Please,please give me some guidance here...

Virgo_RN, BSN, RN · Apr 8, 2010

Honey, you have to toughen up. Don't wear your heart on your shirt sleeve. Take criticism as an opportunity to do better. Do not take things personally.

kfarinato · Apr 8, 2010

I think you should tell you nurse educator that you want to stay on night shift and hope that when the need arises a nurse can guide you through a Critical Care bedbath, they are not different than any other bed bath- just faster.

I had many years experience, but very little in the ICU. When I floated there as an aide I was scared at first. Time and relaxation (you need to be calm in order to learn) will make it better. I don't think they are going to fire you.

Is there a checklist of sorts for the job? Stuff that needs to get done on your shift? If so carry that with you. If you need to duck into a linen closet to refresh your memory then you can. If there is another LNA that you trust tell him/her how you are feeling about not being up to speed and see if they can give you some tips.

I am sort of suprised that they hired you right into an ICU, at my facility it is an easy CNA job and people jump for the chance to float there.

PostOpPrincess, BSN, RN · Apr 8, 2010

If you're going to let this set you back, you're already dragging yourself down.

Chin up, and move forward and go towards your goal.

juliaann · Apr 8, 2010

Like I said last time, you just need experience. Experience builds confidence.

As to "who is right" - if your preceptors are doing things two different ways, find out if there's a policy on it. If there is, do it the way the policy requires. if not, do it the way that seems most effective. A lot of times, there is more than one way to do something "right," especially when it comes to ADLs. Make sure there is no potential of harm to the patient.

You don't always have to copy your preceptor exactly (re: oral care issue). The nurse should not have been nasty to you about your mistake, she should have just reminded you. Things like remembering oral care will come in time, once you get in a routine. In the mean time, try making a list, even just a mental one, and checking things off. If you miss something, hopefully someone will *nicely* point it out, and you can thank them. I'm sorry this nurse did not remind you about oral care in a professional and encouraging manner.

Give it time. You'll get in a routine, and you'll be fine. Orienting some on days is probably good for you in the long run - you do need to be able to do a thorough and proper bed bath, even on nights. Just remember everything you can, make lists if you're a list person, soak it all in, and process at the end of your shift what you did well and what you need to keep working on. Ask for help if you need it when those every 5 minute people ask if you're okay. If not, appreciate their concern and show them with your confident attitude and your competant skills that you are okay, and they don't need to keep checking in on you.

I'm sorry you're still having a rough time. It does get better.

metal_m0nk, BSN, RN · Apr 8, 2010

In answer to your questions:

1. Perhaps asking if you're okay is their way of asking if you need some assistance or if they can clear something up for you that you may be confused about. Loosen up on the paranoia and relax a bit.

2. Who's right? Whoever you're with at the time. Take a few minutes to think about the reasons behind the way each one does things. When you're alone, use that reasoning to adopt your own way - while also following proper procedure, of course.

3. If it had occurred to you yesterday while you were being precepted (is that the right word?), that something was amiss, you should have asked about proper procedure. If you didn't have an opportunity to ask your preceptor, you should have asked one of those nice folks who were asking if you were okay. If they give you to go ahead, take some initiative and follow through with procedure. You are equally responsible for your learning/training. Take that responsibility.

I have attempted to ask for some guidance but my threads are a)ignored or b)are sidetracked so badly by another poster that my original post is largely forgotten. If anyone out there has a moment,please chime in. Please
I am a new LNA(got licensed back in November) and here is what has been going on:
I posted several weeks ago. I am a new LNA and managed to get a job on a critical care floor working nights. I was called, interviewed and hired despite having no experience. When I went in to start work my Nurse Educator expected that I would be available days to orientate; I was not and had made HR aware of this. Apparently, the message never got through. So I orientated 3rd shift-my normal shift.
Well the floor has been very quiet and the Nurse Educator is concerned that I will not be able to cope when it gets super busy. I caved and agreed to orientate some days this week so that (in her words) I could do things like a "bed bath".
So I have worked the past two days. Yesterday was ok. Today was not. My preceptor up and left me to see her sick mother. I was on my own. That in and of itself is ok. Here is what is upsetting me:
1.Every five minutes someone is asking me if I am ok. Well, asking me that makes me nervous and unsure, as if I have something to worry about. I am the sole provider of two kids and making me feel like I am one step away from being fired is not going to make me a good LNA!
2. My night preceptor and day preceptor do things in a different way. So, um, who is right???
3. The last straw..when my preceptor took me around yesterday to do bed baths she did not initiate mouth care on anyone. Granted,I should have asked about that but I am in the monkey see, monkey do mindset right now. So when I did bed baths today I did not do mouth care. And an RN was very nasty to me about it and was not very professional about it. I am not saying I was right but neither was she. I was angry but also hurt as I would never intentionally neglect a patient. I was so stunned by her rudeness I did not know how to respond.
For the past year I have focused solely on changing careers and working toward being a nurse. I am a 36 year old single mom. I have to make a living and have no real skill set. I feel like I don't have what it takes to be a nurse and losing this dream is crushing to me....

