New Grad-What should I do?

Nurses New Nurse

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I graduated in May, pass the board on June 1st. started my unit orientation after 7/04. I am on surgical step down unit. It has been 4 weeks like hell.

During the these 4 weeks, I had 2 meetings with my manager and preceptors. the first time just manager and preceptor. My preceptor said that i didn't pay attention to the report, which is i wasn't familiar with the stuff they are talking about and they went too fast, everytime they gave report, i would try to find things they talked about on the shift report. Also there was one time, we went to help with another nurse who is relatively new too to put a NG tube in, i asked a stupid questions" what is the NG tube for?" I meant why is this patient need a NG tube since i didn't know about patient's condition. This stupid questions made her think that i didn't know my basic stuff. BTW, i am a foreigner came to US 5 years ago and finished nursing program in US.

Later on, I found i wasn't give clear instruction on what to do. After about 2 weeks with my first preceptor, I talked to my manager and changed my preceptor to a tough but a good one. She would watch over my shoulder and really teach me how to do things the right way. I wish i started my orientation with her at the begining instead of waste so much time with the first one. Even with the good preceptor, i still make mistakes almost every day. Such as when i had all 6 patients last Wed, and so much went on at the same time, new admit, discharge, pt went down for surgery. My head went crazy that day. I could catch up with doc's orders, and had miscommunication with my care partner that made me didn't give insulin to one of the patients whose BS level was 377.

After that, i had my second meeting with the manager. This time, they brought the HR person there. They were saying that I wasn't safe enough to practice, i should be able to read doc's order without any problem without keep double checking with my preceptor about the orders, also they were hinting maybe i shouldn't con't practice there.

When i look back, i did see i have ups and downs, but i did try my best. i would always double check to make sure everything i did were correct. The biggest problem is sometimes i get into something, doc ordered some stat meds, i didn't notice, and gave them like 2 hours later.

I asked manager to give me some more time, she goes, "before you get in, we say orientation is going to be 6-8 weeks. In reality after 4 weeks, we do extend orientation 1 or more weeks to certain nurses if we feel they gonna be successful here." They were expecting me to start on my own on this busy floor after 4 weeks of orientation and make money for them.

I am thinking about resign and restart somewhere else. Reason is i believe i can become a good nurse, but they don't give me the opportunity to grow in my own pace. They are not happy i am there, and i am not happy to be there.

Sorry that i typed a lot. Any suggestion would really be appreciated.

Specializes in Cardiac.

I think what happened is that the tech told her about the blood sugar and the need for blood cultures. Then the tech told her that she told her preceptor and that she 'didn't have to do it'. She probably meant that she didn't have to do the BC, but the nurse probably thought that her preceptor covered the BS.

I agree with one very important comment that you made suemom2kay: when you commented on mistakes. I wanted to say it myself but forgot. The PP who found fault in the OP by saying that she would have known better...My first thought was, wait until you make a mistake. Give it time; you will. This job has awesome responsibility and mistakes have nothing but opportunity to sneak in. Beware, because those that think they are immune from mistakes tend to fall the hardest.

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Wow!! I am graduating in DEC 06 and I hope I have more empathetic co-workers than TRUER seems to be. I am an ex Navy Hospital Corpsman who worked in an acute care setting and am just finishing nursing school and I continue to make mistakes- BUT we learn from them. Do not give up! You have worked so hard to get to this point- believe me we all know!

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Specializes in Telemetry & Obs.

I'm sorry, perhaps I was unclear in my first post but I stand by my assertion that if the OP had accepted responsibility in the first place this wouldn't have progressed to the point of HR stepping in and her fearing losing her job. Kinda hard to learn from a mistake when someone won't admit there IS one, you know?

All nurses, especially new nurses, are fallible. Yes, I'm sure I'll make mistakes...but I won't make the mistake of not being accountable as well.

That was ALL I was trying to say to the OP...although obviously I did a poor job of it.

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Thanks a lot for the support and suggestions.

My preceptor said teaching hospital can be even busier. Is that true? I asked one of my classmate who works at the teaching hospital that i wanted to work for, she said with the presence of residents, it seems better than the small hospital that i am with right now.

Anybody can put some input here and tell me more about the teaching hospital vs. non-teaching hospital?

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I understood what your meant. I am not pushing my responsibilities to other people. I was saying that they didn't allow me to learn from my mistakes, they expect me to be able to take the full responsibility too soon without giving me more time.

And i do understand for small hospitals with the pressure of competition with the neighbor hospitals, MONEY is very important to them. But for them to get more from a new grad, they need to invest more too without rushing.

I'm sorry, perhaps I was unclear in my first post but I stand by my assertion that if the OP had accepted responsibility in the first place this wouldn't have progressed to the point of HR stepping in and her fearing losing her job. Kinda hard to learn from a mistake when someone won't admit there IS one, you know?

All nurses, especially new nurses, are fallible. Yes, I'm sure I'll make mistakes...but I won't make the mistake of not being accountable as well.

That was ALL I was trying to say to the OP...although obviously I did a poor job of it.

