new grad struggling with unit politics and poor performance

[pinkiepie_RN]

I've been working as a new grad on a nursing unit for the past few months and things have been going pretty smoothly for the most part. Over the past few weeks to month, I've been experiencing some side effects from a medication that I'm on including the following: excessive sleepiness and poor concentration. During my first few months, I received nothing but positive feedback from both my nurse manager and my co-workers. As a result of the excessive sleepiness, I've had a few tardies (as a result of over-sleeping) and it was brought to my attention that it had gotten back to my nurse manager. I was recently confronted by a co-worker last night about how apparently a few of my night shift co-workers were going to bring to attention the following behaviors that they have deemed unacceptable: apparently I gave a shoddy report one day, I've been "slacking" on doing my work (which I deny. I would say I was a bit of an over-achiever when I first started and have noticed a decrease in the quality of the work that I've been doing and will acknowledge that it needs to be addressed) and that I'm not pulling my weight as I should be. Aside from the one comment where I've been slacking, I think the other complaints sound vague and while they may be true, I wish that this had been addressed when these behaviors first cropped up. On top of this drama, I've been having real trouble sleeping lately and would consider asking my nurse manager to switch me to day shift, but I don't want to rock the boat anymore than I already have.

How do I approach my nurse manager about my accountability for these behaviors? I realize that it's become a problem and I'd like to work on a solution, but I feel like part of it is not my fault and I'm really trying to improve my behaviors, but when I'm on a med that makes me excessively sleepy, it's hard to get everything done to the best of my ability. I have been battling with bi-polar disorder and have been having a particularly tough time with my symptoms lately. I work on an inpatient psychiatry unit and sometimes I wonder if I'm crazy enough to necessitate becoming a patient myself. I feel like I'm providing good care to my patients and I'm making every effort to separate my work life and my personal life, but it's been really difficult lately. How do I bring this up to my nurse manager without making her think that I'm incapable of performing my job? I'd like to improve my behavior and make it up to my co-workers that I feel I've let down, but it's frustrating that this was all mostly hear say and things said behind my back. I feel like my co-workers don't like the fact that I was hired as a new grad and can't help but think that I've fallen into becoming a victim of unit politics. I'm not saying that I shouldn't be held accountable for my own actions, but I would like support and advice on working out a plan to solve this problem.

I've contemplated taking a leave of absence until my medications get sorted out or going inpatient and just getting things sorted out on a STAT basis because this is really affecting me and my peers negatively, but I'm not sure if that's the best idea. I can't afford to make any mistakes and I want to improve my behavior. I should add that I have the next couple of days off from work and I was thinking about scheduling a meeting with my NM on Monday, before I make the decision whether to go in or think about a leave.

[Katie5]

First, I'd suggest, you own it. Then think of a realistic approach to becoming better. Try not to approach your manager until you have some interventions in hand.So that way, when you bring up the problems you're facing then you also have solutions to it.

But also try not to keep it too long, that others have to report you.( We learn everyday).

[roser13, ASN, RN]

I think there are two distinct issues here. One is more critical than the other.

The most critical issue (as I see it) is your mental health. That needs to be considered first and foremost. Do you feel that you need to go inpatient? Completely separate from your work issues, are you in a state where you need more care than you're receiving? What does your care provider say? (I'm not asking for answers to be posted, I'm just trying to suggest priorities.)

Only after you are feeling stable can you consider your job performance and how to address any issues. If that means you must take a medical LOA to receive proper care, then I would certainly consider that. I don't know that it would be necessary to fill your NM in on every step of your thought process. I would advise you to make your personal care decision first, then go to her with your decision.

[guest64485]

good advice above. Also, one thing that I do that may help you, is that before I go to bed I set my alarm clock on the opposite end of the room (to force me to have to get up out of bed in order to shut if off), and then I set my phone alarm for 5 minutes later, also on the opposite end of the room. This has helped during the times that I accidentally set one of my phones to alarm for p.m. instead of a.m., and during power outages my cell phone will still alarm, and if by chance I sleep through one of the alarms, the other will get me, or if a family member accidentally turns off an alarm I'm still covered by the other. I've also occasionally set a 3rd alarm in a completely different room, each alarm a few minutes apart from the others. After I've started doing this I've never gotten up late since. Good luck to you.

