I have been a nurse for 9 months on an ortho/ stroke floor. I continually get out late. I can never find time to sit down and chart as I am always doing some task or another. The charting usually does not get done until shift end.
I have been told by a nurse of 30 years that I spin my wheels and that some things can wait till later. I asked her what things could wait for later she replied, " I have seen you looking up a disease that could have waited till you got home". I was looking up pulmonary embolism. I had never had a patient with that before and I was nervous about it. I remembered from school that it could be life threatening and I wanted to look up the signs and symptoms of a PE so I would know what to look for. I told her I didn't feel like that was something that could wait till I got home. I also do not spin my wheels as I am constantly doing A, B, C, D, .... As soon as I would go to sit down a patient would need something or I would get report that Patient A's vitals were off and off I would go and then that would most like ly lead to calling the Dr., writing the order and then follow through with said orders and then follow up with patient. Oh, and I am also one of those nurse who looks up the meds I am giving if I do not know what they are for.
I don't know how any nurse can be sitting down at 1700 and charting. I am still asseing and giving any meds that are needed at that time. I wish that someone could follow me around for a shift and then they could tell me I was spinning my wheels and suggest ways I could maybe do things better. I do what needs to be done and then I move on to the next task.
I know I have a lot to learn but I am just disgusted that this nurse told me I could wait till I got home to look up the diseases that I felt I did not know enough about. I also told her I did not like to stick people with IV's because I know it hurts them. She told me that she never even thinks about that when she puts an IV in. Maybe I am too sensitive but that statement made me mad.
I feel like I am a good nurse and I feel I am a safe nurse.
I have been a nurse for 9 months on an ortho/ stroke floor. I continually get out late. I can never find time to sit down and chart as I am always doing some task or another. The charting usually does not get done until shift end.
I have been told by a nurse of 30 years that I spin my wheels and that some things can wait till later.
Question for you, SistaSoul -- do you vent about the list frustrations with which you prefaced your post with this senior nurse or other nurses on your floor?
I am a new nurse. I started about 7 months ago. I also feel your pain. I look up meds and diseases in a book that I bought called Med Surg for Dummies. That is exactly how I feel sometimes but I know I am smart and care so much about my patients. I want them to be safe. I work in an environment where my co-workers are so very scared to even have conversations with you because they are afraid someone is ready to backstab you or tell management about any comment of how unhappy we are there. It is like walking on eggshells everyday. The only time management comes to you is when something is wrong. I never get a pat on the back. I work so hard running around all day like a marathon almost. I feel so exhausted, dehydrated, and sick by the end of the shift I wonder what I could be doing wrong or if it is just that there is so much to do all at once. I do hear from experienced nurses that it gets easier. Not sure about that. I saw a nurse that has been there 20 years break down in tears because a patient was yelling at her and she had 6 patients that day. It gets too hard for us out there and we see no relief in sight. I was asked by management to tell them what I thought would improve my work environment.. I was wondering if I should have a director's job if that is the case. I am not sure how they could ask me that.
And..it saves time to ask more experienced nurses then to look it up. It shows your concern and desire to learn from them and care for the patient, and saves time in caring for said patients.
Specializes in Wound care, Surgery,Infection control.
May I gently offer some input? "Spinning your wheels" is a common phenomenon of new grads. You seem to grasp that you do have limited knowledge, which is better than thinking you know things you don't. However, your knowledge is not as limited as you may think. Using your example of pulmonary embolism. As an RN I would expect you to know what a PE is. Beyond that all you would really need to know to look for would be alterations in respiratory or circulatory status- which is included in your ABCs. I know in nursing school you got your patient info and then you had the luxury of looking everything up before clinicals, but those days are gone. I would always tell my students- Nursing school teaches you to practice safely. Experience is what makes you proficient. don't be discouraged. You will get it. Also sounds to me like you are getting the shaft with your orientation.
Good Luck!!
TO SISTASOUL, I am quoting cookienay (with honest respect) with hope in my heart that all new nurses will learn before they burn.
