skills and have the educator monitor the first time. Read Hospital policies. Ask questions. Help people out and try not to stress out. Easier said than done, I know.

This. Also help your coworkers at every opportunity. It sounds like they may be resentful that the aid wasn't hired, so kill them with kindness. It's harder to talk badly about someone if you're helping get their jumper back to bad, with bed changes.

Also focus on what you do know. Be the resource if any pregnant or postpartum patient is on your floor.

It's hard for me to be optimistic. I know that they are talking about me because when I walk past them, it all of a sudden becomes quite and I see the eye rolling when I tell the on coming nurse that I'm sorry I didn't have time to do this or I'm sorry, I don't know the answer to your question. I did hear one of the charge nurses specifically talk about me, the quiet halls tend to resonate sound and I just happened to be around the corner as she was ripping me a new one. But yes, all I can do it try my best. Thank you for taking the time to reply. It means a lot.

I was hired to a med surg floor! I was super excited but, it was the hardest surgical floor in the hospital.. It's a step-down ICU with emphasis on trauma, transplant, and GI. To say that I struggled is an understatement.

I'm a little confused. I work on an ICU step-down unit and it isn't considered med surg- it's considered an intermediate floor/progressive care. We have to take vitals more often, all of our patients are on monitors, and most are not as stable as what you'd find on a med surg floor.

First, I am very sorry that this happening to you. It is uncalled for, and unprofessional.

Secondly, can you approach the NM regarding your experience with the lousy preceptor? Some people may be very good nurses, but that doesn't mean they can, or want to teach. If you over hear a nurse talking badly about you, why not confront them? You could say something like: Yes, I know I'm not proficient at doing xyz, the next time you have a patient that needs xyz, can you find me and you show me how to do it better? Throw the negative comments back on them! If they are going to sit and complain about you, they should be willing to HELP you.

At the start of my med-surge shift (and I am new to it as well), I always write down lab values that could be important, such as, sodium, potassium, H/H, BUN, etc.

Don't worry if you don't know all the answers during report. You only need to give the important facts. Any nurse knows that they can read MD notes, ER notes, etc. on their own. Some nurses use report time as a way to bully other nurses. Don't fall into that trap.

Best of luck!

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