I am a new nurse who has been off of orientation on my own for about 4 or 5 weeks. At times we also have a charge nurse who was just trained and has also been on her own as CN for the exact same amount of time. Everytime I have a shift with her as CN, it is a nightmare. At first, she would never check up on me or ask if I needed any help as all the other CNs would, especially when I got admissions. Then she started to ask me if I needed help, but she would do it while I was sitting on the computer not doing much of anything so obviously I did not need help. She keeps assigning me 2 and 3 admissions at the same time! The first time she did this was on Easter Sunday. I had discharged 3 pts back to back, when I finally had a moment to breathe here arrives my new admission. When I settled that one in here comes the second. Then she assigned me a 3rd on the other side of the unit in a room that I was not assigned for the day. The entire time I am admitting the first 2 pts, she is in the nurses station chit-chatting with another RN who was precepting. While I was on orientation, they never had a problem taking away my preceptor, leaving me on my own, to assign him new admissions to handle. This CN could have asked the RN she was talking to who had left her preceptee alone all day to help me or at least ASK if I needed help. I was so busy I did not have time to say "Hey I need help!" and I did not want to be judged for not being able to handle my assignment, especially when she says to me as shes giving me my 2nd admission " well you only have 3 pts right now....." like I havent been busy discharging and admitting pts non stop for the past 6 hours! She is totally oblivious to what is going on with the floor and crushes me with assignments all at once then does not offer to help. She did this again last night, my first admission did not have all of the orders put in and it was 7pm shift change. I did not know it was a policy to have orders signed and held before a pt is transported to another floor. So when I am giving report to the oncoming RN, she notices theres no activity orders, no precaution orders, etc. There were medications ordered and I was told the pt was on contact and had a hx of seizures, so he was safe in bed with bed alarm, suction, side rails padded, signs on the door, O2 on because he requested it. I got him and once I was done asking him all the admission qs and assessing him, here arrives my 2nd admission. So I had seen the MD go into the 1st pt's room twice and I was working on my 2nd admission waiting on the MD to put in additional orders. I was so busy I was just doing things as they popped up onto my computer screen and that was the most I was humanly able to do. I even asked the RN next to me to give meds to a couple of my pts. The CN was no where to be found. So when the oncoming RN notices orders missing, she says "Hmm the CN shouldve checked on this before the pt came here" and goes straight to her. The CN comes over to me and in front of 5 other RNs embarasses me and chastizes me for not noticing all the orders were not in. I said "I had 2 admissions back to back I did the best I could". So I am afraid I am going to be written up for this so I ask the oncoming RN, and she says no, the ED who sent the pt should have checked for held orders to be in place before transporting the pt, someone over there will be written up. So now I am so mad that I did not have the help and support of the CN, shes only been a RN a year, I feel like it is the blind leading the blind and she does not have an awareness of what is going on in the unit and fails to see the big picture and appreciate the efforts of the RNs. I am mad because I do not know what I do not know, and I do not want to jeopardize my license or hurt anyone because I am being slammed with work by her while she sits in the nurses station doing nothing!
May 4, '13
When the Charge gives you admission number 2, I would NOT be shy about saying, I will take that admission, but you will have to do the orders for me, and get the patient into bed. It will be a half hour before I can assess the patient. I have meds to give my other patients, and I am not done with the first admission. When should I plan report to be given? Be firm, but professional.
If it keeps up, I would speak to the nurse manager about safe ratios. 2 admissions back to back is near impossible for the most seasoned nurse, plus additional assignments.
Another thought is to suggest that if you take the first admission, RN number 2 needs to take the second, RN number three take the third....and so on.
If the charge nurse doesn't take a patient assignment, it is usually due to the fact that they need to assist with admissions and other functions that the primary RN needs.
I would also remember that sometimes an admission can be started, orders in, stat orders complete, but due to time constraints the entire admission is not completed depending on the timing. You are not the only RN in the unit. Sometimes, admissions need to be completed on the following shift.
May 7, '13
Thank you for your reply ,it makes me feel better knowing that it is difficult to handle and that I should have gotten help, but she does not see it that way and I will probably end up speaking to the manager about her.