New Neuro PCU Nurse Needing to Talk to Management

[Jessell, BSN, RN]

Hi all,

I am hoping to just get some feedback and kind of "think out loud" about my situation.

I am a brand new nurse and I have started a grad-nurse program at a local hospital. I was always interested in neuro and also psychiatric nursing, and have been placed in a neuro progressive care unit. Unfortunately, the neuro part has turned out to be more of a rarity. It is really a step-down unit in general. Tele-unit. Intermediate care unit...you get the idea. I don't really have a problem with that except that I am disappointed. I do not normally complain and I feel that as a new nurse I need to just suck it up in most ways, and I am a super hard worker. I push myself. But in this situation, I feel like I am pushing myself too hard...over the edge.

I am starting to feel like when my orientation is over in about a month, I will definitely not be able to handle the constant admits and discharges, being flexed up to 5 patients on a regular basis, and all of the head-spinning that all that entails. I have already started to blank out when I am trying to remember what to do because there is just too much, my brain is fatigued, and I am physically and mentally unable to keep up. I have been so busy that I have been lucky in each 13-15 hour shift to get 1 bathroom break. I have gone without a bathroom break all day most days, and I am so busy that I don't even realize that I have not gone all day. I am just nervous for my patients when I am completely on my own. All this leads me to say that I NEED to talk to my manager about what to do. On one hand, I think they will just fire me if I say this to them. On the other hand, I feel like they are a huge hospital with 5 locations, all sorts of departments, and they really need BSN-trained nurses which I am. I am confident in my assessment skills, my patient advocacy and my patient education skills. I have a good background in pharmacy before going to nursing school so meds are not as hard for me as most grads. Of course so many things are new to me, and I am slower than seasoned nurses at most things. In order to be safe I need to be given a chance to not be speed-nursing all day, every shift. I am a valuable asset as a new nurse...just not in a flexed-to-5 tele unit in a high-turnover rate unit. I need them to give me a different unit. How do I not get fired, but also get out of this unit?? Can anyone here give me some concrete ideas of what to say or do? Thank you so much in advance!

[PixieRN1]

A month left is still a lot of time left on orientation. Has anyone brought problems with your time management skills to your attention? Have you talked to your preceptors about ways you can improve those skills? Short cuts, tips & tricks, etc? Is everyone else on the unit not taking pee breaks or breaks in general?

I guess part of me is wondering if anybody else appears to be struggling or do you feel that it is just you? If everyone is struggling, maybe a less acute unit would be better. If it's just you, you may want to give yourself some more time; you would be surprised how much 4 more weeks of orientation may help you.

Ultimately, only you can decide. But I would start by asking for preceptor feedback first.

Warm wishes!!!

[dhenz91]

I feel like you're from San Antonio.. I'm actually currently at the same situation as you. I don't know. I think i like to have more time on orientation, coz I need to get the that pace like when you know what to do ahead. lol.. but im so tired.. -_-

[JBMmom, MSN, NP]

Are your feelings internal, or have you been given feedback that you're not meeting expectations? You may have unrealistic expectations for yourself, everyone starts out feeling overwhelmed and unprepared. I would recommend you bring your concerns to your preceptor and get some feedback from him or her first. And if you make your feelings known then areas for improvement can be addressed over the next month. And as was already mentioned, four weeks of orientation is a long time, you may find yourself feeling much more comfortable by that time. Don't write it off too soon. Good luck!