I posted this in the graduate nurse forum but thought I would also post it here in hopes of getting advise from some seasoned nurses. All is appreciated!
Original post with grammer corrects :):
I have been working at my hospital since June and was hired on in the Family Care Unit (includes PEDS OB and PP). I worked as a graduate nurse until I failed the NCLEX the first time in late July (second time in late Sept.) and since as a CNA (for the first time ever in my life). I have actually enjoyed the experience and feel that someone somewhere thought I needed to be a CNA for a while so that I will be a more understanding RN. (Please don't crush my bubble here, It is not only a wonderful experience for me that I have taken on whole heartedly but also a wonderful coping mechanism).
I have floated to different areas of the hospital since, with only about 4 nights working in my own unit. That's 4 nights out of 3 months. I am very comfortable in all other units of the hospital and have adapted to the way things are done in each pretty well. When I got back to my own unit to work for a night (or in some cases like last night... part of a night) I feel a bit out of place. My unit does not normally have CNA's, just the one that is Unit Secretary 4 days a week. The RN's are pretty self sufficiant as a result and we have had some issues with know who should be taking VS and such, but that has been worked out. So I thought anyway.
Every unit has been very positive toward me and seems to be very appiciative that I am there and pretty much lets me be on my own to determine what I need to get done. I sit in on report so that I know who is on strict bed rest, has a foley, on strict I&O's, etc...
I'll try to keep this simple (honestly, I WILL try). On Tue. night I was left to work on my unit in FC. I was very excited about working with my own crew again and tried to anticipate their needs from what I remembered needed to be done while working as a GN. I took vitals on the pt's I was allowed to (L/D and NS seems to be off limits for some reason) when I came on after report was done. I have always been in the habit of charting (done on computer) as soon as I am done and I report anything out of the norm or any needs I cannot meet of a pt to the RN I am under for that peticular pt. They usually just shrug their shoulders at me and say, yeah, I know and don't appear to be concerned, which is fine. I am just the messenger and I understand that. So, on Tue. night I cleaned equipment, cleaned and restocked warmers and del. carts after deliveries, put together charts, helped care for NB's in the NS that was full of gagging babies (can't figure out what was up there, must have been something in the milk 
), called new borns to admitting, set up the circ room for an AM circ, did a couple of hearing screens and a midnight weight, got a newly post-partum mom up the first time & also changed her bedding, prepaired a room for an early am C/S, ordered labs on NB's and delivered the cord blood etc... I think you get the picture. It really gave me a good feeling to have the RN's coming to me saying, "Oh, you already did that?" or simply finding me doing what they were going to tell me to do. I felt I had anticipated their needs and that was the best way for me to be helpful on a floor not used to having a CNA. Apparently work performance on my part was not seen by the RN's in the same way.
When I got to work last night I was first floated to another unit and one of their RN's was floated to mine. Around 11:00 I was to go back but nobody informed me of this until after 11:15. I was helping an RN get her hourly BS and VS on a pt with the Dr. present waiting for the results, then I charted it before going to Family Care. I was later told I should have left the pt room and called them to let them know where I was. I admitted it would have been helpful and I even thought of doing that, but felt it would be appropriate to put the Dr. on hold (who was waiting at the bedside) while I did so.
While I was writing down the patient load and finding the information I felt I would need from the cardex I was handed a list of things I would be doing, and at what time I would be doing them, from one of the RN's. It felt strange, kind of like I was a new CNA off the street that had never taken VS or I&O's before and was in need of direction for some reason. It also had on the top a message saying that I would do hourly checks on all pt's and chart it. I felt this was a bit too much and not normal procedure! I could not find a good reason for me to open every door during the night and look at patients on a unit such as ours. PP mom's are usually stable patients, I can not chart on or care for Laboring moms or usually even the new borns (their rules) and they were doing their checks anyway (were they not?). I was answering call lights and doing their VS and I&O's as well. But... I did it. I was told to by my RN's and that is what I did. I might also add that one of the RN's did NO charting until after she gave report to the next shift. The same RN had me do a weight on a 10 year old at midnight that she had already done when he was admitted a few hours before. I didn't realize this until around 0500 though when she charted it in the computer. I thought, "why did she have me get that poor child up and do it again if she had already done it?"
When I was finished doing VS on all pt's I was passing the nursery that had a very upset baby in it and no RN, so I went in to calm the NB. Not 2 minutes after I went in there one of the RN's came in and said, "if you aren't done charting you shouldn't be in here holding babies. I'm just warning you because there has been a lot of drama about things not getting done or charted." I used this opertunity to ask questions and find out the reasoning behind the list. It would seem that the RN's didn't feel I got anything done the night before except hold babies in the nursery (only one of these RN's was on the night before and took her own delivery tray try to soak and cleaned her own warmer and delivery cart while I was in the nursery alone with the above mentioned NB's. It took her all of 15 minutes) and the statement was even made that "everytime we look for you, you are nowhere to be found" this was from a nurse I have worked with all of 3 times since I started there and simply isn't true. If I am going to be leaving the floor I ALWAYS tell someone. I admit I smoke but it does not effect my work. I have maybe 3 cig. in a 12 hours shift and NEVER if there are things needing to be done!
During the night I also found out that they feel I am taking up an RN spot on the schedule and that leaves them short handed. One even mentioned to me that it must be tough and that I must doubt myself on everything since I haven't passed the NCLEX yet. I responded with, "No. I don't doubt myself at all. I just need to figure out the NCLEX, but I think others here do and that's a hard one to swallow". She responded with, "Well, I'll be honest with you. I do that. Since you never worked on nights as a GN we just think, how scary is she? Why can't she pass the NCLEX". I will add that I have a lot of respect for this RN because she will actually talk to me as if I am older than 2 years old and is up front with me at all times. Well, after all this I received an email from my boss this morning and she wants to talk to me. I honestly am not sure if it is about this or not, but assume it is.
I just don't know what to do. I spent most of the night fighting back tears and doing everything in my power to not quit. I don't bring my personal problems to work (which are difficult and many at times) and I remain professional and try my best to give quality pt care and respect to all the RN's I work with.
I do know I need to get my license, I need to pass the NCLEX and then prove myself to them. I can retake it in Nov. but don't know if I will have the $335 to pay for it by then. The $8/hr pay cut was a huge set back. I am stuggling to just pay my bills on time now (have to find another $200 by monday even 
). AND... we have been trying to buy a home for the past 3 months as well and that has only added to the financial pressures (they want the $500 for the appaisal by Tue. 
I realize maybe we should be trying to get this property right now but it something we have dreamed of for the 20 years we have been married and we have fought so hard to get everything moving since Aug!
I am not a spring chicken. I have been in ugly situations with fellow employees before but this feels different. Nobody has ever treated me like I was not a quality worker and made comments to me of that nature. I guess I am like a fish out of water here.
I am sorry this is so long. I just really don't know exacty how to handle this. My boss can be a little scary at times and I never seem to know what mood she is going to be in on an issue. I am the new kid on the block so don't expect her to take my word over the others. I don't think my job is exactly on the line because she did ask in the email today when I was going to test again. I am NOT doing it because she is pushing me to this time (which was the case the last 2). I will wait until I am ready. (which my plan is the end portion of Nov.)
Does anyone have any suggestions for me? I hate to whine but this is giving me a serious headache that even excedrine won't get rid of!!! 
