California New Grad Nurse Struggling With Floor Orientation

[Undftd]

Hi. I was lucky enough to be hired in the ED as a brand new nurse out of nursing school. I'm currently orientating to the floor with a preceptor. I just finished my 20th shift and I have quite a few concerns since I only have a few weeks until I'm on my own.

I'm getting feedback that I'm completing tasks too slow. For example: documenting, giving meds, completing procedures such as IVs, spending too much time in the room with the pt. How can I improve? I've been looking up my IV push medications and the majority have instructions to be given over one minute or more. One solution I've come up with is if the pt has a bolus ordered I'll push the medicine through a port so the med will go in slower plus be flushed afterwards by the bolus. I've also tried documenting in the room while assessing/asking the pt questions at the same time. I'm not sure if this is helping or slowing me down. I'm also struggling when I come on shift and either have to take care of admitted patients we're holding with a ton of orders plus new ambulance patients. There's been times I haven't been able to see my other patients for about an hour. I know they're technically stable but I feel horrible for not doing anything for them for so long.

I've been getting feedback that I'm not asking the right kind of questions or not asking enough questions which is making my preceptor worried about me practicing safely on my own. I'm unsure as to what kind of questions I should be asking. I've asked my preceptor a few times and I wasn't able to get a clear answer. I've been asking questions about policies, how to document certain things, and procedures/orders we have to complete. Any tips on the kind of questions you would be expecting a new grad nurse to ask? I'm kind of overwhelmed at times/takes me a little longer to process everything.

I'm at a busy level 2 trauma center where we receive a lot of septic patients and what I would consider to be critically ill patients. We get our fair share of noncritical patients who I can generally handle fine. Our ED has been on divert a few times this winter, been completely full of patients waiting for beds upstairs, and been holding anywhere from 5+ icu patients every shift. I take care of anywhere from 2 to 10 patients in a 8 hour shift.

[Undftd]

I plan on asking my educator to decrease the patient load so I can focus on patients coming into the ED. This way I can ask questions about plan of care, important things to assess/monitor, relevant labs, and anticipated orders.

[NewGurl, ADN]

When I started off in nursing I went to the floor. I HATED it! My preceptor had nothing but negative things to say and I felt overloaded. I'd leave there crying almost everyday and think how much time I had wasted in nursing school. Then I found surgery. I felt like I was home immediately. Maybe you might reconsider your area of nursing?

[FutureNurseInfo]

You should be given a detailed feedback as to what you need to improve on. Also, give it time; you still have a few more weeks of orientation. Also, you are brand new, expect to struggle at least your first year. I am a teacher of 7 years and I remember my first year of teaching. It was horrible! The worst ever! However, as time went by, I was able to master the skills I am using today. Like I said, try to stay above water and eventually a year from now you will feel a lot more confident.