Hello everyone. I am a new nurse (about3.5 months). I know I am only considered a "newby", and a lot of the more experienced nurses may not feel like I know anything. I, myself, can admit that I know almost nothing and am still learning each and every day I am at work.
I love my job. I love working with my patients and learning more about their diseases and seeing their progress throughout their stay at the hospital. Throughout my 3.5 months at my job, I've definitely made some mistakes. I have let a patient's sats get down below 70 once. I learned to never let that happen again, should it get below 85, alert respiratory immediately. Learned my lesson, and I was grateful for it. The charge nurse that day pulled me aside privately and very nicely have me a teaching moment on it. There have been other instances where I have made a mistake (such as not documenting a temperature -- in order to justify blood cultures), and the charge nurse stated it was a teaching moment, and to take it as such. Again, I am very grateful for these moments. I am a new nurse, still learning...still very eager to learn and to do right by my patients.
Today, I went to work and I always go to work with a smile on my face. Like I said, I love my job. I worked with another nurse (older and more experienced), and a charge nurse (also older and experienced). I was discharging a patient, but prescriptions weren't filled out. The charge nurse told me to ask my patients about what they needed and I did, I got the patient discharged successfully. But it seemed like the charge nurse was upset with me. The patient needed a prescription for a blood thinner, and the charge nurse asked me what the blood thinner was for. I did not know off the top of my head (my fault, I should have known), and I told her I assumed it was because of a knee operation (I know, in nursing there should be no assumptions...but I was trying to do the best I could). I did not truly know how to find out why the pt was on that medication. And instead of helping me figure it out, the charge nurse looked at me with an amused and belittling expression on her face and basically ignored me.
The other older nurse then got onto me, because I had filled out discharge instructions on her patient. I had her patient the day before, and they had already had orders for discharge and I went ahead and filled out their papers. The nurse was upset because I had added on too many education leaflets about his medications. She asked me what was up with that, and I truthfully stated that I was told by another preceptor when I was orienting that if a patient were discharged home, to add all the medications leaflets to their discharge packet. The packet usually comes out to be about 60 pages long. A lot. But it was what I was taught. The nurse told me, "Well that doesn't make any sense. You're supposed to educate your patient about their meds and see specifically what meds they need leaflets for. Not ALL of them". Mind, she said it in a very condescending tone. And then her, and the charge nurse looked at each other, in a weird "this girl doesn't know what she's doing " sort of way, and I am pretty sure the charge nurse said something about me quietly....basically right in front of my face. I then saw the two of them gossiping at the desk, and I am positive I heard them whispiering about me.
Then I was giving report to the older nurse because we were low on patients, and I was PRN and sent home early. I gave the best report I could on her. I did not have time to look over patient history, so I went off what I got from report from the night nurse. One patient was reported to me to have had an MVA and TBI. I reported as such to the older nurse. I went to the desk to pick up my bags and I heard the charge give an annoyed face at me and tell the older nurse "That's not right. Scratch it off, he did not have an MVA. She doesn't know what she's talking about."
I left work in tears. I am a new nurse, and I try so hard to do well at my job. This is the first really bad day I have had. I have had othe rbad days, but today I truly felt like these nurses were almost ganging up on me. I do not mind constructive criticism. Like I said, I am a new nurse...I need it. But what I don't need is people talking behind my bad and gossiping about how I don't know what I am doing. I feel utterly discouraged, and I really hope this doesn't get to where I may lose my job. Even though today was a bad day, I still learned some things...I just wish they were conveyed to me in a more respectful manner, instead of having two nurses basically tell me I don't know how to do my job and gossip about me behind my back.
I know this type of stuff is actually pretty common in nursing. But any advice out there? Is my job in jeopardy? Should I try to talk to anyone higher up about this, or should I just take it as a lesson learned? I have not had any problems with any other charge nurse or nurse. Just these two ladies today, and I am almost confused as to why the work environment was so toxic today....Any advice would be helpful! Thank you so much in advance!
