Am I a bad nurse?

[smartypants22]

I got hired for a PDN agency in April after 2 months of searching for a job and finding this agency on Craigslist. I was and still am fresh out of nursing school and just passed my NCLEX and got my LVN nursing license.

The head manager gave me a case for a boy on trach and has a g-button. I went for training/orientation for 2 days with one of the boy's nurses, the first day, I observed what she did, the second day I did what she did with her guiding me. I was going to be on my own the day after with the mom's help. When I went home after that second day of training, I got a call from the agency that the mom was not comfortable with me and didn't want me to come back, so I would have to choose another case. (The agency sends out daily emails of available shifts).

That was a Friday, so the following Monday, I called and asked for a low tech case (I don't know how it is at other agencies, but my agency has low tech cases, which pays less, but have less medical problems, and high tech for more experienced nurses, the first patient was a high tech case). The head manager sent me the POC and it was a boy with Down Syndrome and he's also nonverbal. I was with this boy for 7 weeks, 19 hours a week, until I received a call that this boy's mom didn't want me to come back because I wasn't communicating with the boy. I really tried my best and I talked to him all the time, but I guess it wasn't enough. That was just last week.

Now I have to choose yet another patient. I don't know what to do anymore because I've only been with this agency for 2 months now and I'm already going to be on my 3rd patient. I guess I just need some advice and reassurance that everything is going to be ok. I truly feel pediatrics is my calling because I love children.

[SDALPN]

I am an experienced nurse. I started in PDN as a new grad. It was hard at first, but I learned a lot about direct care, doing great assessments and more.

I decided that to succeed with families I was going to need to do some CUSTOMER SERVICE. So I was very friendly. I acted like I TOTALLY agreed with their house rules; yeah some rules are really stupid. I told all of the parents, (when asked about my experience or when I could squeeze it into a conversation) "I know the doctors are trying to do the best for kids but one thing I have learned in nursing is that no one knows a child like their Mom/Dad" I will say that this comment has helped to make my job easier. The parent (usually a Mom) tends to be nicer, more lenient and friendlier. Additionally, I will ask the parents before I leave "Is there anything else that I can do with/for your child that will make your evening/night/day/weekend a little easier for you?" One Mom told me that she liked me from the start because the morning she met me (I was orienting) I said to her "I hope I didn't make noise coming in and wake you."

So yeah, we need to be good nurses, use your common sense, protect your patient and yourself and play the popularity / customer service game.

Read about therapeutic conversation. I use phrases like "that must be so hard for you" or "I can't imagine how difficult that must be for you." toward the parents. They seem to like that someone is sympathizing with them. Also, "If you ever notice that I forget to do something or you do not like the way I do something, please let me know. I am always open to suggestions, I know you have more experience at ______."

Also, I never give much personal info. I keep conversation/chit chat to shallow topics like crafts, food, pets etc...

Here is how I respond to certain topics:

Politics = "Oh, I do not follow that stuff, seems so confusing to me."

Religion = I always respect their beliefs. I try to avoid the topic. If they are Muslim or Jewish or another religion that I am not I will tread very carefully.

Mom/Dad complaining about work/love life/neighbor = "That has to be hard for you to deal with." or "That must be so difficult for you." etc.

Anything else = try not to give negative comments. Was a restaurant terrible? too bad, if they ask say "hmmm it seemed like they might have been having a bad day. I think I would need to try it again to give a true opinion" do not say "oh it was awful! blah blah blah" you want the family to associate you with good things, not negative.

When people use those responses with me, it seems fake and reheorificed. While it may work for some people, it won't always work. When I get those responses, I usually call those people out. I would rather someone be real with me.

I just recently had a new supervisor use those reheorificed phrases with me. She was trying to be professional, and I get that. But it just made things cold and fake feeling. I told her to relax and just say it like it is. She did just that, and our communication is so much better now. Instead of trying so hard to sound good, she now gets her point across more efficiently. Instead of coming across cold, she shows a very nice personality. The same approach across the board doesn't work. Its better to cater to the family and their style of communication.

On the flip side off that, sometimes it works with the right family. I'm with one now where the parent was asking how much there was left to do on a project. Instead of answering like that, I said "look how much we have accomplished". She saw through it and said something about viewing it positively. But she seemed less stressed by seeing that so much had been accomplished and there isn't much more to do. But...she saw through it.

Personally, if I had a nurse with that approach, they wouldn't last long. I would prefer the warm and friendly type. If you aren't a fit for the family and you fake it, they will soon figure it out.

[NagathaChristie]

Well telling someone what is left on a project is not really being negative. I would probably try to state both what was done and what needs to be done and when I expect it to be done.

[LVN2BSN2016]

Sounds just like the company I just got hired by. Signed a 1 year contract with this agency who also has low and high tech cases. I just graduated about 3 months ago and have been with this company for about 3 weeks...

Not what I wanted, but in Houston(is yours in TX?), there aren't many places for LVNs to work. I'd love to work in a hospital, that's for sure.

That's a main reason I'm trying to go back to school so quickly to get my RN.

[smartypants22, LVN]

Yes! I'm in Houston, TX. We're probably working for the same agency.