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I need help. =(

Hi,

I never thought I'd actually have the need to make an account on here until now. I'm a new grad nurse working at a free standing emergency room, basically an emergency room that's not connected to the hospital but at an offsite location.

Anyway, I was called into my manager's office last night and he asked me what I feel like I am struggling in. I mentioned pediatrics and he stated he was glad I said that because it is one of my weaknesses. I know that it is, as are so many other things too. I'm thankful he us giving me a chance to improve on my nursing. But here us the thing, if I don't do well on a med/surg floor for this upcoming month, they will have to let me go.

That's what terrifies me. I moved 1600 miles to where I'm at now, sacrificed my friends and family and happiness to get the experience that I need. I'm now at a loss and I'm afraid that I'm going to slip away and end up getting fired.

I have a lot to learn and I'll be working on med surg for a month. I need advice and lots of it. I'm feeling very discouraged at this point in time. If I get fired, I don't even know what on earth I'm going to do. Help me, I'm scared. =(

TakeTwoAspirin, MSN, RN, APRN

Specializes in Peri-op/Sub-Acute ANP.

It's not clear what is going on. Are they taking you out of the ED and putting you onto a med/surg unit for a month to see if you do OK there?

If this is the case, then they sound like they are willing to help you get up to speed and are giving you a chance in another department, even if you are not ready for the ED yet. Buckle down and make the most of the experience - they are giving you a chance to thrive in a different environment rather than let you drown in the ED.

It's not clear what is going on. Are they taking you out of the ED and putting you onto a med/surg unit for a month to see if you do OK there?

If this is the case, then they sound like they are willing to help you get up to speed and are giving you a chance in another department, even if you are not ready for the ED yet. Buckle down and make the most of the experience - they are giving you a chance to thrive in a different environment rather than let you drown in the ED.

Yes, I wasn't clear on that. They're taking me out of the ED to have me do training on med/surg to improve my skills. I've strictly been in the ED the past nine months and I thought I was doing well. I know I have many things to work on and a whole lot more to learn, I'm just terrified this will be the end of the road for me. I've been working so hard each and every day, go out of my way to help my team members, but still that doesn't seem to be enough. Some days can be overwhelming, especially since we do see a lot of children. Children are not my forte and I know I didn't do well in peds during nursing school. I'm going to go in with a positive attitude and soak everything up like a sponge. I have to pass this, otherwise I don't know what I will be doing.

blondenurse12, MSN, NP

Specializes in Family Practice.

Yes, I wasn't clear on that. They're taking me out of the ED to have me do training on med/surg to improve my skills. I've strictly been in the ED the past nine months and I thought I was doing well. I know I have many things to work on and a whole lot more to learn, I'm just terrified this will be the end of the road for me. I've been working so hard each and every day, go out of my way to help my team members, but still that doesn't seem to be enough. Some days can be overwhelming, especially since we do see a lot of children. Children are not my forte and I know I didn't do well in peds during nursing school. I'm going to go in with a positive attitude and soak everything up like a sponge. I have to pass this, otherwise I don't know what I will be doing.

Hmm...it sounds like poor planning on their part. Have they put you through ENPC or PALS? They should have staff that is dedicated to peds ER if they have such a high volume of pediatric patients. I worked ER for three years when I started and then per diem after that when I went fulltime to ICU. Even after all that, I would not say I was anywhere near a good pediatric ER nurse. It's really difficult, inserting IVs into those tiny veins, trying to give them medicine while they are screaming kicking and spitting at you, parents passing out.

I know it must be really scary for you right now but if you've been able to keep afloat in the ER, you can do well in med surg. It's much more predictable and you can get into a routine. Admitting and discharging is really similar to the processes of triage and discharge in the ER. Prioritizing the sickest patients and time management is more important than skills, really. Most nurses on med surg don't do much more than inserting Foleys, IVs, and NGs which you've probably been doing for the last 9 months. Good luck!

I'm confused. They are going to put you on an adult med surg floor because you're struggling with peds? This sounds like a shady transfer. Are you coming back to the ER?

You would do well to start a job search in case you can not turn it around. Not to say you should not give this your full effort, but you can not know for certain that you can convince this employer to keep you. The sooner you start looking for another job, the less you will stress about what you will do next. If you get a part time position, all the better. You will have the part time job to fall back on if this does not pan out. Best wishes.

They will have me come back to the ER when I show I'm capable of surviving on the Med/Surg. Once that happens, I'll be cross training in pediatrics. I have my PALS and TNCC. The next ENPC course isn't until July of this year.

And I agree, they should have specific pediatric nurses for those pedi patients, but it doesn't work like that down here. It's so much different than how I had seen ERs been run in California.

I appreciate them giving me a chance and not giving up on me. My manager says that I can do this, otherwise he would have just fired me if I had no chance whatsoever.

Also a little back story to where I am. I moved to a very densely Hispanic populated area, about 95% are Hispanic here. A lot of the population we see at the freestanding ED are children, most of it is simple stuff, just ibuprofen and Tylenol, but sometimes we have to start IVs on them, I'm okay with it, not the best, but I've started several IVs on babies. I guess my critical thinking when it comes to children is sub par.

Either way, I'm welcoming the experience I will get from med surg, I hope I do well.

OrganizedChaos, LVN

Specializes in M/S, LTC, Corrections, PDN & drug rehab.

