a new grad's gripes

[LoveActually]

I really hate it when the ED brings me a pt. on levo, takes them off the pump, doesn't tell me, and leaves the room, and then I take a pressure and the BP is TANKED, and I'm like CRAP! THE LEVO isn't even hanging! I have been a nurse for like 5 minutes, and this has happened to me 3 TIMES!!!!!

Or when the ED chartS they gave Vanco at a certain time, but when I mull it over a little later, when I get my bearings, and I realize that Vanco should have been still hanging when they arrived, and then I call pharmacy, and they tell me Vanco was NEVER dispensed for this patient.

I don't want to turn this into an ER gripe session. I'm just venting.

Or when fellow nurses who CLEARLY have MUCH easier assigments, or ONE PATIENT sit around and ******** while I run around frantically with a newly admitted, unstable patient. (This doesn't often happen)

Snotty doctors.

Docs that don't order labs for patients that REALLY need them. And then I have to choose between getting the info we all need to care for the patient properly, and doing things that kinda out of my scope of practice. Someone who had blood transfused the day before & was on K-phos doesn't get a CBC, BMP & phos, or ANY other labs to boot? Really?

Docs that aren't on board with protocols, that don't care, and want to do their own thing. Eg: sepsis protocols. Protocol says I use a Vigileo, and I have to report, and chart CVPs, SVV's CO's, CI's, and no one uses those numbers to guide the patients care, or gives a rats a$$?

Day shifters that think we don't do anything at night.

Our nurse aides which are totally useless. Not nurse aides in general, just the ones on our unit.

Paper charting.

Orders that take me a half hour to decipher.

When the doctors STEAL my bedside charts.

Not beginning report until 0715 because people are late.

Not getting to go home on time because someone didn't show up, and I have to come back that night. This happened to me twice in the last 2 weeks.

Nurses that forget it's 24 hours of care.

Super Nurses.

Nurses that forget what it's like to be a new grad!

ok, I feel better now. And with all of these negatives I just mentioned, I remembered a bunch of positives

[Laurie52]

Perhaps you were just tired when you posted this, but overall it is really negative and you seem really unhappy about where you work.

I really hate it when the ED brings me a pt. on levo, takes them off the pump, doesn't tell me, and leaves the room, and then I take a pressure and the BP is TANKED, and I'm like CRAP! THE LEVO isn't even hanging! I have been a nurse for like 5 minutes, and this has happened to me 3 TIMES!!!!!

If this happened to me once, the next time I would have a pump available for all admits. When I admit a patient from the ED I always have at least 1 and usually 2 pumps available, I also try to be available when the patient gets to the SICU so I have the ability to ask any last minute questions.

Or when fellow nurses who CLEARLY have MUCH easier assigments, or ONE PATIENT sit around and ******** while I run around frantically with a newly admitted, unstable patient. (This doesn't often happen)

Are the other nurses assignments really so much easier, or are they just a little more experienced in caring for these patients? Have you asked for help and they refuse or are you expecting them to just know how busy you are?

Docs that don't order labs for patients that REALLY need them. And then I have to choose between getting the info we all need to care for the patient properly, and doing things that kinda out of my scope of practice. Someone who had blood transfused the day before & was on K-phos doesn't get a CBC, BMP & phos, or ANY other labs to boot? Really?

Someone who was transfused yesterday does not necessarily need aCBC daily unless you have some evidence of active bleeding. Depending on how much electrolyte supplementation your patient recieved, they may or may not need to have them rechecked. Did you ask the physician for his or her reason for not ordering the labs.

I have worked in critical care for 35 years. Maybe you can find a mentor in the ICU you are working in that can help you be happier and more comfortable in the ICU.

Good luck and I hope things get better for you.

[Nccity2002, MSN, RN]

....and you know what I hate the most?? New grads who always blame others for their obvious lack of organizational skills...

[missbutton]

To the OP: I'm a year out and I'm still there many days. But you learn to tread water. And after switching units, I now know how important unit culture is to my professional satisfaction.