I started my first hospital job a month ago as a resource pool nurse. I graduated a year and a half ago and went to work outpatient as a mental health nurse. So, whatever skills I had after hospital clinical rotations, they have faded away. Today I was told, I've been too slow to work in my unit. In other words, by the end of the week 3 I was expected to be mostly independent with 3-4 patients, have all the charting done by 1330 pm, meds, cares.
Can I vent here? I just don't understand. I hanged IV piggyback all by my own alone the first time on Tuesday, I learned how to place and remove Foley, I learned what to check when I give certain meds. Every week was another floor, patients with so many and so different problems. I know I had only half the load, but it was just three weeks. I never had more than 2 patients as a student. I am also not a native speaker, so, I struggle when people are talking to me very fast with a lot of acronyms over the phone. I just barely started grasping what was going on with my patients and what to pay attention to. Am I really unacceptably slow? Did I make a mistake switching to acute care. I do like that job and I love to learn but it does not matter if I cannot do it well enough.
Floating kills more nurses than the meanest professors.No one should have to float,except in a declared emergency and then only in a like to like unit. Some places never float senior nurses,many looking forward to the day when they hit that number.
Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
2 minutes ago, Leader25 said:
Floating kills more nurses than the meanest professors.No one should have to float,except in a declared emergency and then only in a like to like unit. Some places never float senior nurses,many looking forward to the day when they hit that number.
Floating has it's upsides. For us that is guaranteed hours. My hospital doesn't low census us ever. Our hours are guaranteed. But the other side of that is that we may have to float if census in our home unit is low. We only float to the same level of care or down one level, so ICU nurses only float to other ICUs and step down, Step down to to step down and med-surg, med-surg to other med-surg and rehab.
This was something the nurses wanted and that our union fought for years ago.
Nobody floats until they have a year of experience.
This is likely nothing more than a mismatch between their desires and reality.
It may not have been a great choice of position for you if they were not willing to provide training similar to what they would provide a new grad. In a way it was a bad position for them to give you and a bad position for you to accept. Traditionally resource nurses were very solid nurses with some experience and expertise that they were good at applying to different situations. More recently, some new grads have been doing well in resource/float positions when there is a plan and concerted effort to still give them the proper new-nurse training and support. I still think it's a roll of the dice, though, and in your situation if they had hoped you would operate more like an experienced acute care nurse, that was wrong on their part.
I'm sorry this happened, but you just have to chalk it up to something that happened. Don't be creating some deep personal meaning from it.
Where do they want you to go? Are they releasing you from their employ or do they just want you to move to a position in a single unit?
Thank you. No, I am still there. I guess they are figuring out where to send me. All units are constantly short, float pool is severely short. They higher new grads and inexperienced nurses like me and cutting down training at the same time.
This is now an end of my week 6, I have been to 5 different units and worked with about 10 preceptors. Now I work with 4 patients and mostly do OK. But I am constantly on the run and rushed through things. That results in mistakes and omissions. Today, for example, I forgot to verify the rate on the pump when I changed one bag for the exactly the same. The erroneous rate was much slower. My bad obviously. Now I feel unsafe with the training provided and the speed required. I was told today that at this point I should be on my own with full load, that I am behind and that I should have known how to deal with NG tubes and feedings. They don't care that I had my clinical rotations 2 years ago, that I worked outpatient psych since then. And in my clinical rotations I had a couple opportunities to give meds via NG tube and once this training. As far as I understood if I did something once I am supposed to do it fast and independent next time. I was also told that I did not know my patients in the beginning of the shift. I counted and found that I had 3 minutes to read about each one, all new. Now I agree with two other hospitals that offered me night/rotating positions in one unit. It would be safer and better mentally, but unfortunately I am about 3 month from being able to do nights without sacrificing my whole family (have a baby and a toddler).
This is why I'd never take a float pool assignment. The few times I had to go task due to low census the nurses didn't understand I never worked true in-patient. They expected me to be competent similarly to the float pool team.
I started in an obs unit and sometimes I felt like those nurses didn't appreciate a new grad with zero in-patient experience. The skills I lacked wouldn't show up often and when they would I'd need to wait on a experienced nurse to assist.
I work in a clinic, but if for whatever reason I had to go back bedside I'd need more than 3 weeks.
It is not like 3 weeks, officially it is 8. However, I don't think 8 weeks is OK training time for 8 units to float for somebody with zero experience. I believe the whole strategy is bad. They had to put me on meg/surge for 4 weeks and 12 hours shifts to learn the basics. Then they might move me from unit to unit to pick up specifics. I work mostly 8 hours days, I am constantly running, I have no time to reflect and discuss. I just go home and whenever next time happens with a particular skill I am expected to do it independently and very quickly. It is either or. I will never go to this hospital as a patient, truly.
Since you are not a native English speaker, please do not take offense if I offer you the following corrections.
You have hung (not I have hanged)
On my own (or "by myself" , or alone) (not "all by my own alone")
Why did charting have to be done by 1330? What were/are the shift hours?
Please read the Nursing/Medical dictionary. Read it page by page, letter of the alphabet by letter of the alphabet. Eat, sleep, breathe all the info you can get about acronyms and procedures on which you are rusty or inexperienced. Study just as you must have in school.
Keep on putting one foot in front of the other, Girl. Let NO ONE put you down. You never should have been hired for Float Pool if you have never worked in the inpatient ward.
Thank you so much, Kooky, for the support, kind words and some grammar notes ))). There is no way to edit the initial post. Float nurses may have 2 assignments in an 8 hours shift. So, charting should be actually done by 10:30. I managed to do that with 3 patients and by noon with 4. I think I will talk to my manager next week. I improved a lot, but not to their expectations and now I feel that this is getting unsafe.
I agree you should look for another employer. Obviously your current one is either ignorant of, or just doesn't care about evidenced based practice.
You are essentially a new grad and need to be invested in like a new grad. 3 weeks for a nurse with no previous independent practice as an acute care nurse is nowhere near enough.
You should be in a residency or training program for new acute care RNs, not on "orientation" as if you are an experienced acute care nurse moving to a different unit or hospital.
Your employer has chosen to inadequately train and support you. It's not your fault, at least not yet. We have all known nurses who are ill-suited to acute care nursing. You may be one of them, but you haven't been afforded the opportunity to know yet.
Please read about Dr. Patricia Benner's Novice to expert nursing theory.
Thank you! I remember that theory from school. But as one of my preceptors told me the other day, the hospital does not care, and I have to learn in the time I am given. Many years ago it took me 2 years to reach the point when I started feeling confident in what I was doing. Currently I feel unsafe. I am so rushed through everything that I started making mistakes. They push me and make me feel that everybody else can do it, but me. Well, I am not a bad learner, I was at top 20% in any class I ever took, sometimes at top 5%. And I am a thorough employee. I will talk to my manager next week. This is obviously not working.
Leader25, ASN, BSN, RN
1,348 Posts
Floating kills more nurses than the meanest professors.No one should have to float,except in a declared emergency and then only in a like to like unit. Some places never float senior nurses,many looking forward to the day when they hit that number.