New nurse needs help. Long....sorry!

Published

Hi all,

I'm a new nurse in my 2nd week on the floor in a MS Tele unit. I am orienting with a preceptor. This week I have had 3 patients, and feel like I am drowning most of the time. I don't know when they will expect me to take on an additional patient, but how can I handle 4 when I'm having trouble with 3?

There are things that I do really well, like the clinical stuff. But, I am struggling with the stuff they don't teach you in NS.......the work flow of the unit, implementing new orders, where to find stuff, deciphering MD handwriting, and all the paperwork. I try to tell myself that I'm new and it will take time, but I feel like they are expecting more out of me than I can give them right now. Everyone is nice and helpful and supportive, though.

I was a good student in NS, am mature, motivated, and want to do a good job. My patients love me because I take time to listen to them and keep them updated on what's going on with their care, but I do realize that this takes precious time I need to complete my work.

My preceptor is a good nurse and is easy to work with. She shows me HOW to do things, but doesn't give me a whole lot of feedback or suggestions for improvement, even though I ask. My hospital offers a mentoring program, and I plan to take advantage of that to get more of the support I need.

I'm slow because I need to think through things, but I feel like I'm being expected to do things faster. Like when I'm at the Pyxis, my preceptor points out the meds to me instead of letting me find them on my own. Or, when I'm reading orders, she jumps in if I'm not going fast enough.

I made a mistake yesterday. The doctor gave me orders over the phone. He has a thick accent and I was having trouble understanding him. I ordered a test for the next day when he actually wanted it done during my shift. So, the MD shows up on the unit wanting to see the results....ooops. I learned from this, and will clarify timing the next time I receive orders.

Anyhoo..... shift change is a nightmare. They rattle off all this info that I don't even have time to write down, let alone think about how what they are telling me is significant. They tell me results of all the tests the patient has had, even from 4 days ago. I can't remember all this, and I haven't yet figured out how this info impacts my work, except that I can tell patients or other staff involved in caring for the patient when they ask about it. They also tell me about what consults are outstanding, but I don't know any of the MDs yet, so I don't know how this is significant. I miss half of what they are telling me, and spend a great deal of time figuring out the info on my own. I guess I have a hard time getting a good picture of the patient from shift report. How do I get my mind around everything?

Thanks for your feedback.

Up Vote Up Vote ×
Hi all,

I'm a new nurse in my 2nd week on the floor in a MS Tele unit. I am orienting with a preceptor. This week I have had 3 patients, and feel like I am drowning most of the time. I don't know when they will expect me to take on an additional patient, but how can I handle 4 when I'm having trouble with 3?

There are things that I do really well, like the clinical stuff. But, I am struggling with the stuff they don't teach you in NS.......the work flow of the unit, implementing new orders, where to find stuff, deciphering MD handwriting, and all the paperwork. I try to tell myself that I'm new and it will take time, but I feel like they are expecting more out of me than I can give them right now. Everyone is nice and helpful and supportive, though.

I was a good student in NS, am mature, motivated, and want to do a good job. My patients love me because I take time to listen to them and keep them updated on what's going on with their care, but I do realize that this takes precious time I need to complete my work.

My preceptor is a good nurse and is easy to work with. She shows me HOW to do things, but doesn't give me a whole lot of feedback or suggestions for improvement, even though I ask. My hospital offers a mentoring program, and I plan to take advantage of that to get more of the support I need.

I'm slow because I need to think through things, but I feel like I'm being expected to do things faster. Like when I'm at the Pyxis, my preceptor points out the meds to me instead of letting me find them on my own. Or, when I'm reading orders, she jumps in if I'm not going fast enough.

I made a mistake yesterday. The doctor gave me orders over the phone. He has a thick accent and I was having trouble understanding him. I ordered a test for the next day when he actually wanted it done during my shift. So, the MD shows up on the unit wanting to see the results....ooops. I learned from this, and will clarify timing the next time I receive orders.

Anyhoo..... shift change is a nightmare. They rattle off all this info that I don't even have time to write down, let alone think about how what they are telling me is significant. They tell me results of all the tests the patient has had, even from 4 days ago. I can't remember all this, and I haven't yet figured out how this info impacts my work, except that I can tell patients or other staff involved in caring for the patient when they ask about it. They also tell me about what consults are outstanding, but I don't know any of the MDs yet, so I don't know how this is significant. I miss half of what they are telling me, and spend a great deal of time figuring out the info on my own. I guess I have a hard time getting a good picture of the patient from shift report. How do I get my mind around everything?

Thanks for your feedback.

You are only in week 2, it's ok, you sound like you are exactly where you should be. How long is your orientation?

