I feel so unprrepared

KristeyK · Jul 17, 2012

Don't sweat it too much. I feel pretty much the same way you do, and I am four weeks from graduating. LOL. I have yet to have an instructor or a nurse at a clinical site tell me that I will be comfortable from day one on the job. EVERY.SINGLE.ONE. has said it will take at least a year before you get half way comfortable with everything.

llg, PhD, RN · Jul 17, 2012

Comfort is something that comes only with time -- lots of time. Learning to live and work with a little discomfort is a necessary part of the process. Learn to identify your resources, learn to look things up when you don't know something, learn to admit that you need some help, learn to make friends with co-workers so that they will want to help you, etc. These things are just as important to learn for career success as anything in your textbook.

Also, you said that you still have 2 more semesters to go. If you were ready to be an RN now, there would be no need for the 2 more semesters.

nurseprnRN, BSN, RN · Jul 17, 2012

you're right, you're not ready to be a nurse--you haven't finished your basic education yet, and you haven't passed your licensure exam. no one will ask you to take a regular patient load tomorrow.:hug:

that said, when you have done those things, we would be worried to death about you if you weren't a bit nervous when you start work. anxiety kicks your epinephrine level up a bit, which does a lot of useful things: it releases glucagon from your liver to give your brain and muscles extra fuel, it makes your heart beat more strongly and rapidly, it dilates your eyes so you see more sharply, it increases your hearing acuity. all of these things are useful adaptations, and you should be aware of them and use them consciously. that's why you have them.

we worry a lot about new grads who don't feel nervous-- they're the ones who think they know it all and therefore they make the mistakes it takes us ages to clean up. we've all been there, we sympathize.

RN/stilllearning · Jul 17, 2012

I remember those same feelings. I dont know how big your school is, but mine was a small community college and the small community hospitals where we had our clinicals just didnt leave me feeling like I had seen or done enough to actually do it on my own. The best advice I can offer you is to find a nurse tech position, now while you are still in school. I was able to find a nurse tech position at a teaching hospital. Instead of one instructor having to find "learning opportunities" for my whole clinical group, I had one on one instruction with an experienced RN getting to see and help with everything she did. It was an awesome experience to be able to go with a different RN everyday in the step-down unit and see how all have their own ways of accomplishing the same things. They know you are learning and most of them love for you to ask lots of questions, plus you are getting paid for this also. Win-Win situation if you are able to work during school. My time as a nurse tech rolled over into a permanent job once I graduated and passed my boards. That puts you a step ahead of all the others graduating and then looking for a job. Best of luck!

Jessicias85 · Jul 18, 2012

The best advice I can offer you is to find a nurse tech position, now while you are still in school.

I was a tech, but I was let go. There were a lot of false accusations that led to me getting let go. I did make some mistakes that I did own up to (nothing life threatening) but there were things that I ABSOLUTELY did not do that I was let go for and I was then told that if I did not learn to listen and to work with in my scope of practice, I would be a very dangerous nurse.

I think that has messed with my head too. I don't mind to share details if any one wants to know

Esme12, ASN, BSN, RN · Jul 18, 2012

What Happened? It has obviously impacted you maybe it will help if you talk it out.

Jessicias85 · Jul 18, 2012

I was a tech at a local hospital from Dec 2011- April 2012. Everything was great during my 9 wk orientation period. I was praised for how quickly I caught on and observant I was. My DON came to me about 5 weeks in and said that she was considering switching me to a different unit. I did not want to at the time as I liked who I worked with. As I came off orientation and began working on my own, attitudes changed. The nurses were no longer nice and were actually quite rude to me. I was the only tech on the floor that was in nursing school and I think they held that against me. One incidence of this, i had a pt who was a very sweet old man who had not asked for anything all day. about lunch, he asked me if he could have a couple of Tylenol that his legs were aching. I told him I would ask the nurse. I went to the nurses’ station and told his nurse that Mr X would like some Tylenol. Her response was given with the most annoyed look on her face "You don't have to come to me with everything a patient asks for, you are getting on my nerves." I responded with "I am just relaying what the patient asked" Her response "well, you need to learn when not to come to me about stuff"

Mistake #1: I had a patent that was being discharged. I was off the floor so the nurse took her down to meet her family. They came right back saying that the family was not there. They put her back in her room and the patient asked me to call to see where they were. i went to the nurses desk and call the number that the pateint gave me. the nurse came up demanding the phone so I told the family to hold on the nurse wanted talk to her. I handed the nurse the phone. End of story.

