New Grad Help

[babynurse101]

Hey everyone. I never intended to make a post like this because I know about the "new grad blues" and how hard that first year is. I expected all that. However, my job is becoming more stressful than that. It's going to be super hard to explain here, but I'll do my best.

I was hired onto a mom/baby/L&D/NICU rotation. So far, I've completed mom/baby. But - and my educator has admitted this to me - the orientation is not geared towards new nurses. The hospital usually only hires experienced nurses, so the orientation itself is about 4 weeks. I started in August with the scheduled 4 weeks - 1 of which was spent only in hospital wide orientation (didn't set foot on the floor), and another 1 of which I was out incredibly sick. So they "extended" my orientation to 6 weeks. Even though I still only got 4 like everyone else, they documented it as I "needed an extended orientation."

Since the beginning, I've made a few silly new grad mistakes. Forgetting to unclamp an abx piggyback once everything's primed and ready, giving narcotics 12hrs after the sections instead of 18, and once I drew up insulin in the wrong syringe. Like I said, really stupid new grad errors that shouldn't have happened, but I was nervous and they did. I'm very proud of the fact that I've never once repeated a mistake though.

My problem is the fact that the hospital management where I work are saying I have many more "concerning" errors:

1) They've brought up the fact that I did a transcutaneous bilirubin on a baby and it was low, then later that day the baby needed to go under lights. When asked what else I should have done in that situation (our policy states only if the TC is "high risk" on our chart can we put orders for total/direct), they said I should have "used my nursing assessment" - but the baby wasn't symptomatic in any way. Not yellow, pooping great, etc.

2) Many many other nurses have apparently been emailing my educator with - and this is her quote - "nitpicking" things like I said the orientation was "******" (I don't curse, so I can't even imagine where that came from), and when I try to explain myself after certain "attitude" comments like this, they say I'm too defensive. I can't adequately put what's been said in this, but suffice it to say that if I am defensive, it's been demonstrated exactly like this, "You didn't unclamp that antibiotic you hung just now but I caught it." -- "Oh, thanks! Sorry, I must have gotten distracted by something else in the room."

3) One of my patients the other night began to get a little tachy on me. I assessed her vitals frequently (q2 without orders) and at the highest, her pulse was 128 radially - this was at 2215, and I paged the doc immediately. As I was giving report to another nurse at 2300, another nurse called our hospital's version of a "pre-code" on her because she was tachy in the 170s (on the dinamap) and claiming she was SOB. I had documented every word this woman told me of her symptoms, and SOB was never one of them. She said she felt like her "heart was racing" and that she felt "a little jittery." I asked if she'd eaten recently and she admitted not since the day before. When I had her eat a meal, she told me she felt fine afterwards. I haven't really been called to task over this one yet, but with everything else I feel it's only a matter of time.

My educator has flat-out admitted to me that she thinks there's a certain group of nurses out there "waiting" for me to make a mistake and are constantly sending her "nitpicking" emails that she doesn't care about. However, I'm still being made to feel incompetent over everything. Everything I've stated here has been the worst of my errors. All other complaints have been "personal." But I just had a meeting with my educator and manager where they said I'm making mistakes "right and left" - however nothing but the insulin (my stupidest and most egregious mistake at the very beginning) and when I gave narcs too soon have been put before me as real mistakes. They are discussing putting me on a performance improvement plan for the insulin.

I know it sounds like there must be something else for them to act like this. I've thought the same. But the things I've listed here are the only things that have been brought to my attention apart from "defensive" and "personality" comments. I've been at this hospital 5 months now, and I just don't know if this is going to get any better. I've never once repeated a mistake, and my educator says that herself, they're worried because "new mistakes keep happening." But - and I'm trying really hard not to sound like "I'm perfect, they're all out to get me" because I am FAR from it - like my educator said, I really feel like I just can't win with some of these nurses. I've won the patient satisfaction polls we've had the last two months running, and many of my coworkers say I do fine. But apparently with management, I'm a "concern."

My main question is at this point, what's the better option? I'm not a quitter by nature and I love mom/baby, but I really don't know if I can go through another couple months of this. I just don't feel like I can ever win here. Do I attempt to find another job now, or stick it out?

[lanoneus]

Maybe your reaction the the narcotics and the insulin is what has them concerned. Honestly, part of their judgement call on how they will respond to your mistake is whether or not you recognize the gravity of it. I don't know how you responded in person, but you sound kind of flippant in your email.

[adamRn79, BSN, RN]

Insulin is the only red flag to me. Why do you have to wait anytime to give narcs to c-sections? The likely issue with the other nurses is that you got the job as a new grad and they probably had to "pay their dues" elsewhere first, but that's not your problem.

[babynurse101]

Thanks for the responses. I agree my original post sounds flippant, but I wasn't in person. I am flippant about more light things like I forgot to give such-and-such room diapers when she asked, but I knew how big - and ridiculously dumb - the insulin was.

Narcotics can't be given until 18hrs after a c-section because the anesthesia they give during the surgery is considered strong enough to last - and therefore too strong to give additional - drugs with sedative/respiratory-depressing side effects for 18hrs after. Whether the moms agree with that or not is another story.... :)

I was not put on a PIP or really taken to task in any way, just warned not to do it again. However the gossip and back-biting within our department has gotten horrendous. Even though I am still doing well in patient satisfaction scores, my peer-reviews (both done by nurses I have never personally given report to or worked with), said I was lazy, denied ever being wrong, and that my patients either requested other nurses or waited until I was gone to ask for things because I "blew them off." I honestly tried to think about if I'd ever blown someone off, and I couldn't come up with anything. I've given everything I've personally been asked for, or if our floor is busy and a patient is ambulatory but asking for a lot of kitchen stuff, I walk them to our kitchenette and show them where everything is. I know the lady I mentioned in #3 in my original post requested that I not be her nurse again, but she's the only one I've been informed of.

It's honestly gotten a bit too much for me. I can't think what else I could do to change their minds. I haven't seen or heard from my manager/educator since about January, but to hear my coworkers speak of me, I'm incompetent and lazy. I do the hourly rounds mandated to us, I fill every need a patient asks of me and prompt them for needs they might not have thought of yet (baby supplies in the bassinette, supplies in the bathroom, etc), and I try to help my coworkers whenever I can if they're busy and I'm not. I'm really really trying to think of other ways to improve myself. I apologize for my mistakes and try to take every bit of advice given to me to heart. But very few of my coworkers don't actually give advice or constructive criticism, they more or less just email my superiors. Any other ideas I can do? Or am I fighting a losing battle, like I'm starting to think?

[IHeartPeds87]

I think you are fighting a losing battle. I hate to say this, and I am sorry, because I know it isn't what you want to hear. A unit where other nurses are constantly going over your head and reporting things to educators/management is not where you want to work anyway!

[Wave Creation]

All new grads are "targets"; one just has to develop a thick skin.

What was stated in the OP, not a unit for (usually) for new grads...