New ER nurse- not coping well

[mlRN15]

Hi everyone,

I live in Canada and joined this website in hopes of getting some advice.

I am a new ER nurse (began fulltime at end of July). I always thought my passion was in ER nursing. I love how I get to see a little bit of everything, and that I'm not consistently doing the same thing. I did my consolidation for my BScN in an ER at a different hospital and loved it then. My problem is that I feel like I'm already beginning to be burnt out. Everyday the ER is insanely busy. Some days are bearable and I enjoy it, but it's often that I just feel overwhelmed. Sometimes it's so busy that I go my entire 12 hour shift without a single break. A lot of the time, I feel like I don't have any support from my coworkers when I have a critical patient and 4 other full care patients to look after. They make me feel bad for asking for help. I have one charge nurse in particular that makes my shift a living hell. All of my very bad days, she was in charge and failed to assist me when I was completely overwhelmed and even asked for help. She speaks to me as if I'm stupid. It doesn't help that I did my new grad in ICU last year and spent about a year in ICU before getting permanent fulltime in emerg. It was at the same hospital, so people know I worked ICU and expect me to be able to transition easily into emerg and deal with the workload. The reality is ICU and ER are completely different. ICU was a little repetitive for me and I've always wanted to be in ER.. but now that I'm there I feel like I'm failing. We do paper documentation and I find it impossible to chart continuously when I barely have a minute to even sit down. I feel like I'm not charting as in depth as I should be because there is simply no time. A lot of the time I have to backtrack and put in as a late entry. I feel like my license is at risk. I know I am a very safe and efficient nurse, however the workload is just insane. I've become miserable, I'm always tired. I don't know what to do.. I just started a few months ago and I'm already feeling burnt out. I got warned about our ER and told to protect my license due to how busy it is in there. I know what they meant now.

Do I give it more time and hope it gets better? What if it doesn't? I'm unsure of what to do. I left ICU because it was a little slow and repetitive as I said, but also because my heart has always said emerg. Help!!

[Ruby Vee, BSN]

The first year of nursing is rough, we all know that. It takes about two years to become competent as a nurse. Before you had a chance to become competent in the ICU, you jumped ship to the ER. If, after barely a year in the ICU you found it "slow and repetitive", you weren't fully engaging your brain. You failed to learn everything you could in the ICU. And now you've added a whole new environment into the mix, no co-workers, new physical layout, new job flow, new patient populations and hundreds more disease processes, protocols and drugs to know. You're doing your first year of nursing all over again for the second time.

The complaints you're expressing are all "first year of nursing" complaints. And if you've shared with your new colleagues how you found ICU slow, repetitive and not challenging, they perhaps find you a know-it-all. Or they're reluctant to embrace you fully because they fully expect you to jump ship again after barely a year.

To quote a former charge nurse of mine, "Most new people are here on the two year plan. They stay just as long as it takes to get into anesthesia school and they jump ship. It gets old trying to teach a steady stream of newbies on the two year plan, so they don't get as much mentoring or development as someone who isn't on the two year plan. The only way to prove you're not on the two year plan is to stay more than two years." I'd argue that many of today's newbies are on the one year plan. I'm not saying that my former colleague's attitude was correct or desirable; I'm saying that it exists. A charge nurse given the choice of helping out a colleague who will have her back two years down the road and a newbie who is suspected of being a job hopper will, all other things being equal, help the colleague who will have her back. Again, I'm not advocating this line of thinking, but it is out there and after a revolving door of orientees who stay the minimum amount of time to get into graduate school -- some not even making it off orientation -- I'll admit that I do understand that thinking.

Your charge nurse -- the one that is speaking to you as if you are stupid -- she's speaking to you as someone who spent a year in the ICU without fully engaging her brain. There is so much to learn in the first few years of nursing, you could not possibly have learned it all in barely a year in the ICU. If you've told people you left because it was slow and repetitive, they'll know you weren't learning as much as you could. Perhaps they suspect that you're approaching ED the same way.

[TheSocialMediaCoach]

mlRN15 Tell me more about your support network outside of your facility.