Mistake #2: Pt was bed ridden and had been awful for 2 days this had been the first day that I had cared for him. He had hit kicked punched spit cursed screamed. You name it he did it. He had family finally arrive that evening just before change of shift. I was sitting at the station fininshing my charting when the family came and said he had messed the bed. I went in to change the bed (he refused to wear a brief) and he said that he was not done that he was still trying to go. I told them to let me know when he was done. I was REALLY fed up with this guy at this point. The family came back and said he was now done. This was right at 1900 shift change I asked the night nurse if there was going to be a night tech and she said no. I told the family I would be there in just a few I had to fininsh my charting as it was time for me to leave the floor. The night nurse and charge nurse went in and as I saved my work I went in as well to help change him. The family called in an complained that I was allowing to sit in his own mess and that for days I had not treated him well ( as I said I only had him 1 day)

After these 2 incidences I was pulled in to the DON’s office. No write up was given just a watch what you do and be mindful.

ashleyisawesome, BSN, RN · Jul 18, 2012

I was a tech at a local hospital from Dec 2011- April 2012. Everything was great during my 9 wk orientation period. I was praised for how quickly I caught on and observant I was. My DON came to me about 5 weeks in and said that she was considering switching me to a different unit. I did not want to at the time as I liked who I worked with. As I came off orientation and began working on my own, attitudes changed. The nurses were no longer nice and were actually quite rude to me. I was the only tech on the floor that was in nursing school and I think they held that against me. One incidence of this, i had a pt who was a very sweet old man who had not asked for anything all day. about lunch, he asked me if he could have a couple of Tylenol that his legs were aching. I told him I would ask the nurse. I went to the nurses’ station and told his nurse that Mr X would like some Tylenol. Her response was given with the most annoyed look on her face "You don't have to come to me with everything a patient asks for, you are getting on my nerves." I responded with "I am just relaying what the patient asked" Her response "well, you need to learn when not to come to me about stuff"
Mistake #1: I had a patent that was being discharged. I was off the floor so the nurse took her down to meet her family. They came right back saying that the family was not there. They put her back in her room and the patient asked me to call to see where they were. i went to the nurses desk and call the number that the pateint gave me. the nurse came up demanding the phone so I told the family to hold on the nurse wanted talk to her. I handed the nurse the phone. End of story.
Mistake #2: Pt was bed ridden and had been awful for 2 days this had been the first day that I had cared for him. He had hit kicked punched spit cursed screamed. You name it he did it. He had family finally arrive that evening just before change of shift. I was sitting at the station fininshing my charting when the family came and said he had messed the bed. I went in to change the bed (he refused to wear a brief) and he said that he was not done that he was still trying to go. I told them to let me know when he was done. I was REALLY fed up with this guy at this point. The family came back and said he was now done. This was right at 1900 shift change I asked the night nurse if there was going to be a night tech and she said no. I told the family I would be there in just a few I had to fininsh my charting as it was time for me to leave the floor. The night nurse and charge nurse went in and as I saved my work I went in as well to help change him. The family called in an complained that I was allowing to sit in his own mess and that for days I had not treated him well ( as I said I only had him 1 day)
After these 2 incidences I was pulled in to the DON’s office. No write up was given just a watch what you do and be mindful.

wow sounds like a horrible place to work. i might have stopped my charting to go change the pt when he was done, then charted, knowing i was going to be there longer than i had planned, but people make mistakes. i know ive done plenty of things wrong as a tech, but the people i work with just explain to me what i did wrong and i learn from it. the nurses you were working with sound miserable..

anyway, does your school do a preceptorship at the end? i felt severely underprepared until i did preceptorship (almost done with it, next weekend! yay!). i honestly feel very prepared to start an orientation as a new nurse now without feeling like a total idiot. i am far from being confident having a full pt load to myself, but i shouldnt be. when you get a job, you will have extensive orientation as a new nurse (or you should). real life nursing is NOTHING like clinical.

what specifically do you think you need more experience with? the lab values thing, i admit i dont have them all memorized yet. just look them up if you dont know. not a big deal. and after looking at them every single day, you WILL get to know what is normal and what is not. dont forget you wont be working alone either. there are always other nurses with you so ask them questions, and ask for help. hopefully they will be more supportive than the ones you were working with at your previous job.

