Career Correction

[Aonedayatatime]

I got hired at a great hospital level 1 trauma facility. I worked through school as a CNA for 3 years at this same facility. I never had discipline issues or excessive callins etc.

I am in a nurse residence program and its going poorly.

I seem to have preceptors that tell me "its okay its good" then get called to the residency management office since I am underperforming in expected time management. I am new and need to improve but I am not sure what to do. I feel upset with the underperformance. This is considered a write up for HR. I am on week 9 taking 4 patients. I should be at 5 patients now. I need to improve my "time management" to correct the course I am on. I need help on ways to do this.

Part of the problem is I took 3 patients now taking 5 floor status. However this problem has been haunting me the whole time. Additionally I am switching between days and nights and this pattern disruption is hard for me to adjust too. (I had spent 2 years nights, 1 month days,1 month nights, 2 weeks days, and next week nights) I cant sleep when I should or eat at work because of this.

I am afraid I will loose my job for this (next step is written warning). I am not sure how to approach this situation. The team is disappointed because I should have better time management since I have worked here. I have 2 weeks to sink or swim. I don't know how to do this because the anxiety of being new is bad enough. This is almost too much.

any advise on

1. time management/ med passes

2. Organization tips for adhd rns

2. should I quit or get fired which is worse

I want to be a great nurse. I feel pretty hopeless and useless and like no unit will want me. I feel that out of the 30+ new grads I am the one no one wants.

Thanks

[INN_777, BSN, RN]

Hi, aonedayatatime,

Sorry to hear about your challenges. I am a new grad as well just 2 weeks off orientation, but had a prior career in business. So take my thoughts for what they are worth.

I don't understand how you can be getting different feedback from your preceptors and your residency program. Who is providing feedback to the residency management? If it's your preceptors, I think you should have an honest talk with them and ask where it is that they think you are under-performing and what recommendations they would have for you to improve.

I would ask the same of the residency management next time you talk. What recommendations and tools do they have for you? They can't just be telling you you are not doing well enough and "starting the clock" on you and not telling you exactly what to improve or offering tools to do that. That does not seem right, seems very punitive.

Best of luck to you! I hope you survive this and thrive.

P.S. I hear you about the day/night rotation. I am in the same boat. Right now coming off two weeks of nights and transitioning to days. Crankier than cranky and always want to sleep.

[browneyes3000]

My manager called me to her office twice for bad time management. It was not an easy feeling, but I appreciated the fact that she gave me an opportunity to improve. I have 5 patients each shift. At the beginning of the shift, I write down important lab orders (some labs need to be drawn on time), to do lists, medications for each patient. I also look at the patient diagnosis, age, and labs to decide who I will come to see first.

-If patient A has 0730 meds and 0900 meds. I will check the vital signs and give all medications at 0800 unless there is a contraindication.

-I look at the PRN medications and the previous shift charting to see if the patient takes pain med, anxiety med, stool softener, etc exactly q2h, q8h, or just as needed. If they take it frequently, I will go ahead and bring it with the scheduled medications. It will save me a trip back to the patient room.

-Before I come into the patient's room, I try to think of what I will need such as saline flushes, dressing change supplies, tubing, fluid bag, juice, ice, etc. (I ask the nurse from the previous shift to see what the patient's preference with taking pills. If they prefer to have their pills crushed and put in chocolate pudding, I would bring pudding and spoon to save time.)

-While I am in the patient room, I will go ahead and empty the urinal, take out dirty tray, and ask if the patient need me to do anything before I leave. If the patient want me to help her/him to the restroom and the tech is not available, I will stay in the room charting while I am waiting for the patient to use the restroom. By staying in the room, I can be available right away to help the patient back to bed safely.

-I am bad at charting, but I learn to make time for charting as I go. I tell myself "it only takes a couple minutes to chart patient rounding, don't leave it until the end of shift." Charting is part of the job. I used to run every time a patient call for coffee, coke, ice, or whatever. I delegated these things to the tech if possible, but the tech is super busy so the patient or the patient's family has to wait. These things are not life threatening issues. I will try to finish what I have to do first, and then I will take care of it.

-For emotionally needy older patients, I will chart at the bedside. Sometimes, it helps a lot because I am right there to open a bottle of milk, give them a straw, or just simple tasks and be done. If I was at the nurses's station, I would have to stop charting to go check to see what they want.

-I tell the tech thank you many times/day because I truly appreciate their work. Without them, the job will be so much harder.

My time management skills are not great, but it has improved significantly. Being a new nurse is not easy. I was super slow after I got off orientation. I have 1 year of experience now.

You can do it. Ask experience nurses at your work to see what they do differently, don't give up. You have my support!.

[Aonedayatatime]

Thanks for the support. I think it's frustrating because I feel like I am told one thing to my face and another is said to my supervisors. I appreciate the tips. I guess I thought too that on orientation you didn't get written u0 for not being good. The support is needed