Newly qualified (sept 2018) I need advice!

[Yellowdiamonds]

Hi everyone, first time posting here! So I qualified Last month and have been in my job for in August. I am working in a nursing home. (Previously worked here as a carer), anyway I am really struggling, I feel like I do not have the knowledge or understanding for many clinical decisions. I am scared and have no support or training on the job. I am severely stressed as the nurses in this home are counted in the staffing numbers and are expected to be on the floor assisting the care assistants with getting residents washed/dressed etc. Which is fine, I love this part of the job as I have been a carer for ten years and I feel this is the best time to chat with you patients etc, however I am struggling because I am running around doing meds at the same time and dealing with gp visits etc.

All medication rounds are interrupted and the carers approach me with "eh you will need to help me as (resident) needs the toilet etc. I do not mind taking anyone to the toilet, however I feel that nurses should not be getting interrupted whilst doing mrs rounds when they're other staff who can assist. I feel I am not getting a chance to learn medications and take my time because I am expected to be doing so many other things at the same time. I am then left having no breaks and leaving half an hour later than I should because I am then having to catch up with writing notes for my patients as I haven't had time throughout my shift because I have been too busy helping the care assistants. Now they get all their breaks with no interruptions ( as everyone should). I am feeling completely exhausted and burnt out! What should I do? I just feel like one day I had a student uniform on where I was full of enthusiasm and eager to learn and the next day I have a staff nurse uniform on and feeling completely out of my depth and exhausted trying to help the carers.

Many advice would be great! Thank you!

[K+MgSO4, BSN]

Part of the issue may be that you worked here as a HCA. You may feel a sense of loyalty to you fellow carers and currently are unable to say no as I am betting there has been comments along the lines of "too posh to wash", "the staff nurses don't help" etc.

You still have all the carer roles to fulfil but you now have the staff nurse role to fulfil and until you feel comfortable coordinating GP visits, administering medications you may need to say no to you colleagues, some may be mean behind your back or even to your face...as a staff nurse you need to make it clear to them that you can and will help with ADLs but there are things only you can do and that sometimes has to be the priority.

Talk with your manager and see if it is possible to get some guidelines e.g. not to be disturbed while doing meds ( what about the medications tabard project from a few years ago?)

[Yellowdiamonds]

Hi,

Thanks for your reply! I think you are right, the problem is I worked here as a care assistant and know all the staff well. I have worked along side them and I am finding it hard to say no I am busy with this just now. Genuinely, I think nurses should wear the tabard while doing meds and should not be disturbed unless it is urgent. I can now see it from both sides as carer and nurse. As a carer I had it great in there, got all my breaks, never stressed and really enjoyed my job. Now as a nurse I am very stressed, trying to keep everyone happy by trying to help everyone, constantly apologising when I have to be off the floor to deal with GP visits etc. I just want to leave but unfortunately, the job situation in my area is not great right now.

[K+MgSO4, BSN]

Take a breath! You are in a transition phase and you time management skills are getting battered.

Your job is not to make your peers happy. It is to deliver safe, competent care to the residents of the nursing home. This means learning to say no to your HCAs at times. This stress is because you are trying to be all things to all people.

It has been a few weeks. Give it until spring to settle and then if you still feel terrible reassess but I'd put money on you being happy.

I am guessing from your terminology that you are in the UK or Ireland. Have a poke around Facebook for newly qualified nurse groups for support, reach out to your classmates who I'll bet are struggling in ways as well.

Take care.

[kbrn2002, ADN, RN]

It's difficult transitioning from the role of personal care giver [certified nursing assistant in my area] to the role of nurse as you are discovering. It's especially difficult when you are placed in the role of supervising the assistants you previously worked side by side with. You can speak to your assistants either in a group or individually, but you need to be firm in reminding them that while you can do their job they can't do yours and you need to be allowed to do your job.

The next time somebody interrupts your med pass to ask for help if you really can't drop what you are doing say so. Let them know they have to either find another aid to help or they will have to wait until you are done doing what you are doing before you can help. You'll probably get some push back initially. They will either complain to you, or more likely about you to each other. Eventually though they will learn that you have a new role as the nurse and they will need to respect that.