Jessicias85 · Jul 18, 2012

After all of this, I began floating to other floors as much as possible. I even put in for a transfer to the step down unit. I really liked working there and the nurses were open to answering questions if I had them.

I had no more incidences for quite a while then I mistakenly took a temp without a probe cover on. I did it before I thought about it. I knew I screwed up and even went to the charge nurse and told her. I tried to make light of the situation to myself and tried to not dwell on it as I get myself in a funk if I have messed up.

I get a call out of the blue on a Monday from my DON that I will no longer be needed. I was PRN and census was too low. I asked if she just ment for the week or I would not be needed at all? She said at all. I had no clue why or what had happened.

That Friday I get a call to come in with her for a meeting. It was for Monday so I go in and meet with my DON and the head of HR. It was basically a meeting to throw everything up in my face. There was a list of things that I had supposedly done. The “Mistake #2” was not brought up but the phone call issue was. When I was taken into the office the first time, it was just to say let the nurses handle that type of stuff. When it was brought up in this meeting, they said there was a patient complaint about it, and that several nurses complained about it. I was never shown the patient complaint.

I was told that I had reset the volume on an IV pump of heparin and that the house supervisor pulled me aside and talked to me about it. I had NEVER been talked to by a house supervisor and I had never adjusted a pump. I told them this and I was told that I should not argue and that not listening is what got me into trouble.

I was also accused of questioning a nurse on where she should or should not give an injection. There were supposedly several emails from several nurses on both my unit and the step down unit complaining about me but I never saw those emails.

Esme12, ASN, BSN, RN · Jul 18, 2012

I wonder why the nurses would be jealous of you being in nursing school. They are nurses as well. What did they say about the family not being there? Did the family say that you didn't call? Did they say you were rude?

Remember when talking to families try to remain neutral in tone and words. "Hi! xyz.....I'm calling about ABC and her discharge today? we must have had a miscommunication. I was under the understanding that ABC was going to be discharged at 123 and I feel so bad that we packed her up......... but I must have misunderstood because no one came at 567....... Could you re-verify what time you are available to pick her up? Thank you so much" I don't care if they are the biggest jerks on this earth....remember as far as they are concerned you are the one wrong. Paving the way with honey is much less painful than paving it with flames.

The second......patients and their families don't care if you are in the middle of giving birth right there is the nurses station....your issues are of no concern to them. Their family is the only family that matters. I have had families walk right into a trauma room full of medical personnel obviously busy with resuscitation a trauma with an open chest and blood everywhere and demand water for their loved one that is there for nausea and vomiting for 3 hours. Some people have no compassion NOR common sense that there might be something else going on.

Now this family I must say I was slightly less than therapeutic in my response.....but the whole room turned and shouted in unison "GET OUT" so loud I think I actually saw their hair blow back from their face.........but for the most part you need to keep it to yourself and say..."Of course, I'll be right there....."and get up. Families don't care what time it is or that you are going home. They care about their loved one. Period. Especially in this environment the family will always be right.

Try to always look at things as to how you would feel if someone said this to you and it was you father in the bed lying in his own feces. How would you feel if someone called and told you that your family "was waiting for you to pick them up when you said you would and you weren't here...... what time are you coming?" I am not saying that is what you said but always take it from their point of view.

Facilities can fire for whatever they want essentially.....even with labor laws, you are pretty vulnerable without a written contract which only unions provide (in the nursing profession). Especially during probation which is commonly 3-6 months post orientation....with a simple, this isn't working out. The only thing they need to write out is your termination and information for unemployment IF you qualify.

The path to what you really want isn't always easy.....but the trip makes it worth getting there. Try to learn from this experience and move forward towards your goals.

I wish you the very best!:loveya:

Jessicias85 · Jul 18, 2012

With the phone call situation, I never got a chance to talk to the family. They answered and I said Hi this is jessicia with ABC Hospital, (the nurse walked up to the desk) The nurse would like to speak to you regarding Mrs . X.