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. What do you think I should do?
Specializes in ICU/CCU, Home Health/Hospice, Cath Lab,.
Good luck on finding the right place for you. I would caution you about LTC for looking at working on the basics. If you feel you are overwhelmed now - try 30 patients with a 3 day orientation (which is what I got in LTC). I barely had time the first month to complete med passes let alone concentrate on anything other than critical vs fine with my patients.
You might think about a small specialty unit - peds, ccu, step downs which might let you work on a smaller load to hone those skills you want to do.
Sounds like a very unsafe situation. Where ever you go, always remember that it's your license that is at risk and you worked very hard to earn it! Best of luck to you.
It is always ok to ask for a new preceptor if you are not getting what you need to learn. It is even more important that you do it if you intend to keep your job! If the preceptor gives you a hard time about switching, it is helpful for you and the preceptor for you two to sit down and have an open discussion with they about your needs.
In fact, you should be speaking to your preceptor about your needs before considering switching preceptors. If after a couple of conversations nothing seems to have changed just tell you manager AND your preceptor that it is not working, that the preceptor's style isn't a good match for your learning need to be successful on the unit as a safe and productive nurse.
Oh my goodness! That is WAY too many patients for a day shift! How are you getting assessments & vitals done, all meds passed, cares done, etc?
It sounds impossible! Are there any larger hospitals close to your town you could look at? It sounds like both hospitals have staffing issues that will make things very difficult for a new grad. Good luck and let us know how everything works out.
Well, I'm on a different floor. It is a general medical, oncology, & peds floor. I am MUCH, MUCH happier now. I have a wonderful preceptor & the staff on this floor are really wonderful. Most of them are seasoned RNs/LPNs & they have been very kind & have offered me help & encouragement, so things are looking up for me.
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. What do you think I should do?
Any advice would be greatly appreciated.
Love to all,
Dawn
Dawn,like you I am a nw grad .I start my job next Monday on medsurg.My manager said the pt rario is 6:1 and I get 12 weeks,that is also around the time that I sit for boards.My advise that is too many pt for a new grad,that is too many for a seasoned nurse.My instructors in nursing school told me over and over Protect your linsense,you worked for it.From your description ,I would not want to work there even if I got the 6 weeks orientation.Girl pack your bags and get out of there you deserve better
Congrats Dawn!!! That sounds like a very interesting floor- I bet you will learn a LOT. So glad to hear that things are going better for you there! Good luck to you :)
Dawn, im so glad your at a better place now. It sounds thru your words that you are very happy where your at. Thats wonderful news. Hope all goes well for you.
Well, here's the latest....my director attempted to move me back to the floor I hated. I told her "no way" & that I would go to another department but not that floor. So she said either I go back or I'm fired...so I ended up quitting. Another new grad RN who went to school with me had the same experience & she also quit. I went over my director's head & the hospital's HR people said that they didn't have any other positions open for me...yet on their website they have 3 pages of openings! This same hospital also has been running ads in our local newspaper. I have come to believe that it's not me. The hospital is just a very poor place to work. Anyway, I've been looking on-line for hospitals that have new grad programs & I've heard from some that I am really interested in.
Good luck to you, Dawn....Just want you to know, unfortunately, you are not alone..... please see my Help!! post......Sounds like you have done the right things all along....I wish you luck- maybe now you can give me some advice on how to deal with my difficult bipolar orientation nurse!!
Best wishes to you Dawn. Sorry you had to start off at such a horrible place and not to mention have an awful experience with your preceptor and director. But look at it this way......... their loss is someone else's gain. :wink2:
What do you think I should do?
patwil73
261 Posts
Good luck on finding the right place for you. I would caution you about LTC for looking at working on the basics. If you feel you are overwhelmed now - try 30 patients with a 3 day orientation (which is what I got in LTC). I barely had time the first month to complete med passes let alone concentrate on anything other than critical vs fine with my patients.
You might think about a small specialty unit - peds, ccu, step downs which might let you work on a smaller load to hone those skills you want to do.
Hope this helps
Pat