6 months in the ER, too early to move on? Long.

[SeekingAdviceRN]

I need some advice. I've been a nurse for 3 years, an ER nurse for 6 months and I hate it. I'm doing well and had a great review, love the management and leadership, but my coworkers are sharks and I feel like I'm standing in the middle of the road waiting for the bus to just come hit me. There's the typical cattiness that coworkers have pulled me aside and warned me is going on behind my back with a couple coworkers in particular, but then there's also the charge nurse who tries to drown me by giving me ridiculous patient assignments just to test me, like giving me 3 new patients at once and not telling me I have them but signing up my name next to them on the board, so by the time I sit down to document on a patient I see I have 3 more and have no idea how long it's been since they were brought back and they all need everything done at once...giving me an ESI 1 patient tubed and paralyzed with a GI bleed, with 7 meds going and other things I can't give details on because it would be too specific who is really circling the drain, with 3 other patients who are all admissions (DKA and hypotensive, confused GI bleed, and PNA) My coworkers helped me to task some of the things they needed, but it was still up to me to document everything, q15 minute vitals, give them meds, and call report. It made me feel like a crappy nurse because I could only give everyone else the bare minimum, one of my patients was still in agony, and I didn't have a chance to organize their admission paperwork and documentation before they went to their units.

Anyway, any other nurse with an ESI 1 patient always gives up their other patients to the charge nurse to focus on the critical patient...you would think this would be the case, seeing as this was my first critical patient I've been responsible for. This nurse constantly micromanages, makes snotty irrelevant remarks, gives me flat out wrong advice, and everything they tell me is the opposite of what needs to happen or what I should be doing. I usually ignore it or stand my ground, but it's getting old fast.

For the first time ever one shift recently I felt like my nursing license was at risk. All of this is making me feel like ER is not really where I want to be anyway. I have always been passionate about two fields, and the more I work this one the more I realize my love for the other. Is it too early to move on? Would it look bad to try and explain this on a resume for the job field I'm thinking of pursuing? Should I suck it up and stay for a few years to not look like a job hopper? They told me when I started that nurses generally don't last more than a few months on this shift, and now I can see why. The only ones left are the clique that runs people off. I've been determined to come in, keep my mouth shut, give the best care I can and go home, but it's becoming really hard to. So stay and deal with it for another year, or run and try to explain why I only have 6 months in and already want to change fields? Any advice is greatly appreciated. Thanks for getting through this long-winded post.

[tokmom, BSN, RN]

Well, you have been a nurse for over 3 yrs, right? Have you job hopped prior?

Personally, if you are that miserable and the people you work for are ones to throw you under the bus, I would leave..period. I can't imagine working in a job I hated.

Good luck and keep us posted. :)

PS What is the other field you are thinking about?

[SeekingAdviceRN]

Not sure how to answer that. I've held a per diem job for 3 years that I just left in November because it was time to move forward, a FT job for 1 1/2 years prior to starting in the ED and I'm still there per diem (so total of 2 years there now), and I had one job that I've been on and off at depending on their needs for the past two years. I have had several jobs at the same time, but they have longevity. I just don't know how that looks on paper to see so many jobs with 3 years of experience. I'm more concerned that it would look like I'm burning the candle at both ends.

The field is L&D.

[carolmaccas66, BSN, RN]

I don't think recruiters see changing jobs a lot as job hopping now. When I'm asked why I've changed jobs, I say I have to go where the work is.

If you have ED experience you can get a job anywhere. What about networking in the hospital you are in? Are there any jobs there at all? What about a site like Linkedin, (www.linkedin.com) where you can actually contact the people advertising the positions. You can put your CV on there, general experience & ways to contact you. It's worked for me, I already have an interview lined up for a job in another state.

Why don't u also try the nursing agencies? Then you can try working the shifts/hours you want where you want.

Let us know how u get on anyway.

And that NUM signing you up for patients without telling you, if that is standard practice, you need to see the medical director about this, or ask her to tell you at least. That's just BS.

