So I moved for a job 300 miles away from home...this was my first nursing job...I have no prior hospital experience,this was a big change for me but I was also quite excited (it took me nearly 6 months to find a job)...well the position I found was in a private teaching hospital on a telemetry floor...very nice unit,nice people I guess you can say a dream job...I was happy despite being far away from my hometown and my family,friends and a boyfriend..When I was first introduced my preceptor she appeared to be nice and pleasant but also had that look about her that told you "be aware of her she might smile but she looks tough" Well at first she was nice and enouraging,telling me when she first started working on this unit she felt overwhelmed and she didnt know a lots of meds etc..so I thought that she was humble and "cool".Then fast forward to a day when she asked me to give an IM injection in the arm (flu shoot) Ok so I graduated from a ADN program and we didnt get any experience in a flu clinics during our school so I asked her if she could demonstrate an IM injection on a patient just this one time for me (since I never had given an IM injection in the arm before) Mistake number one!! She got upset and was "shocked" that I never gave an IM injection in the arm...then she told me straight up to my face "that I must come from a lousy school" That day she went into manager office and told her that my school didnt prepare me well enough for the real world,strike number one....then she went ahead and told everyone on the floor that I dont know anything...oh and she also asked me "if I like it over here and if I ever though about transferring?" Mind you this was my second week on the floor!!! But despite being discouraged I kept going and showing up every day one hour earlier before my start time....It is worth to mention that my preceptor never discussed our patients with me,never asked my opinion,what was the plan for the day etc,during lunch never spoke about our patients,nothing....I often had a feeling that she "was bothered by questions and I was hesistant to ask questions and I often felt discourage to ask questions or even scared at that point! Well then came strike number two,patient had a low blood pressure and she asked me to take his bloood pressure manually,so I put on a cuff on the patient inflated the cuff but for the life of me I couldnt hear a thing....so anyway since the patient was unstable and she was in the room with me I told her if she could recheck for me since I couldnt hear anything....she did..Later I realized that my stethoscope somehow got turned off,but I guess it was too late cause she run to the manager office and told her that she doubts that I can handle unstable patient,so later that day my manager call me and her to the office for a meeting.....the manager voiced her concern to me with the preceptor backup,the manager told me that according my preceptor I'm not meeting my goals and she is giving me one week to improve (I should have known right there and then I was going to be terminated in the near future)..so I tried my best the following week,yes I did my share of mistakes (nothing major,nothing to do with a patient safety)...all of the sudden (that week) my preceptor started to take interest in me....asking me which patient I think I should go see first,what did I think the plan for the day was for each patient...asking me did I check my labs etc??? I swear to you she never bothered to ask me that before...I guess she got scared after the previous meeting with the manager...So like I was saying that week I made some mistakes but also I caugh a lot of things (like inflitrating IVs,patient pulling out IVs,pressure ulcers) my skills were getting better,I was gaining more and more confidence and started to feel that I can do it....still had some trouble with prioritizing but I think that is expected of a new grad,unfortunately not on this floor..well fastforward to yesterday (sunday)...very busy day,my preceptor was a charge nurse and one of the nurses overslept and she had to take care of her patients so she left me with 'our patients" well I handle my patients quite smoothly,finally felt like a real nurse and went home with a light heart and happy that things finally are coming together for...hah what a dillusionment of my part....today monday my manager calls me home in the morning to come in to see her ( I was suppose work a night shift today with my preceptor)..I have a feeling that something is wrong...so I go with a heavy heart...the human resource person is there,all of the sudden I know I'm getting fired...so the manager tells me that she doesnt think I'm a good fit for this floor,that she spoke with my preceptor friday and she still thinks I have trouble prioritizing...I'm crushed I'm trying to explain that I'm a new nurse and that comes with an experience and that there is always someone there to help...but my manager is set on her mind...she tells me that I should go into med surg first and then maybe after one year reapply if I want (is she ******* kiddding or what??)..I almost burst into tears,yep,signed the termination papers and left...yep so that is my story what do yo think?
wow! sorry to hear that. look for another job. you should be able to collect unemployment. everyone else is. if you are uncomfortable performing any type of procedure, or being your first time, you have the right to inform your higher up for assistance . nursing practice . don't let this job scare you in performing any other task. you will find something that you will be happy in. collect your unemployment.(lol) best of luck to you.
I think the OP is understandably upset, and sometimes the written word on a message board may not adequately convey 100% of someone's intentions or ideas, so I tend to give some leeway.
Being a brand new nurse is difficult, both mentally and physically. Regarding responding in a stressful situation, there is no way to actually LEARN this skill (and it IS a skill) until someone has observed it, assisted during it and then graduated to performing independently. You don't get dropped from the womb knowing how to function like this.
Honestly, I would rather have a new grad be a bit timid and err on the side of caution. I have precepted; I can build confidence, provide experiences and guidance. I can't teach away a bad attitude. I can't help someone that nods their head at me when I counsel them on how to do something, then proceeds to go ahead and do it their own way ultimately doing it completely wrong. I can't help someone that has a complete lack of critical thinking skills which cause the same errors over and over even though we've discussed it previously.
I expect a new nurse to "freeze up" sometimes, that's why I'm there to help! Critical thinking skills are a work in progress, I don't expect them to be perfect to begin, they are a lifelong learning project, sharpened with years of nursing wisdom. Passing the NCLEX basically tells me that someone is likely to not kill someone, but it's not guaranteed. I have had very bad experiences with overconfident know-it-alls that tell me how great their clinicals/schools/they were. Notice the word "were" in that sentence. They don't last long because they either couldn't learn from their errors or just plain couldn't get along with Mother Theresa herself.
