Hate my new job...

[JLMG]

Hi,

New RN grad here and landed what I thought was going to be a great first job to gain some experience and make me marketable to the local hospitals. I found a job in a skilled nursing facility.

Long story short: Ive had four days of training and am supposed to be on my own now. I am responsible for 16-21 patients, admissions, med passes, orders from physicians, pharmacy, labs, charting, treatments / dressings. They are 12 hours shifts.

Today I got a from my supervisor who said I didn't get a tx done on my shift and it was unacceptable. Ive worked about two hours overtime each night this week and still couldn't get done with everything. I was under the impression that we "passed along" what we didn't get done and specifically heard in a nurses meeting that there is no reason we need to be staying more than 30 minutes past report.

My supervisor today (on the phone) told me that if I had to stay until midnight (five hours late) to get it done then thats what I needed to do. All of this occurred while I had another nurse "training me"...which meant, she did the admissions, physicians orders, and labs while I passed meds, did tx, and charted. I asked for more training and she directed me to call someone else to see about it but she wasnt sure. A CNA told me that every nurse only stays a month or two because its too much for one to handle alone.

Im not a crier but I have cried all morning. I was hoping this would be a challenging and positive experience and it doesnt feel that way right now. I'm so angry, exhausted and dont know what is expected of me. I don't want her to think I'm not doing a good job but this really seems impossible.

Any advice / insight would be amazing. thank you.

[BSNbeauty, BSN, RN]

Ugh, that place sounds like a hell hole. I would hang in there until something else better comes along. My first nursing job was like this and I managed to make it through my first year. It was not easy but I had to get some type of experience in order to move on to a better situation.

[Been there,done that, ASN, RN]

You've been set up for failure.

A new grad cannot care for 20 patients after 4 days of "training".

You've been given an excellent heads-up from the CNA. The place is a revolving door, that does NOT appreciate nurses.

Who CARES what she thinks. She is fully aware that it's not doable. Quit beating yourself up over this.

[scaredsilly, BSN, RN]

You've been set up for failure.

A new grad cannot care for 20 patients after 4 days of "training".

You've been given an excellent heads-up from the CNA. The place is a revolving door, that does NOT appreciate nurses.

Who CARES what she thinks. She is fully aware that it's not doable. Quit beating yourself up over this.

EXACTLY! I have read some other horror stories from new nurses in places like that. Do you feel like your license could be in jeopardy? With only 4 days training and that sort of patient load, it well could be. Protect yourself and get out while you are still in good standing with the BON!

[estrellaCR, BSN, RN]

This happens at my hospital also, new grads get hired into busy medsurg units however RNs on those units have 10 patients each(or more patients each depending on the day). They get an 8 week orientation though. The shifts on medsurg are also 8 hours so imagine 5 days a week of leaving 2 hours after shift is over and being completely overwhelmed. No wonder these new grads leave after 6 months or a year when they get into a hospital with better conditions and hours (12 hours). Time management is a big reason for new grads being overwhelmed. Obviously whoever trained you did not teach u time management in 4 days (too short a time).

That said, my suggestions to you:

1. When you start shift, make a list of what each patient needs (meds, treatments, what time, etc) and check them off as you do them.

2. Delegate any work to CNAs or LPNs (hopefully u have at least an LPN) that is within their scope of practice. For example, LPN can help with med passes and treatments (wound care) to stable/less sick patients.

3. Anything that is not urgent you can hand over to the next shift.

I hope this helps. Hang in there. These tips made my life easier at my first job, hopefully they work for you until you can find somewhere else to work. If all fails, and you continue miserable then for your sake and license sake, resign.

[firstinfamily, RN]

The sub-acute center I worked was a 21 bed unit, we had 2 LPN's, 2CNA's and the unit manger along with a secretary. There is no human way you can take that many patients and do everything else. You are going to have to delegate as mentioned above, as well you should have received a copy of your job description which should define what your responsibilities. If the wound care is every 24 hours then if it is done on another shift that is still within 24 hours. You should have more than 4 days of orientation regardless. Are you the only RN on this floor? Staying over for 5 hours is utterly ridiculous. The work should be divided between all the shifts, not just all on one shift.

[RN_2012, BSN, RN]

Also, prioritize your treatments. Wound care first, lotion for dry skin last.

[JLMG]

Thank you all so much for the replies and suggestions! I am going to apply them all and hopefully things will get a bit smoother until I can find a position in a hospital!

[malamud69, BSN, RN]

Ummmm.....practice self preservation! Quit and move on-simple, done -no regrets

[Pepsi700]

Good Luck, and most of all PROTECT YOUR LICENSE, and your patients, you worked hard for it/and them so, don't let any facility cause you to jeopardize that or the care you offer your patients.

[estrellaCR, BSN, RN]

Quitting should be your last resort. First try to incorporate the big three: time management, delegation, and prioritizing. These are often a challenge for new grads. These are also keys to finishing everything on time. Besides you as an RN, you should have at least one LPN , and some CNAs on the floor. Some simple non-nursing skills can be delegated to CNAs and nursing skills for stable patients can be delegated to LPNs giving you time to complete RN work. You dont want to just quit and then have a huge gap in your resume and then be jobless. Try different strategies as advised above by me and the other posters. Quit only when everything fails, but at least you will know you tried everything. Also before quitting see if the administration can provide more assistance may be an extra LPN?

[JLMG]

Thanks again to you all! I've regrouped and am prepared to prioritize and delegate more. I've made a "brain" sheet to help me organize my day and am going in with a good attitude. I really appreciate all the good (and varied) info you all posted in reply!!!!