Just wanted some thoughts on my situation, here it is...
I graduated in May-gotta job on a med/surg floor- 4-weeks of orientation-and I'm now caring for 6-7 pts all by myself.
But get this. I have no resource person, no one offers help, and I'm still working under a TEMPORARY LICENSE! What's the legalities on this?
Also, yesterday a doctor asked me why I turned off a morphine drip when respirations were 6, and this pt is braindead after a massive MI. The order said "titrate to comfort". A dnr ofcourse but, I almost laughed and said kiss my a**.
Not really-I just told him i learned it in school and the ativan was working just fine until respirations came back up. LORD HELP ME!
How scary for you! I graduated last year, started in the ER, and had a 6 month orientatation. If you feel like you need more of an orientation, you need to speak up. OR you need to just cut your losses. Did you sign a contract with money stipends? You may be able to get out of it seeing as you're still in a probie period and they're pushing you to do unsafe care (in your eyes). Definitely speak to your manager, and just tell her you don't feel comfortable being on your own after only 4 weeks and being a GN. Are there other GNs on your unit? How do they feel? If this is a general feeling throughout the rest of the new grads, it may add some power to your words. Good luck.
i totally know how you feel. graduated in Dec., boards in March. i started orientation in February but wasn't allowed to do anything till they could confirm my license. now i have been working on my own for a few months, and feel like they are head hunting.
a few weeks ago, a senior nurse on previous shift gave me report at shift change. he stated that their was a problem with a patient's wound vac. in nursing school...we didn't come into contact with wound vacs..didn't even talk about them. he stated that their were no more supplies and if i (emphasize I) couldn't get it running and keep it running. that i would have to apply some type of dressing to the wound after removing the wound vac dressing...vaguely remember something about a wet to dry. I got the vac running and was able to keep it running until about 2 hours before my shift was over. i ended up shutting it off about 45 minutes before the end of my shift. gave report and asked the oncoming nurse what to do. she said to leave it and she would have our wound nurse take care of it when she came in (about 20 minutes later).
yesterday, i was written up for the entire incident. the nurse who was having the problem with the vac in the first place told them that he told me what to do with it....but failed to tell them that the vac was off when i came on shift and the other nurse never notified the wound nurse until 2 hours after i gave report. she wrote me up because it took almost 1 hour to peel the wound vac dressing off the patient.
like an idiot, i stood there with tears streaming down my face and took the blame for everyone else's negligence including my own.
i decided right then and there...never again. the male nurse i work with is a hot shot who gets away with a lot of things he shouldn't and passes alot of stuff onto the new nurses and laughs when we don't do it right and get called on the carpet. i have written a detailed letter to the wound nurse detailing the events of that evening...i admitted my responsibility but also stated that it is important that he be held responsible for his actions as well
and he was......i feel like i won a little battle but not the war cause now they are scrutinizing my every move and nursing action.....gonna have to fire me though....i am not giving up
keep your chin up and talk to someone in management....my ally was the wound nurse's boss....our DON
So what did the doctor say in response. Its sounds legitimate to me that you would not want to continue morphine (at least at that drip rate) if the respirations were 6? I was more curious about the situation... I think the above advice is all good advice.
:angryfire I know how it feels to be thrown to the wolves.... I just passed my nclex in may. Right now i'm on my 7th day at my 1st nursing job... It's a scary thing when someone hands you a list of 10 patients and says have fun........ No I'm not kidding either!!!
:trout: It's not fair and it's not right. You should go talk to the person who recruited you OR talk to the head nurse/nurse manager. Good Luck....
I couldn't even start with hospital orientation or begin my critical care course, let alone take care of patients without the manager seeing my license in person.
hi I'm a canadian nurse and work in an Icu unit. We are in great need of nurses. Senior nurses like to have their holidays stats ect off so it only stands to reason that they should encourage and help our new nurses. We usually do not get brand new nurses in ICU (good idea to have at least a few years experience) but with that being said we do have one new nurse and thank god our manager is having him mentored for four months . We were all new nurses at one time in our lives so lets help out our younge ones:kiss
...........yesterday, i was written up for the entire incident. the nurse who was having the problem with the vac in the first place told them that he told me what to do with it....but failed to tell them that the vac was off when i came on shift and the other nurse never notified the wound nurse until 2 hours after i gave report. she wrote me up because it took almost 1 hour to peel the wound vac dressing off the patient.
like an idiot, i stood there with tears streaming down my face and took the blame for everyone else's negligence including my own.
i decided right then and there...never again. the male nurse i work with is a hot shot who gets away with a lot of things he shouldn't and passes alot of stuff onto the new nurses and laughs when we don't do it right and get called on the carpet. i have written a detailed letter to the wound nurse detailing the events of that evening...i admitted my responsibility but also stated that it is important that he be held responsible for his actions as well
and he was......i feel like i won a little battle but not the war cause now they are scrutinizing my every move and nursing action.....gonna have to fire me though....i am not giving up
keep your chin up and talk to someone in management....my ally was the wound nurse's boss....our DON
Sounds like another typical story of "nursing eats the young". I feel for you and I had a similar situation when I first started. The co-workers there were not supportive and finger pointing was the only way to solve problems. I decided not to fight, just felt like it won't even worth trying. I quitted and got my present job which nurses are more supportive. Basically, my take is no matter how hard we try, we are going to make mistakes one way or the other. A supportive co-worker is willing to help you get things straighten out. And you do the same when they need help. A lot of people think by pointing finger and cause someone in trouble will make them more successful. And you will continue to see many people like this on the floor. In fact, this reflects how insecure they are. I believe a mature nurse will never need to point fingers to get security. With time, we will build up our skills and knowledge. Things will become easier by then. :)
Just wanted some thoughts on my situation, here it is...
