I've worked on a tele floor for 6 months. Great hospital, great co-workers. I'm 50x faster than I was, and 110% more experienced, but I feel grossly inadequate. (I'm a LPN, finish RN in Dec.) I'm haunted by being told (4 weeks ago) that I was "unsafe" by a charge nurse. (ESRD pt w/low platlet count and possible PE, MD ordered heparin. I couldn't start IV #2 on pt and asked charge to help. I then thought (duh), isn't heparin contraindicated w/ low platlet count?? Why didn't MD see that in the labs? Anyway, I was told that I'm unsafe because I didn't catch the contraindication right away. ~geez, I'm an inexperienced LPN.)
I've talked with the charge nurses, and with the manager who hired me, and they are all very supportive. I just feel like crap, and can't seem to get out of this rut. I'm told this feeling is "normal", but I don't think that crying myself to sleep every night seems normal. How long will this go on?? I don't want to quit my job, but I hate my job. I feel pulled in every direction all at once, as if I'm required to be all-knowing and all-seeing. (I'm sorry if you got d/c orders at 0830, I've got meds to pass before I can do your paperwork, and the charge nurse has to approve the paperwork... after I track down the MD who ordered "continue home meds" without specifying on that pesky MEDICATION RECONCILIATION FORM exactly which meds are to be continued. And, oops, the pt across the hall claims to be having 10/10 chest pain.)
I recognize that this is stuff that happens every day, and will continue to happen forever. I just HATE the way I feel about it. How do I get through it without being so miserable?
I've worked on a tele floor for 6 months. Great hospital, great co-workers. I'm 50x faster than I was, and 110% more experienced, but I feel grossly inadequate. (I'm a LPN, finish RN in Dec.) I'm haunted by being told (4 weeks ago) that I was "unsafe" by a charge nurse. (ESRD pt w/low platlet count and possible PE, MD ordered heparin. I couldn't start IV #2 on pt and asked charge to help. I then thought (duh), isn't heparin contraindicated w/ low platlet count?? Why didn't MD see that in the labs? Anyway, I was told that I'm unsafe because I didn't catch the contraindication right away. ~geez, I'm an inexperienced LPN.)
I've talked with the charge nurses, and with the manager who hired me, and they are all very supportive. I just feel like crap, and can't seem to get out of this rut. I'm told this feeling is "normal", but I don't think that crying myself to sleep every night seems normal. How long will this go on?? I don't want to quit my job, but I hate my job. I feel pulled in every direction all at once, as if I'm required to be all-knowing and all-seeing. (I'm sorry if you got d/c orders at 0830, I've got meds to pass before I can do your paperwork, and the charge nurse has to approve the paperwork... after I track down the MD who ordered "continue home meds" without specifying on that pesky MEDICATION RECONCILIATION FORM exactly which meds are to be continued. And, oops, the pt across the hall claims to be having 10/10 chest pain.)
I recognize that this is stuff that happens every day, and will continue to happen forever. I just HATE the way I feel about it. How do I get through it without being so miserable?
Thanks in advance for the moral support.
i have not read all of the posts but i would say the most important thing is, remember that you can only do one thing at a time. if you have d/c orders at 0830 and meds to pass and paperwork, then only one of them can be done first. i would do the medicines first, that would be my priority. the paperwork can be looked at and given to the charge nurse. let them know what you have to do and ask for help. you can only do one thing at a time properly. otherwise it is not safe.
i used to pass meds on a medicine ward with 25 pts, avg 9 diabetics, who would all need F/S before breakfast so i would do that first. i didn't have to do any discharges, but i had to check all of the f/s, give all the insulin, and then check all meds before starting out. the rest of the morning i was doing meds and checking orders. it was a mess. but being organized was the main thing.
it is hard when people make negative comments and are not supportive. but that is how it is most of the time.
don't allow others to dictate how you feel, you are giving them waaay too much power. i know what i am talking about. after 22 years i will be leaving nursing at the end of the month.
