Are you satisfied with your first RN Job?

[RNSuzq1]

Hi All,

Just wondering if everyone is satisfied with the position they chose. I was really happy to get my first choice of hospitals, but after only a month there, I'm considering looking into other hospitals in the area. I was told in my interview that New Grads are started off slowly (to get the feel for the floor, how things are run, etc.), then gradually build to 5-6 patients. From day (1) on the floor I was told that I was expected to get in and out of the patients rooms in 15 minutes and have all morning work - assessments, charting, meds, etc. done for all my patients done by 9am. At the facility I did clinicals and where I worked as a tech. through school, the Nurses there considered it a good day if all their morning work was done by noon.

What I wanted was the time to do really good assessments, be extra careful with meds (especially those I'm not familiar with) and get a good feel for everything before being rushed. But - I've been rushed and pushed from the start. I really don't like being rushed at the Pixis - I don't want to make a med error, so I'm taking the time to compare the pixis to the MAR. I'm told to look at the clock before I go in the room and make sure I'm back out in 15 mins. - knowing someone is watching the clock is making me a nervous wreck and I'm scared I'm going to make mistakes or forget something important.

My preceptor said she noticed that I take the clipboard out of the pt's door to look at it before going into the room. It's something I was taught to do in school and I think it's just a good practice in case something was overlooked in report. She said I got everything in report and looking at the chart was wasting valuable time and I needed to work on my time management skills.

I'm just not comfortable where I'm at, it's just get in and out as quickly as possible, leaving no real time for the patient and true, hands on patient care is the main reason I chose Nursing. So, my question is - is this the way most of you are being trained or are you given more time to perform everything until you feel comfortable in the job? Thanks, Sue

[st4wb3rr33sh0rtc4k3]

Wish I could say the same. Unfortunately, my problem was some managers how some real power trips.

First, tone down my personality.

Second, I can't wear pig-tails.

Third, I cannot punch out an hour late. Although, I just sent someone out at 6:00 a.m.

Finally, I was asked to stay another 8 hours - so someone didn't have to float. Thirty seconds later I said no forget it. I had tons work to finish before I had to switch to the other side. Well, the manager said I was being selfish and she was telling on me to the DON.

These were minor problems - it was worse when the manager was new and didn't know how to manage. They would yell and say, "I am the manager so I say what goes!"

It was too much for me. Never got written up or made mistakes. But, I was targeted. I started in Long Term Care and I would like to continue it. Give me luck with looking for something new.

[NurseBunky]

I'm sorry your'e having such a rough time. I work in a pediatric facility and everything is based on caring and safety. They want meds, charting, and assessments done by 9am too but there's no one watching the clock on you and it's not a big deal if it's not done by 9am. Safety of your patients, patient's families and yourself comes first. They started me off the first week on the floor with one patient and gradually worked me up to 4. The max on our floor is 5. We also have systems set up in our compters to tell us about medications. I love what I'm doing, I love the facility I'm at, and I love the people I work with. It's all about team work and learning.

[EDGRADNURSE]

Timothy,

Thanks for your post w/such valuable advice. I like your idea of 3 rounds. How would you fit those into this scenario?

I get to work and immediately have to get my assignment. I print out unit census and mark my patients (my crib sheet for the day) and have to print out the appropriate tele strips. Then, I'm expected to get report. Ideally, I'd like to get my assignment and check on the patients first. However, I don't want to hold up night shift--they're ready to give report and I don't blame them. So, I end up not seeing my patients until 45 minutes after I get there. Even later than that if report is loooong.

Makes me very uncomfortable. When I was in school I chose to look up patient info on a computer outside my patient's room (rather than at a central nursing station) and caught one in respiratory distress before I was even supposed to be working. Hate the idea of no one checking on patients during shift change.

Ideally, checking on 6 patients shouldn't take too long, just peek in. However, you KNOW that someone's IV will be beeping, someone will want to get on the bedpan or want ice water--whatever.

Any thoughts?

At my former job, we had taped reports. Loved them. Night shift would watch the patients while you went and listened. Taped reports were short and to the point and there was time to talk to the other nurse if you had questions.

[kellerpatty]

Thanks, Timothy for the extremely valuable "how-to-organize" post. I never have more than two patients at a time in the BICU, but boy does it get hairy and scary sometimes keeping up with things. Your suggestions are great and very helpful...yeeehaaaw! I'm going to print it out and put it into my tool box at work...Appreciate it and thanks for taking the time to put it out to the group!

[K98]

So far, so good. My preceptor is the bomb.

[youngatheart]

Timothy,

Thanks for all your helpful hints. I did the three round check on my patients and it really improved my morning. Before I felt like a chicken with my head cutoff, It feels more organized and as a new nurse i need all the organization tips I can get. Shift reporting has been getting easier now that I have a mental template to go by. I get more information now out of the previous nursing shift, sometimes the only report i received was that the patient slept all night, boy that doesn't tell me much does it.

[ZASHAGALKA, RN]

Timothy,

Thanks for all your helpful hints. I did the three round check on my patients and it really improved my morning. Before I felt like a chicken with my head cutoff, It feels more organized and as a new nurse i need all the organization tips I can get. Shift reporting has been getting easier now that I have a mental template to go by. I get more information now out of the previous nursing shift, sometimes the only report i received was that the patient slept all night, boy that doesn't tell me much does it.

You're welcome. I'm glad it helped.

~faith,

Timothy.

[NPvampire, MSN, RN, APRN]

No, no, and no. I hate it and am already looking for a different job. I took the job, Med-surg in small hospital, b/c it was right down the road and I was promised certain things (like ability to go part-time in a few months--lie) and misled in the interview ("only" have 5-6 patients, yeah, try EIGHT is more like it and they are sick, sick puppies too). And my preceptor is a total @#%#$ who needs to not even be working as a floor nurse. She actually got on me the first night for wearing gloves when I wouldn't be "touching" a patients' blood. Um, I was screwing something into an IV catheter. Plus it's just habit as I had most clinicals in innercity hospital with lotsa AIDS. She got p1ssy with me when I had to use the restroom so I didn't go as often and now I have an infection. Stupid me, but you can't imagine the bad attitude on this woman. Plus I am working 12-hour nights & I hate that too, I can't sleep long enough before work and am dead by the end of the shift. I'd rather do 8's and work more days per week or 12-hour days and that's saying something because (like myusername) I am a night person.

I HATE MY JOB and I hate my choice and am praying one of my other prospects works out at this point, even if I will be driving hours a day and/or working in the ghetto again.

[kit3375]

That makes two of us. RNVampire. I feel all the same feelings you're feeling.

[RN1263]

timothy,

i really like what you had to say & i hope i get someone like you as a preceptor when i'm done w/ school!!!! AWESOME:wink2:

[PickMePlze]

I already have a job and have been interning there since june. There's a few nurses there I can't stand, and I know I'm probably going to be miserable when I start working there after graduation. I signed a contract and probably will buy myself out of it as soon as I can.