I need help. =(

Dexterosa · Mar 26, 2015

Hi, first of all I keep fingers crossed. It has to be very stressful for you and I just imagine, I would not be able to focus on anything else. But, in my opinion - they are not pushing you away, they are giving you a chance, that is great news! I would take it and try to do the best out of that. Focus only on the patients and the work. I do things the way that I come to work early, I try to find out what is my assignment, I check telemetry strips to see what is going on with my patients. I check all information in charting in pc or in paper and what was ordered and try to paint a picture what is going on. When you wrote time management but you are quick with patients, then what is it what makes you fall behind? Spanish? Then tell them you are not fluent, you need to do blood draw, and you let them know as soon as you can if it is good or no. Don't pressure yourself with you have to be outstanding. No one expects you. Just do what needs to be done and keep learning. You will become outstanding eventually. I wish you the best of luck!

MissyERnurse · Mar 26, 2015

Thanks you guys so much for all the wonderful responses. You're giving me the confidence I need in order to excel in this! I know I can do this. If I can manage during stressful busy tines in the ED, I know I can manage the med surg floor. I'm now a sponge and will soak up all the information they will be giving to me these next few weeks. I will work as hard as possible as if my life depended on it.

I have never been written up, only gotten verbal warnings. I have not had any med errors or procedure errors either, I'm pretty proficient with administering meds and if I have a question I always call the pharmacy and verify with the MD. So this has come as a shock to me, but I've been there almost 10 months, so I'm doing something right. I'm glad they are giving me a chance to redeem myself. I'm just hoping what I do will be enough to keep me here. I fully intend on applying to other positions back home and hope I get something there. My family is supportive and will welcome me home with open arms.

I just hope the hospital is not setting me up for failure.

brandy1017, ASN, RN · Mar 26, 2015

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.

Hospitals are required by federal regulations to provide language interpreters so why don't you have access to them when you are caring for the patients?

Gooselady, BSN, RN · Mar 26, 2015

Thanks you guys so much for all the wonderful responses. You're giving me the confidence I need in order to excel in this! I know I can do this. If I can manage during stressful busy tines in the ED, I know I can manage the med surg floor. I'm now a sponge and will soak up all the information they will be giving to me these next few weeks. I will work as hard as possible as if my life depended on it.
I have never been written up, only gotten verbal warnings. I have not had any med errors or procedure errors either, I'm pretty proficient with administering meds and if I have a question I always call the pharmacy and verify with the MD. So this has come as a shock to me, but I've been there almost 10 months, so I'm doing something right. I'm glad they are giving me a chance to redeem myself. I'm just hoping what I do will be enough to keep me here. I fully intend on applying to other positions back home and hope I get something there. My family is supportive and will welcome me home with open arms.
I just hope the hospital is not setting me up for failure.

You are explaining everything perfectly clearly. I was going to ask if you could give a specific example of where you are supposedly having trouble with peds. Then I read you've made no med or procedural errors and need to work on your Spanish.

What you are describing, IMO, are some unusually high standards of expectation, that may not reflect your actual 'deficiencies'.

It's a possibility, anyway. I admire your continued willingness to improve, your refusal to take a 'victim role', and your perseverance! So far, you sound like a remarkably talented new-ish nurse in a job role that any experienced nurse would struggle with. I'm not saying your management is definitely being too hard on you, but it is a possibility.

Not a possibility that you need take all that seriously. Just keep it in the back of your mind.

It sounds like your limited Spanish could be a focal cause for most of your 'issues' as described by your manager. Apologies if it's already been mentioned, but in your 'spare time' (ha ha) try and get some conversational/medical Spanish under your belt. Make it a game where you try to 'think' in Spanish, speak to yourself in Spanish at home, speak to your pets in Spanish, listen to Spanish books on audio, immerse yourself in it. Find a Spanish-as-second-language group to participate in.

It can only help you with your new med-surg adventure, besides :) I'm not clairvoyant or anything, but you SOUND like you are gonna be FINE. This is just a rough patch that your superb attitude will get you through :)

MissyERnurse · Mar 26, 2015

Thank you for the advice. I had never thought I needed to be fluent in Spanish in order to keep my job. I always learn new words every day in Spanish and I can pretty much get the information I need from a patient. I'll have to look into taking Spanish again. I kind of already have a second language I speak fluently that I don't want to lose at all, but I have to do whatever it takes to get to where I need to be.

I think their expectations are a bit too high being that I am a new grad. I keep thinking back to everything I have done so far and just trying to figure out where on Earth I went wrong. I've worked so dang hard and even taken certs in a timely manner too. *sighs* I'm just so shaken by this and having no support system here makes this all so much more difficult.

I've had stuff hit the fan on me before in my life many times in my life and I've always pulled through. I just hope that I can this time around. At least make it to one year and apply back to California. This place is consuming me and I don't know how much more I can take of being here alone.

jadelpn, LPN, EMT-B · Mar 26, 2015

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.