Unfortunately, nothing will prepare you for the rigors of nursing except nursing itself. You will learn how to do things in school, but you won't really know how to prioritize your shift until you are in the thick of it..and it will take you some time doing it. That is the KEY...develop your own way of getting through the night. For example, I used to open my charts a million times during the night thinking I forgot to do something or forgot to do a chart check, sign off an order, chart a med, etc. I wasted a lot of time doing that. Then, I made a check list on my kardex...once my task was checked off, I didn't fumble through the chart checking it again. You can't store everything in your brain...you'll either forget it or obsess over it if you try. Perhaps during clinicals, you can practice keeping all your ducks in a row. Once you have a system, you will feel that you are in control and be able to manage your time.
Thank you for the good advice!! I will definitely work on that during clinicals. I know there will be so much to learn and yet once I have learned everything for nursing school I will have just begun the learning process !! I know I thrive in a challenging, ever-changing environment, but some of the stories I have read are just frightening to a newbie.
I've survived another month on the floor, become 120% more efficient and equally more knowledgeable. I'm more confident and capable, and although I love my work, I loathe my job. (I'm quickly developing the essential "thick skin.") Patient care is why we decided to be nurses in the first place. I can't give the care the pts deserve (tele floor) when the floor is badly staffed (one tech, no HUC, one nurse short, 7 pts assigned q nurse.) This seems to ALWAYS happen on Sundays (I work weekends and one weekday). The weekdays are okay... yesterday I found myself LOOKING for things to do (which, didn't last long.)
I've been doing a lot of tire-kicking lately. There are a lot of nursing jobs out there that will allow me to do what I love, and don't involve torturing myself. I interviewed with hospice, and think I may accept their offer. I still want to work at the hospital a couple of shifts a month, but I haven't had that conversation with my manager yet. At this point, what I'd really like is a couple of weeks off....
This has been a very interesting and enlightening thread. School clinicals cannot prepare you for the real thing. (I've had some PN students lately, and shared this insight with them.) I don't know how I would change that aspect of nursing education. I guess it's like any job. Nothing replaces experience. It's just that this experience is life and death, loose/keep your license, as if your neck is always on the chopping block. I guess that's where the intuition and thick skin come in. Whew... talk about "another day, another adventure."
Again, thank's for your moral support. We are an exceptional group.
Thank you for this post. I too graduated in Dec from an Accelerated BSN (first degree in Psych). I am on a step-down/Tele floor and my orientation is wrapping up (started last week in March). Do I feel ready to be on my own? No way. However, I told my manager recently I don't think I will ever feel "ready". It's my own low confidence as well as the acuity of our patients.
I still get knots in my stomach when I go to work but usually once I greet my patients and see why I am there, I feel better. I know it will get worse before it gets better, but I know I am not alone!
Wow, I too thought I was the only one working in a place like this !
I believe the worse situation is when the coworkers are not supportive. I work in a tele floor and was floated to a med/surg floor yesterday. Although, I had 6 pts to start with (then one AMA, 2 D/C'd and a new admit), I had a chaotic day mostly because of things not being done by the unit clerk/CNA. STAT orders were not put in. Unit clerk chatted a lot but not paying attention to MD orders. CNA disappeared from noon to 7p etc.....However, the charge hurse was very supportive but there was only so much she can do.
Being less than one year in nursing, I have yet to establish an effective routine. I have yet to know how to prioritize those 15 important things when they happen all at the same time.
I still don't understand the med/surg working environment (where most new grads start), but I think it is designed for failure. Administration wants us to do everything they want (also with a high pt load). But if they think it can be done, they'd better work the floor with the same patient load and show us how.
I'm haunted by being told (4 weeks ago) that I was "unsafe" by a charge nurse. (ESRD pt w/low platlet count and possible PE, MD ordered heparin. I couldn't start IV #2 on pt and asked charge to help. I then thought (duh), isn't heparin contraindicated w/ low platlet count?? Why didn't MD see that in the labs? Anyway, I was told that I'm unsafe because I didn't catch the contraindication right away. ~geez, I'm an inexperienced LPN.)
I wouldn't feel too bad about it. I'm working as an extern and my RN with four years experience almost made the same mistake just the other day. Luckily, I had just studied this in school and pointed out the patient's low platelet count to her. The RN thanked me and held the drug.
So ... we all make mistakes ... including experienced doctors and RN's.
Wow, I too thought I was the only one working in a place like this !
