Having a Hard Time

[SDA3694]

I am a new graduate working in the ER...Today marks my 16th 12 hour shift and I am having such a hard time...I knew going into this that it would be a little tough because after all I am a new graduate and Im still learning BUT I am really struggling...last week I felt really good, I felt like I could keep up got my IV's and didnt have to ask for any help ..come back today WHOLE new story felt like I was back tracking couldnt do anything right on top of that my preceptor got on to me really bad and alll I can do now is cry....(which is basically all Ive been able to do since I started this job)...the deal is I went into a patients room was starting an IV and what I've been doing is starting the IV ,connecting the lock and then drawing my blood through the lock before flushing it with saline but he told me that I should insert the iv then connect the syringe to the the little knub before even connecting the lock ...anyways this conversation took place like 30-45 mins after it even happened but he yelled at me in front of everyone at the nurses station told me that I was playing around with patients lives and that I could have caused an air embolism but what I dont understand is how his way makes any difference he wants me to connect a 10 cc syringe to the end of the hub and I have been connecting it to the end of the lock if I were gonna cause an air embolism would it not cause one either way. His deal was that he wasnt as concerned that I was in the vein but that I was putting an empty syringe to the end of the lock ...instead of the empty syringe to the end of the needle hub??? I only have 4 more 12's before Im suppose to be on my own I just dont know what to do It just seems like everytime I do something he always calls me out in front of everybody, I just feel so stupid. I have prayed and prayed that this situation will get better I feel like Im trying as hard as I can I DO NOT know what else to do. I have so many times walked up and heard him saying stuff that I know was about me. Any advice for me??? Thanks God Bless!!

[HM2VikingRN, RN]

After I hit enter on my last post I remembered what I really wanted to say. The most important lesson for us all to remember is :

The nurse you trash today just might be the nurse that can save your behind tomorrow!!

We're here to help each other be right not wrong...:>>

[Jaila]

You will get through this just fine! You just have the misfortune of what I think has happened to most over the years and that is first hand experience with nurses eat their young! Very disheartening! But, remember although you may have a lot to learn (I personally graduated got a job and said they didn't teach this in school, ***?) it doesn't mean you shouldn't be allowed due respect. You need to have a stronger backbone for yourself. It will get easier....just remember this so that when you precept some young nurse down the line they won't feel the same way you are now. Good luck......and dear oh dear I hate hate hate to say this, but...."you teach people how to treat you".

Good luck, chin up!

[Virgo_RN, BSN, RN]

You're in the home stretch. Just get through your last four, then you'll be on your own. Do not be afraid to ask questions; it's the ones who don't ask questions that are worrisome, but you'll be able to be a little more circumspect about who you ask.

Also, identify your resources; more experienced nurses, the facility's P&P manual, your drug guides, phlebotomists and lab techs, pharmacists, etc. As long as you follow P&P and published drug guidelines, nobody can give you grief.

[PostOpPrincess, BSN, RN]

BTW, if you read this OP, I personally feel he is behaving as a lateral aggressor. This is making the working environment very difficult, and is a form of harassment.

I'm not sure the overall bosses and HR would like how this nurse is behaving.

Like I said before, make sure you document each incident.

And as for blood infusing, unless the Protonix is a stat order--I wouldn't stop the blood for anything.....

That's just another way of doing things, though.

[diane227, LPN, RN]

You know the expression "there is more than one way to skin a cat?" Well, that applies here. Every nurse has a different way of doing things and as long as the end result is the same and the task is accomplished with the least amount of discomfort for the patient, then do it your way. Some people just watch you like a hawk and if you don't do something the exact way they do it, then you are wrong. These people would benefit from a beer and a valium.

You make notes and read everything you can on emergency nursing. You are still in school here and it is a whole new speciality to learn. Hard for a new grad. But you hang in there. If someone starts yelling at you in front of people you look them in the eye and say I am not going to stand here in front of people while you yell at me and turn and walk away.

How long have you been in the ED so far?

