struggling with med surg expectations

  1. 0 I recently transitioned from psych inpatient nursing to med surg. I quit my job in psych - working there for a year as a new nurse. I didn't want to lose my nursing skills and wanted to be involved in more acute medical care nursing. I applied and got hired on a busy medical surgical unit of hospital and although this is my fifth week of orientation, I have only had 10 days on the actual unit. The other days were for trainining,equipment,and computer classes... I feel that I am doing my best to improve and catch on quickly (it does take me a little longer to learn things , im not a "see one, do one, teach one" type of person and I don't feel that is safe practice anyways.

    Well, my last week of 3 days training were kind of "rough" and did review at home iv pumps, computer charting, etc..this week when I came back to work I felt my confidence was up more at ease, although I guess I still appear nervous to others. I have been given 3 patients to care for and I am still falling behind. It seems like multiple issues keep me distracted and have been late on administering medications today.

    My NM called me in her office and spoke to me about how she feels that maybe this is not the right fit for me..etc..bottom line is it sounds like I am going to be fired UNLESS i can prove that I can take care of 4 patients next week without issue. I just feel that 10 days into orientation is so short with such high expectations. I am NOT one to give up and I continuously strive to manage my time better and prioritze.

    I am scared for next week. I need to be able to take care of 4 patients without issues or late med administration. I understand NM perspective but really had to hold back tears and choke it up to finish my shift. I was hurt to hear that other staff had "concerns" on if I would make it. I don't feel like I am getting enough feedback until now -that it seems too late. I was also given a "checklist" for orientation with weekly reports on my progress.

    I have yet to see a written eval or check off on anything. It is basically sink or swim. and I have been sinking. I feel that they think I am "sinking" because I ask a lot of questions. If I have not done a skill since clinical and/or only read in textbook I want to ensure safe practice and barely feel like 10 days is sufficient for me to practice as RN on unit.

    While I am hurt that others (not only nurses supposedly) are saying im less than adequate I am also saddened that I quit my previous job and will probably be fired next week unless i can care for 4 patients on my own without any issues. I just don't understand how healthcare is safe anymore with this mentality/demand on nurses. It is expected that I will be off orientation in 2 more weeks. (6more days, which would give me a total of 16 days orientation on a busy med surg floor-is this typical???-in psych i had 30+ days...)
  2. Visit  sleepdeprived1 profile page

    About sleepdeprived1

    From 'Wisconsin'; Joined Nov '10; Posts: 48; Likes: 5.

    15 Comments so far...

  3. Visit  Stcroix profile page
    1
    I am a newbie and can't speak to typical, but I had a total of 10 weeks (including classwork) for orientation. I am told this is average but what do I know? I felt confident in daily routine tasks, but needed extra help any time I encountered something relatively new to me. Good luck.
    sleepdeprived1 likes this.
  4. Visit  Little Panda RN profile page
    1
    I am also new to med surg. I have had a total of 9 shifts on the floor myself. I on the other hand work a full time job so scheduling the days I am able to orientate have only been 2 a week. It is very busy and on Saturday I had 3 pts that had a lot going on. I forgot to give one of my pts their scheduled 1330 med. The oncoming nurse noticed it and asked me if I would give it before I left. I did tell my charge and she states that "it does happen". Thank goodness the med was not a critical one to be given. I felt really bad and realize that I have to figure out a way to get more organized.

    It really is sink or swim in med surg. I am hoping I learn to swim just as I hope the same for you. Hang in there and hopefully it will get better. *hugs*
    sleepdeprived1 likes this.
  5. Visit  RachelRN89 profile page
    1
    Wow I am so sorry you are going through this I am also new to med surg, but I had a 10 week orientation. I didn't even start caring for three patients until my 4th or 5th week! It seems as though your unit does not have an adequate orientation that includes weekly feedback and positive encouragement from a preceptor? Maybe you could inform your nurse manager that you haven't even had any evaluations or anything checked off yet, and ask how you are supposed to care for 4 patients without proper support? Do you have a preceptor?

