Less than 2 yrs experience in a 20 years

[pookiesmom]

Ok so I'm not a spring chicken, I'm 44 yrs old; but I"m not old either; however, my total experience in acute care amounts to 16 months in 20 years, since I graduated!

Now, I've completed the refresher course in August, but some days think I should've done the whole nursing school over again! I did however, get some experience in a Dr's office and in home health. These were much more simplistic jobs than hospital nursing.

Now, I am working in a sub acute floor and finding it very challenging. New grads are much more adept than I, I think b/c it has been too little, too long ago.

I cannot go backwards, but I need some advice: how do get up to the speed; both knowledge wise, psychomotor-wise and more 'in tune' with nursing, because I have lost all this time (doing other things, most not related to nursing).

I am still working after 4 months, but feel that it is difficult for me, and not all my coworkers seem to want to support me.

Advice please!!!!!!!!!!

[NYRN05]

pookiesmom,

well i def think it is hard for you but....you have to determine what is the cause to why you are behind?

do you have a simplistic report sheet that fits the needs of your nursing unit-it helps to organize info that you can have in your pocket or notebook when you don't have the chart or computer in front of you.

is it computer charting? try to take basic computer classes...some jobs offer it for little or nothing to the employee

is it paper work?

organizational skills? hard to prioritize what you need to do first? this is where its just gonna take getting to know what to do and when...what can wait and what can't.

do you have a nursing skills book ( SMITH, S & DUELL, D-good reference) you can refer to of common bedside procedures that occurs in your unit?

access to your facilities policy and procedure book or online? or basic knowledge of? for example say the MD wants to do a bedside procedure...do you know what supplies they need and you need? if you have to hang blood-do you know the supplies and documentation as per your facility requires. it will happen in time, but sometimes when you don't know and have to look these things up often it delays you. so reviewing it or printing out the most common ones and keeping it with you could also help when you need to reference and don't want to walk far to look it up.

are you going home after work or days off and reviewing patient scenarios?.....like dx? s/s of dx? pathophysiology? pharmacology?....treatment given?...labs ordered-norms/abnorms?.....the plan for the patient as per textbook and what was done in the hospital?

i also found it helpful to review the physician daily progress notes that we have in my facility-everything is listed there. don't know where you work or if you have enough time to go over it but their history, meds, labs, and plan of care is all there on a single page, and any events over the past 24 hours. also the initial history and physical, which directs the plan of care for the hospital admission and the daily notes following.

i know it seems like you are flailing. but hang in there...it can be discouraging. don't be fooled either....i've noticed that sometimes when new grads or new nurses to the unit...even just down right lazy nurses that i have worked with...those who seem like they have it all together-DON'T...sometimes do and sometimes don't. sometimes they are not giving the meds-witnessed! sometimes they are ignoring patients requests for things that you might go out of your way to do...like changing linens...toiletries-witnessed, or even spending a few extra min talking to the patient about their concerns or answering questions instead of saying "i don't know! or ask the MD!-witnessed.

what unit are you working on? could be that it's not the fit for you as well. well i hope my advice helps. feel free to continue to vent as necessary.

Shanna

[Jules A, MSN]

not all my coworkers seem to want to support me.

Advice please!!!!!!!!!!

Well I'm guessing it isn't a news flash that not all your coworkers seem to want to support you.

No matter what your skill level, not all of your coworkers will be helpful, thats a fact of life, in any field not just nursing. If you are humble, open to suggestions and helpful to them with the skills you can do most of them should warm up.

[NYRN05]

i agree with "Jules", not everyone wants to see you succeed. thats how some people get thir kicks. How about asking THOSE who do want to help or with whom you are friendly with, for some constructive criticism. Ask them what they see of why you are constantly behind. It may or may not be helpful, or asking the educator or supervisor to come in and shadow you for a few hours and then see what they say. They mainly don't want to see you fail becuase there is a lot of time, investment, and money spent to train you to be able to function in the facility, and they probably don't want to have to hire someone again to do it all over. Even though you took a refresher course...maybe you just need more exposure and more orientation. There is nothing wrong asking for help when you need it.

Best of Luck !

[pookiesmom]

Thanks to all of the posts; some great input. I do need more exposure, but also need to spend time when I'm off honing up my knowledge and reviewing pt scenario's, meds, some skills I should anticipate doing, step by step processes with admissions (ton's of paperwork and lot's of detailed stuff that is very important..but not clear in my mind..), etc.

Thanks to all for your good input.

I will try to ask those that I can for feedback, and be humble, and try to help those that I can that are not so friendly with me. Maybe one day they will be, if I can just hang in there.

Thanks all!