People think I am stupid

jadelpn, LPN, EMT-B · Jan 4, 2013

I hang antibiotics often not "piggyback." If the pt has no fluids running, we direct line the antibiotics and administer them that way. To me piggyback means via IV, not necessarily with another fluid. The same with other meds, they are either IV push or piggyback. I guess I don't get what you mean by your comment.

A practice issue. Often nurses do run the antibiotic right in, others are taught to get the "entire" antibiotic into the patient, to piggyback into a line of fluid so there's a significant flush at the end of the infusion of the antibiotic. Things like vancomycin that relies on a vanc level, I was taught it was always prudent to do that piggy back. This is all assuming you are using a pump. In any event, this co-current thing is odd to me. Unless one is all nudgy about getting an order to stop fluids--if say patient is on NS at 100 an hour--and they do not want to stop it to infuse antibiotic without an order to do or the need to have fluids run co-currently with the antibiotic--which is seemingly wacked but anywho, have at it, but I think it is a nursing judgement/practice issue.

What the OP is describing is not stupid, doesn't mean that she has a psych or ADHD issue--but seemingly is being led down the wrong path by those who are in "charge". However, OP, automatically assuming that people believe you to be stupid, lazy, etc. and you feel that you have a hard time making friends--this is something that CAN be dealt with--and will only benefit you to at least explore that with an open mind with a professional. Good luck!

OCNRN63, RN · Jan 4, 2013

Not everyone is going to be "warm and fuzzy." That doesn't mean you have a personality clash with them. Take the example of the first nurse. If you wound up learning a lot from her, then that was good, right?

Part of growing professionally is learning how to take a deep breath step up to the person you think/you know you have a problem with and ask "How can we fix this?" I've tried to disarm bullies by complimenting them, e.g., ""Hey, do you think you could show me how you do (insert skill)? I'd like to get better at doing it." This could be total BS, but if it smooths over some rough edges between you and another nurse(s), then it's worth it.

You've identified that you have some problems. That puts you way ahead of many of your peers who lack the self-awareness to know that they have a hand in their difficulties. Ask for feedback, find a few nurses who can give you constructive criticism and keep an open mind. Don't confuse being told you did something wrong with being told you're a bad person.

SNB1014, RN · Jan 4, 2013

ouch. firstly, i think you are confusing absentminded with stupid and different personalities with work enemies.

i think also at this point you are broken down enough to be tricked into thinking anyone who has an itch they cant attend to at the moment is indeed making those awkward gestures toward you.

that said... you need constructive criticism that you could only receive from people who know you well enough (good and bad) and who want you to succeed. i am surprised that seeing as you're a recent graduate no one has suggested you emailing/calling up prior nursing faculty that you had a good academic relationship with. you know which ones will be valuable to you. your success as a nurse reflects on their instruction and the schools reputation.

i just graduated but i have already chatted with 3 former clinical instructors. one of which i didn't "like" very much, but i knew she would be honest. the other two i was just tossing ideas around with. my school heartily encourages alumni to come back and have a "real world day" where the teachers get the stick out of their tushies and stop with the nclex nonsense for a day and allow new grads to tell how awesome, horrible, surprising and whathaveyou their workplace is like.

anyway, your instructors might have seen some curious behaviors and tendencies along the way. perhaps you could talk to them as two professionals, two RNs. there doesn't have to be that weird hierarchy.

also, constantly missing little things and blowing them off as little is a slippery slope. you may not be so lucky next time with the allergy sticker. yes, there should be more than just a brightly colored sticker to be the barrier between you and full blown anaphylaxis, but you never know. hey, i know numerous former classmates that a bit of adderall and therapy helped them tons

HM-8404, BSN, RN · Jan 4, 2013

Well let's see, in 26 posts you have been diagnosed with ADD, ADHD, and even Aspergers. It has also been determined you need professional counseling.

Do you think your problem may be that at this point in your career you are unsure of yourself and this makes you timid?

I have noticed that MANY new nurses keep their first job just long enough to get some experience, about a year, then they move to another job where they are not seen as an inept dumb***. Once someone gets that reputation it can take a very long time to shake it.

redhead_NURSE98!, ADN, BSN · Jan 4, 2013

I guess Stargazer is the only other person besides me here who knows about Zosyn (practically) continuous infusions? They have apparently decided that you don't have to be on it for as long if you run it in this slow manner over 4 hours instead of 100/hr q6 hours. You hook it up to its own primary and Y- it in, like you would potassium.

