cousx2 1,167 Views
Joined: Feb 10, '07;
Posts: 32 (22% Liked)
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Thank you for letting me know I am not alone in how I feel. The other night nurses I work with seem fine, so I feel like I am just being weak, but I see from everyone's posts that this can happen to some people who work nights. I am so sorry to hear that you are going through a similar situation. I wouldn't wish this feeling on anyone. I hope you're able to get the changes you want made.
I have been a nurse a little over half a year. I started working night shifts in the ER (7p-7a) in mid December (I worked in the ER prior to that so I knew what I was getting into). Since then, I have gained 25 lbs, I sleep up to 18-20 hours a day when I am not working, and I despise going to work. I have lost all desire to do anything on my off days. I feel ill all the time. I have withdrawn from everyone, my friends and family, because I don't want to bring them down. It's so bad many times I wish I would have a car accident on the way to work. I'm careful only because I don't want to hurt anyone else on the road because of my stupidity and self-centeredness. I have never been this depressed in my life. My co-workers are mostly ok, the work is hard of course and we're always busy and understaffed, but usually I deal ok with that when I am at work. So far, my state of mind has not affected the care I give--I am actually getting the hang of things at work and have received compliments from the higher ups and other nurses on how well I am doing. If they only knew what was going on inside.
Could it be just working night shifts? I really think working night shift has messed with my mind. Unfortunately, there are no earlier shifts available. I did tell my manager when I started that I have always been a day person and to please keep me in mind for a day position when one becomes available. I thought, I would pay my dues. I thought I would be fine after I adjusted, but my mental and physical health are at the lowest I have ever felt in my life. I am already on anti-depressants (not working) and I had my physical recently (nothing unusual except for a depressed WBC count).
Am I just too weak? Should I give it more time? It's only two months, but instead of improving, I am getting worse, having thoughts that would get me involuntarily committed if I ever told anyone in the ER about them. Should I talk to my manager and beg her for a transfer? My ER has no day shifts, but two of our sister hospitals do. The problem is my dept paid for this internship program and I agreed to stay with them for a year. At the same time I don't think I will make a year in my current state of mind. I tell myself to snap out of it and quit the pity party, but it's not working. I hate that I feel so mentally weak. Any words of wisdom or advice would be appreciated. I am desperate. Thank you.
ok, so i'm a new nurse in the er. i am in my 5th week after finishing a 12 wk emergency nurse internship program which consisted of classroom time and clinicals. yesterday, my preceptor and i met with our nurse educator. the good news was that she told me she is hearing good things about me (phew)! she asked me where i felt i was in my training. i told her i felt my weakness was time management. my preceptor agreed, telling her that i am very smart, that i have good judgment, and that i am very focused, however, sometimes i focus too much on my more critical patients and spend too little time with my other patients (although i kind of feel if you're not acute, you can wait--i'll glance at you and make sure you're pwd, and then i'm more worried about the guy who can die within the next 5 minutes). i guess part of the reason is that i prefer the more challenging cases as opposed to the otherwise healthy 20 yr olds who have the sniffles yet feel that merits a trip to the er, but i know they come with the deal too. anyhow, my nurse educator asked me to come up with a document listing some strategies to improve my time management skills. i have no clue--if i knew, i would do them! do any of you more experienced nurses have some strategies i could use? i did a search through the threads, but i'm looking for more specific strategies. what makes it worse is that we're one of those hospitals with a 30 minute promise (which i dislike, because i think it encourages non-emergent patients to come to the er), so i always feel rushed, rushed, rushed. the good news is that my preceptor said no one expected me to be as fast as a more experienced nurse. she says it will come with time and experience. also, i don't know if this will affect the advice you have, but i work the night shift.
i think one thing i could suggest is that my preceptor stop trying to assist me with my assignments. she should supervise, review my charts, but otherwise back off unless i am absolutely drowning. although she doesn't say it, i know she gets impatient because i am not as fast as the others so she jumps in, but if the patients are not critical and we don't have a waiting room full of people or ambulances backed up (we're a relatively small er, so we do have our down time), she should just let me do things at my own pace because it's the only way i'll learn to become faster--practice. what do you think?
(and please, no offense, but no lectures about me needing med-surg experience first. i know a lot of nurses feel that way, but it just motivates me to work harder to prove them wrong. the reality is that i'm here and i'm not going anywhere. i know it's not the same thing, but i was a tech in the same er prior to becoming a nurse, so i am familiar with the pace. all i need is some help to get up to speed and i would really appreciate any advice that you have. thank you so much!!)
Usually PCTs, but RNs aren't above the job if no techs are available.
as an undergrad, i volunteered for a suicide hotline and in our training, we were always taught that a person on the verge of suicide would have a plan--a method, a time, a place. i always wondered though, and i am not being facetious, what if this person just isn't that organized? what if they're the impulsive disorganized type (e.g. bipolar mood disorders or borderline personalities) who doesn't plan anything and all they know is they want to die? the particulars will occur to them when they do it--jump out in front of traffic, drive the car of a cliff, grab a knife, take every pill in the house etc. it doesn't take that much planning to kill yourself, you know?
coincidentally, a story about one of the hospitals in my area discharging a suicidal patient who went on to commit suicide by throwing himself from the top story of the hospital parking garage was on the front page of our sunday paper today:
sad story. wasted life.
discharged with his demons
I don't think you would be seen as a poser if you brought in a stethoscope. I know most techs don't carry them, but it's a tool of the trade. There are many times when you need to take a manual bp--machines don't always pick up everyone's bp. And I can't tell you how many times a nurse asked to borrow my stethoscope when I was a PCT because she (or he) forgot to bring hers into the room (I kept mine in my HUGE pockets). I even had one of our doctors ask me once. Now, if you brought in a $500 Littmann you might be seen as a poser... :wink2: It's so cool you're so excited. I wish you could come work in our ED!
