A VERY frustrated nurse

RNnewbie2014 · Feb 19, 2015

Also, the patient I had to restrain was not oriented to place at all.. Hallucinating etc.... And the seasoned nurse told me you have to start on an IV on a disoriented pt regardless if they want it or not since they aren't in their right mind and don't know what they are saying...

allnurses Guide · Feb 20, 2015

The seasoned nurse was right.

Incremental overtime is huge when it comes to the unit and the hospital budget. It matters a LOT. The fact that others get out on time is not indicative of poor care on their parts. It is indicative that it is both possible to do it and that you can learn from them.

It doesn't matter if the tech gives you the cold shoulder. You aren't there to be friends. As long as you are respectful and polite there isn't much you can do. New nurses need a lot of help and that can wear them out. It will get better as you get better. Ask them and move on to the next thing. Do hourly rounding with purposeful questions. If a patient always asks for a Coke, bring one every time you enter the room. Address the four Ps before you leave...pain, potty, personal items and position.

Find out how others manage their day. If you aren't using a brain sheet very shift you need to start immediately. And keep your chin up. What you are experiencing s normal. Nobody thinks you are incompetent. They do think you are new and that you need the feedback.

RNnewbie2014 · Feb 20, 2015

Well, I say that they don't care because they leave things for me constantly that in my opinion should have been done prior.. And all the nurses on my unit that report off to me on day shift have been a nurse either as long as I have or little longer not much longer.. Most nurses on my floor are not experienced.. At least on that particular day shift rotation.. I mean I had a patient crying in my pain as soon as I come on and the day shift nurse that reported that pt off to me knew that pt was and KNEW that pain medicine could have been given... That is the sort of stuff that stresses me out.. I guess I just catch on a little slower.. I think I am going to start taking my C.O.W. into the rooms during my assessments to see if that helps. And I usually write out sheets of my medications, labs, diet, iv site and fluids and if they ask for pain medicine frequently, fill it in my medication list on the times.. Sometimes I don't get to do it though if I have multiple patients requesting things as soon as I come on.. And I try to start passing medicines as early as 2030 but my tech sometimes doesn't even have vital signs done therefore I am not going to give a BP medicine without knowing a blood pressure and heart rate..

SierraBravo · Feb 20, 2015

OP I have to chuckle because I feel your pain, I've had days exactly like you described. Do you have EMR? We use EMR and I find it so useful. Also, if you bring your computer with you then you could chart a little bit in the room while the patient is in the bathroom. Finding your stride is difficult when you're new, but know that eventually you will.

BrandonLPN, LPN · Feb 20, 2015

It is no huge mystery as to why a 4-month RN is staying over to finish while her more experienced co-workers leave on time.

It does not mean the nurses leaving on time don't give a crap about their patients, nor does it mean the new nurse is incompetent.

No one expects you to function like a seasoned pro right out of school.

but don't fall into the new grad trap of thinking that your seasoned colleagues "must" be cutting corners because they leave on time. They leave on time more often than you because they have more experience than you do. Which, when you think about it, only makes sense.

thenightnurse456 · Feb 20, 2015

Even though I understand your frustration and the pressures your facing as a new RN, I can also see the concerns from management when one staff member is frequently staying behind 4 hours late.

And I agree with Brandon, a lot of new grads who are still learning time management skills often develop this attitude that their seasoned coworkers are some what lazy and must be cutting corners or leaving things for you to come along and find and solve. When in reality, they are just experienced and have become more efficient with practice. You'll get faster too with time.

Instead why not try to focus on further developing your skills or talking to your manager, educator, preceptor or mentor about your frustrations. They might be able to help or offer some advice or wisdom.

You sound like a very competent new grad, I'm sure you can push through and be successful.

Good luck.

danielle2000, MSN, RN · Feb 20, 2015

Let's keep it real you are doing your job. Some seasoned nurses simply cut corners. You have to put foot ass with your techs. You are an RN delegate with assertiveness and keep it moving! In time you will get it and devise a system to make your life easier.

RNnewbie2014 · Feb 20, 2015

I just am saying from my experience that they are... Hence my manager thinks this new nurse hired (very sweet girl, I have no problem with her) has caught on quicker than me with time management yet when I come on the shift.. This nurse missed 3 medications to be exact that were all due on day shift schedule.. Yet because I am staying late and being quite thorough in my opinion, I am getting in trouble with my manager... My manager thinks its absurd I am staying as late as I am and I got in trouble for it...... Thinks I should be catching on by now..

