Am I a Product of My Environment, or Just a Crappy Nurse?

Nurses General Nursing

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I've been on my own on the floor for a whopping 1 year and 2 months. It really has been a sink or swim first year, and up until recently I honestly thought I was doing a fairly decent job at swimming. I haven't been counseled nor written up, I received a moderate raise at my first review a couple months ago, and my PCS often mentions how I "think outside the box" or am "a great resource for the team".

With that humblebrag out of the way, the past two weekends have seriously made me question my abilities as a nurse. I've been struggling with suddenly not having time for lunchbreaks, and just the last two shifts not only was I late getting out of work (after finally nailing down the time management to being out on time most shifts) but I had a doctor shred me to tears and a family fire me from their care.

I know my floor has had staffing issues and did just hire a bunch of new grads. I'm wondering if my new-onset inability to manage my time correctly and feeling overwhelmed with the acuity of my patients has to do with me getting heavier loads while we ease the new nurses onto the floor, or if I truly am just not trying hard enough.

I guess what I am wondering is, how do you know if your sudden suckiness is simply that you suck as a nurse, or that your floor is really screwing you over in the short-term?

Specializes in Neurosciences, stepdown, acute rehab, LTC.

True horseshoe ^^ .. Just a premature assumption I made

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I would say crappy situation. I've butted heads a little with you at times, and I would say you usually have NO problem standing up for yourself, or your patients, which is a great thing.

I don't think you're a crappy nurse.

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They fired me because they felt I was withholding pain medication from the patient. At that point in the week, I was fine with being fired, because I was damned tired of explaining, over and over, that they can't just go for the IV fentanyl every time they had a twinge, they had to at least TRY the PO hydrocodone. And for longer than 10 minutes, too. The patient got angsty that I was leaving him "to suffer" despite the very clear instructions on the MAR, and the wife was very cranky that I wasn't handing the PRNs out on schedule, so they fired me.

And then they fired the next nurse for not suctioning him often enough.

And then they fired the next nurse after the CT and MRI showed there was nothing wrong with the soft tissue nor the bony stuff, and the nurse suggested to the physician that we look into psychiatry/psychology for ineffective coping during a traumatic event.

I guess logically it wasn't me they were targeting personally, but more just exercising their options out of frustration. Still stings after the last couple go-arounds.

Normally I don't hide in the bathroom and cry (last time I did was when I turned an obviously jonesing, helpless young man back on the streets after he signed himself out AMA) but that Dr... man, I never saw it coming. Thankfully my charge was less than impressed and had a terse word with him or two - I was too blindsided to stand up for myself.

I'm struggling with our doctors being a little more blase about patient care right now too. How does a new nurse deal with physician burnout?

Hindsight is always 20-20. The Fentanyl family needed to be handled through a unit patient care conference and management /physician review. Nurses do not have to handle this type of behavior alone.

Agree you were blindsided.The one and only time I was yelled at by a doctor it was over before I could tell him where to go. I have since then been loaded for bear.. ready to walk away to a private area and call nursing supervision for back up.Report the behavior, depending on the facility Dr. Jerk will be hearing from administration.

Please expound on " blase patient care".

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It gets better honest. Hang in there and don't let cranky doctors get you down. The situations don't get better but your reaction to them will.

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Agree you were blindsided.The one and only time I was yelled at by a doctor it was over before I could tell him where to go.

Sounds like one of those times when you wake up at 3am with the EXACT perfect thing you wish you'd said. Grrr...

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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
They fired me because they felt I was withholding pain medication from the patient. At that point in the week, I was fine with being fired, because I was damned tired of explaining, over and over, that they can't just go for the IV fentanyl every time they had a twinge, they had to at least TRY the PO hydrocodone. And for longer than 10 minutes, too. The patient got angsty that I was leaving him "to suffer" despite the very clear instructions on the MAR, and the wife was very cranky that I wasn't handing the PRNs out on schedule, so they fired me.

And then they fired the next nurse for not suctioning him often enough.

And then they fired the next nurse after the CT and MRI showed there was nothing wrong with the soft tissue nor the bony stuff, and the nurse suggested to the physician that we look into psychiatry/psychology for ineffective coping during a traumatic event.

I guess logically it wasn't me they were targeting personally, but more just exercising their options out of frustration. Still stings after the last couple go-arounds.

Normally I don't hide in the bathroom and cry (last time I did was when I turned an obviously jonesing, helpless young man back on the streets after he signed himself out AMA) but that Dr... man, I never saw it coming. Thankfully my charge was less than impressed and had a terse word with him or two - I was too blindsided to stand up for myself.

I'm struggling with our doctors being a little more blase about patient care right now too. How does a new nurse deal with physician burnout?