[pinkiepie_RN]

I think there are two distinct issues here. One is more critical than the other.

The most critical issue (as I see it) is your mental health. That needs to be considered first and foremost. Do you feel that you need to go inpatient? Completely separate from your work issues, are you in a state where you need more care than you're receiving? What does your care provider say? (I'm not asking for answers to be posted, I'm just trying to suggest priorities.)

Only after you are feeling stable can you consider your job performance and how to address any issues. If that means you must take a medical LOA to receive proper care, then I would certainly consider that. I don't know that it would be necessary to fill your NM in on every step of your thought process. I would advise you to make your personal care decision first, then go to her with your decision.

I'm going to be meeting with my therapist on Monday at the earliest and I don't want to go into work without having a game plan. I'm scared about not meeting with my NM before I go back to work because I feel like since I've come out as having mental health issues to one of my co-workers, that it will come back around to her before I can get the words across. I feel stable most of the time, but I feel like this additional set of problems is adding to my mental instability.

[pinkiepie_RN]

good advice above. Also, one thing that I do that may help you, is that before I go to bed I set my alarm clock on the opposite end of the room (to force me to have to get up out of bed in order to shut if off), and then I set my phone alarm for 5 minutes later, also on the opposite end of the room. This has helped during the times that I accidentally set one of my phones to alarm for p.m. instead of a.m., and during power outages my cell phone will still alarm, and if by chance I sleep through one of the alarms, the other will get me, or if a family member accidentally turns off an alarm I'm still covered by the other. I've also occasionally set a 3rd alarm in a completely different room, each alarm a few minutes apart from the others. After I've started doing this I've never gotten up late since. Good luck to you.

This is a good idea, and I'm thinking of getting a really obnoxious alarm clock because I think I've gotten so used to the sounds of my alarm clocks that I'll actually not even get up to turn it off but sleep through the entire time it's on before it turns itself off. It's also been brought up my my fiance when I have him try to wake me up that I fight with him about getting up, you know "5 more minutes please" and it gets to a point where he gives up. I will definitely work on setting more alarms.

[caliotter3]

good advice above. Also, one thing that I do that may help you, is that before I go to bed I set my alarm clock on the opposite end of the room (to force me to have to get up out of bed in order to shut if off), and then I set my phone alarm for 5 minutes later, also on the opposite end of the room. This has helped during the times that I accidentally set one of my phones to alarm for p.m. instead of a.m., and during power outages my cell phone will still alarm, and if by chance I sleep through one of the alarms, the other will get me, or if a family member accidentally turns off an alarm I'm still covered by the other. I've also occasionally set a 3rd alarm in a completely different room, each alarm a few minutes apart from the others. After I've started doing this I've never gotten up late since. Good luck to you.

Every device I have that has an alarm or several alarms gets set when I need to get up. I set all the available alarms on my cell phones and move them close enough so I can hear them but far enough so I have to get up to go get them. And each one has a slightly different alarm time to keep at me until I really do wake up and get up.

[zuzi]

DBL, sorry to hear that about you. My first question is... when they hired you the knew about your mental health issues? Because if so... then NOW, when yourself have concern about yourself, they need to act and help you to pass by it, because a mental helath issue, even if is medicated, could have relapses, so by law you need to be protected, see employee rights.

If not, and NO ONE knows about your mental problems, may be is the time to know now, your openess is supossed to change them behavior and the actions to came from upside down, to balance the situation created, not premeditated by you at all, but because of your illness.

Do you have someone to talk about? Ask your therapist about your options! Try to obtain a DX paper with his recommendations and talk after with HR. Togheter you need to make a plan! You will be ok, go to your MD for reasses of meds. Hugs hon!

[pinkiepie_RN]

DBL, sorry to hear that about you. My first question is... when they hired you the knew about your mental health issues? Because if so... then NOW, when yourself have concern about yourself, they need to act and help you to pass by it, because a mental helath issue, even if is medicated, could have relapses, so by law you need to be protected, see employee rights.