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Specializes in Burn ICU, Psych, PACU.

I'm working in a teaching hospital as a new nurse in the Burn ICU (cross-training in the Surgical ICU). My orientation, and preceptors, have been great...tough? Yes, but thorough. Communication has been the key and that goes both ways. If I have a question, I ask it...like my SICU preceptor has told me numerous times...there are no stupid questions (especially when caring for extremely ill burn or trauma patients). I guess I'm lucky when I read all these posts about new grads having such a hard time. A large Level I Trauma (teaching) hospital has been a great experience for me, but then again, I tend to expect to be taught and focus really hard on being teachable and it actually happens! Best wishes to all new grads out there...work as hard for what you need in your new jobs as you did during nursing school. If you're a new nurse, that means you've put your shoulder to the wheel and gotten this far...dream big and work hard :) !

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Teaching hospitals have their good points. So do smaller hospitals.

The pace in a teaching hospital is usually "full-tilt boogie" but some people excell in that atmosphere. I like teaching hospitals....but I also like non-teaching hospitals. From experience...I can tell you that residents can be a royal pain the the behind! It seems like you just get one set of residents in line...and it's time for a new crop of them....then you start all over from square one again.

Until you get your feet firmly under you...and get your skills down pat....which will build your self confidence... Maybe you should look for a slower paced unit....one where you won't have as many patients. Or an institution that will give you a full orientation period. Sounds like the unit that you are currently working on is not new nurse friendly...with that short of an orientation for new grads. Good luck. Please keep us posted.

And remember...we are all human, and humans make mistakes....learn from them and grow in the process. Again...good luck.;)

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Specializes in Trauma ICU, MICU/SICU.
I'm sorry, perhaps I was unclear in my first post but I stand by my assertion that if the OP had accepted responsibility in the first place this wouldn't have progressed to the point of HR stepping in and her fearing losing her job. Kinda hard to learn from a mistake when someone won't admit there IS one, you know?

Where do you get she won't admit to a mistake? She admitted to all of her mistakes. She just feels that they are rushing her into independent practice too quickly and she is absolutely correct? 4 weeks of orientation for an american born nurse is not enough. A foreign born nurse will need even more due to the language barrier. I wouldn't want to be rushed. Even if I was transplanted to the UK where they speak the English there are cultural and yes, language barriers, which would make me want a longer than normal orientation.

BTW, how long have you been a nurse? Because your responses seem something born of nursing school and not born from experience. I see you've just passed NCLEX so it cannot be more than a month or so. I think you need to listen a bit and post less when it comes to mistakes, since you haven't had the opporunity to make many yet.

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Specializes in Trauma ICU, MICU/SICU.
Thanks a lot for the support and suggestions.

My preceptor said teaching hospital can be even busier. Is that true? I asked one of my classmate who works at the teaching hospital that i wanted to work for, she said with the presence of residents, it seems better than the small hospital that i am with right now.

Anybody can put some input here and tell me more about the teaching hospital vs. non-teaching hospital?

Yes teaching hospitals are very busy. But most have learned how to effectively orient nurses. Don't be afraid to apply. Ask how long orientation is and get it in writing. Your contract should say the minimal amount of orientation you are entitled to. Also, you may want to have a clause added to give you more time since there is a language barrier. I know you've been here 5 years, but it still may take you some time to get everything. I don't know you and have never spoken to you, so I don't know where you are at with language.

You are doing a great job and asked for help and time and it wasn't given to you. A "busy" teaching hospital will be much more likely to give you a reasonable orientation. Like 12 weeks for med-surg, even longer for critical care.

Good luck!

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Specializes in Telemetry & Obs.
Where do you get she won't admit to a mistake? She admitted to all of her mistakes. She just feels that they are rushing her into independent practice too quickly and she is absolutely correct? 4 weeks of orientation for an american born nurse is not enough. A foreign born nurse will need even more due to the language barrier. I wouldn't want to be rushed. Even if I was transplanted to the UK where they speak the English there are cultural and yes, language barriers, which would make me want a longer than normal orientation.

BTW, how long have you been a nurse? Because your responses seem something born of nursing school and not born from experience. I see you've just passed NCLEX so it cannot be more than a month or so. I think you need to listen a bit and post less when it comes to mistakes, since you haven't had the opporunity to make many yet.

You know...I've had a great day being a great nurse today to come home to this crap. For the LAST time, I simply meant that if she had said "YES, I should have covered the BG of 377.....YES, I should have given the STAT meds on time" then perhaps management would have been more willing to work with her instead of calling in HR.

I HAVE made mistakes, I WILL make more. I don't need you or the other posters to rub my nose in it. Nor do I need you to tell me what and when to post.

Btw, learning to be accountable isn't exclusive to nurses. I learned it long before nursing school.

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exairex-

Maybe hospitals just aren't a good fit for you. I do think 6 patients is way too much for a new nurse. Your hospital doesn't sound like the best place to be....perhaps you should look for a job that isn't so demanding, like a Dr's office or something. You probably wouldn't feel so lost there.

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