New Nurse HELP!!!!!!

[stephi13]

Hi, I am Stephanie and I am still a new nurse, just coming up on a year of working as a nurse. I received my RN in October 2015. In December 2015, I began a nursing job on rehab floor to get experience that was absolutely terrible; I floated (which did not help me get a routine or know my patients), had 18-36 patients by myself, no one helped not even ADON or DON, admissions would come through the door without notice and I would get 3-4 of them a day. I made it through this job until August 2016 and began another nursing job again on rehab floor to get experience.

I did not feel like I had much orientation and I told my manager that (whom I feel comfortable talking to) and did not give me any more orientation at that time. Then the DON pulls me aside 2 months later in the nurses station and tells me I need more basic nursing knowledge and I agreed and was appreciative of the feedback and the effort. I was then placed on long term for this knowledge however did not feel that I was getting much and any routine I did have on my rehab floor prior to this, had to be reestablished when I returned. And since I work 12hr shifts but those on long term work 8 hour shifts they had me do busy work like doing skin assessments nurses should've done for that month. I was theirs to control the last 4 hours so I felt.

Now here I am December 2016 and again I need orientation for critical thinking skills. Not specific enough? But again not on my floor and here is my problem.

When you are being orientated aren't you being orientated to your floor you will be working mostly? My manager also seems to think I don't have a routine, which in fact I do as much as possible. But taking me off my floor where I do have a routine and I deeply care about my patients is not going to help me learn. And I am afraid to tell them this. The whole time I was on long term floor last time I was worried about what was going on with my patients and the floor. I am the only routine day shift nurse over there and most days it's agency. And even after my 2nd orientation, my manager said that I was doing better. She didn't make a big deal of saying this because she slid this statement into a conversation.

But critical thinking skills? Don't you learn this as you go? I mean what an experienced nurse sees and a new nurse sees are two different things? It's just that I feel that I am doing absolutely nothing right when on the other hand in the past week I have been complimented by two family members of the same new patient. I've also been told by my routine aides I work with I am a good nurse as well as by my night shift nurse who follows me and trust me if I was doing something wrong she would call me out on it.

I'm sorry I needed to vent. This is my last day off before I go back on orientation tomorrow and I woke up at 4am and did not fall back asleep because my thoughts kept racing. I don't know what to do.

[NotMyProblem MSN, ASN, BSN, MSN, LPN, RN]

If you've been here for a year, I'd start looking for an acute care position that provides a more extensive orientation period so that you can get more of what you need. Critical thinking skills sharpen with experience, but your being made to float very early own in this position is not conducive to learning, in my opinion.

[WestCoastSunRN, MSN, CNS]

I agree with BSNbeDone. I think you need to get acute care experience. Look for med-surg. The fact that everyone besides you are agency nurses is a red flag. You need a proper orientation and you would do well to see a variety of patients such as you will see on med-surg. Acute care nursing lends itself to teaching critical thinking skills. It will be a starting over for you -- but will have long-term benefits. If you absolutely love rehab nursing, you can go back to it as a more experienced nurse and you will have had ears to the ground for awhile to lead you to a better facility.