New Grad, new job, night shift, SAFETY

fergus51 · Apr 17, 2005

Talk to your manager. Don't sit and stew about it. Do something about it. The sooner you talk to her the better because she has to arrange staffing and the more notice she has the better.

Why wasn't this discussed BEFORE you were scheduled? Did you know that you would have so many shifts in a row or that you would be rotating? Did your manager know you didn't have a lot of experience in this area in school? If so, you need to demand a proper orientation. I also think your school failed you by not having you do some night shifts before you graduated, btw. Nursing students need to see the real world before graduation.

RNinRubySlippers, BSN, RN · Apr 18, 2005

so curious...where did you go to school? How long was your perceptorship? I am sooo curious as to how each school provides experiences for students. Thanks and I hope this all turns out well for ya!

nurse_ange1 · May 22, 2005

Hi All,
Well, I've been officially indoctrinated into the wonderful world of real stress, nursing shortages and safety issues. I just received my schedule for my new job, which I start next week. Yesterday was my first day as a grad nurse (I have a BSN), I now operate under my own license. I went to get my schedule, and found out that I am working primarily nights (8 hour shifts) and many of them. Some 9 in a row with one day off. I also go from nights to a stretch of days with only one day off in between. I will have 6-8 patients, and might the one whose "title" holds the most weight, ie. I will have undergrads working under my license. I have been told by the manager there is indeed a nurse shortage, and one on the unit I am working on. I am the only grad nurse who applied for a job. I am worried about many things after reading similiar situations on this site. We have no "long" preceptorship programs. We are thrown to the wolves right away. To make it more "stressful" in my situation, I chose to go into surgery, a new area for me, after doing my final focus in a completely different area. So I am not going to be "up to speed" like someone who has being working in this area for a while, skill wise. I obviously need to talk to the manager about this, but I've been told by other former grads, this is COMMON. Safety is a big issue here, I don't want to hurt someone or worse. I have NEVER done nights, I don't know how I will handle them, other than staying up all night to get a paper in, which made me feel sick for days. I need some guidance. My vetran nursing friends, the "old timers" who've all done night shifts, say in their day, this would not have happend, i.e. one new grad and 3 undergrads on a night. So I think their at a loss, other than to advise "don't do it". I don't want to look like I"m complaining and being difficult because it is a new job, one that I really wanted. I don't have the issue with the night shift other than having adequate, number of days off to readjust for a new shift (the union says at least 22.5 hours between shifts). What to do

Okay...I thought my local hospital was bad with less than 2 weeks orientation. (Which is one of the reasons I won't work there.) I would call CNO first for some advise on the legalities of the situation. You say you have your own license... you took the exam in January? or are you under a temp licence. Because if you are under a temporary license you cannot be in charge of the unit or other undergrads. Talk to the CNO, and then have a frank discussion with your manager. Be prepared to fight your case with real facts.

On the night shift thing... I went to school Mon-Fri and worked 12 night shifts as a nurses aide on Fridays and Saturdays. (God only knows how I did it). Anyway.. My advise is cut out the coffee/pop after 2am. Drink lots of water. Go home, take a shower and put on the radio or use a sound machine (you know ocean waves or rain etc). Keep the blinds close, turn on a fan (for white noise) and keep the bedroom door closed. Turn off the phone. HOpe this helps. Let us know what happens. I'm waiting to write my exam on the 8th... yikes.

take care

Hairstylingnurse · May 22, 2005

Hi All,
Well, I've been officially indoctrinated into the wonderful world of real stress, nursing shortages and safety issues. I just received my schedule for my new job, which I start next week. Yesterday was my first day as a grad nurse (I have a BSN), I now operate under my own license. I went to get my schedule, and found out that I am working primarily nights (8 hour shifts) and many of them. Some 9 in a row with one day off. I also go from nights to a stretch of days with only one day off in between. I will have 6-8 patients, and might the one whose "title" holds the most weight, ie. I will have undergrads working under my license. I have been told by the manager there is indeed a nurse shortage, and one on the unit I am working on. I am the only grad nurse who applied for a job. I am worried about many things after reading similiar situations on this site. We have no "long" preceptorship programs. We are thrown to the wolves right away. To make it more "stressful" in my situation, I chose to go into surgery, a new area for me, after doing my final focus in a completely different area. So I am not going to be "up to speed" like someone who has being working in this area for a while, skill wise. I obviously need to talk to the manager about this, but I've been told by other former grads, this is COMMON. Safety is a big issue here, I don't want to hurt someone or worse. I have NEVER done nights, I don't know how I will handle them, other than staying up all night to get a paper in, which made me feel sick for days. I need some guidance. My vetran nursing friends, the "old timers" who've all done night shifts, say in their day, this would not have happend, i.e. one new grad and 3 undergrads on a night. So I think their at a loss, other than to advise "don't do it". I don't want to look like I"m complaining and being difficult because it is a new job, one that I really wanted. I don't have the issue with the night shift other than having adequate, number of days off to readjust for a new shift (the union says at least 22.5 hours between shifts). What to do

:uhoh21: Hi I have a quick question for ya, how long would you like to keep your lisc?????? I never can understand how an RN especially with a BSN, would let anyone put them in such a situation. You as an RN with a BSN, can call all the shots. They need you, you DON'T need them. You can get a job anywhere, and I mean anywhere. I do pretty decent as an LPN getting what I want, and I know you can get what ever you want as an RN. Best luck to ya whatever you do, but don't let them put you in unsafe situations. You and only you are responsible for your situation if you sit back and let others make your important decisions for you.

markjrn · May 24, 2005

the one whose "title" holds the most weight, ie. I will have undergrads working under my license.