My take: I thought the patient with the 70's sat was probably not on a continuous sat monitor; on the floor they sometimes use those cheapo finger probes that will not show a pleth wave. Many chronic lungers "live" in the 80's, so a sat suddenly in the 70's wouldn't be that unusual. If the patient was that unstable, he should've been in a monitored unit. As for the "blood thinner," TBI and MVA, a nurse of 3.5 months is still just trying to keep her patient alive, learn time management, etc., so I don't find that unusual. I have worked with plenty of "old" nurses who don't have time to learn every little thing about a patient. And, doesn't a physician or nurse practitioner write the scripts? Why would that be the nurse's responsibility? Or aren't they faxed into a pharmacy? This just makes me think of the "blame the nurse" mentality; nurses are the do-all, see-all, be-all of everything. Not charting a temp and making too many copies of discharge meds? Good grief. The things they whine about. We get cultures on people ALL THE TIME who don't even have an elevated temp. These catty, older, experienced nurses probably ARE "whispiering" (sic) about you, because you are new, younger than them, and it may be the only way they can make themselves feel superior. If they were smarter they would help you become a great nurse, which would actually benefit them in the long run. Hang in there.
I will say that working in the world of women can be brutal at times.
I alway find it interesting that when someone post about gossip, bullying, cattiness, etc. in nursing, it does not take long for someone to say something along the lines of "well, whenever you work with a group of women…"
I case you can't see the little icon by my name, I am a male, and I generally don't find my female coworkers catty and I very, very rarely see any bullying. (There is plenty of gossip, but guys seem to engage in a fair amount of it in addition to the women.)
I've had doctors ask me why their patient is on a blood thinner. And I have done it myself, not known why a patient is on a certain med while giving report. Yes I feel stupid but there are some days where I don't have time to even read a H&P on my patient so I just trust what the previous nurse told me in report. Yeah, you should know this and I can guarantee next time you go to work and see a blood thinner on your patient's orders you will research it and ask why. It's a learning process. Don't beat yourself up too much.
I'll address the workplace bullying you're experiencing. That's what it is, plain and simple. These older, more experienced nurses are doing nothing to help you become a more competent, confident nurse. In fact, they're doing the opposite.
The eye rolls, the knowing glances, the sarcasm, the whispering, etc. are meant to induce one thing: Shame.
Shame does not make us feel bad about what we do -- it makes us feel bad about what we ARE. Shame is a feeling of deep humiliation. It damages self-confidence and self-worth.
You're there as a brand new nurse, so everything you don't know is exposed. And instead of experiencing empathy from these nurses -- who should know how you feel since they were once in your shoes -- you're experiencing judgement and rejection.
I'm very sorry you're experiencing this. You don't deserve it. When you need guidance and instruction, they should provide it without their condescending and belittling attitudes. You shouldn't be left wondering where you stand. I think an honest meeting with your nurse manager is in order. You shouldn't have to be subject to this kind of abuse. Yes, it's rampant in nursing, but that doesn't make it right. Best of luck to you.
Some facts about nurses and bullying:
Bullying decreases job satisfaction and morale and increases absenteeism
Almost 21% of nursing turnover can be related to bullying
60% of new RNs who quit their first job in nursing within 6 months report that it is because of being bullied
Replacing one nurse can cost up to $88,000 USD
In a study on workplace bullying, most of the respondents reported being bullied by the charge nurse, manager, or director
One in six nurses (13%) reported being bullied in the past six months
Bullying of nurses leads to erosion of professional competence as well as increased sickness, absence, and employee attrition
Bullying victims may suffer stress-related health problems, such as nausea, headache, insomnia, anxiety, depression, weight changes, and alcohol and drug abuse
Nurses who survive bullying early in their careers tend to carry their learned behaviors with them. They accept the bully culture as part of the job and eventually may choose to bully other nurses
The Joint Commission (2008) acknowledges that unresolved conflict and disruptive behavior can adversely affect safety and quality of care
I think, first of all, you need to stop focusing on the geriatric status of these old crone nurses.