That's really confusing. I don't get why they're having you go to an adult floor (especially when you state peds is your main weakness) when you work in the ER. Weird. Good luck!

Believe me, I'm just as confused as you. If I do well, they'll let me cross train on peds. =/

OrganizedChaos, LVN

Specializes in M/S, LTC, Corrections, PDN & drug rehab.

Believe me, I'm just as confused as you. If I do well, they'll let me cross train on peds. =/

It seems like if your weakness is peds, you should go to a peds floor to get some practice. I don't know, maybe I just think differently. :p

Right,? I will talk be talking to the floor manager and make mention of it to him. I'll let you know what he says, I'm meeting with him soon.

OrganizedChaos, LVN

Specializes in M/S, LTC, Corrections, PDN & drug rehab.

Right,? I will talk be talking to the floor manager and make mention of it to him. I'll let you know what he says, I'm meeting with him soon.

You sound like a smart woman, I'm sure you will do well!

amarilla, RN

Specializes in MS, ED.

Yes, I wasn't clear on that. They're taking me out of the ED to have me do training on med/surg to improve my skills. I've strictly been in the ED the past nine months and I thought I was doing well. I know I have many things to work on and a whole lot more to learn, I'm just terrified this will be the end of the road for me. I've been working so hard each and every day, go out of my way to help my team members, but still that doesn't seem to be enough. Some days can be overwhelming, especially since we do see a lot of children. Children are not my forte and I know I didn't do well in peds during nursing school. I'm going to go in with a positive attitude and soak everything up like a sponge. I have to pass this, otherwise I don't know what I will be doing.

Please take this gently, OP, but sometimes we aren't always doing as well as we think we are. A month on med-surg to work on your skills may just mean that you're lacking the assessment skills and time management of your more experienced ED peers at this time. It's just something that comes with time. No knock on you, but I can't tell you how many clogged NGs, missing or overlooked labs and unfinished stats I've received from new(er) nurses who handed them off to me without even mentioning what was undone. While I try to mention these things as they come up, not everyone does and I've seen new(er) nurses blindsided by complaints later on when they otherwise thought they were doing well. Sometimes you just don't know what you don't know. Not saying this is the issue in your case, but try maybe to get some specifics to work on from your manager before you go to the floor?

Last thought: make contacts while you're on the floor, in case this isn't just for a month. You'll want to be able to keep a job - even if it's not the ED - rather than be let go entirely. Best of luck.

Thank you for that. I got clarification from my manager and the things he wants me to work on are time management, prioritization and team work. I thought I had been working on all of that and I know I need improvement. It's not something that can happen over night. I am a new grad and I have loads more to learn and I do learn, every day.

Where is this... El Paso?

You said "down there," 1600 miles away, and 95% hispanic.

That doesn't seem very specific... sometimes people on here who are almost let go are very specific with what they did wrong. Are you just slow in the ER?

I'd also start applying for other jobs, just in case they do let you go.. you'll have 10 months experience (almost a year) to help with that. It's always good to have plan B,C, D... and so on. :) Good luck!

Not El Paso, I'm in McAllen, Texas. The thing is I'm not slow, I'm pretty quick when it gets to getting things done on patients. The only set back I have is when I'd need to do everything for a patient that is a baby and there is no one around to help keeping the baby steady, or even with translating Spanish so the parents understand what I am doing. I can simply tell them that I'll be drawing blood and starting am iv, but explaining it's not pleasant and it's scary is a whole nother ballpark.

I'm going to try my hardest with this med surg floor, I have to excel, and I hope I do.

OrganizedChaos, LVN

Specializes in M/S, LTC, Corrections, PDN & drug rehab.

Not El Paso, I'm in McAllen, Texas. The thing is I'm not slow, I'm pretty quick when it gets to getting things done on patients. The only set back I have is when I'd need to do everything for a patient that is a baby and there is no one around to help keeping the baby steady, or even with translating Spanish so the parents understand what I am doing. I can simply tell them that I'll be drawing blood and starting am iv, but explaining it's not pleasant and it's scary is a whole nother ballpark.

I'm going to try my hardest with this med surg floor, I have to excel, and I hope I do.

Yikes, you're in McAllen! I worked in Robstown & people told me I needed to learn Spanish. I should've but I quit my job. :p

Yea, I think that's my main problem is that my Spanish isn't up to par. It's a huge setback for me, I think. That's what stalls me the most when it comes to care for the patient. I can explain simply, but when they start asking questions, which is fine, I know they'll need more information than what I can give them. That might put me behind, way behind on my time management because now I'm having to find a nurse who speaks Spanish so they can help the patient. This happens more than once in a day. My Spanish today is way better than it was 10 months ago.

OrganizedChaos, LVN

Specializes in M/S, LTC, Corrections, PDN & drug rehab.

Yea, I think that's my main problem is that my Spanish isn't up to par. It's a huge setback for me, I think. That's what stalls me the most when it comes to care for the patient. I can explain simply, but when they start asking questions, which is fine, I know they'll need more information than what I can give them. That might put me behind, way behind on my time management because now I'm having to find a nurse who speaks Spanish so they can help the patient. This happens more than once in a day. My Spanish today is way better than it was 10 months ago.

Lol. I know the problem. I had to find another nurse or CO who spoke Spanish. My Spanish was never good so if I didn't know the word I had to act something out or we just stood there staring at each other awkwardly. Lol. Oh the fun.

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