New nurse... might be alone on Med-surg unit at night

[brina8615]

I graduated from an accelerated BSN program back in May but have only been working since mid November. I'm about 7 weeks into a 12 week orientation on a busy Med/Tele floor. Most days I feel completely overwhelmed. The environment is chaotic and loud because there are about 4 nurses, 2-3 aides and a secretary at all times; it's attached to the Telemetry unit and the ICU, plus the interns/residents home-base is on that floor, and some of the administrative offices, so it's usually crowded, which adds to the busyness.

In comparison... my preceptor and I floated to the Med-surg unit 2 times and it is super small and isolated, so it's really quiet. There is only 2 nurses and 1 aide on the floor, and since it's out of the way of pretty much everything else in the hospital you don't really come in contact with many doctors/other staff often. I actually felt like it was a really good environment for me to learn on because it was somewhat slower paced.

However, for some reason this unit is really short staffed and if there is less than 10 patients, they usually try to transfer patients to other floors so that they only need to have 1 nurse staffing the unit at night... sometimes they even close the unit entirely and float the nurse(s) to other floors.

My preceptor told me yesterday that she thinks I may be ending up there when I'm done with orientation.

I'm kind of relieved in a way because it's less stressful than my floor, but also really nervous about the idea that I could possibly be completely alone at night (with 1 aide... no secretary) on a whole unit as a brand new nurse. I still need to ask lots of questions and still feel like I have so much to learn. I know they say the real learning starts when you're on your own... but it just seems really hard to learn when you have no one around to ask questions of. What if it's a really difficult group of patients? What if someone is coding? Yeah I know I'm still in the hospital and I can call a rapid response / code, but it just seems a lot scary having to face these things without a second opinion.

On the other hand... it might be a good opportunity to face my demons. I've always been kind of afraid of being independent and maybe I rely on others too much. I'd certainly have to learn to rely on myself more if I was by myself with 7 patients in the middle of the night.

What do you guys think? It is safe to put a new grad on a unit as the only nurse? Am I going to be okay?

[NoviceRN10]

I can't imagine it's actually hospital policy to leave one nurse alone on a unit, I know on my unit that would NEVER happen. We had only 5 pts on New Year's Eve and there were still two of us RNs, but no aide. There is always at least two nurses, or the unit closes if census is that low. I do not think it is safe to leave a new nurse to her own devices with only an aide for support.

[llltapp]

That is not a good idea. Not even for a seasoned nurse. For the very LEAST reason, you need cosigns on blood, insulin, heparin drips......... plus staff safety, coordinating issues if a patient crumps, and the list goes on. Talk to your preceptor, tell them your fears, and don't listen when they try to BLOW SMOKE up your &^* and tell you you will be GREAT !!! If you do decide to do it, make sure you have your house supervisor on speed dial and bring him/her candy every night LOL

[CAL05699]

It is a very bad idea to have any nurse (but especially a new one) alone at night. Most of your learning will come from other nurses, not from patients. With no one there to discuss things with you, answer questions, show you procedures, I think it is a poor learning opportunity, not to mention a dangerous situation.

[NYCRN16]

Heck no!! Even with experience, I would never agree to work on any floor or unit alone. Don't let them convince you that this is safe in any way, and if they assign you to work alone, you draw up a note that says that you are protesting this assignment and make them sign it. You are doing this so that when something happens, the hospital shares responsibility. If this is how this hospital runs, than I would be looking for a job elsewhere.

[shoegalRN, RN]

Totally not safe! Not even safe for an experienced nurse.

[Harrrg]

I hope you didn't stay here. You need to run....very very fast to another area or another hospital. It is critical as a new nurse to have experienced nurses around you to guide you. I've been nursing for 27 years and still ask my coworkers opinions about patient care. That's what team work is all about. I am now in a position where I have to work by myself on a Pediatric unit due to low census. I mean totally alone with 1-2 patients or I may have a secretary if there are 3-4 patients. It is not good practice, nor is it safe.

[Music in My Heart]

I can't imagine it's actually hospital policy to leave one nurse alone on a unit, I know on my unit that would NEVER happen. We had only 5 pts on New Year's Eve and there were still two of us RNs, but no aide. There is always at least two nurses, or the unit closes if census is that low. I do not think it is safe to leave a new nurse to her own devices with only an aide for support.

We sometimes end up with solo nurses when the census is low. I don't think it's a great idea but it does happen, by policy even. Our nurses, however, are all experienced.

Leaving a new nurse solo is not right for the patients and not right for the nurse.