I don't see this as bullying. You are brand new and you sound insecure. It's great that you love your job, you mentioned that several times. But you don't get awards for showing up with a smile. These old hags might be a little irritated with your perkiness.
You need to give it some time and prove yourself to these old biddies. And, like one poster said, don't assume every conversation they have is about you.
Old fart nurses do, sometimes, get nervous about newbies who don't act on things like O2 sats in the 70s. And, maybe something in your personality is a little exasperating to the over-the-hill gang.
It seems some people understand how to approach people to foster true learning moments and some don't. Never roll your eyes, be sarcastic, etc when you're pointing out someone's mistakes! Who are these behaviors helping? No one. All this does is put a wall up between yourself and others. It possibly makes the new nurse want to avoid coming to you with questions in the future. There is always a better way to convey a message.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Quote
Today, I went to work and I always go to work with a smile on my face. Like I said, I love my job. I worked with another nurse (older and more experienced), and a charge nurse (also older and experienced). I was discharging a patient, but prescriptions weren't filled out. The charge nurse told me to ask my patients about what they needed and I did, I got the patient discharged successfully. But it seemed like the charge nurse was upset with me. The patient needed a prescription for a blood thinner, and the charge nurse asked me what the blood thinner was for. I did not know off the top of my head (my fault, I should have known), and I told her I assumed it was because of a knee operation (I know, in nursing there should be no assumptions...but I was trying to do the best I could). I did not truly know how to find out why the pt was on that medication. And instead of helping me figure it out, the charge nurse looked at me with an amused and belittling expression on her face and basically ignored me.
The other older nurse then got onto me, because I had filled out discharge instructions on her patient. I had her patient the day before, and they had already had orders for discharge and I went ahead and filled out their papers. The nurse was upset because I had added on too many education leaflets about his medications. She asked me what was up with that, and I truthfully stated that I was told by another preceptor when I was orienting that if a patient were discharged home, to add all the medications leaflets to their discharge packet. The packet usually comes out to be about 60 pages long. A lot. But it was what I was taught. The nurse told me, "Well that doesn't make any sense. You're supposed to educate your patient about their meds and see specifically what meds they need leaflets for. Not ALL of them". Mind, she said it in a very condescending tone. And then her, and the charge nurse looked at each other, in a weird "this girl doesn't know what she's doing " sort of way, and I am pretty sure the charge nurse said something about me quietly....basically right in front of my face. I then saw the two of them gossiping at the desk, and I am positive I heard them whispiering about me.
Then I was giving report to the older nurse because we were low on patients, and I was PRN and sent home early. I gave the best report I could on her. I did not have time to look over patient history, so I went off what I got from report from the night nurse. One patient was reported to me to have had an MVA and TBI. I reported as such to the older nurse. I went to the desk to pick up my bags and I heard the charge give an annoyed face at me and tell the older nurse "That's not right. Scratch it off, he did not have an MVA. She doesn't know what she's talking about."
I left work in tears. I am a new nurse, and I try so hard to do well at my job. This is the first really bad day I have had. I have had othe rbad days, but today I truly felt like these nurses were almost ganging up on me. I do not mind constructive criticism. Like I said, I am a new nurse...I need it. But what I don't need is people talking behind my bad and gossiping about how I don't know what I am doing. I feel utterly discouraged, and I really hope this doesn't get to where I may lose my job. Even though today was a bad day, I still learned some things...I just wish they were conveyed to me in a more respectful manner, instead of having two nurses basically tell me I don't know how to do my job and gossip about me behind my back.
I know this type of stuff is actually pretty common in nursing. But any advice out there? Is my job in jeopardy? Should I try to talk to anyone higher up about this, or should I just take it as a lesson learned? I have not had any problems with any other charge nurse or nurse. Just these two ladies today, and I am almost confused as to why the work environment was so toxic today....Any advice would be helpful! Thank you so much in advance!