Can you please explain what this means? In all honesty, between 2 countries and multiple facilities, it doesn't matter if you have a BSN, Diploma, ADN, etc. Heck, I even worked the floor with someone who had their Masters. I don't think I understand...

Obviously, this place doesn't sound great and you need to speak with your NM. But at the same time, I guess you kind of have to look at it like a lesson learned - know what you could be getting into before you get there.

I know it's no consolation, but unfortunately I have heard of worse working conditions out there. Scary, isn't it? Best of luck.

joey1967 · Jun 2, 2005

Well,

Thanks to all those who responded. I did cancel many shifts, but not without facing the wrath of my manager. Nights are hard, not because they are nights, but because there are 4 nurses on for 32 patients. The nurses that work nights are often tired, and burnt out, a very very unhappy lot.And of course, with 4 nurses, that means 8 patients, plus paperwork. If someone calls in sick and they can't cover the shift, the patient load goes up. It is a hellish shift, one I will not do again after the summer is out.

So, what have I learned about the "real world" of nursing in the last 2 months?

1. Nursing patients in a hospital environment in Canada is nothing like "having" patients as a student. It is one hundred percent worse, and is nothing like you imagine. Hence, I stronly feel that school has left me very unprepared. For those of you who have not worked as an undergrad prior to graduation, I stongly suggest you get some "real life" experience before you start as a grad.

2. What you learn in school and should be applied, often isn't, because of time constraints, patient acuity and patient load. I went to set up a sterile field the other day and was chewed up by another nurse who said "we don't have time for this, you must be new to the profession".

3. When a manager "promises" you on time of hire, a wonderful picture, of happy unit, with a well functioning team, the more skeptical you should be of not only that unit, but the manager.

4. Other nurses will welcome you with open arms and readily assist you when you need assistance. Other nurses will become your worst enemy and will only see you as another burden to their already stressful workload.

5. Some nurses, i.e. like the charge nurse on, may take into consideration your "newness" and "inexperience" to the profession when assigning patients. Others may give you the heaviest patients on the unit and then give you no assistance or guidance. Why they do this, I have no clue, other than to think that it may because they personally suffer from some sadomasochisitc internal haterd for the profession itself.

6. You will learn that nurses do things their "own way" including giving drugs that have no dr's order and do so without even getting a cover order. Yes, this is done. Should you question the nurse doing this as a new grad, be prepared, you might just alienate yourself. Should you question the charge telling you to do this, be prepared for a hostile working relationship.

7. The only one looking out for patient safety is you. Do not expect your manager to step in and think about those we are caring for. They are too busy thinking about dollars and budgets. Be prepared to be "blacklisted" from picking up "casual" work if you start quoting union rules.

8. "Passing the care" has become the new unofficial nursing motto. This means that don't come on shift expecting your patient to be well cared for. Expect the exact opposite. And I should make it clear that nurses are not at fault here. With patient load, and complications and acuity, we do not have enough time even to do the basics. Things will not get done on your shift that need to be. And nursing assistance, well, they are run off their feet too. The best hope for the patient is that they do not go out worse than they came in, and yes, this happens all the time.

Welcome to the real world of nursing.

Jay-Jay, RN · Jun 2, 2005

Well,
Thanks to all those who responded. I did cancel many shifts, but not without facing the wrath of my manager. Nights are hard, not because they are nights, but because there are 4 nurses on for 32 patients. The nurses that work nights are often tired, and burnt out, a very very unhappy lot.And of course, with 4 nurses, that means 8 patients, plus paperwork. If someone calls in sick and they can't cover the shift, the patient load goes up. It is a hellish shift, one I will not do again after the summer is out.
So, what have I learned about the "real world" of nursing in the last 2 months?
2. What you learn in school and should be applied, often isn't, because of time constraints, patient acuity and patient load. I went to set up a sterile field the other day and was chewed up by another nurse who said "we don't have time for this, you must be new to the profession".
6. You will learn that nurses do things their "own way" including giving drugs that have no dr's order and do so without even getting a cover order. Yes, this is done. Should you question the nurse doing this as a new grad, be prepared, you might just alienate yourself. Should you question the charge telling you to do this, be prepared for a hostile working relationship.

:eek: :no:

First of all, congratulations on standing up for yourself, and cancelling some of those shifts.

Secondly, let me ask you again what another poster asked above: HOW LONG DO YOU WANT TO KEEP YOUR LICENSE?? What this hospital is allowing its nurses to do is not only dangerous, it's ILLEGAL!! DON'T get sucked in, and jeopardize your license. If YOU give a med without an order, YOU will be the one wearing the goat horns if something goes wrong, NOT the nurse who told you to give it!

And re. the sterile field, what was it for? I work in the community, and a lot of the procedures that would be considered 'sterile' in the hospital are done using 'clean' techique in the community. Still, I would not jeopardize my patients, if there was a break in my techique. And certain procedures MUST be sterile (care of central lines, IV starts).

If I were you, I would be looking for a job elsewhere! I have done casual assignments in many hospitals, and, yes, we were shortstaffed, and you learned that meds were often not given exactly on time, but I never was asked to jeopardize my license by doing something illegal!