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My first cry

First Year   (4,557 Views 24 Comments)
by RNby24 RNby24 (New) New

434 Profile Views; 3 Posts

I'm a new grad working on a med-surg floor. I had my last night of orientation and it was the worst night I ever had. I had 8 patient assignments. I had three post op patients who needed to be assessed q4 hours. One was nauseous all night-nothing I gave worked. One had a completely numb arm from an epidural that I had to call on. And the other was a complete angel and slept all night (thank you!!)

A severely autistic, non verbal, agitated patient who was flailing and jumping off his bed every hour (we had no staff to sit with him either). MRSA. PEG tube.

A crabby, sarcastic a&o x2 patient who was only here because his family couldn't pick him up the day before.

A spanish speaking patient, neuro checks q4 hours. Our translator system wasn't working. I couldn't understand her with even the basic spanish I knew.

May I add, EPIC was working in only 2 of the 8 of these patient's rooms.

A patient who was just plain old weird, wouldn't stop telling stories, of course had no time to listen to these stories even if I wanted to. Going to surgery in the morning. Contact for c diff. Patient develops new wrist pain, very swollen fingers, wrist is hot to touch, rated 7/10 pain, seemed like s/s of gout in hand. Updated surgeon as it was new onset pain even though it had nothing to do with the surgery that was scheduled in one hour. Surgeon proceeds to ream me out for calling him and saying this was a hospitalist issue. Sorry for letting you know :| Don't really care that he yelled at me but confidence -100 at this point for thinking that I was doing the right thing by calling and then to find out I wasn't...

A confused patient who was admitted for a bleed, change in mental status during the night, had ICU nurse come up and give a drug to treat her arrhythmia at one point. No beds available in the IMCU. Pt would be staying on the floor per hospitalist. Gave a unit of blood ( for the first time) Large amount of coffee ground emesis began right before shift change. NG placed. Transferred to ICU. Gave the worst report ever to the oncoming nurse about all my other patients who I felt like I hardly knew. Hospitalist actually came in to my report and gave me a hug and said don't worry you're doing great. Nearly burst out in tears.

Stayed an extra 2 hours to chart after my shift (I'm sure my charting wasn't even complete) and was holding my tears in until I got off the elevator and I was sobbing as soon as I closed my car door.

I know it could've been a lot worse but I was soo overwhelmed and stressed. I felt like if I was on my own I wouldn't have been able to handle it or know what to do. I have the feeling my preceptor wasn't impressed because I had to be given so much direction. I had so many things I hadn't experienced before. And this was my last night on orientation!! I honestly feel like I am in over my head. Will I ever be able to be up to speed and know what I'm doing...

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westieluv has 26 years experience and specializes in Med/Surg, Tele, Dialysis, Hospice.

948 Posts; 19,726 Profile Views

It could've been a lot worse? How, if they gave you the entire floor for your assignment?

I have been a nurse for a long time and I would have been in tears after this shift too. Eight patients? For a new grad, no less? I have never heard of hospital staffing like that, even on night shift and with a preceptor.

Don't be so hard on yourself. Wonder Woman would have cried after the night that you had. You will get up to speed and you will get better, and I really, really hope that your floor's staffing gets better!

Prayers and hugs to you.

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NurseSpeedy has 18 years experience as a ADN, LPN, RN.

1,358 Posts; 18,282 Profile Views

Ok, take a deep breath and relax. You had the night from hell. It does get better. Many nurses will tell you that the first 6 months are the hardest. You're still new, learning a routine that works for you, and learning how to work around that routine because everything that happened in the past 5 minutes s***canned your original plan. After a year, things are a lot better. It just takes time. Don't be so hard on yourself. We've all been there.

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OldDude specializes in Pediatrics.

7 Followers; 1 Article; 4,782 Posts; 30,051 Profile Views

So other than "that" Mrs. Lincoln, how was the play? Sounds like you can expect more of the same from that facility.

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CrunchRN has 25 years experience as a ADN, RN and specializes in Clinical Research, Outpt Women's Health.

1 Follower; 4,190 Posts; 30,398 Profile Views

Holy carp. You did a great job. Next year that assignment will hardly make you break a sweat. Hang in there.

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canoehead has 30 years experience as a BSN, RN and specializes in ER.

2 Followers; 6,650 Posts; 49,188 Profile Views

I would have been behind all night with that assignment. It wasn't you, it was a terrible assignment. And FYI, the surgeon would have reamed you out for not calling if he decided the patient had an infection and antibiotics were needed/surgery was delayed. You weren't going to win on that one, calling was not a mistake! JMO...if you are already overwhelmed and they want to send you a transfer or an admit, it's no sin to say "no." Administration wont like it, charge won't like it, but it's your responsibility to keep your other patients safe. If something happens, admin will be the first to say "you accepted the assignment"

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NightNerd has 5 years experience as a BSN, RN.

855 Posts; 16,138 Profile Views

I'm so sorry you had such a bad night. *hugs* It sounds you handled everything pretty effectively, and you earned the right to a good cry afterward. That feeling when you're giving report and you're like, "...I don't know these people. I did nothing for them," is the WORST, but it sounds like you were set up for inanity with that assignment and did the best you could under the circumstances. Be proud that you got everyone through safely, and do something nice for you this weekend. (If I could, we'd sooooo be splitting a bottle of wine and some cupcakes right now.)

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Here.I.Stand has 16 years experience as a BSN, RN and specializes in SICU, trauma, neuro.

1 Follower; 4,943 Posts; 42,611 Profile Views

Sheesh...FWIW I would have probably cried too. That sounds like a shift straight from the pit. Hugs!!

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3 Articles; 2,107 Posts; 35,259 Profile Views

Ouch, that's a terrible ratio. So sorry!

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89 Posts; 1,105 Profile Views

An eight patient assignment is overwhelming for any nurse, even veteran nurses. If you did your best that's all you can do. You will eventually gain experience and confidence. Someday you will be the preceptor. Be well.

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Been there,done that has 33 years experience as a ASN, RN.

4 Followers; 6,210 Posts; 69,366 Profile Views

I'm crying just reading this. That assignment was UNMANAGEABLE and UNSAFE.

Where was your preceptor during all this mess?

Sounds like a real h-hole that you may or may not want to get your year of experience with.

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traumaRUs has 27 years experience as a MSN, APRN, CNS and specializes in Nephrology, Cardiology, ER, ICU.

166 Articles; 21,045 Posts; 191,596 Profile Views

Moved to First Year After Graduation.

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