HELP! Newbie nurse need your advice!

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Hello all,

I need your help & your advice. I just started a 7a-7p position at a hospital close to my home; it is a very busy vascular & general surgery floor. I have been there for about 2 1/2 weeks. Our orientation is 6 weeks total w/1 week in the classroom so I'm actually only orientated on the floor for 5 weeks.

My preceptor seems to think that she can show me something once & that I should be able to do it & she is often so busy that she doesn't show me anything at all. She didn't even show me the basics like where the time clock is, or where the schedule is, when it comes out, etc.! She says that I should know how to set up IVs & IVPBs yet she hasn't shown me what tubing to use or anything. She does it so fast that I still don't get it.

On Monday we had 9 patients & 2 of them had just come back from surgery. One had an endoarterectomey (or something like that) with a vein patch. The surgical nurse said that he had 'slight' fluid overload (this guy had a history of COPD). When I went in & assessed him his lungs they sounded wet. I told my preceptor & she said to keep an eye on him but then the 2nd patient came up & he was receiving a blood transfusion & she sent me off to assess him. She never showed me what paperwork I need to get from the surgical nurse when patients come up from surgery...she has never shown me how to admit a pt to our floor....or how to d/c a patient....or how to do a blood transfusion. When I went back & reassessed our COPD guy he was wheezing! She went in & looked at him & said "You're wheezing like crazy!" & that's it. Her idea of a patient assessment is to listen to their lungs & that's it. She doesn't even ask them if they are in pain or how they are feeling. Often, she only sees the pt once when she starts the shift & then not again until right before the shift ends.

I have no idea how to read the doctors orders or how or when to call the doctor. She has never shown me where supplies are & what I need for each procedure. All she says is "go in the equipment room & find me ____" but I often don't know what she means or even where to begin my search. She hasn't shown me anything. I feel so overwhelmed & very stupid! I only have about 2 weeks left in my orientation & I am nowhere near able to deal with 9 patients. The avg on this floor is 7-8 but can be as high as 11. When we had 9 pts the other day, there were 21 pts total on our floor w/only 2 RNs & 1 LPN (not counting me ).

HELP....am I just feeling overwhelmed because I'm a new RN or is this just a bad situation? I want to become a good nurse & I want to take excellent care of my pts but I don't feel that I can do that when I have no idea what to do & where to do it & I feel that we have too many pts per nurse to really give good care.:crying2: What do you think I should do?

Any advice would be greatly appreciated.

Love to all,

Dawn

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Hi Dawn,

I am in a similar position as you so I have no real advise, I just want to let you know you are not alone in this feeling. I personally am looking for a new place of employment. Good luck in what ever decision you make!

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Hi Dawn,

I understand what you're going through. I'm in the 5th week of a 12 week rotation in the ICU and my preceptor basically said that I may not be cut out for the ICU. When I spoke to my manager she suggested I work with another preceptor. Can you do that, go to your manager and ask for another preceptor? Try and do it without complaining about your preceptor, that maybe "your communication styles don't match". But i have to tell you that being overwhelmed as a new grad nurse is universal. All my friends feel the same way. Just hang in there, write as many notes to yourself(I keep a little notebook that I write things in during the day).

Ask other nurses for help.

Just hang in there, I'm sure it'll get better

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Specializes in Medical-Surgical/Psych.

That sounds like an awful and unsafe situation. You need to speak to your nurse manager right away that your preceptor is not working out. I work eves. When I was precepted back in February (for six weeks), my preceptor started me out with one patient the first week up to 5 during the orientation period. She showed me how to sign off orders, enter them in the computer, and anything that I wanted her to show me or recheck, all I had to do was ask. Also, I had certain skills that I had to be signed off on. As far as drugs, I would look them up myself, but again, she showed me where the policies are located, etc. etc. Your preceptor is not doing her job. It needs to be addressed right away before it is too late. Best of luck to you. Keep us posted.

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Specializes in Emergency Department.

This sounds like a bad situation. Talk to your manager. (By the way, 5 weeks on the floor is not enough time to learn to manage so many patients!)

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Specializes in ICU/CCU, Home Health/Hospice, Cath Lab,.

I would second going to your nursing manager and asking for another preceptor and more time. Although I would disagree with the "only stating our communication styles don't mesh". I would start with "our learning styles appear really different". If they want more in order to change you, explain what you have not learned and what you feel you need in order to practice safely.

If they won't change you, I would start looking for another job. 9-11 patients is insane for a dayshift surgical floor. Our surgery floors on days take 4. And our orientation is 13 weeks. They are adopting a sink or swim approach with you, don't let them. Ask for what you need, and if they are unwilling or unable to provide it - search elsewhere.

