New nurse-rough start

Published

Hi all,

New here and need to vent...I've been off orientation now for a little over a week and I feel like a complete mess all of the time. I only have a patient load of 6 and I feel like I can't even manage that. I come in, get report and I'm on the floor by 0715. 5 out of my 6 patients have therapy at 0900. Nurses have to do vitals and by the time I finish it is usally 8am. Sad, I know, but usually at least 3 people need to be repositioned, their dressing fell off at night, or their magic bullet decided to kick in. So at 8am I start my med pass. I am lucky to have 2 peoples meds done by 0820 before the call lights start going off because everyone wants their meds now and are in pain. Almost always another nurse has to step in and help me and I am grateful, but I feel incompetent and can't figure out why I can't manage my time better when they seem to have no problem. And my patients are easy by comparison!! There are only 3 aides for 30 patients, so I spend at least 2 hours a day just tolieting people and emtying their commode, setting up trays, etc.

I just can't say to someone who really needs to pee that I'm sorry, you have to wait for the aide because I have other work to do!! In reality, if I did say this, the patient would either wait an hour, or have an accident. If I get to these patients between their therapies to provide nursing care, I am lucky. I do what I can and multitask as much as possible. And this stresses me out. It also bothers me that I feel so rushed with my patients and I can't give them the time they need. I also feel like I still have so much to learn and sure, 4 weeks of orientation taught me the computerized documentation and med sheets, but I still feel like I don't know anything about how to be a good nurse!

Bottom line, my time management sucks, my skills suck and the therapists get angry with me because my patients aren't ready for therapy half the time when they come to get them. I really try. The other nurses try to help me out as much as they can, but I should be able to do this. Today I just wanted to cry because I am thinking that I hate this. I feel so overwhelmed. All the other nurses around me are so calm and saying how bored they are while I am drowning in my assisgnment. Maybe I'm just not cut out for this. :o

Up Vote Up Vote ×
Specializes in Nephrology, Cardiology, ER, ICU.

Whoa there - give yourself a break! While you are on orientation, you are essentially doing things the way the preceptor does them. It is going to take you a lot longer than one week to figure our your own system. Please don't be so hard on yourself!

Hang in there.

Up Vote Up Vote ×

First, I'm not a nurse... but I am a therapist and I am sorry they're getting on your case for not having patients ready at their appointment times. I'm sure each of them gets behind schedule from time to time (I know I do) and I would hope that they would understand!

That said, you might be able to capitalize on the therapists' availability. I know I have worked WITH nursing on med-related issues- as a speech therapist I often try to help people learn the cognitive skills to become more independent with their medications... I LOVE it when the nurses come to therapy and admin the meds with me- I make it a therapy activity and it benefits both of us, since the nurse can then follow through with the strategies I'm teaching! It might not work with PT and OT, but check in with your speech path and see if you can work cooperatively... it might make it easier on you!

Take care of yourself- we need good Rehab nurses!!!

Up Vote Up Vote ×
Specializes in Inpatient Rehabiliation.

I'm new too and work in an inpatient rehab area. I have to say that I would be very overwhelmed too with the situation you describe. That does sound very hard. Fortunately, our patients are divided up in teams and the RN always has either an LPN or a PCA working with them. So when I have a PCA, they do all the vitals while I gather meds and together we get every one ready. When I work with an LPN they are basically doing everything I am, so we divide our group of 4-6 patients and we do all care for those assigned pts. Also, sometimes we have the therapists coming to do ADLs for some pts so those are ones we hurry and give meds to and the therapist actually helps them get ready those mornings. Stick with it. I think rehab is an exciting field and I know that with some more practice we can get better and feel more comfortable with our time management.

Up Vote Up Vote ×
Specializes in Rehabilitation Nursing.

Rehab nursing takes a organized well adapted person to care for the certain types of patients that we take care of. I don't know what else to say besides, it sounds like you are way overwhelmed and you shouldn't have to feel that way every single day that you work. As you gain experience there and gain knowledge about how things can be done in a routine way on the rehab unit, you will feel more comfortable and less overwhelmed.

Keep a smile on your face and try to move on. Get through each day with a good attitude and try your best. Thats all I can suggest.

Up Vote Up Vote ×
Specializes in inpatient rehab (general, sci, tbi, cva).

I understand where you're coming from. Been there, done that.

If you're patients are consistently not being ready on time, ask the therapists if they can alter their schedules. Some patients (quads, paras, etc.) need more time to get ready than your average debility patient.

It does no one any good if you can't get your people going on time. I always hope when I get my team that if I have six people that their therapy times are staggered, (0730, 0830, 0900, 0900, 1000, etc.) If three or all six of your people have therapy at the same time, it makes things crazy.

Then you have to prioritize who gets medicated and assessed first. Here's my rule:

Get the early therapy ones first, especially if they have a dressing or IV.

Get the diabetics (if not early) next.

Get the low BP people after that.

Then go in order of therapy times based on where you are on your list.

If you miss someone, (which you will if they are all due at the same time) because therapy takes them away before you medicate them, get to therapy, stop them and do a quick assessment and give meds. Therapists will usually cooperate if they think your people are a) in pain, b) have potential BP problems or c) need certain meds (insulin, heart meds, etc.) I have no qualms about taking five minutes to check someone out if a therapist "snatches" my person.

Good luck! Every day is different, so keep trying!

Up Vote Up Vote ×
+ Join the Discussion