I had to check to see your location to make sure you weren't working in my ED! Your experience is so similar to mine. I'm a new nurse in the ED too dealing with similar situations. I'm sorry I don't have any advice to give since I haven't figured out how to deal with it. I just wanted you to know that I can definitely feel your pain and empathize with your situation. Hang in there.
Thanks for saying that cmo421--you're right. I should clarify that I personally don't think you or any PCT is the lowest on the "totem pole" either, not in the least. What I should have written is that unfortunately you are perceived as that by some insecure people on the patient care team because you are new and because of your title, and you have to be able to stand up for yourself if and when that happens because ultimately, it's the patient that suffers. I have to watch for that too--as a new nurse, I'm being felt out in the same way too. I don't think anyone outranks anyone, regardless of how many fancy initials you put behind your last name. I won't forget where I came from! :spin:
I am a recent grad who was an ER PCT prior to becoming an ER nurse so I can understand where you're coming from. As a PCT, I truly didn't realize just how busy the nurses are even though I was a nursing student myself. Your perspective will totally change when the patient belongs to you! As for what I like in a PCT now that I am nurse:
1) Take initiative. As a nurse, I appreciate a PCT who takes initiative and doesn't stand around waiting to be told what to do. If you don't know what you can do, take the initiative to ask. I LOVE it when a tech asks me, "Do you need help with anything?" I could just hug you.
2) Communicate. Let your nurse or MD know when you see a change in your patient for the worse. You went to take Mrs. Jones' vitals and her BP went from 128/84 to 72/40? Sats went from 98 to 86? Inquiring minds want to know. I've heard of some PCTs not sharing this sort of info, believe it or not.
2) Learn to prioritize. Don't stock rooms when patient needs are not being met. Remember the patient comes first. When Granny is sitting in her own urine soaked stretcher, stocking the tongue depressors can wait.
3) Do the most critical task and communicate. If you're on your way to get a urine sample for HCG for a stable healthy looking 20 yr and another nurse asks you to do an EKG for the code that just came through the door, hold off on the urine. (But don't forget to get to it later or let the nurse know why the urine wasn't collected.)
4) Document what you've done. I admit, as a PCT, I was not always the best at this, and I didn't understand how difficult I was making the nurses' life. I hope the karma gods forgive me.
5) Be willing to learn. If you're asked to do something you don't know how to do, don't say, "No, I don't know how to do it." Just say, "I have never done it before, but if you show me how, I can learn."
6) Don't let anyone bully you. You're the lowest on the totem pole and some people will try to make you feel worthless and make your job more difficult, which ultimately endangers the patient (monitor techs are famous for this, but doctors, PAs and nurses are guilty as well). Be assertive--not aggressive, and don't be afraid to use the chain of command.
If you have any questions, feel free to contact me. I hope this helps! Good luck!
I have to defend my old hometown. NYers aren't the only ones who complain down south about having to wait or having someone else going before them, not realizing that a stroke gets priority over a toothache no matter how long they've waited. I get plenty of complainers from native Floridians and Southern twangs too. Whining knows no borders. People are basically self-centered no matter where they're from, especially when they're not feeling 100%.
Anyone from NYC who says the wait to get into an ER isn't 8 hours on a good night is a liar. My dad still lives in NYC, and I was born and raised there, and a 24 hour waiting room wait is not unheard of. Now I know why. I had no idea the ratio of patients to nurses was that high. No wonder patients have to wait so long. I would move out of the tri-state before I worked 8:1. Oh wait, I did move! Phew...
the way my preceptor with 35 years of experience put it was: "med-surg floors make med-surg nurses. the er makes er nurses." i do not subscribe to the old school thinking that med-surg nursing is the only way to learn how to be a nurse and it sounds like your hospital doesn't either. that's why they're offering this course to new nurses only.
i just got my nursing license in july and i am currently taking my hospital's version of your hospital's "critical care university" and i love it! they are paying me to learn!!!! paying me to do what i love to do! does it get any better??? like you, i knew even before i started nursing school where i wanted to work: the ed. i also know that eventually, i want to move to the icu environment. working in med-surg is a waste of time, to me, when i know i hate it and am poorly suited to that environment.
if you know this is what you want to do, then take advantage of this wonderful opportunity. if you love the critical care environment and the er as much as i do, you won't regret it. :spin:
The fact that you are nervous, while uncomfortable for you, is actually comforting to observers. If you were going into this after a few weeks or months of orientation 100% confident and sure of yourself, then *I* would be seriously worried for your patients! Your anxiety means that you take your responsibility very seriously, more proof that the positive feedback you have received was justified. It will subside with time. Remember to ask for help before you're buried. You'll be great! :spin:
I always knew I wanted to work in an ED. I get bored easily, I like the adrenaline, and I like seeing different things--ED suited me. HOWEVER.... I spent 120 hours in the ICU last semester of nursing school. Before I started I thought I would be bored and that I wouldn't like it. I was so wrong. I loved it too, and surprised myself by being a good ICU nurse. So now I know, when I get burnt out from the ER, I'll give the ICU a try.
Sometimes you know, but keep an open mind. Try something--you just might like it. And if you don't, try something else. Eventually, you'll find your niche. Usually your gut instinct is right but if isn't, give something a try that you never thought you would like.
Aprilequinox, I knew you passed as soon as I read your first post. Your experience sounded IDENTICAL to mine--the type of questions you got, the # of questions you got, even the having to go pee so bad but waiting till 75 questions to take a break--and I passed. My heartfelt congratulations to you.
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