Advice please....

[kimlpn]

I have been an LPN for several years and graduated recently from RN school. I am working on a peds step-down unit that gets pretty busy. We usually have 2-3 patients. We see lots of the home vent kids (I worked the past 5+ years with home vents--so this is an area I am comfortable with). My discouragement comes from the way assignments are made out. It seems like because I am the "new" nurse that I tend to get rooms that are far away from each other or if I get a difficult patient and a more stable one, they move my more stable one and give me an equally difficult one. When they move the patient it is usually just to another room in our unit. Several nurses complain about the moving of patients. Now, I can see this being justified if they move a patient who is not iso out of an iso room to make way for an iso patient... There seems to be one charge nurse who likes to give her buddies these really easy assignments (same room patients, less demanding patients with lower acuity)...it is just frustrating!!!! I see them sitting together gabbing and eating while I (and others) barely get a bathroom break! Anyone else have these problems or similar??? How do you handle this??? (I am not the only one that notices this either...no one says anything because they don't want to get on anyone's bad side) I like this job and plan on staying a year to get good experience...I am just down about some of the unfairness I see....and so little that can be done. Thanks for listening.

Kim

[heysmalls]

Hey! Congrats on graduating RN school. Now, I think you need to really go to the charge nurse or to the main person in charge and just explain your feelings to them. I think you need to confront these people (in a nice way) and see if they will compromise with you. If you don't say something, I'm afraid they are going to continue to take advantage of you and your hard work. Good luck Kim.

[Daytonite, BSN, RN]

I see this as a interpersonal communication dilemma. Did you study any interpersonal communication techniques when you were in school? Did you have any assertiveness training? I think there is a way for you to communicate with these nurses and get your concerns heard without upsetting or insulting them. It requires tact. What I'm hearing, however, is that you are saying nothing, watching what is going on from the outside, and it is eating you up. Perhaps one of the things you can do is to make sure you take a few minutes to join this charge nurse and her buddies while they are eating and talking to get to know them and for them to get to know you. You don't have to be pushy about it, but let them "see" you for a few minutes at a time. Another thing you might do is talk to your supervisors and ask for advice on how you might deal with this. They will be much more able to evaluate what is going on than us anonymous posters. Everyone has a different opinion. Someone may have one that will sound workable to you. As a new person you are in a very sensitive position so you have to be tactful, but I think you understand this. When they are more accepting and trusting of you they will gradually include you in their group decisions. However, if that doesn't happen by your first year of work, I would say it's time to get out the big assertiveness guns and let your opinion be known at that time. I am not defending these co-workers of yours, but one of the reasons that justifies people in charge and with more experience taking on patients of lower acuity is to be available to help out the rookies when something goes awry. Also, some units do not like to make patient assignments based on geographical location as this tends to really make assignments unequal in terms of acuity. Are you absolutely sure that there aren't very good reasons for the way the assignments have been made? You will learn more from working with harder patients than easier ones. Despite the fact that you were an LVN, you are now an RN and there are many things a new RN needs to learn that as an LVN you did not do. One of them is taking more responsbility in solving your problems and making decisions. Can you not find something positive in the way your work has been assigned to you? Surely, there must be something positive going on with the work you are doing.

When, in the future, you find yourself in a charge nurse position, remember what it felt like to be new, powerless and isolated from others and remain sensitive to this in your dealings with other people.