You love your job. I got that. You go to work with a smile on your face every single day. Got that, too. And interestingly, the nurses you are having difficulty with are old(er). Oh, and by the way, you know that "this type of stuff" is actually pretty common in nursing.
You're a newbie, and because you're new, you've made mistakes. In the case of a potentially life-threatening de-saturation, the charge nurse took you aside and you had a "teaching moment." That's great. But there are times when the old, experienced nurses are stressed, busy or having a flare-up of their chronic back pain, and when you do something stupid -- and even you admit you've made some stupid mistakes -- that wonderfully calm and supportive "teaching moment" may deteriorate into something less wonderfully calm and supportive and more direct and to the point. In the case of discharging a patient on a blood thinner, not knowing why the patient was on blood thinner and then claiming not to know how to find out why the patient was on blood thinner . . . that's a series of stupid mistakes. And then to utter "But I was doing the best that I could" might make someone cranky want to sigh, roll their eyes or even fantasize about *****-slapping you into the next county. (But of course we wouldn't do that.) That charge nurse who looked at you with "an amused and belittling" expression and then ignored you was being far nicer than you deserved.
Knowing you're doing something stupid, admitting that you should know better and then continuing to do so and making excuses for it isn't deserving of respect. (Oh, we all deserve respect for being human and all that, but it certainly is not behavior that is deserving of professional respect. I kinda think you know that, but you're still making excuses.)
You've made a lot of assumptions about what these nurses were thinking about you, what the expressions on their faces and the tones of their voices might have indicated, that you THINK they said something about you and that they were whispering behind your back. And you made note of each and every one of these nurses being OLDER than you. Oh my . . . are you biased against older, more experienced nurses? Because that's pretty much how it looks. Ganging up on you and gossiping behind your back? In truth, you don't KNOW what was said or how it was said because you weren't part of the conversation. Could be you know how incompetent you sounded and are projecting.
Discharging a patient on blood thinner without proper education is incompetent. Not knowing why your patient is on blood thinner or how to find out is incompetent. After 3.5 months, you should know how to find out why your patient is on a medication and make a point of doing so -- especially before discharging that patient with that medication. What happens if the discharging physician put the prescriptions in the wrong chart and that patient shouldn't be on blood thinner at all?
Not recording the temperature to justify the blood cultures -- it was a stupid mistake, but it happens. Letting your patient into the 70s without intervening -- not the best practice, but we all make mistakes and hopefully you'll never make that one again. You had a bad day, you did a number of dumb things and the charge nurse and her friend may indeed have been rolling their eyes and talking about you behind your back. So what? It was a gossip-worthy day. Grow a thicker skin and stop letting it get to you so much. I'm pretty sure that if you observed another nurse making a series of mistakes, you'd probably gossip about it to your friendly co-worker as well. But it may NOT have been gossip -- it may have been two experienced nurses making a plan to educate you on your knowledge deficits while the memory of those deficits was still fresh.
I think you're looking for older, more experienced nurses to be mean to you -- you've stated that you believe "that kind of thing" is common in nursing. If you look for it, you're going to find it, even if it isn't there. So far, you haven't brought any evidence of mean or nasty behavior to the discussion -- just a lot of assumptions about what others are thinking and saying when you're not there. Although I do see a bias against older nurses that is troubling.
I am a new grad so this is not coming from a seasoned, experienced nurse
I have let a patient's sats get down below 70 once. I learned to never let that happen again, should it get below 85, alert respiratory immediately.
Patient's O2 sats drops into the 70s and you didn't see that as a problem. Were you waiting for the patient to collapse on the floor to think it was a problem?
The patient needed a prescription for a blood thinner, and the charge nurse asked me what the blood thinner was for. I did not know off the top of my head (my fault, I should have known), and I told her I assumed it was because of a knee operation (I know, in nursing there should be no assumptions...but I was trying to do the best I could). I did not truly know how to find out why the pt was on that medication.
