HELP I'm falling apart!!!

[longjourneydream]

I am a new grad who was formerly a ER tech/PCA with total of 17 years exerience.

When I joined the ER as a nurse in June of this year, there were high expectations of me.

Into my 12th week, I was let go take on patients on my own.

The ER starts to gets busy Oct- April, and the chaos starts Nov-March.

The pace is now picking up and I am now falling apart.

At one time I was asked to work 4 in a row, and that stressed me out to the max.

I told my supervisor that I was not ready to function as a fast paced, efficient nurse, they had all expected me to do!

One example is:

One charge nurse tells me to sit at computer and get patient d/c'd to floor ASAP, while one client comes in with CP and needs immediate attention, and nursing supervisor yells at me and tells me I need to get this lady taken care of ASAP. I just started to fall apart.

My ABC's went out the window.

Now they are all watching me carefully now, picking me apart, and my nursing supervisor telling me she worrries about me.

She does not want to see me lose my licence.

The plan is to put me with a seasoned nurse I take 4 patients, and she takes 2 combined with me.

She is all over the place, because she is the charge and has a massive responsiblility.

They want her to help me devise my plan of attack, as far as time managment.

I know the basics on what to do for the patients.

CP- EKG,nitro if needed, asa if needed, IV, labs,O2 monitors, chest x-ray, fluids etc...

Belly pain,IV labs, sometimes fluids, sometimes ekg, labs always etc...

SOB, if extreme; bipap ABG,breathing tx, chest x ray, IV EKG Labs

OD- EKG, IV labs, fluids bipap or intubation if extreme

On and on it goes.

If no labs are ordered I try to think of what the problem is then order the appropriate lab, when in doubt CBC and BMP are always right.

All child brearing women with uterus must be Hcg must be done prior to any tx or x-ray.

I just cant seem to focus on what I need to do when there are many things coming at me at once.

I have been told to put all tx and assessment in computer right away as soon as I have triaged assessed, IV and labs.

Our electronic charting is a bear.

We never have enough computers around.

I am falling apart HELP...

Any advise for a new RN in an ugly envirionment?

[Hellllllo Nurse, BSN, RN]

Give the job a good shot. Hopefully, working with the seasoned nurse will help.

If you don't find things improving after a while, ask if you can transfer to another dept, or find another job. ER is too much for many new grads.

I think a big mistake that a lot of new nurses make is to keep trying and trying, and stay on and on in a job that is not right for them and makes them miserable. I know I did this when I started.

If you find that things do not improve, try to find a position where you will feel more comfortable.

[SuesquatchRN, BSN, RN]

Just to say I'm thinking of you, and understand the stress.

[llg, PhD, RN]

I agree with Helllllo Nurse. It's not just that other people have had high expectations of you ... you have had high expectations of yourself. Perhaps you need to cut yourself some slack and be OK with publically acknowledging that the pace of the ED is too fast for you as a new grad. You may need to go to another area of the hospital first to make that transition to the nursing role. Then, if you want to tackle ED, then do so with a strong foundation of nursing skills, including those essential time management and prioritization skills.

Give their plan a try, but start thinking of other alternatives. Talk to the hospital's Nurse Recruiter about your other options. Stay on good terms with your current manager so that she can feel good about helping you find a better fit elsewhere.

Good luck with whatever you decide to do.

[gam3rchic]

Ok, i know you are a new grad and it's hard to do ER right out of school, but some things seem kinda wrong to me:

First, you said that you told your supervisor that you were not ready, but yet you were expected to carry the load anyways. I think since you've worked for so many years as a tech, they expected you to be able to jump right in as an RN, which is not fair! You told them you were not ready, and they should've listened.

Second, your manager is saying she worries about you and that she doesn't want you to lose your license? What manager says those things unless you've done something REALLY WRONG? To me, this sounds like overkill. The only ones in danger of losing a license are those who've done really bad things, not nurses who need help with time management. Please, if time management was a standard on if you keep your license or not, I'd lost mine several times over in my first year of nursing.

