Asking for advice

[blahblah0012]

Hi, everyone. I'm new to this forum, and I'm also a new grad. I need some advice. I moved to a new state a couple months ago a short time after I graduated, and I got hired by a local community hospital. I was supposed to go to their renal department that they would be opening up. However, due to delays in construction, I was put on the telemetry floor for training until the wing opens. I accepted the job in hopes that the wing would open soon, but the latest I heard was that the wing was going to open on Dec. Meanwhile, I finished orientation and started working on my own. I find myself hating the unit that I am working at... I feel overwhelmed, and very much scared working on this unit. I am not tele-certified (i.e. have not taken all those EKG classes and stuff), so someone else in the unit does the strips and there are other meds that I could not give to the patient. About a week after I was on my own, I had a very hectic day and missed one of my patient's labs. The charge nurse totally chewed me out in front of everyone and thought that I made a med error by giving the pt. Aspirin when I should have withheld it because of the pt.'s drop in H&H when in reality, I just forgot to check the labs. I really felt terrible and didn't say anything, and she never gave me a chance to explain myself. By that time, I was totally embarrassed and just crushed. To make it worst, my husband came into the unit (just to say "hi" and to pick me up) and heard the charge nurse talking to the unit receptionists about me and just totally badmouthing me. He said that he could hear her talking all the way down the hallway. Needless to say, I was in tears all the way home. The next day, I got a call from the management stating that they wanted me working with a preceptor without further explanation of why. I was scared and just totally devastated and called my manager asking if I can be transferred to another unit stating that I wasn't hired to work on the telemetry floor in the first place, and feel that I am not cut for that unit. She, however, told me that they could not transfer me since it hasn't been six months yet, and I am under the introductory period.

I went through the "reorientation" without really knowing why I was put through it until the last day, when I had a meeting with my supervisor... it came out that it was because of medication error that I was put through reorientation. The next day, which was the first day of being on my own for the second time, I was given an admit. The patient was very tachy (hr was on the 150s) and had an order for a cardizem push and drip... meds that I could not administer. I tried to call our "crisis" nurse, but was told to ask the charge nurse for help since she was busy. When I asked the charge nurse for help, she referred me to the crisis nurse. I tried the "crisis" nurse again, and was told that she was still busy, so I went back to the charge nurse, but was told by her that I could not just come and bother her anytime since she is busy with her scheduling. To make a long story short, the "crisis" nurse finally helped me.

I am so fed up with this job. I don't want to quit nursing, but I feel like I am not cut out for this floor. I am thinking of resigning if I don't get transferred to another unit or transferred to a night shift at the least (I heard it is not that hectic, and the people there are more supportive). My husband feels like I should quit since I am not happy, and this job is slowly draining the enthusiasm that I have for nursing. After hearing the charge nurse badmouthing me in front of the other staff, he is just very negative about my workplace. I am worried that I may have difficulty getting another job if I quit now since I am still under the introductory period.

[Tweety, BSN, RN]

There are a couple of issues here.

First you are a new grad, and you're going to feel overwhelmed wherever you start out.....that's a given. Renal patients take tons of meds and get very sickly, etc. etc. and those floors can be very stressful. Transferring to another department, probably isn't going to change things either.

Second, you've given them permission to not listen to you by not demanding that they listen to you tell your side of the story. Also you've given the charge nurse permission to bully by allowing her to. These kind of people need to be spoken to about how they make you feel at the time, or very soon after. You should never be reduced to tears, swallow it up and say nothing. Her behavior in talking about you loud enough for your husband to hear is not acceptable.

Perhaps an incident report should be written about the delay in patient care over giving the cardizen drip to the patient in need.

You are going to have to be your own advocate here and start speaking up for yourself. It's not easy for a new grad, so choose your battles and be strong.

Hang in there. :)

[TazziRN, RN]

I agree with most of what Tweety said, but I disagree that this is happening because you're a new grad. Not all new grads get raked over the spikes when a mistake is made. There are places that are supportive to new grads; while you have to take ownership of mistakes, they are willing to help you learn how not to repeat them. Humiliation is not the way to do it.

[Tweety, BSN, RN]

I agree with most of what Tweety said, but I disagree that this is happening because you're a new grad. Not all new grads get raked over the spikes when a mistake is made. There are places that are supportive to new grads; while you have to take ownership of mistakes, they are willing to help you learn how not to repeat them. Humiliation is not the way to do it.

I didn't mean to say new grads are raked over the coals.

I meant to say it's a near universal experience to have feelings of being overwhelmed with that first position. The orginal poster would have been having typical new grad feelings of being overwhelmed no matter where they started.

[nursingisworkRN]

sorry to hear you are having a difficult time adjusting. i am also a new grad and new to telemetry and it is giving me a run for the money. i have made mistakes too, but that is a part of nursing. i also get overwhelmed on a daily basis. just when i start to feel more comfortable, i get sicker pts and then i am back in the high stress zone. it is very challenging when everything is new, and i can only imagine being in a new state. yikes! :uhoh21:

i was wondering if you have discussed any of this with your clinical manager? the charge nurse who yelled and publicly criticized you to others was out of line. even if you made a mistake and something horrible happened, that doesn’t warrant poor behavior. i had a terrible incident that was not my fault (can you tell it is still a touchy subject?) involving a charge nurse yelling at me, and i was so devastated that i wanted to quit. i had a few days off, and then when i went back to work i was still devastated so i scheduled a meeting with the clinical manager of my unit. she was very upset that i was treated the way i was. we reviewed the incident, as well as the incident report. she wanted me to do an incident report on the charge nurse for my public flogging, but i didn't want to. it is possible that your manager is not aware of the charge nurse’s behavior. try to be strong and view it as an opportunity to give your side of the story. it is also important to let them know how you are feeling. you could use support from the staff.

is there anyone on your unit that you feel you can talk to? maybe your preceptor? what about other new grads that you went to school with? for me, it really helps to have other new nurses to talk to. i don't feel as isolated when i talk to them. many of the nurses on my floor have been nursing for years, and it is hard for me to see them be very great nurses while i struggle with the heart rhythms and medications. i chose to work on the telemetry unit, and it is still very overwhelming. my renal pts give me the most run for the money. they are very sick, have tons of medications, and the funniest heart rates/ rhythms that i have ever seen. however, if that is your interest, i would pursue it. it is important to get experience, and i think that even if you started on the renal unit you would be challenged (it is a very demanding job!).

i was unsure as to why you could not give the cardizem. however, it would be very important to determine whom you are to go to as resource for duties you cannot perform. ask your clinical manager about this. are you allowed to push atropine/lido? who will implement the tele orders in an emergency? i am very concerned about this…hopefully you know or plan to find out? delays can be costly to the pt, and high unstable heart rates often lead to codes.

just wanted to let you know that i know where you are coming from and to remember that you are definitely not alone. i am in your shoes and it is not easy. every new nurse i know has had problems and conflicts. i will be thinking about you. i am sure you are a great nurse. have faith in yourself and be patient. please check back in and let us know how it is going for you! good luck!

[erichRN]

It's usually better to try to work out your problems. I agree with most of what has been said up to this point, but I would add that you need to get your ACLS like yesterday. That extra training/knowledge decreases your fears proportionately and, of course, provides you with tools for better patient care. I can't stand nurses who bring their issues to the floor, but they have their needs, too.