Lastly regarding the stethoscope situation...we've ALL done it, some just may not want to admit it. It takes us all just once and a healthy dose of embarrassment to remember to always check for that problem when we are troubleshooting our equipment. Congratulations, you'll never do that again!Orientation is the time to learn from your mistakes. And, no matter what anyone tells you, every nurse makes mistakes even when they are no longer on orientation.
Okay, don't take offense, but here goes. Please bear with me:
I would be shocked too, if a new grad had never been taught IM injections in NS. IM is a route of medication administration that falls well within RN scope of practice. Having said that, it is not your fault if your program did not prepare you for this, and you were correct to speak up that you had no experience with it.
With the unstable patient, your inability to take a blood pressure no matter the reason would have stood out to me as well. Obtaining VS is such a basic nursing task that unlicensed assistive personnel do it as part of their normal job duties. If I were precepting a new nurse and had an unstable patient to deal with, and all I asked of the new nurse was to get a BP and they couldn't even do that for me, I'd have some concerns too.
Difficulty with prioritizing is definitely normal for a new grad, so I wouldn't hold that against you as a single factor. But, combined with other things, it can be part of the bigger picture.
Stating that you think med/surg is harder was a mistake. You're free to think whatever you want, but the things that come out of your mouth do influence what your preceptor and your team mates think of you as a nurse and team mate. There is a reason patients are on telemetry. While many of them are not nearly as physically demanding and don't have as many medications and treatments as your typical med/surg patient, the risk of becoming unstable is real enough that they require continuous cardiac monitoring.
Hiring a new grad with no hospital experience into a tele unit was poor hiring practice, IMO. That is not your fault.
This type of environment is very much sink or swim. If you are not swimming reasonably well after a woefully short and inadequate orientation, then one should not be surprised to be let go. Is it right? No. Is the "sink or swim" approach good for patient safety? No. But it is the reality.
Pick yourself up, dust yourself off, and get back out there and find a job, knowing you gave it your best. But, I suggest you find something more entry level and get some experience under your belt.
Best of luck to you!
I agree with everything you said except the part you said hiring new grads into tele is poor hiring practise. I started in tele and turned out just fine.
Blackheartednurse,
I also completed nursing school without giving an IM shot so don't feel bad. I learnt how to do it in the learning lab but no opportunity ever came up for me to do it despite the fact that during clinical I spread word to all nurses to let me do any IM shots that they had. But during orientation we had a different system at my hospital. The first month was about floating to all departments with a different preceptor and having the feel of it all then this was followed by the 5 week orientation on your home department. My first IM shot was in the ED, on a sick coworker that came to ED...yikes. My ED preceptor was those sarcastic, mean people who turned out to be a cool friend after that day. I told her I never gave an IM shot and she was like damn what kind of nursing school is that. That hurt my feelings but I turned it around and made a joke out of it and said well its one of the most prestigious schools in the state but I guess we were too many to each get a chance to give the IM shots.
Well I knew how to give IM shots just never gave it on a person. She gave me the vial and the needle and the MAR and left to go attend to some emergency, I quickly reviewed my IM steps and off I went to the patient's room. I did my rights and gave the shot. Later she asked me...was it that bad?I was like mmmhhh actually not. And my coworker said that was the best shot she had:yeah:. Point is you can turn a bad situation into a good one like you could quickly go over the steps with her and ask her "Ms XYZ I think am gonna do it in the deltoid" and use your body to point out where and how you are going to do it and then ask her to come watch you.
Humility is key to learning. Thats one thing you need to keep in mind while looking for the new job. And watch what you say. You may not agree with what they are telling you but you don't want to be mistaken for a rebel either. Once you are on your own with lots of experience and therefore indispensible then let your self out. And no, med-surg is not harder that tele. I work tele, I know what am talking about. Those med surg patients that were brought to your floor were brought there for a reason.
Don't be defensive with preceptors but in a nice light hearted way let them know when they wrong you or disrespect you.
Lunch time is lunch time...nobody wants to talk about their patients at this time. It break time!
I think your preceptor was a little weird though, because a good preceptor should discuss patients with the preceptee at the begining of shift for example the plan, labs, possible discharge, abnormal vitals etc.
Don't give up, it time to reflect on yourself as a person and see what you could have done different.
I still thank God for my preceptor, he was the best thing that happened to me and we are still best friends.
i really dont think that your preceptor was a "back stabber". (watch what you say, seems that you need to check your attitude..remember this is a "profession") you also have to remember that you are dealing with peoples lives... and that if you cant take a simple bp reading how would you react or handle a situation that actually required critical thinking and application of that skill?? i am only in my second semester of an adn program and from what you described i feel more advance than you?? so something is not right there? i hope dont dont take this the wrong way, but you need to remember to be a nurse takes alot of skill...(yes most comes with time) but you should still have a solid base line.... you are dealing with lives... not dummies like in school!! ekk... i hope you find your zin ... much love
you are only in your 2nd semester of nursing school and you think you know it all? you sound like you will be one of those stubborn new grads. please finish school first, pass nclex and start your orientantion then come back and talk to the poster with this kind of attitude.
Yeah and you think you will be a fabulous nurse who knows everything and will never make a mistake,good luck to you!!! Just dont be surprised when you come here to whine about your preceptor screaming at you for doing a head to toe assessment...but then again something tells me that you and my preceptor would get a long just perfectly.
Ps..thank you for a good laugh:lol2::lol2:
Your instinct to make retorts like this is one reason why you no longer have a job.
:lol2:
tobesmartt
135 Posts
wow! sorry to hear that. look for another job. you should be able to collect unemployment. everyone else is. if you are uncomfortable performing any type of procedure, or being your first time, you have the right to inform your higher up for assistance . nursing practice . don't let this job scare you in performing any other task. you will find something that you will be happy in. collect your unemployment.(lol) best of luck to you.