If you have to run Zosyn at 25/hr for 4 hours, is that patient staying hydrated by that

joanna73, BSN, RN · Jan 4, 2013

I don't run my antibiotics with fluids. We piggy back them or use a syringe driver. Unless you the nurse has to reconstitute the antibiotic, they come already prepared. I also don't think you're stupid. You're a new grad who is learning, just like we all had to do. Furthermore, nursing is continuous learning, whether you're experienced or not. We all make mistakes.

canigraduate · Jan 4, 2013

As far as the abx infusion goes, it depends on your order set. I always run concurrent for a rate of 75 or less if the patient has maintenance fluids running. I may slow down the primary rate to keep the IV site from infiltrating, though.

If a patient has a small catheter like a #24, then I may not run them concurrently so as to keep the site. This is part of nursing judgment, which you may not have much of yet. It builds with experience.

BostonTerrierLover, BSN, RN · Jan 4, 2013

Hi, you have received some good advice, and I am here to say how you "feel" is important to some extent. If you feel totally isolated from the other staff, dread going to work, are a nervous wreck the whole 12hrs,.....I say run!!!! Sometimes thing are just a bad fit, but if this continues- please seek some help, I suffered General Anxiety- and now I am at the top of my game- and don't sweat a few "hushed secrets."

InfirmiereJolie · Jan 4, 2013

OMG you are not stupid, you've only been on the job for 3 weeks. If everyone could be perfect 100% their fist day we would have a utopia society.

I say work EXTRA hard, like push off breaks and ALWAYS look busy. Never stand around and if there's nothing to do... clean or talk to/serve the patients. Probably though, there is ALWAYS going to be something to do. I heard that the best work is work which is not noticed, meaning, you do it without being asked once you've learned how to do it under supervision. If you see it needing to be done and you've already learned how to do it, do it, without the co-workers supervision. Keep doing this until you are nearly 100% on your own. Your boss will LOVE not having to watch you and you'll change your rep from being "new" to "hard worker and best of all, GOOD worker."

I say work way up to down in terms of getting along with co-workers. The boss/ your preceptor director is the PRIORITY. Win their love first and you will win the other's loves too. In a conversation take their side... but try not to alienate the co-worker either. It's about balance and being friendly, but usually, "the boss is always right" . Co-workers like, actually, the co-workers which get along great with the boss because they want to get on their good side too. good luck! (and ignore the people who say it is your problem, psych ect., this doesn't really help at all guys... being the perfect worker and figuring out everything takes time )

Hope this helps!!!!

I am a new nurse who just got off orientation a few weeks ago. I have worked at the hospital where I am for more than a year and was hired from a tech position to a nurse once I passed my boards. I thought everything would go smoothly once I got off orientation, but I've been wrong so far. During orientation, I managed to make a lot of really stupid mistakes that I should have known better than to make, had numerous personality clashes with a couple of my preceptors, and got on my nurse educator's bad side. I know that people at work talk about me. I have heard it first hand and get the sense that people do not like me. Although some of it is unwarranted bullying, I realize that some of it is my fault as well. I take the blame because my problems with coworkers seem to follow me wherever I go. I have never had an easy time making friends at work and have always gotten the reputation for being stupid, lazy, etc... I guess what I am asking for is help. I realize that I can control how I present to other people. I am tired of being "that person." I need some tips on how to better my reputation and gain friends at work. I also need some words of encouragement. There is a girl at work who I know has spoke poorly about me to various people and I feel like as a result, these people now have a very negative opinion of me. I can tell by the knowing looks, sideways glances, and hushed whispers in the hall. I realize that I cannot control what other adults do, but these things have really put a beating on my self esteem. Any advice on how to not **** other nurses off, how not to look stupid, and how to overcome a bad reputation? Thanks!

chevyv, BSN, RN · Jan 4, 2013

Knowing you accept some of the blame regarding not getting along well with some people is a really good start! I normally get along well with people but have had a couple of run-ins with some staff on the unit I currently work on but on a different shift. Now, I have both of them talking all kinds of garbage to other people who may work with me on a particular day from another unit. I can tell because I too get the side glances. By the middle of the shift however, those staff are telling me outright that I'm wonderful to work with. Because I know there are a few who talk the talk, I just keep on walkin my walk and let others decide for themselves if I'm that nasty to work with. I don't say anything, I let my practice speak for itself and I'm confident in what I do to let them decide about me. So far, the ones talking are looking like sour grapes.

I guess what I'm saying is be yourself but watch how you act or even your body language. It takes some time to find your niche within a unit. You are not alone!

Guest343211 · Jan 4, 2013

There are actually several ways to run antibiotics, depending upon what the actual antibiotic is. I have run them via piggy-backs. I have given them in solu-sets.I have given them in ports, adapters, and other lines, and I have given them byinfusion pumps. It depends on the system and what is going on with the patient,the particular antibiotic, and then of course the access/accesses you have. Ifa person needs continuous intravenous fluids, another line, port, and or aninfusion pump delivery system will work. If the antibiotic cannot be run withthe other fluids or infusions, then you have to take that into consideration aswell.

Dear OP. We always have to ask ourselves the following:

What amI giving?

How andI giving it?

Why andI giving it this way--as well as perhaps—

Whereshould it go--i.e., which port, etc?

Different things have to be given different ways depending on those and perhaps other factors. This is another reason why nursing isn’t a job “any monkey can do.”

Another example is say you have a patient or kid on a particular infusion, but you don't want to bolus, say, a particular inotrope, that is another consideration, even if pharmacy considers it compatible.

About the personality stuff... Look, in my many years, I have seen a very high percentage (sorry fellow nurses, just one person's humble opinion here) of nurses that don't have the true gift, ability, and insight to be adult teacher/preceptors. Some of them may be fine with teaching little children, butnot adults. At the same time, too many may even NOT want to precept, or they may have inadequate instruction, and they themselves have received little or inadequate observation in appropriate models, and/or they aren't working with a system that promotes or allows for good precepting.

And then some people are just way too insecure to be in a position of guidance or even one-on-one leadership, which is part of what precepting/teaching is. These folks have made it more about them--they don't understanding that part of the role of teaching and preceptingis about having a giving, tolerant, spirit. Sure, they may have to get you through guidelines and competencies, and so they have to stick to those and the deadlines, but there is a weakness in how this is done from what I have seen overall.

Finally, as I have said a zillion times, nursing education systems in hospitals and otherwise, need to develop way more objective systems of measurement of progress and evaluation.

Regarding one of your preceptors you mentioned: It is in NO WAY professional for a nurse(preceptor) to stand gossiping about her or his preceptee with such subjective comments as "She is clueless." I mean,OK, he may be in some areas, and in other she may not be, and then again, he or she may not be at all clueless, the preceptor may not have keyed into what’s going on with the individual. Either way, it was counter productive and grossly unprofessional. That preceptor should be given some counseling and taken out of the role until she is re-evaluated for the role of preceptor. As a manager or nurse educator, I would NOT tolerate that--even if it seemed quite apparent that a said nurse does seem grossly ignorant or incompetent--NOT at all implying that this is you OP.

The point is, there are professional and objective ways of handling this kind of thing. Maybe the nurse needs time and appropriate remediation, or maybe she needs to work in another area for a while,or maybe there is this problematic dynamic between the preceptor and the preceptee, or perhaps some other honest issue. Yes, there's a limited time in which to get someone up to novice-competency speed. But places are cutting their own throats by hiring inexperienced and unready GN/BSNs over experienced RNs, period. Again, not saying that is your situation OP.

The orientation-precepting situation is a two-way street. When parties aren't capable of or able to provide what it is needed, it's a waste of money and it is a lose-lose situation.

But you may well never know, OP, unless your nurse educator and hosptial/floor/unit has the value of objective systems of measurement and evaluation and prognostic indicators, and if these are fairly and consistently used, and then, if youhave someone that is able to evaluate both sides of things without bias. To this I say, Good Luck. Such a situation is VERY hard to find in nursing, I am very sorry to say.

amygarside · Jan 4, 2013

What mistakes occurred? Is it intentional? I believe that we can make mistakes and we learn from them.