This is actually my second year as a nurse. I was working at a LTC/SNF for a year. The whole time I dreamed and pray of a job at the hospital figuring I need that 1 year of med-surgical experience. I finally got called for a job in a big hospital here. I felt really excited at first. However, I finally know now why they say nurses eat their young.
I got a really awesome preceptor during day shift. However, I was schedule for night shift so I had to get a preceptor at night. this preceptor is fairly young around my age and has been a nurse the same amount of years as I. However, she has been working in the hospital the whole time.
I really feel stress out and overwhelmed. My old job was a lot of physical work but less mental stress. This job is a little less physical work but 2x the mental stress.
My preceptor told me that my charting is falling behind. She told me that I should be done charting around 10pm and that each assessment should only take around 5 to 10 minutes. Last night I had 6 patients. I literally was on my feet from 7pm (beginning shift) to 2 am passing meds. Then I got a small break ( I didn't want to because I wanted to get everything done but she insisted I have one. She told me that orientees should get 30 minute break so the hospital wouldn't have to pay). Anyways she said I should only focus assessing on the reason why the patient came to the hospital. In my head I figure how can you assess a person in 5 minutes without taking your stethoscope out and listening to their heart, breath sounds, and bowel sounds. You should check them from head to toe. There is no way she could assess those patients in 5 minutes. I never see here pulling her stethoscope out or even checking the patient feet. She told me I miss two medications for a male patient so she pulled the medication out. I was so tired that I didn't even check the name on the box. Luckily the computer caught it and pop up a warning sign saying this medications wasn't in the patient MAR. I went back and told my preceptor. She made me look like a total fool. She said well first of all its the wrong name. Well she should of looked at it before pulling it out and at least tell me it was for the right patient.
Most of the nurses at night pulls their computer to the nursing station to talk to each other and chart. I mean how could you possibly chart on the patient if you are not using the bed side computer. Then they drink their coffee and sleep. I literally saw one nurse slept throughout the whole shift. I was basically on my feet from 7pm to 2 am. Then got a 30 minute break and walked around till 9 am (Stayed over almost 2 hours to get things done). I had to hold my pee in until I got most of the medication and charting done at 2 am. I also heard my preceptor telling other nurses at the nursing station that I'm not up to par. I walk really fast and quiet so they don't know I'm coming up and I could hear them. Then they get quiet. I also talked to other 2 orientees and they also heard their preceptor talking about them. One of the orientees told me he overheard a preceptor for another orientee stating, "Oh gee, I have this person today (not mentioning any names), I'm going to be here till 9 at least." My friend heard his preceptor telling other nurses (Man this guy is too slow). Luckily the charge nurse is very cool and nice. I just don't know how they find that much time to sit down and chatter while I'm on my feet giving meds. I do my assessment while giving medications and at the patient bedside.
I don't think I'm meant to work in this environment. The turnover rate is extremely high. The longest one orientee work there was for 2 years. I'm just really stress out basically walking from beginning to end of shift and still hearing from my preceptor how I miss this and that. She basically sits and text on her phone then call me on the hospital phone to come check on a patient pump or that she need me to do something.
The sitters and CNA gather in one room and use the patient bedside computer. I had to chart and scan a patient. However, I was new and I didn't want to bother them so I just pull my computer in and even have to navigate through them to scan the patient and medication and do my charting while they look up houses and see if they could look up their background online.
I'm ready to quit. Its almost 2 months, and I don't think if I will be happy in the long run. I was happy at my old job and love my patients and want to go work. However, this new job almost made me cry and I'm a guy. I'm just afraid that I will lose my license at this job. I don't know if it would affect me finding another job. i was able to go to school fulltime and worked at my old job. I got my BSN this December. My old manager is also at a new LTC facility and told me to come work for her so I will probably do that. Any advice guys? Sorry for the grammar and mispelling. I have been up for 15 hours.
Write a letter and send it certified, return receipt requested. You will have done what you needed to do and no longer have to be concerned with talking to them and getting upset by them.
A full head-to-toe assessment is not always necessary nor warranted every single night. There are times when a quick focused assessment will suffice. Focus your assessment on the reason why the patient is in the hospital.
I've said this before and I'll say it again: the acute care hospital is not the exalted palace that many nurses make it out to be. Give it some time. Eventually you will find your stride and things will progressively become easier. Good luck to you!
I don't agree with your post. A full head to toe assessment is necessary every single shift. Of course focussed assessments are done most of the time BUT if you don't do at least one full one at the beginning of your shift how can you really catch things you didn't get in a report or changes that were not noticed before?
I don't agree with your post. A full head to toe assessment is necessary every single shift. Of course focussed assessments are done most of the time BUT if you don't do at least one full one at the beginning of your shift how can you really catch things you didn't get in a report or changes that were not noticed before?
I agree. It really doesn't take that much more time to do a complete head to toe, than a focused assessment.
I haven't read all the responses yet. This may be an unpopular bit of advice, but here goes...if you liked LTC and you have a job offering for LTC take it. I am in LTC because I want to be, no interest at all in the hospital setting. You gave the hospital setting a shot and didn't like it, so go back to what you do enjoy.
caliotter3
38,333 Posts
Write a letter and send it certified, return receipt requested. You will have done what you needed to do and no longer have to be concerned with talking to them and getting upset by them.