Confused with new role as RN

Nurses General Nursing


Hello all. I am a new nurse and have recently started my first job and I am having some reservations. I came here to get some insight on other people's experience.

So, I have worked in a hospital environment for about 8(fish) years but never as a nurse. I was a phlebotomist for years and then a nurse intern (tech) for a few months before graduating. Because I have worked in these roles plus clinical environments for school and my time spent in my practicum I never thought I would have such trouble and so many reservations. I have a wonderful preceptor and half-way through it I was caring for a full load of patients (5-6) entirely, including charting. Ok, moving along. I am now in my first position as a RN and it has been a mess from orientation to now and I have literally only been on the floor for 3 days. So, the hospital I work has a residency program just as most other hospitals around here. To be honest, I did not want to sign contract but one of the hospitals that doesn't have contracts right now is/was on a hiring freeze and the other is HCA and did not have any of their StarRN programs coming up until October. My contract payout is 5K and I am starting to think that eventually it may come to that unless they accept my husbands orders since we are technically not living in the county and they said that the orders have to be outside of the county of where the hospital is..... Let me digress!!

In orientation is when I got my first shock. I have never worked for a company that was not going to be joint commission accrediated but this hospital will be. They are moving to a different body of accreditation once they run out with joint commission. They will be moving to DNV I believe.

So when I get to the floor I am following another preceptor for 12 weeks until I am set free on my own. But..... My preceptor is technically still a new nurse herself because she barely has 1 year experience. So for three days now I have been at work 3 hours past getting off then I have to drive an hour home. She absolutely has terrible time management. I all of this in the nicest way possible because it is not that I do not like her as a person it is just that I do not think she is ready to have a new graduate with her. I have done everything I could the past few days to kind of lead her on patient care time management. For instance, yesterday we had to give blood to a patient and it took me hours to finally get it started (it was not emergent). She kept finding other things to get done when we could have just taken the 15 minutes and start the blood then work on the other things. Instead, we were getting the blood down and vitals 40 minutes after the END of shift. Ok, so the day before I offered to chart some and she didn't seem like I would be any help in doing so, I suppose. We were very busy and didn't get any charting done which lead to not leaving until 10!!!!

Even the person who was her preceptor tried to tell her that I have a license so.... It will fall on me if I do something wrong! Keep in mind I offered to help chart because I took care of and assessed the patients, otherwise I would not have offered to assist.

Now there is more. It appears there is a milieu to accept that some of the doctors will yell at you just due to being busy. So, I understand not all doctors are just super pleasant but I just don't feel comfortable with accepting this and on all the floors I have been on with school plus working as a tech I never seen other nurses accept this either. If you are scared that a doctor with literally yell at you then that is going to lead to a miserable environment.

There really are more things I am uncomfortable with but this is already so very long. I want to be a nurse. I love the patient care aspect but what I am seeing is that it could be improved. Obviously I do everything I can more my patients but it does seem to go beyond this. I just want to be a SAFE nurse. I would rather question doctors orders than just follow them if something seemed "off", after all, I have a license to look after too..

SO, what do y'all think? What is the best way to handle the situation or is it something I just should get used to?

P.S. I apologize if there are any grammar mistakes but I did not proofread due to it being so long.

Specializes in Psych, Corrections, Med-Surg, Ambulatory.

First of all, take a breath. A lot of what you're describing is NewGradCrap and it just goes with the territory. Also, you have a somewhat rambling writing style which makes things a bit murky. You said "I have a wonderful preceptor" and then you described a preceptor with terrible time management skills. Maybe you had a previous preceptor you liked, but that is unclear.

It appears you signed a contract and have now been assigned a new grad preceptor who shouldn't be precepting. Is that because there has been such heavy turnover recently that there are simply no seasoned nurses to precept? (By the way, I'm really wondering about that blood. If it was available to be hung by a certain time, where was it sitting until she finally hung it? And it was still good to hang?)

If you're on a unit with fast staff turnover, new grads precepting new grads, it's going to be chaotic. That will make the doctors testy. Only you know if it's worth sticking this out or if you need to break your contract. HR will probably not tell you upfront if they can/will enforce it, because of course they want you to stay.

Three days is a bit soon to tell. Give yourself a month, then reevaluate. Meanwhile, since your preceptor seems to be slowing you down rather than helping you, ask your manager if you can come off orientation early. If not, you have to find a way to work around your preceptor. I'm betting you don't get paid overtime while you're on orientation, so 3 hours late every day is not acceptable.

Good luck.

Specializes in Neuroscience.

3 days in and nursing isn't what you thought it would be? Reality bites.

Calm down and breathe. Nursing takes a year to get to the point you feel comfortable, and you'll feel that way whether you are at this hospital or another. You have a lot to learn about "real world" nursing. That is okay! Like the previous poster stated, give it some time.

Thank you both.

Yes, I apologize for the rambling. I was typing way too fast and trying my best not to make it entirely too long even though it was still long. I should have proof read it.

Please allow me to clarify.

Firstly, I don't want to come across to anyone as whining. I am attempting not to whine about it because this is actual questions/concerns that I am having. I know it has only been 3 days but that is why I feel the need to figure out how to address this early because I WANT to succeed, I love being a nurse in all the aspects of it. I don't mind staying late but I also don't want it to be a habit related to things that could have already been done with time allowing. I know there are days where you just don't have enough time.

