!st BAD day of orientation

[sandy123]

Today I had my first bad day and just need to vent and hopefully get some support from my fellow new grads. I am 4 weeks into orientation on a heavy med surg/oncology floor. I am orienting on days but go to nights this weekend. Til today I have had good to okay days with a couple of great days. Today totally sucked canal water!!!

First I had a preceptor who is nice but talks alot to other people. Three times when I came up to her for questions, I literally had to wait a couple of minutes while she finished her personal stories...I didn't have the time but waited patiently rather than be rude.

Then had a large guy with a HUGE wound (total abdomen, thigh, buttocks involved) that took literally an hour and half to do dressing change with 4 of us in room whole time. This man had PCA, IV ABT X4, the dressing change from hell, TPN, et all....

I never got a lunch and then 25 minutes before I to leave, an admit. That would have been ok but his doc was a total jerk. Guy comes in from chemo yesterday with dehydration, n/v, diarrhea....anyway long story short, his stool looked really mucousy and smelled like c diff so I asked for a rule out and was treated like a complete idiot by the oncologist...His diarrhea was from chemo, but if I felt like it I could get a rule out. Our protocol at the hospital is if suspected, isolate and rule out. The doc made me feel an inch tall and was really a jerk...but i still sent the sample and if it is cdiff i will bring it up :)

Anyway...today left me totally drained and needed to vent.

Thanks for reading/listening.

[Hands and Heart]

I'm sorry you had such a rotten day. But I guess all days won't be filled with sunshine and lemonade.:urgycld: Hopefully, these totally rotten days will be few and far between. Wishing you much brighter days.:weatherhot2: And great job standing up to that doc. Not that I wish your patient any problems, but if the stool comes back positive for C. diff, that would be great for your nursing intuition.

[rhondaa83]

I rarely every get a brake for lunch. I am lucky to sit down and inhale my food over 10 minutes. I really hope that test comes back positive for you. You live and learn.

[northshore08]

You did the right thing; see, you are advocating for your patient already!! Sorry your day was hellacious. As posted before, we can hope they will be fewer than the great days. :redbeathe

(Now after orientation, if the bad days vs good days ratio becomes very high on the bad side consistently, start looking around. You will have had some great training, though.)

Sign of a good floor with good management: you get relieved for lunch most of the time (unless all hell is breaking loose,) you get supported in patient advocacy, and your fellow nurses have got your back.

(One more thing. There are many jerky doctors, but if you stand your ground often they will come around to rely on you and your judgment. He did not see or smell the stool; you did. If it is positive, the doc will have to acknowledge you were right and you have learned to ignore the jerky behavior and follow your instincts. If it is negative, you have learned something as well--how post chemo stool can be--and ignore his jerky behavior anyway.)

BTW, there is a new JCAHO standard I have read about intimidating behaviors in physicians. It will be interesting to see how this is mandated!!

[PICNICRN, BSN, RN]

Sorry you had a yucky day!!! But GREAT JOB on advocating for your patient with that jerky doc! Unfortunately, this will not be the last yucky day or jerky doc you will deal with........ but sounds like you will be just fine!!!

Hang in there and good luck.... sounds like you're doing a great job!!

[kmoonshine, RN]

Sorry about how your preceptor treated you. Helping you succeed should be a higher priority than chatting about her personal life (unless she is off the clock, which I highly doubt was the case). I too have been in your situation and it is completely inappropriate for her to be behaving the way she is. It makes for a very uncomfortable situation and should it continue, I'd suggest talking with your nurse educator and get another preceptor.

Doctors can be jerks sometimes; just let it roll off your back. I find that floor docs become so dissociated with nurses and what we actually do, that we become a scapegoat for their frustrations. Since you're on a chemo floor, you have every right to rule out c.diff; does management want to have a hospital floor full of immunocompromized onco patients with raging cases of resistant c.diff?

If it comes back positive, kudos to you. If it comes out negative, kudos also; at least then you'll know that you're not dealing with c.diff.