MomBSN · Apr 8, 2010

you received some great advice here...

1. look for a skills checklist, ask for an expected schedule (routine)...if you have an orientation packet this type of info should be included.

2. keep the mindset that you are "learning". when we are learning, we expect to make mistakes....hang in there...you are not alone :)

3. talk to the nurse educator and preceptor...review the expectations with both and review policy if answers are unclear

4. as for the unprofessional nurse...sorry she was acting like a jerk...and i could say..see it from her perspective but i wont...as i fail to find that reply helpful.

I will say how i would respond...i'd reply with an apology (not because she is right in the way she treated you). Starting with apology will take the fight out of her little tirade. I would then tell her that I am doing my best to learn everything as quickly as possible but that I am going to have to ask for guidance. I would also ask her if she has any tips or suggestions. I would even add that i know that she is busy and would appreciate any recommendations. Asking for help, acknowledging her experience...etc are ways to enlist allies.

Please keep in mind that this isn't exclusive to nursing....all jobs, professions have bad eggs, bad days, etc.

Listen now...your a single mom...that is quite a challenging position..if you can do that...you can do nursing :)

Your dreams is to be a nurse...don't you dare let that go!

jrsmrs · Apr 8, 2010

Something I have learned: there are as many different ways to do things as there are nurses. It is up to you alone how you will care for your patients and just because you see someone doing something or not doing something, or doing it a different way does not mean they are right. Truth be told there are a lot of crappy nurses out there who will slack off or take the lazy road, or who were simply never taught how to do something properly. You need to decide based on your education, policies, best practices, common sense, etc what is the proper way to care for your patients. My first clinical experience I shadowed a nurse who did not wash her hands the entire morning I was with her... straight from BM wiping to carrying breakfast trays with the same gloves. I never wondered if this was the proper way things are to be done; it made me realize that once you are hired there is really no one following you around to make sure you do your job well. Your integrity is on your shoulders alone for the most part and you need to make sire your practice is evidence-based and current. If everyone takes the attitude that mouth care is optional, what will these poor patients mouths be looking like in a few days. Take tips and advice as they come and with a grain of salt. Only you can decide how well you will care for your patients.

resumecpr · Apr 8, 2010

Do not apologize for something you didn't know. "You don't know what you don't know." - As my Critical Care School instructor once told me. I do agree that you should toughen up. There are old, mean nurses, and old cheerful, helpful ones. We all have something in common in that we have our experience to offer. In this career, we have to learn to take the good with the bad, and not focus so much on one particular downfall. Oral care is important for every patient, and evidence based practice has suggested that it be done on vented patients at least q2h, and on non-vented every 4h. There is nothing to lose (except if they're on bleeding precautions) by doing what's best for your patient within the scope of your practice. Good luck, chin up, all will fall into place.