I can see the frustration with your preceptor, she thinks she is helping you. Maybe one day go in and say, "I am going to try and find everything in the pyxis by myself today." It is hard when precepting people, because you know where things are and you are about 5 steps ahead of where your orientee is, you think you are helping them so you can move onto the next challenge.

As for report. I usually write things down on my report sheet that the other nurse tells me, once you are on your own for awhile you will know what is important and what isn't. You can come up with your own shorthand. I also wrote things down in a notebook my first year or so and gave the list to my educator. She made a list of things new folks should know from it. It was little things specific to our unit that you don't know until you have that experience.

Please be kind on yourself, nursing is hard, and it takes time. The first year is tough, that is part of the reason there is a whole forum devoted to the first year on allnurses.

Up Vote Up Vote ×

Thanks WeeBaby.

BTW, our orientation is 8 weeks total, but the first 2 weeks are not on the floor. I am almost done with week 2 on the floor, and have 4 more weeks with a preceptor before being on my own. I'm also switching from days to nights in one week, so will have a whole new set of tasks to learn for night shift.

Thanks for the encouragement.

Up Vote Up Vote ×
Specializes in CTICU, Interventional Cardiology, CCU.

Take it from me, IT WILL GET EASIER!!!!!

I started out last year as a brand new grad on a Interventional Cardiac/CCU step down floor. When I got the job it was for nights 7p-730a. I oriented on days and went to nights. The floor I work on is a CRAZY fast paced floor. I felt like a fish out of water literally, flapping and trying to catch my breath. I also had moved from out of state a few hours away. So I knew no one at the hosp. and the hosp. is an innercity hosp.

It takes time..and time is on your side. I was yelled at by MD's, ignoored bu fellow nurses who are now my friends, humiliated by an APN in front of the entire unit including MD's my first week off orientation during shift change...I was giving report at the end of my shift, my pt. has SSS(sick sinus syndrome) the MD's were aware but apparently the Nurse Practioner wasn't, the APN asked me something and I had said the pt's rhythm been like that all night but asymptomatic...the APN threw the chart on the floor at the nurses station, mind you it's like 7:30am so EVERYONE IS THERE, he began screaming at me in front of my director, the head of cardiology, the other nurses and worst of all the pt. He was beet red screaming in my face with coffee breath..I camly said, "are you done throwing your temper tantrum, b/c the pt's cardiologist(who was the head of cardiology) is standing right behind you, and if you took 5 min. to READ the note he just wrote , along with the other 15 pages of notes over the last few days from EPS MD's, ect..you would know the pt has SSS." The unit went silent..I was literally 1 week off orientation. It took everything in me to put on my game face and say that. In reality I just wantedd to curl up in a ball and ccry and quit...let's just say thet APN never yelled again on my unit.

As far as the accents go...ask the MD to slow down and if you still can't understand ask them to spell out what they want. It saves you butt from making an error.

You will become an ace with the pyxis in a few months..I was the same way.

as far as shift report..sweetie I am one year in and I hate giving report. I just try to ask as many questions while I am getting report b/c some of the nurses I work with say 'don;t worry about this that or the other thing' I say wait I am going to worry b/c I don;t want a train wreck when I have to give the next nurse report. so when I give report I know what to say..Report is awful..but know labs for you shift, any pending tests, any tests that were done in the last shift or so, allergies, PMHx, Md's involved, any pending procedures, dietary stats (npo ect), if the pt is IDDM, what arm/hand the heplock is in, IVF the pt has, neuro status, ambulatory status, foley or not, daily wt's or not esp. if the pt. is CHF, any orders that may need to bbe renewed, and don;t let nurses steam roll you with stuff that isn;t relevnt ....

if ou have any ques..message me I will be happy to help..and always remember if the nurse you are giving report to isn;t in a great mood, it's most likely they are tired, have a crap pt. assignment, have something else they are worried about are just on their 3rd shift in a row and it's not you. That's one of the MAJJOR thigs I have learned.

It gets better I promise!!!

Up Vote Up Vote ×

wow! that sounds awfully familar to me! i'm going on my 5th week orientation on a cardiac floor and although things seem to be getting easier, everyday brings new challenges. my hospital has attending dr's, and hospitalists, and then there are the specialists. the nurses who know all the docs can grab them when they see them coming on the floor, but i can't put a face to hardly any of them. it is a big adjustment from school and i also feel like when i get home from work i need to study things that had me wondering during the workday. i hear that it takes a good year to feel "kind of comfortable". great. take care!

keri

Up Vote Up Vote ×
Specializes in Med Surg, Ortho.

The original post sounds like something I should have written. LOL

It's good to know that I'm not alone. ;)

Up Vote Up Vote ×
+ Join the Discussion