If not, and NO ONE knows about your mental problems, may be is the time to know now, your openess is supossed to change them behavior and the actions to came from upside down, to balance the situation created, not premeditated by you at all, but because of your illness.

Do you have someone to talk about? Ask your therapist about your options! Try to obtain a DX paper with his recommendations and talk after with HR. Togheter you need to make a plan! You will be ok, go to your MD for reasses of meds. Hugs hon!

Zuzi, thanks for your support. No one officially knows about my DX, with the exception of Employee Health, who has a list of the meds I was on and my tox screen from my pre-employment physical. I'm scared of telling my NM because I'm afraid I'll be treated differently, like I'm special and I don't want special treatment.

[catshowlady]

A couple of items to add to the above:

Re: alarms, look for a device called a Screaming Meamie (I think that's is how it's spelled). It's an alarm that works on batteries only, so you don't have to worry about loss of electricity. This thing is so loud and obnoxious, I don't think anybody who isn't stone deaf could sleep through it. I used it when I was working nights. I got mine from my ex's brother, who was a trucker. The best place to find one would be a big travel plaza on an interstate, the kind that do a lot of business with OTR truckers.

On another topic, are you new to the facility? If not, and you have been with the company for more than a year, you need to apply for FMLA. It can help cover for those tardy occurrences. Even if not, you may want to look into whether laws like ADA laws can help protect you while you work on improving things. Does your facility offer an Employee Assistance Program? The EAP counselor may be helpful to you as far as working out a plan for performance improvement. Also, when you approach your NM, ask for her help in developing a performance improvement plan, and ask her to work with you regularly to help you meet the goals in your plan. Basically, demonstrate that you are not there to make excuses, but need her to help you work on your issues.

Hang in there. :icon_hug:

:paw:

[pinkiepie_RN]

A couple of items to add to the above:

Re: alarms, look for a device called a Screaming Meamie (I think that's is how it's spelled). It's an alarm that works on batteries only, so you don't have to worry about loss of electricity. This thing is so loud and obnoxious, I don't think anybody who isn't stone deaf could sleep through it. I used it when I was working nights. I got mine from my ex's brother, who was a trucker. The best place to find one would be a big travel plaza on an interstate, the kind that do a lot of business with OTR truckers.

On another topic, are you new to the facility? If not, and you have been with the company for more than a year, you need to apply for FMLA. It can help cover for those tardy occurrences. Even if not, you may want to look into whether laws like ADA laws can help protect you while you work on improving things. Does your facility offer an Employee Assistance Program? The EAP counselor may be helpful to you as far as working out a plan for performance improvement. Also, when you approach your NM, ask for her help in developing a performance improvement plan, and ask her to work with you regularly to help you meet the goals in your plan. Basically, demonstrate that you are not there to make excuses, but need her to help you work on your issues.

Hang in there. :icon_hug:

:paw:

Thanks for the advice about the alarm clock - I will keep my eyes peeled!

I am indeed new to the facility and therefore don't qualify for FMLA yet, but I never even thought of consulting with EAP (which my employer does provide) and looking into ADA laws. Thanks for your feedback about approaching my NM. It was really helpful.

[SheaTab]

Dolce:

I'd like to applaud you for owning your part of the issue that has resulted in others questioning your performance at work. Bipolar meds are major funk factors because almost all of them result in excessive drowsiness. This is an issue you might want to aggressively pursue with your psychiatrist because there might be an alternative you can try. The problem is that if you are difficulty controlling your bipolar symptoms, you are likely to have your dosages increased which will compound the problem. Maybe there is an alternate dosing schedule you could try?

I'm not so sure I would be quick to share your diagnosis with your NM. Wrong as it is, there is a stigma attached to mental health issues, and you might find yourself sliding down a slippery slope admitting to a mental illness and medication regimen being responsible for your poor performance. I would let her know that you value your job and will work diligently to improve your performance. Alternatively, you could work hard to improve your performance issues and not request a meeting unless one is requested of you. You might be able to fix this without drawing further attention to yourself.

Are you presently in therapy as an adjunct to your psychiatric treatment? You might consider this to help you with life management challenges and effective stress management.

What do you think?

Wishing you the best,

Tabitha