Need to go back in orientation?

[ksparks]

Ok so I have been out of rhe hospital doing LTC for 7 years and finally got back in the door and was hired on a Medical Stepdown unit. I was on orientation 8 weeks, my preceptor was very critical, never had anything positive to say. I finally requested a different preceptor when it was getting close to me being on my own. The second preceptor had very little criticism and they signed off on me being by myself. I've had terrible anxiety since I started I've been on my own 5 shifts and they were horrible. Most of my orientation they were choosing the easier patients for me to care for. So now I get no shield at all. It's been horrible. I'm so scared all the time. I feel like I'm tasking and not able to critically think. Plus getting used to computer charting is hard. So yesterday I emailed my manager telling her my concerns. I said my anxiety was awful and I felt like I needed more training. She said more orientation won't help anxiety. I felt so inadequate and not sure what to ask for. I don't want to lose my job but maybe this floor is too much. The only problem is that there is a policy of no transfer for a year. I don't feel safe caring for these patients! How should I handle myself in the meeting with my manager monday? Should I tell her how I really feel without holding back anything? I don't want to be known as a problem person but I know as soon as I sit down with her I'm gonna cry...hard.

[HouTx, BSN, MSN, EdD]

So sorry you are in such a difficult place right now.

FWIW, I agree with your manager about not extending orientation. You've moved from a more predictable environment that you had mastered (LTC) into a much faster paced setting with much more unpredictable patient care. As if that wasn't enough, you are back in "beginner" mode.... and that is a hugely uncomfortable place to be for an experienced nurse.

It is very difficult to cope with the faster physical pace & high volume of information that has to be processed on a continuous basis. In order to do so, you have to be adept at multi-tasking. In scientific terms, it's called "cognitive load". There is an increasing amount of evidence that human beings vary considerably in their ability to multi-task. Some people can manage 5 or 6 separate things simultaneously, while others need to focus on one task at a time. This has NOTHING TO DO WITH INTELLIGENCE. It's just the way our brains are hardwired. Most acute care areas are very stressful and challenging for anyone that is not a natural multi-tasker.

The secondary phenomenon that characterizes successful acute care nurses is Time Management. This is the ability to continuously review and prioritize all the 'stuff' that has to be done... pushing high priority things to the top of the list, and focusing on lower priority tasks only after the high priority ones are taken care of. The environment is dynamic. Each time something new pops up, it has to be prioritized & slotted appropriately into the ongoing flow of work. This is very difficult to do for non multi-taskers, who may have to consciously stop and reorganize their to-do list.

Bottom line? If acute care is not for you, then please don't feel bad or inferior if you move into another practice area. There are too many other types of patient care environments and nursing roles. Be kind to yourself. You will have nothing to give to your patients if you're physically and emotionally wrung out all the time.

[ksparks]

See my up updated situ by looking up the tag "ok this is BS"

[Nsg is an art]

If you don't feel like this job is a good fit, move on. You owe it to each patient to give safe, optimal care and I agree that you need to be kind to yourself and honest and say this isn't working. If anything were to happen you would feel terrible. I would ask to speak to the unit educator and nurse manager and see if having less patients may help

for some time or if you can be transferred- despite the one year rule, the hospital has spent a lot of money to train you, taking a different position on a slower paced floor- or just give your notice. Safety and self preservation.