I believe the worse situation is when the coworkers are not supportive. I work in a tele floor and was floated to a med/surg floor yesterday. Although, I had 6 pts to start with (then one AMA, 2 D/C'd and a new admit), I had a chaotic day mostly because of things not being done by the unit clerk/CNA. STAT orders were not put in. Unit clerk chatted a lot but not paying attention to MD orders. CNA disappeared from noon to 7p etc.....However, the charge hurse was very supportive but there was only so much she can do.
Being less than one year in nursing, I have yet to establish an effective routine. I have yet to know how to prioritize those 15 important things when they happen all at the same time.
I still don't understand the med/surg working environment (where most new grads start), but I think it is designed for failure. Administration wants us to do everything they want (also with a high pt load). But if they think it can be done, they'd better work the floor with the same patient load and show us how.
I have the same problems...certain unit clerks and cna's can make or break you.....in nursing school there is so much about delegating tasks...but i find there is noone to delegate the task to ....so much falls on us..we have ONE cna for a 35 bed med/tele/surg unit so you can only ask that person to do so much. It is very frustrating at times . I do really love my job but
. it will messed up your work and even your confidence.. nobodys perfect but learn how to handle difficult situations..its the nature of the job.:o.i myself wanted to quit last year in handling tele pts..plus delayed salary!! what a crap!! but I continue to learn and face the work..yaiks!!...goodluck and Godbless!!;)
I have the same problems...certain unit clerks and cna's can make or break you.....in nursing school there is so much about delegating tasks...but i find there is none to delegate the task to ....so much falls on us..we have ONE cna for a 35 bed med/tele/surg unit so you can only ask that person to do so much. It is very frustrating at times . I do really love my job but
I think we need more staff.
True ! There is nobody to delegate the task to. Schools teach theories only. How can someone working on a floor be able to do their job by textbook standard? This is impossible !
I do love being a nurse but I don't consider myself doing nursing in the hospital. I found I am constantly being tied up by paper work and not able to spend the time that I need to spend with my patients. Yes, we need more staff, and there are nurses being called off because the hospital administration is picking pennies. :angryfire
Hey you guys thank you for making know I have not been alone. Yuo know how horrible it feels to go through all the CRAp of Nusing school only to find out you SUCK at what you really want to be. I work on a specialized unit and have been ther for 1 yr now. I love being a nurse. I love where i do it. However, i feel that out of 12 hours I feel like a nurse maybe 1 hour some days. Some people are so mean to give report to the IBS I was plauqed with in school returns. I DONT KNOW IT ALL. I would love to leave one day and not worry I mnade a med error I did not catch or forgot to sign something or forgot tolook up labs. The list goes on. Anyway, whendoes all that self doubt fade???
What a nice message you are so right. It is hard to get to that place. I dont hate my patient population some of the girls I work with are just miserable.
WOW. You have to find a different place. All the hell of school and all things you had to have gone through and had the people that love you go through with you is not worth that. The biggest problem with nursing are nurses. As a whole we tend not to be nice to eachother, for what ever reason. Those reasons others are like that are notyour problem and dont let them be go to HR and find your "happy place" good luck and take care
. it will messed up your work and even your confidence.
. nobodys perfect but learn how to handle difficult situations..its the nature of the job.
:o.i myself wanted to quit last year in handling tele pts..plus delayed salary!! what a crap!! but I continue to learn and face the work..yaiks!!.
..goodluck and Godbless!!
chrispicritah
34 Posts
i have not read all of the posts but i would say the most important thing is, remember that you can only do one thing at a time. if you have d/c orders at 0830 and meds to pass and paperwork, then only one of them can be done first. i would do the medicines first, that would be my priority. the paperwork can be looked at and given to the charge nurse. let them know what you have to do and ask for help. you can only do one thing at a time properly. otherwise it is not safe.
i used to pass meds on a medicine ward with 25 pts, avg 9 diabetics, who would all need F/S before breakfast so i would do that first. i didn't have to do any discharges, but i had to check all of the f/s, give all the insulin, and then check all meds before starting out. the rest of the morning i was doing meds and checking orders. it was a mess. but being organized was the main thing.
it is hard when people make negative comments and are not supportive.
but that is how it is most of the time.
don't allow others to dictate how you feel, you are giving them waaay too much power. i know what i am talking about. after 22 years i will be leaving nursing at the end of the month.
good luck
and be well
cc