    From experience, the first couple of months starting out were the scariest, most stressful, longest months of my life. I don't think there was one day that I went home without worrying about possible mistakes, or what I could have/should have done in certain situations. Just absorb everything you see like sponge...good & bad. That's what I do and I learn so much. About asking questions..don't ever stop! I think people got frustrated with the amount of questions I asked during the first few weeks and honestly, as long as it kept my patients safe, I didn't care who got annoyed. Asking questions is the best way to make sure what you're thinking, or doing is correct. I too also became easily distracted and when multiple things were happening, I had a hard time prioritizing my time. You'll learn as you work more what needs to be taken care of first. I don't how it happens, but things just eventually start to click. You'll start using your critical thinking and stuff just makes more sense. Trust me, it takes time but at some point it happens. Keep your head up! You just need more support and more confidence in yourself and you will find things become much easier. Find someone you can confide in, find a good brain sheet, and keep asking questions. Good luck!!
    sleepdeprived1 likes this.
  6. Visit  RN315 profile page
    1
    Wow that is way too little you must speak up and ask if you can have more orientation my orientation for med surg was 6 months!! Yes 6 months!!
    sleepdeprived1 likes this.
  7. Visit  FuturePsychNP profile page
    1
    LOL. My orientation was, "if you have any questions just ask!" My first day I mostly shadowed and helped out and that wasn't even for a whole day. My second day I took a full, four patient load. Six weeks later I was sent to nights to become the shift charge nurse - the role I was hired to do. I still have that job, but I'm quitting hospitaldom in a few months and will probably find some other type of job until I finish grad school.
    sleepdeprived1 likes this.
  8. Visit  sleepdeprived1 profile page
    1
    Thanks for the words of encouragement and feedback! Hopefully the hospital will continue to work with me to develop my skills/training because I know with my time I can be successful as all of us newbies can especially transferring into a new department. I know the hospital needs to stay within a budget, but I would think it would be cheaper for them to fully train their already retained staff, then to have higher turnover and to have to continuously start over with new employees.
    FinallyRNStatus likes this.
  9. Visit  applewhitern profile page
    2
    Well, my orientation was 5 days back when I was a new nurse. We only give a few weeks now. If you aren't taking at least 5 patients by about the 3rd week, they start worrying about you. Medical-surgical nursing is hard simply because you have so many patients to care for. You must learn to prioritize and manage your time. Don't worry about what your co-workers say about you~ what matters is that your patients are being safely cared for.
    tiff82 and Susie2310 like this.
  10. Visit  lynds80 profile page
    2
    Quote from sleepdeprived1
    I recently transitioned from psych inpatient nursing to med surg. I quit my job in psych - working there for a year as a new nurse. I didn't want to lose my nursing skills and wanted to be involved in more acute medical care nursing. I applied and got hired on a busy medical surgical unit of hospital and although this is my fifth week of orientation, I have only had 10 days on the actual unit. The other days were for trainining,equipment,and computer classes... I feel that I am doing my best to improve and catch on quickly (it does take me a little longer to learn things , im not a "see one, do one, teach one" type of person and I don't feel that is safe practice anyways.

    Well, my last week of 3 days training were kind of "rough" and did review at home iv pumps, computer charting, etc..this week when I came back to work I felt my confidence was up more at ease, although I guess I still appear nervous to others. I have been given 3 patients to care for and I am still falling behind. It seems like multiple issues keep me distracted and have been late on administering medications today.

    My NM called me in her office and spoke to me about how she feels that maybe this is not the right fit for me..etc..bottom line is it sounds like I am going to be fired UNLESS i can prove that I can take care of 4 patients next week without issue. I just feel that 10 days into orientation is so short with such high expectations. I am NOT one to give up and I continuously strive to manage my time better and prioritze.

