Hello To all nurses or on the way to becoming one! First I would like to say thank you to who have posted or have replied to posting on this web site. Everyone has been supportive with great advice given to those in need. Having read as many post, it has encouraged me as well as given me insight into what I need to do to succeed and excel as a new nurse. I graduated in May from an ADN program. I have never worked in a hospital setting before my graduation so the setting was all very new to me. Let's be realistic 16 clinical's a semester does not give enough training for anyone to be proficient in nursing care. Growing up my mom was a nurse and I knew that is all I ever wanted to do. My mom worked at a bigger hospital so I wanted to follow in her footsteps. I took a 12 hour/3 day a week midnight position at a hospital approximately a little over an hour away. I orientated on days and then after 6 weeks went to midnights. I never realized how much I was going to like days. Also another negative was the driving (took added time away from my husband and kids) and the increased cost of gas (500 dollars a month). I decided after total of three months of working at this extremely fast paced surgical floor I would closer to home for a daytime community hospital. I found the perfect job 4 days a week on the 7am to 3pm. No more 2 hours of driving and I would be home when my husband and kids would be home. I started on November 20th with two weeks of classroom orientation. Then I started my clinical orientation. The work schedule was detailed and well exceeded my expectations. I felt at home at this hospital because it was where all 3 of my children were born. My assigned preceptor was a girl whom I attended high school with. She was one year younger than me and was basically a "nerd" in high school. Not that I classify people but that was her social status 15 years ago. She was not over friendly to me at the beginning of my clinical orientation. When docs gave her verbal orders or spoke to her about my assinged patients she did not communicate to me on what has transpired. I was also not familiar with all of thier supplies such as their syringes had safety switches on them and the hospital before that I orientated did not have. So I had to learn the ins and outs of their equiptment. I alos was not familiarized with their standing orders laid out by the docs, the ones that seasoned nurses know like the back of their hands. I would ask questions about standing orders and would get a short and incomplete answer as this girl was not overly commucative with me and definately not friendly. I had the feeling that she had a grudge on me from her high school experience many years ago, which did not make me comfortable to perform my newly trained nursing skills with her present. On the second day of orientation, I had a cancer pt. who was in for increasing right flank pain due to pneumonia. My preceptor informed me she had a strong urge to void yet could not. She said that she attempted once on the toilet with out success. During my intial assesment the pt. was kind of showing signs of confusion and not respoonding completely coherent.She stated she had the urge to void again. I let her know we (daughter-in-law and myself) could assist her to bathroom. Directly in front of toilet as I was pulling pants down the pt. proceeded to become unresponsive and fainted. I knew she had fainted but her time unresponsive did not make me comfortable. I was the only nuse around and no immediate help was coming so I had the daughter pull the CODE BLUE button. Son and I carried her to bed before the room was filled with the code team during which she was still unresponsive. Immediately after the aid did the first blood pressure reading the pt. began regaining consciousness. The code was being dismissed and the doc, my preceptor, and I was present. I was recalling the information on what had happened up to calling the code. Doc asked me to do another B/P reading. At this time I was already very nervous. I did a completely wrong B/P reading by not inflating the cuff completely and gave him a inaccurate reading. Did it again still not sure how accurate it was. Just a bad situation!! My fault though. My precptor brought it to my attention on how the doc was upset about the readings and advised not to talk to him about it. Sorry, but I need to make myself feel better so I did talk to the doc about the situation and appologized about my inaccuracy and told him it I had never been in a code before and I was extremely nervous!! He gave me advice and was very nice in the advice he gave me. I told my preceptor that I talked to him and she replied, "You don't have to tell me, I saw you talking to him." and then walked away from me. I kept asking for a debriefing on the situation but failed to get one. The next day the same preceptor asked me about the temp. on a polar care for a total knee surgical pt. I told her I looked over the setup but did not specifically look at the temp. I told her I would check it. At 8:30 (about 15 minutes after she asked me to check it) I got a temp reading of 48 degrees. I then remembered from my school clinical training that there is a part on the computerized charting to document temp. The previous palce I worked, which used the same computer program, did not have the option of charting the temp. So it was not at the top of my documentation list but I now know. As the days went on the preceptor continued to make me more and more nervous. Before giving toradol IV push I forgot to flush then administer med. I had brought in the flush but began first by pushing med!! MY MISTAKE!! I acknowledged it as my mistake. I will never omit that again. Over the days my preceptor would let me do less and less making me feel less comfortable. Even though I had a solid 8 week orientation at another hospital this was a all new setting with a whole new set of docs with different policies and procedures. I continued to ask whatever I could even though I was not getting complete answers. I also knew she was talking about me to other staff because she would "call" me on stuff that I asked them about a procedure. I thought the other people I was asking were there to help me but in actuaility they were back stabbing me. Which I can blow off but it does not make for a good learning environment. At one point I went to the nurse manager hoping to get a preceptor change but was unsuccesful. The nurse manager did tweak my schedule to give me an additional week of orientation. So the dreaded day came. On December 15th the nurse manager came to get me to have a meeting with her and the DON. They stated that I was not progressing as I should have been (after two weeks on the floor). They made comments about safety issues such the torodol issue and they also brought up the situation about the polar care temp. They said when my preceptor checked on the temp at 1100 it was 70 degrees, I explained that was due to pt. out of bed by PT and when they put her to bed they hooked polar care back up but did not replug unit. Also that was almost 3 hours after I got temp of 48 degrees. Also blood pressure reading was rebought to my attention. I restated that I spoke to doc about situation. Also my preceptor had other nurses document on my inability to perform nursing skills. These are the same people I went to for advice. Unfortuantely it worked to my disadvantage. Some things they siad I replied that I could not admit to because they did not occur. They said they saw a pattern forming and felt their pt. were not safe with me. They gave me the option to resign before they terminated me. I was confused so I opted to resigning, I did not know what would have happened if they terminated me. WhaT I got out out of this experience is MOSTLY we could all increse the safety that we perform with our pt.'s. That is evolving and lifelong when you practice nursing. Second is humility. It has to make me strongerto perform up to standards and keep me in check that I am not perfect and the questions I ask will never end.
I have to admit this has been a discouraging start to my nursing career. What is important though is that my nursing license has not been affected. One more note to be added to this recent experience, is that the preceptor never noted that on one my assinged pt. that when she hung a POTASSIUM RIDER (because I was not competent enough to do it), that she incorrectly set the rate for 500ml/hr and the amount to be infused was 130ml. The rate was supposed to go at 130ml/hr with the amount to be infused was 500ml. She was ready to walkout of room when I professionally told her of her mistake. She never said oh thanks, or I made a mistake. She just changed it and walked right by me. I guarrantee that would NOT have been changed if I did not bring that to her attention. Guess what, she never told the nurse manager or the DON about that. Go figure.
Sorry about the long posting. I just thought I had to state this much to make it clear where I come from and where I stand now. Any replies, advice, constructive criticism, and encouragement would be appreciated! Thanks to all!