I may be old and jaded, but seems to me that Med surg is stuck and wanting a temporary nurse. If this is a freestanding ED and not affiliated with any hospital, then this is just an odd situation.

Never the less, are you going to see many kids on Med Surg? Perhaps a stint in a local pediatricians office would be more helpful to you?

Going forward, don't emotionalize kids. It is not easy. Especially when they don't feel well. Ask for parent's support as much as possible. Or make yourself one with a tech that can help. If you are giving meds, Mom and Dad can assist. If you are starting IV's you need a holder, and I also am a huge fan of bundling in a sheet. You should not have to do this alone. I personally don't mind drawing labs on kids--if there is a tech who does that well, use them.

Otherwise, I talk their ears off, and do what I need to do. I give stickers, high 5's, make the kids part of the process. I sing the sponge bob song......anything that I can do to distract, direct, make them do what I need them to so that they can begin to get better.

And I am frank with the parents. "We need to____________. How would you suggest we do this? I am thinking that we could______________. I know that doesn't sound great, but it is important that your child not move while I am ______________/take all of ________medication."

Lots of communication. You can take medical Spanish at local community schools, online....and there always should be a translator either by phone or in person. Most places that is mandatory.

Best wishes!

asantewaa13 · Mar 26, 2015

if I don't do well on a med/surg floor for this upcoming month, they will have to let me go.

Or.......... You work hard and make the best of the med-surg experience you have been given, form some amazing relationships... and you do so well?..because that is another side of the coin:yes:. Please don't weigh your self down with dread and worry about a job loss that has not or may not happen.You are a capable person with great potential and it seems your manager sees that too .So think positive and do your very best! ((HUGS))

MissyERnurse · Mar 26, 2015

Update: Doing well today on med/surg, they have me only with one patient to familiarize with the computer charting, but I'm going above and beyond, passing meds to all six of the patients my preceptor has, and documented two shift assessments rather than one. It's much different here and I have a feeling, a good feeling that this will be a good match for me. I feel less stressed over here and I don't have to constantly answer for myself and be baby sat, so to speak. I think this will be a good thing. =) And if they ask me to stay over here, I'd be very okay with it. We shall see.

Mr. Murse · Mar 26, 2015

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.

Honestly, I really don't know why hospitals are putting new grads in ICU's and ER's right out of school, unless it's just out of desperation. Sure, there are many new grads that do ok, some even excel, but as a rule I think nurses that have med/surg experience do so much better when they eventually do move into more fast paced, critical areas like that. I'm certainly glad I worked my surgical floor for a few years before moving to the ICU. Not that I couldn't have handled it, but I feel like I have a much more solid and well rounded foundation.

NurseSpeedy, ADN, LPN, RN · Mar 26, 2015

Honestly, I really don't know why hospitals are putting new grads in ICU's and ER's right out of school, unless it's just out of desperation. Sure, there are many new grads that do ok, some even excel, but as a rule I think nurses that have med/surg experience do so much better when they eventually do move into more fast paced, critical areas like that. I'm certainly glad I worked my surgical floor for a few years before moving to the ICU. Not that I couldn't have handled it, but I feel like I have a much more solid and well rounded foundation.

I agree. Also, by working the floor first before going into a specialty it helps with organization skills (as well as clinical background with more stable patients). The areas that I worked (one staff, others agency) it didn't matter where you normally worked, if your unit was slow then they floated a nurse. I would have died if I was used to having two, maybe three ICU patients and then got sent out to tele/med surg to face 10 patients on days (It usually wasn't that bad. The hospital I was working at had some serious staffing issues for a bit of a stretch but that was our reality for a few months). I felt bad for those who weren't used to the ratio that got the unlucky straw to come join us in our misery during that time (I don't care how organized a nurse is, that ratio is NUTS!).

amzyRN · Mar 27, 2015

You'll learn a lot on the med/surg unit and I'm glad you have such a positive attitude about it. Med/surg will give you an opportunity to work on time management and priority setting and your priorities won't change as fast as in the ED. Plus you'll get to work on skills in a slower paced environment and hone those skills so that you have more ability to do them at a quicker pace in the ED. You'll also gain confidence and won't second guess yourself so much. In my opinion, unless the ED has an excellent orientation program, it would be hard for a new grad to survive unless they had some prior experience in the ED. You'll get more clinical intuition by having a little more experience under your belt. The new nurse "doesn't know what they don't know" until they get some real practical experience. That lack of knowing is tough in the ED and better suited to a more predictable environment in my opinion.

MissyERnurse · Mar 27, 2015

I had 6 years EMT experience, which is why they hired me initially. But I'll take any experience I can get. Every day is a learning experience for me and I soak it all up like a sponge. I love to learn and I always psyche myself out prior to doing something new and end up excelling at it. =)