    I am scared for next week. I need to be able to take care of 4 patients without issues or late med administration. I understand NM perspective but really had to hold back tears and choke it up to finish my shift. I was hurt to hear that other staff had "concerns" on if I would make it. I don't feel like I am getting enough feedback until now -that it seems too late. I was also given a "checklist" for orientation with weekly reports on my progress.

    I have yet to see a written eval or check off on anything. It is basically sink or swim. and I have been sinking. I feel that they think I am "sinking" because I ask a lot of questions. If I have not done a skill since clinical and/or only read in textbook I want to ensure safe practice and barely feel like 10 days is sufficient for me to practice as RN on unit.

    While I am hurt that others (not only nurses supposedly) are saying im less than adequate I am also saddened that I quit my previous job and will probably be fired next week unless i can care for 4 patients on my own without any issues. I just don't understand how healthcare is safe anymore with this mentality/demand on nurses. It is expected that I will be off orientation in 2 more weeks. (6more days, which would give me a total of 16 days orientation on a busy med surg floor-is this typical???-in psych i had 30+ days...)
    I just did the same thing. Started In psych and now in med surg for the same reasons. Med surg is tough I want to quit cuz I lack confidence. I have a checklist that we uses at the hospital will help I can email u one please re,ember your doing the best you can, that isn't good enough for them maybe that place isn't for you! Your only one person believe I am in the same boat as you! Please feel free to email if you want to talk lynds80@yahoo.com.

    Lindsay
  11. Visit  sleepdeprived1 profile page
    0
    Well tomorrow will determine the fate of my future with this company..meeting with the NM after/during work to see what she thinks of my progress thus far..I am a firm believer of strong orientation process to the unit-I think its safer for the patients too. my
    #1 priority is patient safety and should be theirs too..im not a turtle but im not gonna hustle and bustle through skills ive never done...without making sure safe practice first..i think im getting there..my patients seem to like me and really enjoy providing bedside care..from the time i get on the floor to the time i leave i am 100% focused on my patients and keeping busy,not much for gossip at the nursing station...but it doesnt matter what anyone thinks..my NM will tell me my fate tomorrow so far she has acted like im invisible maybe thats good?
  12. Visit  Esme12 profile page
    2
  13. Visit  sleepdeprived1 profile page
    1
    Thanks Esme..if given another chance I will use these..I was sent home today and told that this unit was not the right fit for me and that I wasnt making enough progress yesterday i had 4 patients and struggled some and then got an admission which i still struggle thru the computer admission process.and trying to remember my other pts. i still have my preceptor had me go to first patient room in morning administer all meds for time do am assessment and do all am charting on these in room then go to pt. 2 and do same and so on...well by the time i get to patient 4 its a little late and then expected to go to patient discharge meeting which im forever late for or miss..sounds easy but maybe still a bit slow with charting entire am shift assessment...thought itd be better just administering meds doing am assessment noting abnormals to chart..after all meds in on time then going back to chart but then id prob. be behind too ..oh well..in the process of finding right fit for me..obviously 15days med surg training wasnt enough or too chaotic for me
    FinallyRNStatus likes this.
  14. Visit  lynds80 profile page
    2
    Quote from sleepdeprived1
    Thanks Esme..if given another chance I will use these..I was sent home today and told that this unit was not the right fit for me and that I wasnt making enough progress yesterday i had 4 patients and struggled some and then got an admission which i still struggle thru the computer admission process.and trying to remember my other pts. i still have my preceptor had me go to first patient room in morning administer all meds for time do am assessment and do all am charting on these in room then go to pt. 2 and do same and so on...well by the time i get to patient 4 its a little late and then expected to go to patient discharge meeting which im forever late for or miss..sounds easy but maybe still a bit slow with charting entire am shift assessment...thought itd be better just administering meds doing am assessment noting abnormals to chart..after all meds in on time then going back to chart but then id prob. be behind too ..oh well..in the process of finding right fit for me..obviously 15days med surg training wasnt enough or too chaotic for me
    Sorry to hear it didn't work out for you. Chin up something g better is out there for you!


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