Being let go during orientation

[ellie23]

Next week I will most likely be let go from a hospital staff nurse position because of problems with time management. I am unable to finish my charting in a timely fashion and have been told I will be let go if this doesn't improve. This is an ongoing problem that I have been working on, but it is unlikely I will have significant improvement in the time remaining. I am very sad and disappointed about this, but I accept it. I am a newish grad and this was my first hospital job. I will likely go back to my old job at a small subacute facility, but would like to try to get a job at a smaller hospital in a few months. Will having been let go during orientation make it impossible for me to get another hospital job?

Thanks for any help.

[enuf_already]

Sorry to hear about your situation. Do you use electronic charting in your current job? Can you create smart phrases so you are able to basically hit a few keys and type in negative assessments, frequent findings in your patient population, or something to help you avoid starting from scratch every time?

Do you do and chart head to toe assessments in the same way each time? This keeps me on track and helps me avoid forgetting and having to backtrack.

Good luck. The best thing to do is chart as you go in real time. If you can create templates to fill in variances, this can help.

[LadyFree28, BSN, LPN, RN]

To answer your question: in my experience, I wasn't "impossible" to obtain another hospital job.

I learned how self-correct my missteps that resulted in my previous dismissal; My ability to self-correct and improve was a big factor in surviving orientation this time; I still have a lot to learn, however, I am in a very supportive system and take advantage of it.

Time management relies on clustering care, and the ability to adjust to changing responsibilities.

Having a brain sheet and documenting pertinent information helps with transferring info to the EMR, in my experience.

I was let go from a CC unit, went to LTC as a supervisor, then to a pedi post-acute facility, and now I'm at a Level I trauma Pedi ER.

There is nursing life after being let go from a hospital; however, I implore you to learn how to cluster care, use a brain sheet and chart in real time-it is possible.

Best wishes.

[HouTx, BSN, MSN, EdD]

I'm so sorry that your transition to acute care isn't going so well.

A 1:5 nurse patient ratio is actually very generous for MedSurg these days. But the 'actual' workload required for that assignment can vary greatly depending on the setting and patient population. Acute care is very fast-paced, staff have to cope with a continuous barrage of new information and tasks... there's just no way to manage successfully without multi-tasking. That being said, we (human beings) are unique creatures. Some of us have brains that are hard-wired to multi-task and some of us do not. This has absolutely nothing to do with intelligence.... some highly intelligent people cannot manage a very high cognitive load & vice versa. If you're not a natural multi-tasker, you can can use organizational aids to help but chances are, you'll never be really comfortable in a chaotic setting.

Despite all the nursing myths, acute care is not the end-all and be-all where all the 'real' nurses work. Maybe your ideal setting is in ambulatory care, Home Care, or back in your sub-acute comfort zone. Plant yourself in the right area & you're going to flourish and bloom like crazy!!

[_Skittles_]

I would meet with the manager and preceptor to come up with a plan on improvement. It really shows you hear them and want to take the initiative to improve. Also they might have short cuts for your charting system. Personally I find it easiest to chart the detailed information as I go (my nursing note, dressings and I&Os). It's easy enough to bang out an assessment in 5 minutes and chart on lines at any point.