I do not think I am a good nurse

underpaidrn · Oct 5, 2007

First of all, I think you are going to have to explain a bit more when you say your nursing skills were called into question. How much experience do you have? Are you a new nurse? Where do you work? It's hard to help if you don't have all the info. You are reaching out for help, but we don't have much to workk with. Can you give some more info to us? We really care and want to help you through this.

SuesquatchRN, BSN, RN · Oct 5, 2007

First of all, I think you are going to have to explain a bit more when you say your nursing skills were called into question. How much experience do you have? Are you a new nurse? Where do you work? It's hard to help if you don't have all the info. You are reaching out for help, but we don't have much to workk with. Can you give some more info to us? We really care and want to help you through this.

:yeahthat:

I'm feeling insecure, too, lately. Share.

Music in My Heart · Oct 5, 2007

You say that you do not think that you are a good nurse. You also say that your skills are being called into question (by others?).

Certainly more information is in order.

Why do you believe that you are not a good nurse? Is it based on your own assessment of your skills, judgment, knowledge, and attitude or is it something that you're being told (directly or indirectly) by others and choosing to believe?

Many of us (people, not just nurses) tend to be our own harshest critics and hold ourselves to standards that we'd never expect of others. On the other hand, you know yourself better than does anybody else so if you think that you're not very good at it then you should really explore that.

Perhaps you can become a better nurse through additional academic study, time-management workshops, mentoring by a good nurse who wants to mentor, attitude adjustment, skills practice, etc.

I'd encourage you to share here because the anonymity can be very helpful but do realize that you may get some replies that come off as harsh so be ready for 'em.

Regardless of the situation, I think you'll find far more support here than you will criticism and judgment, though.

RN1989 · Oct 5, 2007

I am concerned that you say that you were slamming doors because you couldn't start IVs or draw blood. Not only is slamming doors at work unprofessional but it sounds like this is what tipped anyone off to you having some problems.

Your posting gives me the feeling that you were having anxiety over working in a new environment. Oncology patients are notorious for having bad veins and can be extremely difficult to start an IV or draw blood from. That is why most of them have implanted ports or catheters placed. So not being able to do those things is not the end of the world. After all, 3 years of nursing on a surgical floor does not mean that you are an expert at everything yet.

You said that you were on orientation yet you don't mention a preceptor. At the very least you should have had a resource person to go to. Where was this person and what were they doing to try to help you? Did they just orient you to where the supplies and bathroom were and then leave you to fend for yourself because you weren't a brand new nurse?

There seems to be some things missing here. I think you have gotten so upset over everything that you haven't looked at all the angles here. I can understand that you would be called on the carpet for door slamming, with some counseling, perhaps instructed to take an anger management CE, along with a note in your file. But I feel like something is missing. Either there is more to your actions that you haven't told us, or they did/didn't do something that you haven't told us. Generally you aren't sent home and awaiting an ominous decision for one infraction.

Get yourself together and review the last 4 days at work. Write it down so you can look at it and see what has been transpired. Have you harmed a patient? Have you made mistakes? What were they? Could there have been a systems failure that led to these errors? What kind of orientation were you receiving? What was said to you by the staff? By the patients? This incident doesn't mean you're a bad nurse. It does merit some investigation on your part. You need to step back and look at things more objectively. We don't have the whole story from you and it sounds like there was a lot more going on than what we know or even what you realized was happening. So relax. Be calm. Don't make any rash decisions until you have reviewed things, preferably with a third party so that they can give you some insight that you might not have. Don't make any decisions until you think things through - even if HR pressures you. Tell them nicely you need to discuss this with spouse/parent/etc. We will be here waiting should you choose to give us any more information so that we might better help you.

Altra, BSN, RN · Oct 5, 2007

I don't doubt that you had a rough night. Where was your preceptor? Or the charge nurse?

Slamming doors is one indication that a person may be losing control. Were you sent home immediately following this, or notified later of the one-day suspension?

I wasn't there so I can't really evaluate what went on. But suspension is several steps up from a first-line response to an infraction. Whatever occurred, it is being taken very seriously and I do not think there will be a lot of slack given to you in the future.

You yourself seem conflicted about this, stating "I do not think I am a good nurse." You don't seem to be disputing the fairness of the harsh step of immediate suspension rather than a verbal or written warning.

You'll need to think about whether inappropriate emotional responses to stress have been a problem for you in the past or if there are other things going on in your life right now that are ramping up your stress level.

Good luck to you.

pmw2007 · Oct 5, 2007

I did not know I was slamming doors and I would never slam a door on purpose! I did not think I was doing as badly as I was informed I was doing. One of the complaints was that I kept slamming doors- I said slamming doors? I did not slam doors- and the HR person said: that is not going to cut it obviously you were-

A little later I said the only time we shut doors was night before last- we had a fire drill- I honestly do not think I was doing as badly as they say. They allowed me to pass meds, do assessments- I do not understand- We were being inspected at the time by the big guys- so I know everyone was stressed out. But that is a great idea- I am going to review my night there. I think alot of my problem is confidence and having a hard time at a new place. I should have stayed at my other job - isn't that awful- allowing personel defects to dictate my life- I can not believe that I am scared like I am. Thank you-

RN1989 · Oct 5, 2007

I don't think you have personal defects that are dictating your life. So often people perceive our actions, words, body language in a completely different context than what we intended. Since these people don't really know you, chances are there were some communication issues. Don't let this experience define who you are, especially in a negative context. Learn what you can from this. If your body language gave them the wrong impression, then you need to be aware that this happens and what you need to do to prevent that wrong impression.