Third, the example you gave about the guy with CP....uh, I would've held off on my D/C too if I had a CP come back as well. If the D/C was that important, I would've tried to find someone that could've taken care of either my new CP for a minute or did my D/C. Instead of the charge nurse screaming at you, you should've asked if she could've given you a hand with one or the other, as it is impossible to do both things at once.

Sorry, but what it sounds like to me, is that they did have high expectations of you b/c you've worked as a tech for so long and expect to much from you. I would do the new plan and see how it goes. What does your preceptor think? What do the other nurses think? Get more than one opinion on your performance b/c nurse managers can be wrong too. And also, cut yourself a break b/c you are a new nurse. Give it time. You'll get there :)

[RN1989]

Get out of the job. Transfer to another position. If they are already telling you that they are worried and don't want you to lose your license - they will hang you out to dry in a heartbeat. They obviously have not given you an orientation suited to your needs. And they have ignored you when you asked for help. It's great that they are going to put you with an experienced nurse, but the charge nurse is a BAD option. You are right, she is going to be all over the place because she has to make sure that every one else is doing ok. She is not going to be able to help you when you need it. She will also get resentful because she has so much thrust upon her that she could get passive aggressive with you really quick. I know that you wanted to work the ER, but as a new nurse, it is hard enough to take everything all in and be able to think on your feet. I don't think that the ER is the best place to practice safely when you can't get the orientation that you need. Your job and your license is in jeopardy. And I wouldn't be surprised to see you boss be the one to call the board. You need to get out of there since they are unwilling to give you the support and orientation that you need. You can always go back to the ER after you have gotten all the basics down and can perform nursing like you are on auto pilot -without having to think about everything in such a deliberate manner.

[MedSurgeNewbie]

((Hugs)) I dont do ER and am fairly new too - Will keep you in my prayers..

[NurseCard, ADN]

I just wanted to say that I agree with everyone who has said to perhaps try a different department. Spend some time in Med/Surge and get your nursing skills honed and I'll bet you'll eventually find that you miss and crave the super fast pace of ER and you'll feel really truly ready to go back!

Or, you'll find that you like the (slightly) slower pace of Med Surge better. Good luck!

[ERRNTraveler, RN]

I noticed that you're from SW Florida- you wouldn't happen to be working in Naples, would you??? If so, then the way management is dealing with your situation is just soooo typical..... I have worked as a traveler at both hospitals in Naples, in the ER, and that whole system is just poorly managed.....

[longjourneydream]

If you really want to know, I work for HMA.

They are based out of Naples.

My hospital is just North of Naples between Sarasota and Port Charlotte FL.

Since I last posted though, I have voiced my concerns of being a green nurse that needs more training.

The doctors are also aware,as are the nurses I work with.

Everyone states that they want to see me succeed, and will help me get though these growing pains.

I am fortunate to have built relationships, prior to becoming an RN in the ED.

Managment is a challenge at this point, and many of us do not agree with managments decisions, but I belive if you have enough people in your corner, there is away around almost anything.

I will stick it out at this point rather than start else where, all over again.

I have been told by the veterans that I cannot function alone, until after a year, and nobody should expect it.

By the middle of December, I should feel more comfortable, then by June of next year comfortable to fly on my own.

I noticed that you're from SW Florida- you wouldn't happen to be working in Naples, would you??? If so, then the way management is dealing with your situation is just soooo typical..... I have worked as a traveler at both hospitals in Naples, in the ER, and that whole system is just poorly managed.....

[RN1989]

If you really want to know, I work for HMA.

HMA is the company that owns the hospitals in Mesquite, TX that fired the nurses and started taking other measures to keep the union out of their facilities.

[teeituptom, BSN, RN]

you need to look on the bright side of things. You live close to the beach, spend more time relaxing on the beach. Thats heaven. I also know that area. You are surrounded by wonderfull golf courses. Go golfing. Relaxes you, put everything in focus as you beat the dickens out of that little white ball.