I graduated in May-gotta job on a med/surg floor- 4-weeks of orientation-and I'm now caring for 6-7 pts all by myself.
But get this. I have no resource person, no one offers help, and I'm still working under a TEMPORARY LICENSE! What's the legalities on this?
Also, yesterday a doctor asked me why I turned off a morphine drip when respirations were 6, and this pt is braindead after a massive MI. The order said "titrate to comfort". A dnr ofcourse but, I almost laughed.
Not really-I just told him i learned it in school and the ativan was working just fine until respirations came back up. LORD HELP ME!
had that happen to me also - got a big talking too and i still refused to take care of the man - titrated to comfort is one thing - but the guy i was taking care of titrated till he was out like a light and could not even wake to see his family - when we lowered his dose he came out of it and was still comfortable yet the family had a fit and wanted him out asleep - THEY said he was in pain - the guy denied pain, did not appear to be uncomfortable, and the family wanted him to sleep - i just refused to do the patient - i know many cant do that for fear of job loss - i was pretty secure cause when i came in there was much of a shortage - its a tough call. good luck i am sure many here will have some great advice and also have had the same experience -
It hate it for you and other new grads, because when orientation is over, it's over. But you have to take things in your own hands or you're going to get frustrated and make mistakes.
Good luck.
it is sad - when i was in school i spent the whole last semester interning then i had 2 months of orientation and i hear from new grads around here in hospitals they get maybe a few weeks ands are on their own . i wish it was still the same way like when they did not want to loose me and my orientation was until i was the one comfortable - it appears they don't seem to care of the new grads cause "someone else will come do it" is their attitude - so they don't feel the need to stand by them and teach them.
There was one other LPN in the facility on another floor, and NO RN, which is against the law. As a GPN, i had to work under the supervision of an RN at all times. I pointed this out to the DON the next day, and was told not to worry about it. Long story short, i didn't work there long.
Make sure about the legal aspects of what you're taking responsibility for, and remember, it's YOUR future license you're protecting!
if anyone knows what the actual law says id be interested as we have had this happen quit a bit in our LTC where they have an intern and then only an LPN - i was under the impression that an RN HAS to be INHOUSE with them and have been told they don't have to be INHOUSE just ON CALL - which i find doesn't sound right and personally i feel bad for the LPNs as not to many are comfortable "being charge with an intern" ( not that they don't like interns - they do - its just they don't want to risk their license if the intern does make a mistake - so who ultimately is the one responsible- and am i - as an RN - if i am on a shift and know the next shift has that situation and i punch out and leave the intern ( i am not physically able to pull doubles these days) with the LPN - is it my license for leaving or is it the facility - any opinions would be great. id love to be armed with accurate info to argue it out with the boss and turn them In if they don't comply - thanks
Which one of the RNs on the floor is going to take the fall if you make a major mistake on the floor?? I hope you don't, but it happens. Your facility is setting itself up for lawsuits and putting the licenses of their staff at risk.
id also like to advocate here that any nurse should get their own insurance on their license - it is a very reasonable price per yr - i do not recall off hand but its good price and good policy - i got my through ANA - i think lol - i would never trust any facility to stand up for you in the event of a mistake - get the policy and have the reassurance that you have your own legal help to defend you and defend you against any shinannigans the facility may try ( such as "oh she had a preceptor but she did not ask blah blah - " cause they will do that to save thier butts.
we have new grads on our unit with temp licences. they are expected to do the same work as the rest of us. they only can't be in "charge" experience takes time and patience. however, we do not coddle anyone. we are short staffed and really don't have the extra time to follow someone who's graduated a program and has done the clinical hours. try not to see it as being "thrown to the wolves." every grad has been given the tools to do the job and that is the expectation - that they will do the job.
perhaps you have started on the wrong unit. some units are fast paced and speciallized and you have to really be on the ball. 6 -7 patients is not a hard load when we on our unit have 12 patients on a day shift. we are responsible for 18 on the night shift. our orientation lasts two weeks and a lot of times, the ones that can't "cut the mustard" end up finding work elsewhere. so keep your options open. acute care may not be for you.
where i work, if you have applied for the job, you must think you can do it. you have to learn quickly and make sure you know your stuff. i think maybe perhaps you feel this way because you are inexperienced and your expectations aren't very high. nursing is not an easy job. if there is something you don't know, then make sure you know it. you have to have high expectations of yourself and not make mistakes. and don't worry about your case load. i wish we could have only 6 - 7 patients!!! you lucked out there.
hang in there.
most of the nursing students i have known have not worked as an intern during school but perhaps this may be the ticket to help them being as they are shoved so quickly after grad without any experience- i agree with those saying real life is not anywhere the same as school - so if you are working as an intern ( when i did that i was not paid well and i was used mostly as a cna but the nurses were very good at getting me the experiences and getting me for procedures and "schooling " me on breaks - it helped immensely - just a thought to throw out there.
RunnerRN, BSN, RN
378 Posts
How scary for you! I graduated last year, started in the ER, and had a 6 month orientatation. If you feel like you need more of an orientation, you need to speak up. OR you need to just cut your losses. Did you sign a contract with money stipends? You may be able to get out of it seeing as you're still in a probie period and they're pushing you to do unsafe care (in your eyes). Definitely speak to your manager, and just tell her you don't feel comfortable being on your own after only 4 weeks and being a GN. Are there other GNs on your unit? How do they feel? If this is a general feeling throughout the rest of the new grads, it may add some power to your words. Good luck.