I agree that nursing takes a long time to become comfortable with and by no means am I attempting to say I have it figured out. I do have the idea that time management plays a huge role in the day and I think that where the problem lays with the nurse who is my preceptor. The hospital I am with will hire new nurses but they are required to be in the residency program. This program pairs you with another nurse who is considered your "preceptor" to help you make the transition into the career. I will follow/precept with her for a total of 12 weeks then I will take on my own patients by myself. The program will include classes that I go to monthly for 1 year and then I work for another year under contract or else I pay them 5K back. So, my preceptor just finished her first year. She actually just finished the classes about a month, maybe two, ago. So, I think she is definitely still getting the hang of it as well, or at least I know I would. By no means am I saying she is not a good nurse so please do not take it that way. I just think that either I am slowing her down by being there or that she is really just still getting the hang of it as well. I do hope that it gets better, maybe she just has some things going on at home and next week we both can get the hang of being together or else it is going to be a long 11 more weeks.

I am not 100 percent sure on the turn over just yet. Every interview I have went to that is something I ask about, but of course it is not something that is always answered truthfully. I can say that I went to orientation with another nurse who will be on the same floor I am on and her preceptor is also fresh from the program with 1 year of experience. Also, there are at least 5 people who are new from my understanding with the exception of me and the person I went through orientation with. But when you put it in the way you did about all the new grad nurses and doctors, I can totally see the picture of the doctors being testy because of it. I guess I had just never experienced it before and I know I will have to somewhat get used to them being testy.

As far as the blood. When I said it was ready, I meant that the lab had it ready for pick-up. It was hung immediately after we went and picked it up.

When I talked about my wonderful preceptor, that was for my last semester practicum. She had 8-9 years of experience but I think we worked great together as a team. She was confident in my decisions and seemed to understand that I will not do something that I am not confident in myself, without asking questions. We were also on a busy floor just like I am on now and I think that is where some of the confusion comes from also because we were able to really manage our time well and take care of our patients. There were times that we were there a little late but never 3 hours.

Mainly, I know that if it continues I should figure out the best way to address the situation without seeming like I am being a "bad" person or a person who is a "know it all" because I am not. I just want to succeed and reach out to others to see if some of the things I am experiencing or will experience is justifiable.

I do hope this was a little more organized and better to understand. Again, thank you both for your insight. :)

I agree that it takes a while to become comfortable on your own, but no way no how should your preceptor be a new grad. That is completely unacceptable. I would speak pronto to your nurse educator about that.

Specializes in Psych, Corrections, Med-Surg, Ambulatory.

I totally get that you're just trying to be proactive, so don't worry that we're thinking ill of you. I do think you'll find most new grad orientations to be more chaotic than not; just something you have to get through. Weekly classes for a year? No wonder they want their five grand back if you skip town.

What you're getting is trial by fire, and actually most orientations are like that. I've said this many times: nursing school is a very sheltered experience and then new grads get thrown to the wolves. This is the downside of a good senior practicum experience; now you're wondering what hit you.

I think you're probably doing better than you think. Just plan on hating it for a few months, then reevaluate. You may find you've begun to hit your stride, or you may want to give them their five grand and burn rubber out of there. For now hang in there. Hope it starts to get better soon.

Specializes in Travel, Home Health, Med-Surg.

Being a new nurse is very hard, it will take at least a year to feel comfortable and probably longer. Agree with other poster that if possible I would ask for a more experienced preceptor. It makes no sense to have a nurse with 1 year precepting and yes you probably are slowing that nurse down. Give it some time and hopefully it will get better!

Specializes in Neuroscience.

I didn't think you were whining or complaining. I think you are overwhelmed with everything a nurse has to do. I was when I first started too. It just sounded like you wanted to already call it quits when you haven't even gotten started. Sometimes a bad hand is dealt to us. For you, it's your newer preceptor, but she still has a year on you and may surprise you with what and how she teaches. Or she may not.

New residents and nurses are thrown into the culture and expectations of a hospital, and both mimic an apprenticeship. You have to learn on the go, you will make mistakes, you will grow as a nurse and as a person. You'll become annoyed with your significant other that they just can't admit when they are wrong, especially when you do it on a daily basis and it has helped you. You will think harder than you've ever thought, you will analyze everything you do, you will obsess over the little things. You'll do this until one day you don't.

One day some patient's usually high blood sugar will be 112 compared to his usual 185, and you'll give them orange juice without thinking it through. People will say "Nursing intuition" but that's not it. You'll skip steps in thinking because you've seen this, you've been there, and you don't have to think it through. That takes experience and time. It looks easy for everyone else but you right now. It won't always be this way.

You learn, you become frustrated, irritated, emotionally and physically drained, and you should expect this will happen. You will NOT learn everything you need to know in a twelve week orientation. I'm still learning something new every few shifts, and I've been doing this for 3 years. Relax, deep breaths, it will be okay. Go into each shift with an open mind rather than a negative one. You'll learn so much.

You've got this, so best of luck! Don't give up, you've worked way to hard for this.

Thank you all! I have thought about this situation all my days off and I go back tomorrow. But, it has become a little more complicated. The hospital I worked at for 4.5 years finally called me for an interview for the NEURO floor (they were on a hiring freeze)! I was upfront and honest with the recruiter when she asked which lead her to giving the manager my information and statement about where I work now but the manager decided she still wanted to bring me in for an interview. I decided it couldn't hurt, may help. If I am offered a position then I have a lot of think about and I am not sure what I would do. I hate that I am already not happy with the current hospital I work out. But I also hate the thought of leaving a job so quick.

But if I am not offered the job, I am obviously not going to leave without another position. I decided I would give it a few more days with my preceptor before I look like the bad person and ask for another one. I was thinking, maybe she just had some stuff going on at home and all these days off may have helped her get through it. We will see what happens..

DNV is interesting. I worked for a hospital that had DNV as their regulatory agency. One of the more interesting parts of it is that it rounds yearly on the hospital instead of biyearly. That means that the hospital is almost all in a cycle of "getting ready for inspection." Not really a bad thing in some ways but kinda annoying in others.

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