What do you mean that you don't know why the patient was on blood thinners? Your job is to know why the patient is on certain meds. That was drilled into me in nursing school.
I gave the best report I could on her. I did not have time to look over patient history, so I went off what I got from report from the night nurse. One patient was reported to me to have had an MVA and TBI.
You didn't have time to look over the patient's history? If you are unfamiliar with a patient, you need to review their chart completely. THEY ARE YOUR PATIENT. We were given 15 minutes at the beginning of each clinical to meet our patient and review the chart. Then our instructor would state "tell me about your patient". We had to know what brought them to the hospital, what tests were done, what were the results, what other medical problems they had, what meds they were on and why, pertinent labs for the patient and why they were high or low.
I can understand that you are new, but all of these things are basic nursing school skills. You are a nurse now and you are responsible for these patients, not another nurse or your instructor. Nobody is looking over your shoulder to make sure you don't do something wrong. I can understand why they were acting that way.
Everything you're saying is correct, but as newbie yourself, perhaps you should reconsider the scolding tone.
I think you need to take control of your practice.
at almost 4 months in, there is NO excuse not to know why a patient is on a particular medication (seriously, you don't know why they are on a blood thinner? a potentially dangerous medication if taken incorrectly?)
I recently started in the ICU and trust me, i took control of my orientation, studying on my own time and making sure i did EVERYTHING to become a competent critical care nurse that could be trusted by my co workers.
I still have questions and always clarify things that i do not understand but i have yet to encounter eye rolls and such because my coworkers (crust old bats included) see the effort i make to become a competent clinical nurse.
YOU need to do this.....YOU need to stop making excuses for your weak practice and seek opportunities to improve. There is no more hand holding after orientation.
Specializes in Mental Health, Gerontology, Palliative.
Also never be afraid to say "I don't know, however I will find out and get back to you"
I don't mind if someone doesn't know, I do get somewhat cranky when its clear they don't know and fumble their way through it putting a patient at risk due to their knowledge deficit
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
We have all been there as new nurses and learned lessons the hard way. I started out in a very catty OB department and it was hard at first, very hard. I am pretty sure they were whispering about me, too. But you know what? At the end of the day, you need to quit worrying what others "think" of you. It is none of your business!! I won't rehash the great posts already here, advising you of your responsibilities and faux pas, I think you will certainly get the point. But you DO need to tell yourself you have to learn, ask for help when needed, but use your critical thinking skills, too. Don't just ask if you can do.....do and if unsure, THEN ask. But quit worrying about what "they" think of you. I never went to work looking for friends, if that happened, ok, but that is not the place to make buddies. Do your best, your level best, and ask for help when needed. Good luck.
applewhitern, BSN, RN
1,871 Posts
My take: I thought the patient with the 70's sat was probably not on a continuous sat monitor; on the floor they sometimes use those cheapo finger probes that will not show a pleth wave. Many chronic lungers "live" in the 80's, so a sat suddenly in the 70's wouldn't be that unusual. If the patient was that unstable, he should've been in a monitored unit. As for the "blood thinner," TBI and MVA, a nurse of 3.5 months is still just trying to keep her patient alive, learn time management, etc., so I don't find that unusual. I have worked with plenty of "old" nurses who don't have time to learn every little thing about a patient. And, doesn't a physician or nurse practitioner write the scripts? Why would that be the nurse's responsibility? Or aren't they faxed into a pharmacy? This just makes me think of the "blame the nurse" mentality; nurses are the do-all, see-all, be-all of everything. Not charting a temp and making too many copies of discharge meds? Good grief. The things they whine about. We get cultures on people ALL THE TIME who don't even have an elevated temp. These catty, older, experienced nurses probably ARE "whispiering" (sic) about you, because you are new, younger than them, and it may be the only way they can make themselves feel superior. If they were smarter they would help you become a great nurse, which would actually benefit them in the long run. Hang in there.