New nurse being targeted in ED

Sour Lemon · Nov 5, 2017

Hello,
I'm a new graduate nurse working in a very busy emergency department. I just got off of orientation four weeks ago and have already had many "bad" shifts in which I've become very overwhelmed. I know being a new nurse is difficult, but I am now questioning my career choice.
I work with many charge nurses and have horrible shifts whenever I'm working with one nurse in particular. Most charge nurses give me "average" patient assignments and I feel able to survive the shift, even if we get slammed. This charge nurse constantly gives me the most critical patients in the ER. I think in her mind, she thinks giving me the most critical patients will help me learn and make me into a stronger nurse. In her mind, I need to be able to handle whatever walks in the door and by forcing me to handle the sickest patients in the ER, I will be forced to learn how to "swim".
But I'm sinking. To me, I feel like I'm being hazed and set up for failure. I do not have the experience or knowledge base to gracefully handle the sickest patients straight off of orientation without help. She DOES offer to help me but seems to use any excuse she can find to loudly criticize me in front of others. I feel mistakes I make are exaggerated and any accomplishments are greatly diminished. I recently found out that she has been telling others in the unit that I'm incompetent and she doesn't have the time to walk me through everything. However, she insists that I do not enlist the help of anyone else in unit except her. Now I feel terrified to ask for help because by admitting to her what I do not know, she'll have more to tell other people. She tells me I should be scared to come into work everyday. I am terrified. Not only because of handling sick patients, but because I dread being yelled at in front of everyone and harassed by her. Other people in the unit have made comments about her being harsh to me and it just makes me feel worse.
Any tiny amount of confidence I had is gone. My self-esteem is the lowest it has ever been. I spend my days off crying and dreading going back to work. I can barely eat because of my anxiety. I love the ER and I really like nursing, but I feel like I'm not cut out for this. I feel like a failure and want to quit my job.
Am I too sensitive for the ER? Should I be able to handle the sickest patients off of orientation? Should I find a lower acuity unit to work in? Is my charge nurse unnecessarily aggressive? I don't know. I've never worked as a nurse before. I don't know what is normal. Please give me some advice as to how I should go forward.

You're in the real world now where people might not fawn over every minor thing you get right. Instead of getting anxious and skipping meals, thank your preceptor for the guidance and continue to improve. You're not expected to know everything at this point, but you are expected to be able to take constructive criticism. It sounds like you and your preceptor may have dramatically different styles of communication, but you need her, so you'll have to be the one to adapt.

Newbienikki · Nov 5, 2017

She's not my preceptor. I recently got off of orientation. My preceptor was very helpful and kind.

Sour Lemon · Nov 5, 2017

She's not my preceptor. I recently got off of orientation. My preceptor was very helpful and kind.

In that case, substitute "preceptor" for "charge nurse".

Castiela · Nov 5, 2017

From friends who work in ER, they are started in the areas of ER where the patients are the most stable, and as they progress, they move to monitored patients, to the resusc bay to triage. I know most hospitals in my area use this model.

I find it odd that your charge nurse will only allow you to ask for help from her. Why does she insist that? I would personally probably ask for help from your colleagues. New grads who don't ask questions tend to raise more red flags and increase your chance of making mistakes. I would also keep a journal detailing your interactions with her and what you're overheard her saying about you

Take care of yourself. Can you utilize some counselling to help your confidence? Can you use your preceptor as an ally? A certain amount of fear is good for any nurse, especially in the higher acuity areas. I still worry in ICU that I've missed something but it shouldn't be paralyzing. It should instead encourage you to be more careful.

JKL33 · Nov 5, 2017

I'm sorry this is happening. It is not appropriate if for no other reason than patient safety.

This is not meant to help you or make you stronger by allowing you to learn to swim. Sometimes that can be what people need, especially in the course of facing their own fears and in developing confidence when they already possess the abilities required to handle situations successfully. This is not that, as evidenced by the control features and the gossiping.

This is merely someone trying to feel bigger and better by using someone else for a stepstool. This person doesn't feel good about herself nor her place amongst her peers - which is why she only feels good putting herself up against a new nurse.

I would talk to your manager about it, primarily because you need to know more than just this one nurse's perception of things. You need to know if you're performing according to your stage of learning or not.

I wouldn't talk about your anxiety or your crying and lack of eating or any of that (and regardless of anything else you will need to come to grips with all of this in a more healthy way anyway). You'll need to discuss this maturely and succinctly. And above all you need to be ready to hear constructive criticisms and act upon them. You probably need to step it up a few notches - - you need to take action on that immediately while this other sideshow gets sorted out.

llg, PhD, RN · Nov 6, 2017

She's not my preceptor. I recently got off of orientation. My preceptor was very helpful and kind.

Go to your preceptor and ask for advice. Your former preceptor knows you, your skill level, the charge nurse in question, and the realities of the unit culture. She is in a much better position to advise you than anyone here online.