When I graduated I wanted to work in the ED but I wanted to get some experience under my belt. I did a year of med surg, two years of critical care and then went to a large county hospital that saw about 400 patients per day. I made some mistakes. But after a lot of years there I ended up being the director so I guess I did something right.

You keep working at it. If you make a mistake, report it yourself and try to learn from it. Calm down and don't be nervous. Take ACLS, TNCC and PALS when you can. You might also benefit from an EMT course.

How large is your ED? What shift will you be working?

[belgarion]

It seems to me that some preceptors feel that making life as difficult as possible for a new nurse is an acceptable way to "toughen them up". In just about any other field, with the possible exception of the military, a trainer who yelled at a trainee, especially in front of other employees would be leaving skid marks where his butt met the sidewalk on his way out the door.

If he pulls this stunt again you could always say something to the effect that "I don't think the patients and visitors upstairs can hear you. Could you yell a little louder please?" Okay, maybe that's not a good idea. Remarks like that probably helped get me laid off in my previous career. But you really should let him know you aren't his dog and won't be talked to like one.

You say you have four shifts left with him. Once those are done, you can feel free to ask anyone for advice. There is usually at least one or two experienced nurses who actually enjoy helping the new kid onthe block. Find the way that works out best for the patient and you and you should be just fine.

[freefalr]

SDA, nothing new to add to what above posters have advised. just offering support. have been in that situation myself as well.

i love jopacuRN's step-by-step approach. :) i actually felt calmer just reading the first couple of steps, no b.s. and i think the writing-it-out process can be very helpful. it may be some of the "best" writing you do in nursing school! lol

and like virgoRN said, it's those who -don't- ask questions and act overly confident/competent that are the scariest.

no human knows everything about anything!

hang in there. be proud of yourself for how far you've already made it! don't let his comments sink too far in and unbalance you. keep going! let us know what's going on! :heartbeat

[BmoreCRNP]

Thanks everyone for the positive feedback! Its 2:26 am and I have to be up in 2 hours and I havent even been able to sleep because Ive been so scared Im gonna lose my job when I go in today. He let me go early yesterday after that happened (about an hour and half before my shift ended). I can deal with someone yelling at me...it just really get to you when someone makes you feel like you've harmed your patient ...im glad to know that other people have seen blood draws done this way and that I didnt just pull that out of left field. OHH this is another question he got mad one time and came and got me because I stopped blood to give protonix ...he told me that it was compatible with blood and that I shouldnt have stopped it ...which I had another nurse come and in the room w/ me to make sure I was doing it right ...he came back and kinda got heated w/ he said did you stop the blood on so and so I was like no I clamped it off for a minute to give her protonix and he was like why??? and I was like because I didnt think I could give it while the blood was going he was like yesss you can ...its compatible and I was like well I asked another nurse and she said she didnt think so either and he was like dont ask her she's not very knowledgeable I know you dont know who to ask yet but dont ask her. The thing is ...I dont know where to go with all of this, he is one of the charge nurses and everyone seems to like him (even management) for some reason he just does NOT seem to like me. Now Im not trying to make myself sound perfect because I have asked alot of dumb questions, I am slow on my work there are plenty of things that I do wrong. It just seems like the things that he blows up on ...are things that he shouldnt...thats why I wanted to get some other advice. Thanks everyone...please pray for me as I head in to work this morning I am a nervous wreck!!!!

This guy has the "I'm an ER nurse and I know more than everyone else, including the Attending ER doc" syndrome. I've seen it time and time again, and it makes me sick. This is one of the reasons people don't respect nurses, and why many nurses leave the profession. I always wonder what the point of humiliating someone is. Are you really accomplishing anything for yourself or the patient? Are you really helping that nurse become the best nurse that he/she can be? The answer is usually no. These people feel the need to prove their knowledge to everyone around them. They want to make sure that everyone is aware of how much they know, how much experience they have, and how smart they are. What I've learned over the years is to basically ignore them. Let them feed their own egos. Just learn what you can to improve yourself and provide the best care for your patients. Most of the veteran nurses will tell you that every nurse develops their own style of doing things. To keep the peace just continue to do things the way he would like you to. When you are on your own, you will eventually find what works for you.