I don't think they trust me at work

pmabraham, BSN, RN · Sep 30, 2017

It seems you are basing your feelings on an expectation that if you are trusted, you will get harder and harder cases. My advice is don't go off such feelings. Take each assignment, and do your best; don't worry about the assignments of your coworkers.

Lame · Sep 30, 2017

It seems you are basing your feelings on an expectation that if you are trusted, you will get harder and harder cases. My advice is don't go off such feelings. Take each assignment, and do your best; don't worry about the assignments of your coworkers.

Yes and I'm trying to not worry about others or compare myself, knowing that everyone is different. I think my problem is that I have been there for 4 months and been off orientation for 2 but I have not recieved feedback after orientation so I'm not sure where I should be at. Like I said, I have scheduled a meeting to see where I need to improve...

Pediatric Critical Care Columnist · Sep 30, 2017

You can't take that as a sign you're failing at your job. If you haven't had any feedback since you came off orientation, I'd say that means you're doing just fine. There are only so many "sick" kids to go around. I've been working in peds critical care for 20 years and a lot of the time, my patients are the most stable and straight-forward kids on the unit. Your turn will come, but not if you're perceived as someone who only wants to look after the "sickest" kids. Oh, and sometimes those rock-stable patients, or the chronic ones, turn turtle on you unexpectedly because the signs of impending collapse have been overlooked by nurses who see them as... um... beneath their notice. (Trying to be tactful here.) I recently had one of those chronic kiddos some of my coworkers look down on as a waste of their skills. The kid wasn't behaving the way I expected, having looked after this little person a few times. Sleeping more than usual, dramatically less irritable, but afebrile and otherwise looking okay. Everybody pooh-poohed my concerns until I brought it up to the intensivist - for the third time - during their sign-out. To placate me, he ordered some tests; I could see he was just figuratively patting me on the head. Well, I was right... the kid had recurrent pneumonia and was actually quite ill. Who knows where that would have gone with a different nurse looking after the kid. I guess what I'm trying to say is that every patient on the unit deserves the best nursing care they can get, and if you look at it from that perspective, maybe you won't feel so belittled.

caliotter3 · Oct 1, 2017

When I expressed a similar sentiment at a new job one time, I was told, "No news is good news". Something to take to heart. Bad news will find you soon enough. Don't go looking for it.

Lame · Oct 1, 2017

Thanks for the advice everyone! I definitely don't want the sickest kids on the unit and also know I learn a lot from the more "stable" kids. I hope that I'm at where a person of my experience should be at. My unit has a culture of senior nurses vs. new nurses and I guess I just want to show that I'm doing the best I can.

Julius Seizure · Oct 2, 2017

Trust comes with time. If you have only been off of orientation a couple of months, be patient. I can't speak to the situation with the other nurse being assigned "harder" patients - I don't know all the details. But be patient. Speaking with the educator won't hurt. I know that when I was a new grad in the PICU, I asked when I was going to "graduate" to more complex patients, and I was told they didn't know I was wanting a challenge yet. Maybe they are just waiting to know you feel ready. But don't feel that you need to rush - you have your whole career to stress yourself out! :-)

Career Columnist / Author · Oct 4, 2017

Trust comes with time. If you have only been off of orientation a couple of months, be patient. I can't speak to the situation with the other nurse being assigned "harder" patients - I don't know all the details. But be patient. Speaking with the educator won't hurt. I know that when I was a new grad in the PICU, I asked when I was going to "graduate" to more complex patients, and I was told they didn't know I was wanting a challenge yet. Maybe they are just waiting to know you feel ready. But don't feel that you need to rush - you have your whole career to stress yourself out! :-)

It's a lack of communication problem. I, too, make things up in my head when there's a void.

Good for you for taking the initiative and scheduling an appointment with your educator. Best wishes.

Ruby Vee, BSN · Oct 4, 2017

Hi everyone! Just looking for advice and also to vent. I recently changed from adults to picu after a year experience. I feel like none of my coworkers trust me with the type of assignments I'm getting. I usually get pairs and sometimes a stable intubated pt. My coworker who got off orientation after me has gotten a post op back and has taken care of a kid on ecmo. She doesn't have any prior peds experience. I haven't gotten any feedback from anyone but did make an appointment to speak with my nurse educator on my progress. I'm trying not to compare myself to others but am feeling a little discouraged as maybe this unit isn't the right fit for me. Has anyone been in my situation or have any advice? Does it seem like I'm not trusted?

New people on the unit get the pairs and chronic patients. It happens everywhere. Show that you can take great care of those patients, and you'll gradually be trusted with sicker and sicker patients.

I can't speak to why your colleague got the sicker patients -- perhaps she has previous ECMO experience on an adult unit? Or the assignments were all made out, someone called in sick and she was pencilled in to their assignment without the charge nurse pausing to think about skill level? Or maybe she had taken care of that patient on a prior admission, she had had the patient the previous day or she called in to the charge nurse before the start of the shift to ask for the assignment. (I had a colleague who consistently did this . . . it stinks.)

Medic/Nurse, BSN, RN · Oct 7, 2017

There is some great advice already here.

I'm going to add this â€”

1) Stay out of your own way. This may be hard to do, but IMO it is essential to success. Stop comparing, contrasting & worrying about others (their experience, assignments, acuity). If I was an educator, I would be mildly alarmed if a "new" nurse did this and came to me with concerns about the types of patients they were getting (or not getting) :confused:

Now, even if you don't admit to the educator your concern about other new nurse assignments, it's been my experience that a nurse having "issues" has shared these concerns with co-workers. Word travels fast in some units. Scuttlebutt or gossip or the "concern" often gives folks something to talk about (or at least assure that focus is on someone besides them â€“ lol). It's best avoided. Please avoid it.

Focus on you and set goals for your clinical practice. Decide you'd like to join AACN & work toward CCRN Pediatric certification (long term goal) â€” maybe there are AACN Core Classes offered near you (big plus!). Retake PALS and think about working toward being an instructor. Retake NRP. ECMO class. Do it all, aggressively seek knowledge. Basically never pass on an opportunity to learn something.

2) This is the biggie. Relax. Breathe. Think about where you are and be present. (Kinda an offshoot of 1, but here is the key!)

LEARN. Your patients are now paying your tuition. Never forget that. Ensure that what they "spend" makes you a better clinician.

Learn something from every patient. Every presentation is different. 3 patients may have pneumonia, but not all will present the same. Note the similarities and differences. Believe me, you want to be the goddess of assessment â€” everything starts there.

Treat every patient as an opportunity to learn, improve your clinical practice. Patients that look STABLE have a habit of deteriorating or becoming unstable â€” a thorough assessment and close monitoring allows you to become the nurse that can intervene before things turn deadly. You want to be that nurse. Do thorough assessments â€“ always. Touch patients. Auscultate broadly â€” lol. Reassess and monitor often.

Develop SPIDEY SENSES. They save patients lives â€” those only came to me after I had practice proficiency (been there, seen that, done it).

:angel:

You are 4 months in on a new speciality and you are a relatively newer nurse, but not getting feedback. So, okay â€” IMO no big deal on the feedback. Things are prolly fine. Trouble seeks you out â€” no need to look for it.

Other than head down, working hard, treating patients as opportunities to become proficient to excellent & looking for formal opportunities to learn â€” I'd just RELAX. It will come.

:angel: