Nightmare on Night Shift

OMG, I am sorry to hear you had a very bad experience right off your orientation. Hang in there! As they say, it gets better with time.

Some shifts are just one crisis after another. You'll get used to who to trust, and who just complains no matter how hard you're working. Even a super nurse needs time to get used to routines and coworkers. You'll get there.

sorry youre having such a bad start.

Curious-why starting in ED and not on a floor? granted the floors suck too, but hopefully the pts are more stable than something walking through the door in ED.

Hope things get better for you.

I would consider re-evaluating your current position. You're inexperienced and sound somewhat emotionally spent, so the ED might not be a good fit right now. However, tough patients and shifts can happen on any unit. Also, night shifts can sometimes be more challenging because there are fewer resources available than on days.

I've worked in many different clinical areas over the years, and I don't think the ED is a great fit for the majority of new grads.

Good luck, and do what feels right for you!

Oh, honey! I'm so sorry you've had a rough go of it. I went directly into an ED as a new grad too. Granted, it was a small, critical access ED, but still. I understand the stress and the "Oh my God, what if I can't do this?" feeling.

As awful as many of these assignments are, you'll be laughing and cringing at the memory in a few years, perhaps while sharing it with a new nurse who's in tears over the catastrophe that was her first day. One of my friends was punched in the head by one of her patients on her very first day off orientation, and the rest of her shift was kind of a nightmare too. We laugh about it now. You'll get your sea-legs. For now, just try to enjoy the ride and focus on learning something new every day.

I'm sorry they floated you on your first shift off of orientation. Where I work has its challenges but they have no float policy for new grad RNs I think for the first 9 months. You are not alone as a new grad (or nurse in general) if you feel overwhelmed and frustrated. As other posters have wisely said, sometimes the shifts are just rough, even if you're doing everything right. Concentrate on SAFETY, keep asking questions and do look for mentors around you.

Also easier said than done, but just ignore that CNA in terms of the gossip. Do your thing and if she is assigned to work with you on patients hold her to it. Do not ask her to do tasks..."Please get the fingerstick in room 47. Thanks." Or, "We need an EKG. Thank you." I hate pulling rank but use it when needed and she may be trying to see if you get nervous if she gossips about you. Be completely above it - you are there to do a job and once they see you mean business they usually move on.

No matter where you work you will always encounter great hard-working co-workers and unfortunately plain lazy ones-- just barely doing what they need to do to get by. If you need help then ask for it and if vitals need done or labs done--make a point of asking the pct working in your area if they can do them for you. I work in an ED that does hire new grads and they basically do a 1 year residency that includes some additional classes, meetings, and projects--orienting to the ER for new grads is usually about 12 weeks and then they are on their own. I think it will definitely take some getting used to and you will have very critical patients at times and then people coming in with tooth pain or sore throats--it will definitely always be a mix. Floor nursing can be just as hectic and the med-surg or tele nurse can have around 6 or so patients with one patient circling the drain and still having all the other patients to take to the bathroom, help clean up, do wound care on, confused ones pulling all their lines out, prevent from falling, or give their 15 or so scheduled meds to in the morning, lunch, and at bedtime. I don't think a nurse going into the ER or ICU needs to have floor experience first. It just depends on the person--you sink or learn to swim. You will always have good days and bad days, it is the nature of the job. I have worked in several different areas and even my worst day in the ED is not even close to how bad it could be at times on the floor or in the ICU. Stick with it! I think you will like it eventually and you'll find a routine that works for you in the ED. Just ignore the gossiping CNA--there will always be people like that running their mouths about everybody. Good luck!!

Observation units and ER SHOULD be 2 different areas , completely. No way should you be "floated" to ER. I had 20+ years of experience, worked in 3 different Obs units and would never take an ER assignment. I am not an ER nurse. You must discuss "floating "to ER with your manager.

You will get unstable patients in obs, days or nights. If you have an unstable patient.. then they are no longer observation patients. Stabilize them and ship them to where they need to be. Notify your charge nurse and the physician to get that done.

P.S. Never let them see you cry.

Observation units and ER SHOULD be 2 different areas , completely. No way should you be "floated" to ER. I had 20+ years of experience, worked in 3 different Obs units and would never take an ER assignment. I am not an ER nurse. You must discuss "floating "to ER with your manager.

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From the OP: "So I work in a observation area of the ER."

I have worked in two ED'S that had "observation areas." Both were extensions of the ED, and as such often got acute patients with ongoing issues. In both of these ED's, staff were expected to float between them as needed.

Oh my, I see nothing has changed from the days I used to work in a hospital. I hate to be negative for you, but I see the hospital has no respect for you as a nurse, and likely has a revolving door of nurses. First, the practice of orienting a new nurse on day shift, when they are hired for nights is a bad practice that really has to stop. It is hard enough breaking into the hospital nursing field, without the added stress of screwing up your circadian rythm right from the door. I too had to go through the hell of orienting on a different shift than I was hired for, then adjusting my sleep pattern for my real shift. This is not easily done, and wreaks havoc on anyone, regardless of skill level or years of experience. Second, floating a new nurse anywhere but their assigned unit is a practice that almost all facilities do these days because they refuse to properly staff their floors and units. Thus, new nurses have become everywhere, everytime nurses, to the detriment of themselves and their patients. Third, they already flexed you to stay home...yet another lousy but popular staffing game that is played by all facilities to boost their bottom lines. I can see the work environment is no different now than it was when I started in 2001, and has gotten worse with every single year. I have seen CNAs getting nurses fired, and CNAs so incredibly insubordinate that they should not have jobs. This is intolerable, as is the "floating" and training on opposite shifts, and then on top of it all, being badgered by a charge nurse to boot. This is why I left the field mostly, and only retuned to nursing when I really had absolutely no other choices. This profession is terminally screwed up, because their are so many more nurses than there are jobs, and hospitals can continue to treat us all like slaves for the bottom line. Professionalism is something that has never existed in any hospital or nursing home. The last job I had was through an agency a year ago. They had computerized MARS. My first shift I received no training at all, and had to sweat my way through a unit with 22 patients. I went back the next day to see that I was moved to a different unit, with 22 new faces, to exacerbate the fact that I still had a long way to go before I was clearly functional on the computerized MAR system. I refused the assignment because they could have easily placed me on the same unit, but chose not to. This is inexcusable. When I refused the assignment , the charge nurse threatened to report me to the State Board for job abandonment. I returned home, called my agency, and told them that I refuse to work at this hell hole ever again.

From the OP: "So I work in a observation area of the ER."

I have worked in two ED'S that had "observation areas." Both were extensions of the ED, and as such often got acute patients with ongoing issues. In both of these ED's, staff were expected to float between them as needed.

Seen this as well.

It all depends on the expectation of the unit that OP is on.

It appears that she was not prepared or trained for ER.