First things first; 25+ years in health-care, 18 year RN. My advice to the OP or any new grad ; listen to YOUR heart. It's grand to say words like knowledge, proficient and experience but why should a new nurse be disgusted? "As a Rn" and "I would expect" are red flags that WE are NOT doing our job. Sistasoul does not need to grasp she has limited knowledge: WE DO
New nurses do not need our good wishes or hugs for completing school. Now it's OUR turn to step up, share without boundaries. The unfortunate truth : more "experienced" nurses find you a threat. Yes, you read it here. Why should they teach you everything they know? The patient is our mother, father, brother, sister, and I don't want the nurse to question themselves.
TO SISTASOUL, I am quoting cookienay (with honest respect) with hope in my heart that all new nurses will learn before they burn.
First things first; 25+ years in health-care, 18 year RN. My advice to the OP or any new grad ; listen to YOUR heart. It's grand to say words like knowledge, proficient and experience but why should a new nurse be disgusted? "As a Rn" and "I would expect" are red flags that WE are NOT doing our job. Sistasoul does not need to grasp she has limited knowledge: WE DO
New nurses do not need our good wishes or hugs for completing school. Now it's OUR turn to step up, share without boundaries. The unfortunate truth : more "experienced" nurses find you a threat. Yes, you read it here. Why should they teach you everything they know? The patient is our mother, father, brother, sister, and I don't want the nurse to question themselves.
I respectfully disagree here.
Yes, an RN should know what a PE is. Down to the smallest detail, NO, but in general, of course. That isn't an offensive thing to say. It's just a correct thing to say.
And yes, a new grad DOES need to grasp that they have limited knowledge. Can you tell me anything that is scarier than a new nurse (or ANY nurse) that thinks they know everything? (I realize that isn't the case with the OP, I'm replying to the statement at hand). The one thing that I know for sure is, I'm never done learning, no matter how many years I do this job. The same obviously would go for a new grad, so yes, they should know that. Most do.
I don't find new grads a threat. So you're wrong. I precept most new grads we get, and I enjoy teaching immensely. Even when not in a full-on preceptor role, I share any tip and trick I know with a newer nurse, why WOULDN'T I want them to succeed? That's just ridiculous, and we're not children. Maybe YOU'RE threatened, but let's not make that generalization about all of us experienced nurses, ok?
"Spinning your wheels" is a good description of a lot of new grads. You're always busy, don't understand how the experienced get their work done. There's some experienced nurses that are the same way. The key is working smarter, not harder.
There's a billion things you can do. Not all of them are going to make a difference. If you plan at the beginning of your shift, "What will make the biggest difference?" then you can focus on that. Spend a little extra time at the beginning of each shift getting things settled. Your day will go so much better if you prevent fires instead of spending the whole shift putting out fires.
Focus on your ABCs. Nobody knows all the disease processes. Working on an ortho unit, PE is one you need to get familiar with, but you don't need to know everything before you get going. Since I moved to peds I've got tons of kids with off the wall syndromes. It's amazing how many there are, I learn a new crazy diagnosis almost every day I work. Since I practice smart (not hard!) I do have time mid-shift to look them up, but I can survive until then (even if I have to wait until I get home) by focusing on ABC. Make sure they can breathe, make sure their blood's flowing. Do things to keep both of those things happening and you're good. If one of those things stops happening, you need to call the doc and ask for help from your experienced coworkers. It sounds simplistic, but pretty much everything we do boils down to ABC.
I highly recommend David Woodruff's teaching materials for med-surg nursing. (www.ed4nurses.com) It not only teaches you the stuff you should know as a med-surg nurse, but how to be most effective and get through the day. I wish I'd found it when I was first starting.
Oh, and as for IVs. I was awesome when I still did adult nursing regularly. Because I just stuck. It's gonna hurt, thinking about hurting them doesn't help any. It just makes you too timid to accomplish anything. Since I started peds, I suck at IVs. And it's 100% mental, because I think about hurting them too much. I've got the same hands, same needles, sometimes even bigger veins than I used to stick in old ladies without a problem. But with adults I just stuck, with kids I don't want to hurt them. It's got to be done, it's going to hurt, you just got to stick.
