Disappointed.

tokmom, BSN, RN · May 20, 2011

Why would they change the parameters on the med pass? That seems rather dumb. Do they write you up for it? Personally, if it were me, if they didn't write me up, I wouldn't worry about it and be happy with getting them passed within 1 hr before/after.

As for it being unsafe, if it is as bad as you say, then I would start applying elsewhere.

Are you unionized? You can usually file an unsafe staffing report if you are. If not, and you can't find a job, I would just stick it out for now. Document, document and do the best you can.

Anna Flaxis, BSN, RN · May 20, 2011

What shift do you work? Can you give an example of the dangerous things you have seen?

It's true, the roles of CNA and RN are very different. While you can understand what it's like to be a CNA because you have walked a mile in those shoes, a CNA cannot understand what it's like to be an RN because they have not walked in those shoes. Do you think the CNAs are doing their best, but just stretched thin like you, or do you think they don't really understand how much you rely on them to perform their assigned job duties?

Like you, I worked as an RN on the same floor that I had worked previously as a CNA. It seemed like the CNAs all thought that since I had been a CNA, I could handle their workload in addition to my own. This made things much more difficult than they needed to be.

Another thing to consider is that real world nursing is so very different from nursing school. We learn things the "right" way when we are nursing students, but then once we hit the floor as new grads, we have to learn survival strategies, which may deviate somewhat from the way we were taught in school. Now that does not mean we should put patient safety on the back burner; to the contrary. Patient safety is always the most important thing. It just means that sometimes, you find different ways of getting things done than you were taught in school.

Document like your life depends on it. Your documentation is what will cover you should something go wrong that is out of your control.

Patients and families who are not happy with their hospital stay, even if it's for something as stupid as taking too long to bring jello, will *always* blame the nurse. Make your patients and their family members like you. Patients and families seem to care more that their nurse was nice, friendly, likable, than whether they received their medications on time, whether mistakes were caught and averted before they could happen, whether they were kept safe during their hospital stay, etc.

Even if you don't have time to really have conversations with your patients, you can make them feel like you have all the time in the world. Always take a couple of deep breaths and compose yourself before entering a room. Make eye contact. Sit in a chair at their level. If you do these things, it doesn't matter if you only spend thirty seconds doing it. Their perception will be longer.

Not sure what else to tell you. The first year is always tough, but things usually get better after a while.

Bhavana · May 20, 2011

This is the exact reason why I am not going to settle LT for this type of hospital nursing. I had most of my clinicals on a floor like this, and by the time it was over, I wasn't even so sure I wanted to be a nurse anymore.

classicdame, MSN, EdD · May 20, 2011

Does your facility have a compliance hot line? Is the CNO approacable? As for your license, you are not responsible for what others do. You can call Joint Commission hotline and they may do a survey. The State probably has a hot line. Everything must relate to patient safety, not how hard you have to work. If you find another job somewhere else, take it. All that stress is unhealthy.

sweetnurse63, BSN, RN · May 20, 2011

As a new grad nurse, you do feel disappointed and overwhelmed. There is such a big difference in how you feel during clinicals compared to how you feel when you're out there on your own with 5 or 6 patients especially on a busy med-surg floor. I worked ortho/medsurg for one yr and I had to leave because it was physically and emotionally draining. Floor nursing is not for everybody but pray and ask God to help you to hang in there to complete a yr and put in for a transfer to another unit that you think you may like or try another type of nursing work. I love being a nurse and I know you do too, its' going to be alright and it will get better as time moves on and you become more experienced. I wish you the best.:)

NamasteNurse, BSN, RN · May 20, 2011

Becoming a nurse after being a CNA can be disappointing. I remember feeling the same way you do, that I no longer care for the pts directly in a very private way. ie dressing, changing, bathing etc. The above posters gave you some very good advice about how to feel more connected.

You will not spend the amount of time you did as a CNA but your time is more focused on what's wrong with the pt. You are listening with a nurses ear and knowledge. You will delegate things to do for the pts to the CNA's like repositioning or a back rub. If you want to find 5 minutes to do those things for your pts you can.

Also, you will get faster with the med pass. That will leave you more time for pt care if you want. Give them a minute or two while you're in the room. Calm down it WILL get better! And, yes, I'd stay in one place for the first year. For better or worse, what you learn there will serve you well.

Fiveten · May 20, 2011

The 30 min requirement has to do with the "standard of care" being required to keep hospitals getting approval to take care of medicare/medicaid patients. Our facility is pushing back against this.

Kitty Hawk, ADN, RN · May 20, 2011

This is the exact reason why I am not going to settle LT for this type of hospital nursing. I had most of my clinicals on a floor like this, and by the time it was over, I wasn't even so sure I wanted to be a nurse anymore.

Is that not the truth? That's why I'm so happy I'm nearing the end of my time on the ortho unit and moving on. Only 5 more shifts to go. Ha 5 twelves all nights with only 1 day off in between. And if the CNA on nights is present, we're lucky if we can tear her away from her magazine and napping, usually though on the weekends we're left with none b/c they'd rather lose the CNA's than have a nurse pulled! I too pray to God to get me through these next few days and thank him for releasing me from this insanity.

OP keep your eyes open, yes it's ideal I suppose if you can stick it out for the year. I managed to make it 9mos and an opportunity presented itself so I'm jumping. In a perfect world this job would still be there in August but in the real world, not so much....I believe everything unfolds as it should and everything happens for a reason. Don't be afraid to go after something else if you can just b/c you're not at that exact magical 1 year or so of experience. Best of luck! I wish you peace.

dthfytr, ADN, LPN, RN, EMT-B, EMT-I · May 20, 2011

Any co-workers you can talk to and be assured of confidentiality? It sounds like a lousy situation, I hope you have some support somewhere. A co-worker would be ideal, might be able to give you some help, feedback, or at least comiserate. Two months isn't long, I hope you can hang in there. Maybe another floor or shift would work better for you? I wish so badly to help you because when I'm a patient, I want a nurse who's bothered by all those things you mentioned, not a nurse who doesn't care. Wishing you every day better than the previous.

ahintonRN · May 23, 2011

To all of you that commented, thank you so much for your kind words of encouragement. Just knowing I'm not alone makes me feel much better! To StarGazer, I work days 7a-7p. An example of an unsafe incident actually happened Thursday, the night I wrote this. A patient who wasn't even assigned to me was getting aggitated because she couldn't go outside to smoke. Her primary nurse (who wasn't do anything at the moment) asked me to check on the patient, and I did, even though I was admitting 2 other people at the same time. I managed to get the cigarettes, but the patient backed me up against the wall and grabbed my arms. She twisted my wrist (she has Alzheimer's, and didn't even know what she was doing). Being that she's 80 years old and suffers from dementia, I didn't feel like I could fight back. I pressed the call button and 10 minutes later someone answered. I yelled for the primary nurse (who was also the charge nurse) and she never came. When the patient got tired and finally let go of me, I ran to the nurses' station and found that nurse sitting there... I filled out an incident report and notified my supervisor. Had the lady been any bigger or stronger she would have broke my arm. That's only one unsafe incident. There are more!

I really appreciate all the sweet comments. It feels good to know that so many of you have been in my shoes! I am praying daily and asking God to get me through this time and send me to a better place. I have learned to be a great documenter, probably documenting way more than I need to. I make sure that I spend every available second with my patients. They are the only reason I'm there!

dthfytr, ADN, LPN, RN, EMT-B, EMT-I · May 23, 2011

Sounds like a lazy charge nurse needs a swift kick in the asterisk. Go ahead and do it, tell her I said it was OK. Just blame it on me!