Being the new person on the floor is really difficult to start with. Oncology is sometimes worse. Many times the patients are repeats or longtermers and the nurses get very attached to the patients. The patients become dependent on certain nurses and they don't think that any other nurse is good enough. And the nurses start acting like no other nurse is good enough to take care of their special patients. The staff frequently aren't aware of this bias, but I have seen it many times. Things like this can definitely play into interactions with a new person. If you didn't have issues at your old job, then it is likely that you stepped into this "club" without realizing all the intricacies and nuances that go on. Think of it as being the new girl in school and trying to find where you fit in.

It hurts your heart when this stuff happens, especially the first time. But don't let them make you feel as though you are a bad nurse. Unless you purposely kill someone - you aren't a bad nurse. We all have things we need to learn - sometimes the things we need to learn are about ourselves. But that doesn't mean we are bad, it means we are human.

Altra, BSN, RN · Oct 5, 2007

Again, how closely are you working with your preceptor?

It's important that analyze your situation logically and dispassionately. An emotional response is, "why did I do this, I'm so upset, why is this happening" etc. What is needed right now is "when X happens (unsuccessful IV start, whatever) I have reacted by Y." Then you need to ask for help to avoid the Y reaction.

Are there specific skills you need to practice? Do you need some additional orientation to your physical surroundings - where supplies are kept, etc. Do you need to be assigned to fewer patients right now?

These are things you need to address with your preceptor. Be prepared to contribute in a concrete way, i.e., don't just say, "I don't know where to find things" -- ask if there is a PAR list or other printed resource you can refer to, or ask for time to physically walk through the unit & make whatever notes you need. Instead of "I can't get these IV starts" suggest, "can I spend a day with an IV team nurse for additional practice?" Suggest a steady progression in your patient load -- 2-3 patients this week, 4 next week, etc.

As for the body language issue ... has this been an issue for you before? There are very, very good nurses who are at both ends of the "warm & fuzzy" spectrum and everywhere in between. Ask for specific feedback.

underpaidrn · Oct 5, 2007

I did not know I was slamming doors and I would never slam a door on purpose! I did not think I was doing as badly as I was informed I was doing. One of the complaints was that I kept slamming doors- I said slamming doors? I did not slam doors- and the HR person said: that is not going to cut it obviously you were-
A little later I said the only time we shut doors was night before last- we had a fire drill- I honestly do not think I was doing as badly as they say. They allowed me to pass meds, do assessments- I do not understand- We were being inspected at the time by the big guys- so I know everyone was stressed out. But that is a great idea- I am going to review my night there. I think alot of my problem is confidence and having a hard time at a new place. I should have stayed at my other job - isn't that awful- allowing personel defects to dictate my life- I can not believe that I am scared like I am. Thank you-

Thanks for sharing with us. You have been given some good advice here. Please take a step back and review carefully all of your actions. Perceptions can get many people in trouble. Review your body language. Work with a counselor for anger management. There have been times when I've been so angry I could scream, but I didn't. We all screw up at times so hang in there and listen to what these good nurses are telling you. Good luck.

nurz2be · Oct 5, 2007

I could use some input, advice, opinion or thoughts on the matter-- it appears I have made a mistake with a career change- My nursing skills have been called into question. This is very traumatic for me and I have never been through a situation like this before. Any thoughts?
OK- I graduated in 2004- so I roughly have 3 years experience which should be enough- I worked in a surgical stepdown unit- and I liked it- I decided I wanted to work Oncology- to learn it- So I applied for a position and I was starting in it. I was orienting- 4th day with patients- I could not start an IV or draw another persons blood and I was slamming doors- Anyway HR suspended me for a night and we met the next day with the manager and she was concerned about a number of things- -- my body language around the patients- I do not act very self confident and the patients can tell- I am upseting the patients- and they questioned how I ever nursed prior to this. So the big guy from HR is calling me today to give me their decision- - I feel like they think I have broken the law- I don't know what is going on and I am scared- Does this she more light on it?

First off I would say that slamming doors is definitely not a professional way to deal with frustrations. That can easily be taken care of with an apology. The next thing I would say to you is that you HAVE to be your own best advocate. That doesn't mean you should be over-confident of your abilities to the point of exaggeration, but you should be able to voice your abilities and areas you need work on, we all have that.

My aunt is a oncology nurse, I am a nursing student, I asked her about "normal Oncology patients." What she told me is that, for the most part, they are older, the ones she works with, the are dehydrated from the chemo and their veins are horrid. They actually have to go through a 1 month training with the hospitals Pediatric IV team before starting IV's on these patients. She also said that these patients nerves and patience, for obvious reasons, are nearly non-existent. The nicest people get bitter and almost mean when they are faced with these issues.

My advice, as much as it's worth, is to REALLY evaluate yourself. When you go before those people you need to be able to say to them that you are capable and that you were just overwhelmed and didn't handle the situation correctly. You would be willing to take classes or direction on IVs from someone more experienced with these types of patients. Offer to do stuff to resolve this BEFORE they tell you what you HAVE to do if you want to keep your job. This will show them that you are reaching out and that this is and your patients are important to you.

Good luck.....

SarasotaRN2b · Oct 5, 2007

I hate to say it, but perhaps Oncology isn't for you. To me that would be an extremely stressful department to work in. Do you think that you would be able to go back to your old unit?

Kris