summerrose_10 · Apr 8, 2010

i have attempted to ask for some guidance but my threads are a)ignored or b)are sidetracked so badly by another poster that my original post is largely forgotten. if anyone out there has a moment,please chime in. please
okay i will "chime in" but...you asked for it. never ask for advise if you don't want it.
i am a new lna(got licensed back in november) and here is what has been going on:
i posted several weeks ago. i am a new lna and managed to get a job on a critical care floor working nights. i was called, interviewed and hired despite having no experience. when i went in to start work my nurse educator expected that i would be available days to orientate; i was not and had made hr aware of this. apparently, the message never got through. so i orientated 3rd shift-my normal shift.
hr may have seen great potential in you, and was hoping you would be flexible. when you went in to start work and your nurse educator "expected" you would be available for day orientation was there a negative interaction at that time? you said you still oriented 3rd shift, so it was a non issue then? you also accepted a position on a critical care floor.
well the floor has been very quiet and the nurse educator is concerned that i will not be able to cope when it gets super busy. i caved and agreed to orientate some days this week so that (in her words) i could do things like a "bed bath".
you "caved"(neg), maybe you were "flexible"(pos). perhaps the nurse educator would like to know if your competent and can give bed baths in case day shift gets too busy and needs your help. again, critical care floor. when it gets busy tensions rise and no one will have time to be teaching "bed baths".
so i have worked the past two days. yesterday was ok. today was not. my preceptor up and left me to see her sick mother. i was on my own. that in and of itself is ok. here is what is upsetting me:
1.every five minutes someone is asking me if i am ok. well, asking me that makes me nervous and unsure, as if i have something to worry about. i am the sole provider of two kids and making me feel like i am one step away from being fired is not going to make me a good lna!
this is where communication comes in. ask, "why are you asking?" communicate, let them know you feel nervous and unsure when they ask that question. maybe they see routine/basic things that are being neglected and are wondering why you are not attending to them. this statement "i am the sole provider of two kids and making me feel like i am one step away from being fired is not going to make me a good lna! is defensive. also, they don't "make you feel", thats your choice. let them know you are new to this career field, want to do a good job, and, you are open to instruction/direction.
2. my night preceptor and day preceptor do things in a different way. so, um, who is right???
if there is a policy, go by the policy. remember, there are many good parents out there and they all do it in a different way, the end result is the same. this is where being flexible can be important. you will learn what works or doesn't work for you, give it time.
3. the last straw..when my preceptor took me around yesterday to do bed baths she did not initiate mouth care on anyone. granted,i should have asked about that but i am in the monkey see, monkey do mindset right now. so when i did bed baths today i did not do mouth care. and an rn was very nasty to me about it and was not very professional about it. i am not saying i was right but neither was she. i was angry but also hurt as i would never intentionally neglect a patient. i was so stunned by her rudeness i did not know how to respond.
blaming the preceptor???the monkey see monkey do mindset can cost you your license, be careful with that. it can be the reason you didn't give oral care but it does not excuse it. i'm not excusing the rn for being "nasty", however, she was being her patients advocate, wanting good care for them, (oral care is a basic adl). you say you were "angry"...about what? "hurt" okay, it probably hurt your feelings, again..communicate this. tell the rn "when you talk to me in that tone...say those words..whatever..i get my feeling hurt" again, communication, apologize "i'm sorry, i should have given oral care..." the rn doesn't know if you would/would not neglect a patient, your new, you are the one who has to prove your competency.
for the past year i have focused solely on changing careers and working toward being a nurse. i am a 36 year old single mom. i have to make a living and have no real skill set. i feel like i don't have what it takes to be a nurse and losing this dream is crushing to me....

that is great you want to become a nurse, there is definately a need for them. i too, as many of the people who post here, was an "older" parent wanting to make a better life for my family. it isn't easy. what helps is learning to communicate with others in this profession, asking for help when needed, flicking that "chip" off your shoulder, being humble, and always come to work with a positive attitude. there is way too much drama with the patients and their families, don't need anymore from coworkers. as my preceptor once said to me "check your personal issues at the door, pick them up on your way home". your there to take care of the patient, do your job and there won't be any problems.

that being said, please don't give up your dream, if being a nurse is what you want to be then don't let anything get in your way. especially one rude rn. just use your monkey see, monkey not do for unprofessional behavior. :redpinkhei'm sure this past year has been tough for you. it's only the beginning. nursing school is difficult, and when your caring for kids it only makes it tougher. hang in there. :smokin:

caliotter3 · Apr 8, 2010

Well, did you speak up to the RN? You are too old and have been around too long to act like a fragile flower. You should have told her straight up that you did not do mouth care because your preceptor did not do it. You want to speak up for yourself because for one thing, you have no idea whether or not that RN made a derogatory report to someone about you. You can't expect that people there will let you know when they are making critical assessments of your performance to the person responsible for saying yay or nay to your continued employment. From now on, be proactive with questions. Show that you are more than interested in learning the way they want things done.