Then at your next job interview, ask specific questions about orientation and training for preceptors.

Hope this helps

Pat

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Specializes in Neuro ICU and Med Surg.
I would second going to your nursing manager and asking for another preceptor and more time. Although I would disagree with the "only stating our communication styles don't mesh". I would start with "our learning styles appear really different". If they want more in order to change you, explain what you have not learned and what you feel you need in order to practice safely.

If they won't change you, I would start looking for another job. 9-11 patients is insane for a dayshift surgical floor. Our surgery floors on days take 4. And our orientation is 13 weeks. They are adopting a sink or swim approach with you, don't let them. Ask for what you need, and if they are unwilling or unable to provide it - search elsewhere.

Then at your next job interview, ask specific questions about orientation and training for preceptors.

Hope this helps

Pat

I completely agree. That is no way to work with a orientee. They were once new themself. I would deffinately ask for a different preceptor. If they wont give you a different preceptor, go to HR and ask to be on a different unit. If not then go somewhere else.

No one should expect you to come out of nursing school knowing everything. You have every right to a different preceptor. Good luck to you.

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It sounds like you are on a very busy, understaffed floor. It sounds like your preceptor doesn't have the time to show you everything she needs to. Six weeks orientation for a new grad is ridiculous. You are in an unsafe situation. I am curious as to how burned out the nurses are in your unit. Two fresh post ops on top of 7 other patients is CRAZY, especially when one has a 'little' fluid overload (ridiculous).

You can try to go to your nurse manager, but her management is part of the reason the unit is this way. She may actually turn it onto you and say, well everyone gets 6 weeks and they do just fine.

Best of luck to you, sorry I'm not much help.

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I agree with the previous posts. Sounds like the nurse/patient ratio is unsafe on your unit, and you are not be oriented correctly. I have 2 more weeks on my orientation, and my preceptors are always standing over me showing me how to do every little thing. It's almost to the point where I wish they would leave me alone SOMETIMES. But, I have been shown things multiple times, especially admitting, discharging, putting in orders, etc. and they are always very patient with my questions.

You need to stick up for yourself and ask your manager or HR about your options. You worked hard for your license, and you need to protect it. No one would fault you for that.

If I were you, I would run far far away from there. Hopefully, you are in an area where nursing positions are relatively easy to come by.

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Specializes in Med/Surg < 1yr.

I will be graduating school in 5 more months and I can tell you now that if I have to work somewhere, where the ratio is above 7:1 , I will not accept the position. If they trick me and get me there and I find out that it's 7:1 or above consistenly, then I will certainly not think twice about running because 1. Your license is always on the line and 2. That is way too many patients for a new nurse to be handling! Though the preceptor should know better, I'm thinking she is so overwhelmed herself that she doesn't have time to show you everything you need to know. She's crazy and so are you for working in a place where there is 11:1 on a 7a-7p shift. There are tooooo many other hospitals, clinics, school and everywhere else to work in as a nurse get up and get out before you burn out before your time!

In the meantime, take a day when you're not working to aquaint yourself with where everything is so when you go back to work, you're not so overwhelmed.

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Im really sorry to all of you nurses that are struggling. I can just imagine how hard you guys are having it. Im a new nurse also and have been working on the med-surg unit for 3 weeks.

Did you know that it wasn't working out for you within the first week of work? If so, I think you should have spoken up. It sounds like you are struggling and I agree with everyone else here...... talk to your manager. Thank God, I have been blessed with a wonderful preceptor. She consistently checks on me and is always explaining stuff to me. Even though she already told me something 3x she says she doesnt care if she has to tell me 10 more times. She understands what its like to be a new nurse and how scared I am. She always tells me "I went through the same thing, and I know its hard to remember everything". I really wish you the best. You deserve to be trained the right and safe way. Your story is so insane and If I was in your shoes I would be looking for another job. But definately...talk to get out of that hospital.Hopefully everything works out for you. Keep us posted of what happened.

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UPDATE:

Well, I went to my manager & she said not to panic that if I need another week or two that was fine but that it was normal to feel overwhelmed. I told her I knew that but I wasn't learning anything because my preceptor had no time to teach me anything. She just kinda blew me off. The hospital policy dictates that you must be in a position for a minimum of 6 months before you can transfer so I am looking for another job somewhere else. I'm considering going to LTC just so I can have some time to learn some of the basics.

As far as staffing goes, there are 2 major hospitals in my small town area & they both suffer from extreme staffing issues. Both hospitals allow for 6 weeks orientation with 1 week of that spent in the classroom.

I'll let everyone know what happens. Thanks to everyone who replied. I appreciate the comments & advice.

Take care,

Dawn

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