I'm on an ICU step down floor, we get alot of post CABG from ICU, we get alot of admits from cath lab, and general telly patients. The normal ratio is 6:1!! I just got off orientation, that lasted only 5 weeks. I just showed up one day for work and was assigned 4 pt's! No one evaluated me, or formally asked me how things were going.
I work 7a-7p, and have had 4 pt's on my own 2 times. Both times I've stayed until 9:15pm charting, it's REALLY hard straight out of school. Like I'll get a new admit at 4:30pm...and am expected to do the whole LONG admissions process...which took me 45 mins in the pt's room. I had a pt on TPN...which needed a new bag, pt's who needed Accu checks...and ALL of that was late (TPN LATE...thank God is BS was ok!!).
I feel so overwhelmed....I don't chart on some people until after shift is over. AND there are soooo many things I worry about doing for the 1st time like administering blood products. I'm still nervous calling Dr's.
What am I suppose to do? Is it always like this for new RN's? I don't feel like I got enough time on orientation, some people get months and I only got 5 wks because of short staffing.
I'm so sorry. I wish I could help you. For the moment, I would say to use the tips provided that you think will help you and stick it out as long as you can so you will have "put in your time" and can choose a job or a facility that is more to your liking.
I'm on a cardiac stepdown & im a new grad with 8 week orientation. and the ratio is 2:1 or 3:1 normally. 4:1 if they are stable. My usual load consist of 1 vent, a lot of MI, CHF, pneumonia.. yesterday i had someone complaining of chest pain who had a hx of MI, and a vent with multiple stage 4 wounds, PICC lines, multiple IV fluids, foley, flexi seal, NG, 300 lbs, bed ridden... u know the good stuff. i was overwhelmed!!!!
i think it will get better, but ive worked at places where they do unsafe loads.. everyday i felt my heart was tightening up ( i am only 24) and i feel like a heart attack is about to happen... to ME! if you feel like you're having a stroke while you're working, that is not good..
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
the first year is the worst. if you weren't feeling scared and overwhelmed, i'd be worried about you! you sound pretty normal to me. it'll get better -- one day you'll be going along doing your business and suddenly you'll realize that you get it. everything just clicks. i "got it" well after the one year mark, so keep plugging along. we've all been there.
Yes, I'm sure it's a step down! lol. There aren't usually vent pt's on the floor. We get alot of post CABG from ICU (after they've been there a few days), chest tubes, post cath lab...it is also a telly floor, so there are the generally telly pt's there.
The hospital is a Magnet facility (believe it or not)....
I think since you are now off orientation they will treat like you like any other nurse. You could always try to ask for more orientation but good luck with that. Hospital nursing is way too chaotic in my opinion. I tried it on med surg and resigned after 2 weeks. I just didn't feel safe. You hear lots of people saying you HAVE to do hospital nursing as a new grad..not true. Ive been a nurse for 6 years now and Ive done office nursing, DD/MR nursing, now case management. I have a lunch hour, can go to Dr appts during my workday, can pee whenever i want to lol......I would NEVER EVER try the hospital again! And no working holidays!
I can only hope to get as lucky as you. I am at my first RN job in the ICU, with 12 weeks orientation and for me I felt 16 weeks wouldve been more adequate. I asked for more orientation time when the 12 weeks was up and I wasn't taken seriously. I dont like how I can't go to the bathroom without making another nurse aware that I need to go pee, and I get no official lunch break, so I often go 12 hrs without eating. So my goal is to stick it out for a year at this joint and move on somewhere else. But this year is so hard to stick out. I don't think ICU is for me, and I'm not sure how good or bad 1 yr of ICU is going to look on my resume, but I simply can't fathom working in this environment for 2 years.
I can only hope to get as lucky as you. I am at my first RN job in the ICU, with 12 weeks orientation and for me I felt 16 weeks wouldve been more adequate. I asked for more orientation time when the 12 weeks was up and I wasn't taken seriously. I dont like how I can't go to the bathroom without making another nurse aware that I need to go pee, and I get no official lunch break, so I often go 12 hrs without eating. So my goal is to stick it out for a year at this joint and move on somewhere else. But this year is so hard to stick out. I don't think ICU is for me, and I'm not sure how good or bad 1 yr of ICU is going to look on my resume, but I simply can't fathom working in this environment for 2 years.
It does sound like ICU nursing is not for you but right now you are in a perfect position to set yourself up for a great career. One year of ICU nursing will be fine to move on to another job but I would recommend working a little beyond one year since the first three months could be seen as "not counting". One year is a minimum so, if you can possibly stand it, wait until 15 months have passed. You can simply explain that while you could do the job, you just didn't feel it was the best fit for you. Remember not to complain to a new prospective employer about conditions...make it sound like everything was just fine. Jobs are very competitive right now with hundreds of nurses with similar nursing backgrounds applying for positions (piles of hundreds of resumes handed to recruiters at a job fair yesterday in NYC) so the difference may come down to who is a complainer and who is not.
As far as dealing with it while you are there - Bring your lunch and snacks that you can pop in your mouth in a 1 minute break (grapes are good), Protein bars that you can keep in your pocket, etc. Even with my current job (which is in a procedure lab) I never count of getting a lunch break because sometimes it is just too busy in the middle of the day. But my body can't go without food. I also try not to drink alot of water or coffee during the day so it will cut back on the number of times I need to go to the bathroom. In your case I would probably consider using my pee breaks as a full 15 min (with another nurse covering) three times during the day (if that is possible), then, if you get a full lunch break fine, if not you will be tired but you will have eaten a little and gone to the bathroom...something those in another profession just can't appreciate as real problems.
"I also try not to drink alot of water or coffee during the day so it will cut back on the number of times I need to go to the bathroom." That's why nurses get so many UTIs. :)
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I'm so sorry. I wish I could help you. For the moment, I would say to use the tips provided that you think will help you and stick it out as long as you can so you will have "put in your time" and can choose a job or a facility that is more to your liking.
Best of luck. You will make it!!!