It sounds as if that family firing you was just business as usual. Please don't give that a second thought. It happens all the time and for more trivial reasons than the ones you described. For more absurd reasons as well. I've been fired because of my race several times (I'm white; our predominate patient population is Black) and I've been the nurse drafted to take care of the patient when someone else was fired for their race, religion or country of origin. (You name the race, religion or country of origin.) I got fired once for not voting the "correct" way. Seriously. I walked into the room to introduce myself and they demanded "Are you voting for Mr. FlagrantlyPhilanderingPolitician?" and my response was "Uh . . . " They fired me. My colleague got fired because she's Chinese and speaks only Mandarin, not Cantonese -- it seems they'd rather have me, speaking English only. Oh, and there was the time (a LONG time ago) when the patient's wife fired me for being "too pretty."

As far as the physicians -- you teach them how to treat you. If you don't put up with bad behavior, they rarely behave badly with you. I'm older now; I've perfected the incredulous "I can't BELIEVE you're talking to me this way" stare. There are other ways around physician verbal abuse; but there are also abundant threads on dealing with it. Good luck!

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Specializes in Med-Surg, NICU.

I am learning not to take things so personally. People, especially sick patients, don't always behave themselves. When a patient fires you, consider it a gift. Another nurse now has to put up with the jerks...not you!

Rejection is a form of protection!

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Specializes in 15 years in ICU, 22 years in PACU.
Oh, and there was the time (a LONG time ago) when the patient's wife fired me for being "too pretty."

I lost a job once for being "too pretty" The wife thought the husband was spending too much time with me. I was a church camp activities director, life guard, pool cleaner, watercraft instructor, meal server and store cashier. The husband was groundskeeper and maintenance so we were working all the freaking time but not necessarily together. He didn't spend enough time with her I guess, so it was my fault.

Fired from a church camp and I went on to become one fine nurse!

I hope that helped. ;)

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First of all, it will get better. Give it time. I feel like this is not your fault and it is most likely your facility. This sounds like my situation. I felt like I was doing well and managing my patients well until not long ago. I would be staying an hour over my shift to finish tasks and sometimes longer. I would have 7-8 patients when I was promised a maximum of 5. My manager would be encouraging but would never help when I was struggling. Many people were getting offers for advancement in their position and I was never asked anything. I felt unappreciated and felt like I had no support from management. I also was "fired" from a certain patient and I have had a doctor bring me to tears. Just remember that not everyone is like that! I ended up finding a better fit for a job and resigned from the facility. I am MUCH happier now. Although it is a new position, I feel that it is definitely a better fit. And it will take time for you to find your place. (I'm still finding my place in nursing) There will always be positives and negatives in every field or job you work. Just know that you are appreciated by many even though they may not say anything. I hope your position gets better for you or you find a better fit for a job. Good Luck!

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I lost a job once for being "too pretty" The wife thought the husband was spending too much time with me. I was a church camp activities director, life guard, pool cleaner, watercraft instructor, meal server and store cashier. The husband was groundskeeper and maintenance so we were working all the freaking time but not necessarily together. He didn't spend enough time with her I guess, so it was my fault.

Fired from a church camp and I went on to become one fine nurse!

I hope that helped. ;)

How pretty was the other guy, Mav?

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Specializes in Family Medicine.

This is why nurses burn out. You're doing everything right and kicking major A. At the end of the day, you leave feeling like you didn't do enough or do things well enough. There are only so many hours, everything can't be done to the standards we hold. We skip breaks or leave late to try and meet our standards but even that isn't enough.

Do not point fingers at yourself, point them at the administrators who continue to cut staff while piling on more demands. Well, don't really point fingers or interact with them, it won't end well.

Start looking for another job, this sounds like a burn out gig. Disclaimer: I've been working my burnout gig for almost 5 years. I wish I could take my own advice...

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Specializes in ER, Neuro, Trauma, Educator.

I had just had to respond because what you are going through is completely normal! There's something weird about the one year mark (I've only been a nurse for about 4.5 years and have just started in the ER about 9 months ago). I was on a busy stroke/neuro unit with 6:1 ratio and about 9 months in felt as though I could finally breathe a little, take a pee break, help others because I was in control, etc.... then 1 year hit and I experienced the same feelings of inadequacy. I think it may have something to do with the fact that we finally get a little confidence in ourselves at that point so its extra painful when the inevitable happens: getting fired by an unreasonable pt, verbally assaulted (NOT ok by the way, did you report this unprofessional behavior?), making an error, etc.

It may just be me but I wanted to share! You are not a crappy nurse, get that out of your head.

Also, have fun getting to be the "cool nurse" that those new baby nurses look up to!!! They really look up to the more recent grads (1-2 years in) because they feel like you can relate, so be good to them and enjoy sharing all you've inevitably learned so far! :)

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