Getting used to new....everything.

[catsmeow1972, BSN, RN]

So I am currently working on a med/surg unit at a really great hospital. I worked OR for 15 years. My original offer for this hospital was in the OR. Due to some "interesting" antics pulled by IPN, the OR offer went down in flames. The hospital was awesome enough to find me another position that satisfied the dorks at IPN. Happens to be on a med/surg floor. The management/leadership team is great. The majority of my co-workers are great. My last couple of jobs were just complete hell holes. The other day I realized that it had been 6 months since someone had screamed at me. So far, pretty nice.

It's a very busy unit. I am accustomed to OR, which is busy too but in a different way. Whoever said floor nursing was easy is an idiot, because it isn't. i don't seem to have the organizational skills to do this. On days the ratio is 5:1. By 10-11 or so, I see my fellow nurses sitting down to do their charting and I'm still running around like Beaker from the muppets. To often, i am there late doing charting and/or i don't have summaries done for the oncoming night nurse. My assignment is no different from anyone else. That means it's me. What am I doing wrong? I just feel like I am doing a crappy job.

I can't screw this up because all of us know how hard it is to convince IPN to allow anything that might be construed as an opportunity to advance our career, or to actually move beyond their clutches.

I've carried the IPN soup cans for almost 3 years now with a little more than 2 to go. I don't even have an addiction issue, never did.(if they were worried about that, why am I on a floor that hands out narcs like water?) In their eyes mental health issues are a crime that must be punished.

I have to go see my manager tomorrow "to discuss some issues." I have an ugly feeling that this will not be good.

[1sttime]

Congrats on the job- sorry you are having difficulty with some of the aspects of it. I used to be a nurse manager- one of the things that nurses working in our unit did that drove me crazy was think that they could wait until the end of the shift to chart. This is likely what you are going to be talking with your manager about.

For this I recommend saying that this bothers you too, and would there be someone available to help set up your navigator to make charting more efficient. Hopefully your facility has software that is customizable for users- and then you can have 1 or 2 flowsheets that encompass all of your charting needs. Much easier to have a checklist. If this is not an option, make yourself a paper template that you can follow.

The other part of the workload- patient care. As a floor nurse I would be busy all the time, then I went to the ICU- after some time I would float to the step down unit and be done with all of my work at 10. I had to ask my old co-worker who was now the manager of the floor if I was missing something- no, just more efficient.

Coming on shift I would get everyone up out of bed to a chair- no choice- they eat and have their meds (My facility had a 1 hour window for meds- so at 8 they would get their 07-08-09 meds at the same time- document as given). Ambulate down the hall and back to bed for a nap. Then I would chart, take my lunch, then do it all again for noon.

Without knowing for certain where you are getting hung up I would suggest taking the lead here- you have a finite amount of time to get a certain amount of activities done for your patients. Too many years of "customer service" has made many a nurse bow to the whims of a patient- you are the provider of care- you run the schedule.

The hypocrisy of the IPN system is something that may change over time- nurses that text all day at work are working distracted. I worked with a group of nurses who would get near black out drunk often. Many a nurse works without proper nutrition, hydration, rest, etc...

Try to use this time to take care of yourself, find your limits as to what is acceptable for you, make a life where you can thrive. For me this meant taking a job that doesn't have prestige to the outside world, or even one that I thought I would want for long. My life is totally different- thank the gods.

[catsmeow1972, BSN, RN]

The thing with the charting is that is does bother me. I feel like my charting is crap. I do wind up doing it all at the end of my shift and i know I'm forgetting stuff. We have a great team of aides that do a lot of getting folks out of bed , to chairs, etc. We even have a team whose sole responsibility is to get patients up and walking in the hall, even with a platform walker.

We have a rather good charting system that can be just about as customized as you want. the more I work with it, the better I find I like it.

I've been there 5 months and still feel very awkward and disorganized. I used to run a very tight, efficient OR. So this is quite a foreign feeling for me. I do think maybe if they would let me drop back to the 4:1 ratio for a while (you do 4:1 for orientation and the first coupe of months) It seems that adding that 5th patient just does me in.

[catsmeow1972, BSN, RN]

Chat with manager went okay, I guess. Pretty much she had concerns over the same things that are worrying me. We meet again on Monday and she is mapping out some things that I need to work on (it's actually an "action plan") I suppose that's technically a write up, but unlike every other job I've had, it's not punitive. She really wants to help. We also discussed that this may just not be a good fit. Every other time I've heard that phrase it has usually preceded me getting canned. I don't feel that way this time. I think genuine help is being offered. It's not a bad thing that I can;t make it in this unit. it's VERY busy with a lot of patient turnover and wildly varying acuity.

So in the background of this "action plan" I am possibly going to be able to transfer to something different. My manager does understand what my background is and that bedside nursing is so much a new concept to me. I am so grateful to her for giving me a chance and She has said to not feel guilty about looking to transfer. I honestly don't know what to do right now.

I'm not accustomed to failing at anything.

[1sttime]

It does sound like your manager wants you to be successful. Sometimes that comes in being able to improve your skills, sometimes it comes from knowing your limits and finding the right fit.

Not being in the right fit for a job is not a failure- this is about you and your needs intersecting with a job. Go ahead and look for that other job!