MatrixRn · Feb 20, 2015

I hate to say it, but what you describe is common for new grads. [i lived through very similar to you when I first came out.] Nursing school does not prepare us for the reality of nursing. We go to clinicals and see a few patients and all the while we are supported by our instructors. Real nursing is just not like that.

I have to agree with the other poster in that staying an extra 4 hours to do charting is not something that you want to do. If you are doing your charting that late...there is little chance that it is accurate. The time stamps will be off and you are bound to forget items. I would suggest pulling the COW around with you everywhere you go. Even if you cannot chart fully, at get the time stamp in and open the areas of the record that you will later fill in.

Their are so many issues about staying late to chart......1) if you are working you must get paid for your time, so if you stay 4 hours you must charge for 4 hours. It is the law. 2) OT, few hospitals want to pay 4 hours of OT for someone to chart, when the other folks can get it done, 3) taking 4 hours to chart on your patients is incredibly long, especially if you have an EMR. Consider reaching out to your educator to get support on streamlining your charting.

Nursing is about delivering nursing care, yet it is also about charting what tasks we have done. In this business [and nursing is a business], charting is how we show we have value. Take credit for the nursing items that you do!!!

How do you show value in fetching milk? Answer: you don't. The value comes for nursing when someone, again does not have to be you, documents the input of fluids.

Many of items above should be delegated off to the techs--- soda runs, cereal and mild duty or reapplying a colostomy bag etc. It does not matter if they are unhappy doing their JOB ask them anyway, and if they do not comply talk to your charge nurse. It is not an option for them to shirk their duties. You are a new nurse on a new floor, you will need to set boundaries and expectations as to how you want the care of YOUR patients to be handled by them.

As to the CVP and the missed pedal pulses, well this is where you set boundaries with your fellow floor nurses. You do not need to be ugly, however the next day after one of those 'missed' events, say hey guess what happened to Mr. Jones after you left yesterday and fill her in. No judgment, just give the facts. If the nurse is a good one she will make a mental note to pay more attention to her hand-offs in the future.

As time goes by it will get easier. Give yourself a break you are just learning.

TheCommuter, BSN, RN · Feb 20, 2015

I want to know WHY is it such a big deal for me to stay late?

Staying late costs the hospital money. Staying four hours late every night seriously costs the hospital money. Since hospitals are businesses first and foremost, a nurse who stays on the clock four hours past the end of the shift is cutting into the budget.

Another forum member wisely mentioned that compassion is not efficient. Although the seven patients have their different needs, they can be prioritized. The guy who calls for snacks and soda hourly can be made to wait. The patient who is being combative doesn't need an IV line restarted immediately. Yes, some things can be completed late.

I only spend 15 to 20 minutes with each patient. In this 15 minutes I do a quick assessment, administer medications, change any dressings that need to be changed, then move on. This might sound cold of me, but the patients are not my personal friends. With an average patient load of 8 to 10, I do not have the time to keep catering to someone who rides the call light for incessant snack requests.

I chart immediately after I've done the assessments and medication pass. The techs do as I say. I get out on time. Time management is king. Good luck to you.

RNnewbie2014 · Feb 20, 2015

And this past week has just been miserable.. Some days with 7 patients I leave at 0730.. BOOM perfect.. Just these past 3 days I have been leaving late because of chaos.. And we chart on EPIC.. The girl who preceptored me was very thorough on charting so I super OCD about getting a green check mark by the patient's name before I leave... Also, I have came on as night shift and none of the medications on the PTA have been reconciled or wrong dosage.... When I go to pass medications and call out what I am giving, uhh no ma'am I don't take that or are you not gonna give me this? So I call the doc to get Geodon ordered for a patient who HAS to take it and get chewed out for calling about reconciliation of medications at 2200.. I really don't care about doing all these things.. It's just I am going to be late if I have to do tons of things like that so I feel like.. Oh well, I guess.. I know over time perhaps it shall get better.. I love taking care of people and I guess being speedy gonzales is not really how I would like for it be but just how it has to be lol