I truly don't think that nurse meant harm with telling you what she did. She's probably so seasoned now that she gave it to you, the only way she knew how- which is straightforward.
You can't be getting upset or "disgusted" over contributions like that.Would you rather she babied you? When you're much calmer:p, sit back and honestly try to see things from her point of view. If it still looks the same, that's, but if it makes more sense, then great, you learned something.
Thank you for all of your responses and the time it took to reply. I really do know what a PE is. I wanted to refamialiarize myself with them as that was the first time I had a patient with one. Everyone has given great advice. I was not really offended by what the nurse said to me it is just so hard to see how I am spinning my wheels when I work so hard.
Theres no harm in looking up info on a PE to refresh....if you do it briefly. The other day I had a pt with something called "Chiari 1 malformation." NO clue what it was. I waited until I had some down time and looked it up. You are smart enough to know when something has gone wrong. Have some confidence!
You probably are spinning your wheels....all new nurses do. Heck, even some seasoned ones still do. Its hard to get a routine down. Its all about prioritizing.
The comment the nurse made to you would have bristled me a bit too. Dont take it to heart. If she didnt want to help you, she never would have offered you any advice.
TO SISTASOUL, I am quoting cookienay (with honest respect) with hope in my heart that all new nurses will learn before they burn.
First things first; 25+ years in health-care, 18 year RN. My advice to the OP or any new grad ; listen to YOUR heart. It's grand to say words like knowledge, proficient and experience but why should a new nurse be disgusted? "As a Rn" and "I would expect" are red flags that WE are NOT doing our job. Sistasoul does not need to grasp she has limited knowledge: WE DO
New nurses do not need our good wishes or hugs for completing school. Now it's OUR turn to step up, share without boundaries. The unfortunate truth : more "experienced" nurses find you a threat. Yes, you read it here. Why should they teach you everything they know? The patient is our mother, father, brother, sister, and I don't want the nurse to question themselves.
Sistasoul's supervisor was direct, but, unfortunately, the supervisor did not explain more fully what "spinning your wheels" meant and provide tips to avoid it. So, yes, I agree with you that experienced nurses SHOULD share. And, we novice nurses should always remember what it's like to be new when we become experienced. And, we will get there.
However, I'm just a student now, but I don't see how what cookienay or cherrybreeze said was unhelpful. It's a fact that experienced nurses have thought processes that are much more efficient and more goal-oriented than novice nurses. There is research to support that! I see it in my clinical instructor and my professors. The trick is to get MY mind to work like that, which only comes with time and experience and experienced nurses explaining their thought processes, which the two posters mentioned did.
This reminds me of a time when I was working night shift on a med/surg floor in a county hospital in Texas. More often than not, one of the nurses was pulled for duty somewhere else in the hospital, and most of the time I volunteered. I thought it would be a good chance to work different areas and see if I liked them (nursery, post-op, etc.)
Well, one night they asked me to work CCU-telemetry. I knew what an EKG was, but I knew NOTHING about recognition of BBB, MI, or anything else cardiac related.
The charge nurse told me something that served me in good stead both that night, and for 30 years since then:
"Just watch the patterns. If you see something change in the pattern, call me."
Sure enough! Each patient's pattern was a bit different from the next, and I pored over them for 8 hours that night. Twice I saw a change. Once was when the QRS wave changed drastically and remained that way, and once was when the QRS waves got really, really far apart. Both times I called the charge nurse, and she hauled ass down the hall to the patient's room and did whatever she did.
But what I learned was that the important thing in patient care (almost always) happens when there is a change
If you can assess what you have when you get there, and then recognize a change in the condition... in the color or condition of the skin... in the vital signs... in the LOC... in the general behavior... then you usually can get the orders you need from the doctor... unless you have orders already for whatever change is anticipated.
Most of the time I have waited until I got home to study up... (I did end up taking a basic EKG interpretation course some months after my CCU experience, because I found it to be rather fascinating). Never used it since then, though
thehipcrip
109 Posts
Question for you, SistaSoul -- do you vent about the list frustrations with which you prefaced your post with this senior nurse or other nurses on your floor?