New Hire Blindsided by Feedback!

[CardiacRNLA, BSN]

Hi all,

This is more of a rant that anything. I started at a new hospital about 3 weeks ago on a fast paced cardiac intervention unit. I came from a medical unit, so obviously everything will be new to me. It's been a steep learning curve and this hospital is much more disorganized than my last facility. So on top of learning new medicines, procedures, etc, I am learning who does what, who doesn't do what, variations to the rules, etc.

Anyway, I thought that these were regular growing pains and that it would work itself out. My manager called me into the office with others from the leadership team for a "check-in." I felt completely blindsided.

1) I was told my problem was that "because I have some experience, I act and think that I know things, but I really don't know them." She told me to just listen to report, soak it in and ask questions, etc.

2) Also I was scolded for leaving the patient for a few moments during the settling procedure post-heart cath (I realize how stupid that was!). I was told that I left a CNA with a patient that it's not the CNAs responsibility, etc.

3) I received a patient from the ED who had a NSTEMI and was placed on a heparin drip. The ED nurse said he stopped the Heparin drip due to some lab result and that he felt cardiology would keep it suspended (without actual proof from cards). Like I said, all this is really new to me. So as he was telling me, my preceptor (not my primary preceptor) was getting upset with me because she wanted to know when the ED nurse stopped the drip so we could know when to restart it if needed. She's upset at me. The ED nurse is mad at me because he doesn't get why I'd ask that question (This is all happening during the phone report). So I get flustered and upset. After the fact, I guess the ED Manager complained about me to my boss and my boss said I need to be professional and work with others, context be damned.

4) At this facility, other departments can "write you up" with incident reports that go to your manager, which I think is petty. I got written up for abbreviating "wound vac." Then I had another patient who was going for a procedure. I didn't hear in report that the night RN had already called report to the OR. I just knew the time for the procedure and tentative OR time. So transport shows up out of nowhere (at my old facility both the OR and transport would call before sending for the patient), and I was scrambling to get his blood consent and complete the anti-sepsis protocol. It got done, but apparently because it was a near miss, that was a mistake also.

At any event, I just felt really shocked and hurt at some of my managers comments. I thought things were relatively okay and now it seems like I am in deep trouble. Also her initial assessment gave me the impression that she thinks I am a know it all who doesn't want to learn and has a flippant attitude towards patient care. That is NOT true. Most of my problems are from fear and timidity. Not from pride or arrogance. I know absolutely NOTHING about cardiac! I will tell everyone!

Also in regards to those mistakes, I felt that I have corrected some of those things. For example, I have since NEVER left an immediate post-cath patient room and recognize it is stupid to do so! I told my preceptor to allow the nurses to give ME report and not her so I can learn. I recognize it is on me to ask questions, get over my fears and not be intimidated.

My boss told me to act like a GN and just soak it in, ask questions and learn. But on the other hand, she is telling me it's the 3rd week and I shouldn't be making certain mistakes. So should I act like a GN or am I supposed to be on the ball? Especially when just about every nurse leader asking me if I am off orientation already. Like I said, the comments and even the feedback blindsided me. I didn't know things were being perceived that poorly. I am scared of losing my job.

Any thoughts on how to move on, improve, etc? Thanks!

[ProgressiveActivist, BSN, RN]

You are rubbing people the wrong way and they are nitpicking you apart. Accept the feedback give em what they want and get on with your life.

If they want you to write out wound vac say ok wont happen again.

Never say I know. Its irritating to hear that when youre trying to orient. A little humility and appreciation is in order at this phase of orientation.

You really need to step up your game. Look up, learn and understand your protocols and order sets. Post here if you need help with that.

The cardiac forum and CC forum are good resources.

[CardiacRNLA, BSN]

Hi Libby,

While I appreciate the feedback I'm having trouble with it. I never said "I know" or keep saying that during orientation. As my post mentions, I do the opposite. I'm nervous, timid and scared because I don't think I know.

I agree I need to learn my protocols, no question. I need to take a step back no doubt. But I'm not sure why you're advising me to be humble and appreciative when I'm timid, feel dumb and as far as being unappreciative, this was a meeting called by my manager. It's not like I'm complaining or saying anything.

But thanks for the feeedback.

[ProgressiveActivist, BSN, RN]

The scariest new nurse is the one that doesnt ask questions.

never be afraid to ask for help when you dont know wth to do.

[CardiacRNLA, BSN]

You are absolutely correct! I just get so intimidated and feel like I should know. But ill read my binders, info and ask for help. I want to do better. I was just shocked that's all. Thanks again.

[VANurse2010]

For what it's worth, if this hospital is indeed disorganized and you didn't have trouble at your old facility, the problem is probably them and not you. If your preceptor had such concerns during that conversation with the ED, she should have spoken to the ED nurse herself.

[Been there,done that, ASN, RN]

Jesus, Mary and Joseph!! You are in orientation, you are not being precepted. This facility wants you to jump in blind. They must need a fully functioning nurse, STAT.

"my preceptor (not my primary preceptor) was getting upset with me because she wanted to know when the ED nurse stopped the drip so we could know when to restart it if needed. She's upset at me. " This is where the preceptor TEACHES, not get upset with you.

Only 3 weeks in, I would say thanks, but no thanks. No one can survive in that environment.

[noyesno, MSN, APRN, NP]

Sounds like a bad environment. Disorganized, hostile, bad communication.

Keep showing up, get some cardiac experience, and leave for a different facility.

[AuDDoc]

Wow sounds like you are being expected to work as an experience cardiac nurse from day 1 and any mistake you make rather than being a teaching moment is an excuse for a write up.

I would just keep my head down and get some cardiac experience and then transfer elsewhere to another cardiac unit in another hospital. I agree with another poster if you never had these issues at your previous place and this palce is that unorganized then it's most likely their problem not yours. You just need to go with the flow and cover your butt until you get your experience and can walk.