[Perpetual Student]

I'd consider trying to talk to the charge nurse regarding your concerns. Explain your desire to provide safe, excellent care and your motivation to be an effective member of the team. If the folks aren't really nasty people and are just somewhat clique-ish they might end up respecting your dedication, courage, etc. and accept you into the unit.

There's often a certain stage during the orientation (I realize you're probably off of your formal orientation, but you're still in your informal one) of a new person into a highly specialized area in which he's being tested. This treatment could be an attempt to give you a trial by fire and things will improve once you've proved yourself. Your team-mates will want to know that when everything totally goes to heck in a hand basket that you're able to step up and shine.

I recommend busting your butt, holding your head up high (but with humility), and plugging away for at least another 6 months or so. I wager things will end up changing for the better as you gain more experience and confidence.

[hiddencatRN, BSN, RN]

It sounds like the issue is the particular ER, not ERs in general. I work in an ER and have wonderfully supportive coworkers, charge nurses who have my back and who I feel comfortable going to for advice and concerns, etc. From what you describe, I would move on. It sounds like you do have longevity in your career so I would just explain this position as "not a good fit" if asked and leave it at that. Chances are, if you were told not many people last long on that shift at that hospital, it has a reputation for not being a good place to work.

[canoehead, BSN, RN]

If you keep getting patients without report speak to her once, then start writing up the incidents. I'd also document the acuities for good measure, but I'm mean. If she's doing it to you she's gonna do it to the next guy, and even if you decide to leave, you can start the documentation.

[Maggie09]

..giving me an ESI 1 patient tubed and paralyzed with a GI bleed, with 7 meds going and other things I can't give details on because it would be too specific who is really circling the drain, with 3 other patients who are all admissions (DKA and hypotensive, confused GI bleed, and PNA) My coworkers helped me to task some of the things they needed, but it was still up to me to document everything, q15 minute vitals, give them meds, and call report. It made me feel like a crappy nurse because I could only give everyone else the bare minimum, one of my patients was still in agony, and I didn't have a chance to organize their admission paperwork and documentation before they went to their units.

Anyway, any other nurse with an ESI 1 patient always gives up their other patients to the charge nurse to focus on the critical patient...

If you have a tubed ESI 1 patient circling the drain, there is no way that you should have three other patients that aren't stable. That is completely ridiculous, and I would have probably raised heck and refused the unsafe assignment...then I would've gone to upper management if anyone gave me any crap about it. Especially since it's obvious that other nurses don't have that problem.

It sounds like you're a good, solid worker. There might be some jealousy going on, or it might just be that there are a few key people there that are nasty as all get-out and will never improve. Regardless, I would be having a talk with the charge nurse ASAP. Call her out on her partiality. I am so sick of nurses having to sit back and put up with cruddy conditions just because they're being "tested" by the higher-ups. While it is perfectly fine (and appropriate) to "challenge" someone, it is ridiculous to give someone the assignment from Hades and watch them while they drown. Approach the CN and management (if necessary) in a polite but firm way. Tell them you want to provide great care, but there is no way a nurse can safely and effectively care for the kind of assignments you're getting. I would also be sure to document any patients you don't receive report on. Heck, I'd be filling out incident reports. If you don't see changes and the working conditions are consistently cruddy--MOVE ON.

I wish you the best. I'm a newer ED person as well. I have my rough days, but for the most part I never feel like I'm put in completely unsafe situations. Coworkers can be a bear anywhere you go, but at the end of the day it is essential that the majority of people have your back if for no other reason than patient safety, otherwise you're just going to be S.O.L.

[RNperdiem, RN]

Do you have the option to move to another shift away from your trouble-makers?

If you have self-scheduling, there is the option to work with a different set of people, and the environment can be very different.

I once talked to a nurse manager who said that when she hired a new nurse for her unit, she would only hire new grads for night shift because on her unit, the night shift group tended to be more nurturing. She would only hire very experienced nurses for the day shift, since her day staff tended to be less patient with new staff, but were excellent nurses.

[Nurse SMS, MSN, RN]

I find it odd that you said the management is awesome but the co-workers are horrid. The management is responsible for keeping the teamwork of the floor intact. They sound like failures in this situation.