problems w/ my unit. Any ideas?

[rags]

I have been working at my hospital since June and was hired on in the Family Care Unit (includes PEDS OB and PP). I worked as a graduate nurse until I failed the NCLEX the first time in late July (second time in late Sept.) and since as a CNA (for the first time ever in my life). I have actually enjoyed the experience and feel that someone somewhere thought I needed to be a CNA for a while so that I will be a more understanding RN. (Please don't crush my bubble here, It is not only a wonderful experience for me that I have taken on whole heartedly but also a wonderful coping mechanism).

I have floated to different areas of the hospital since with only about 4 nights working in my own unit. That's 4 nights out of 3 months. I am very comfortable in all other units of the hospital and have adapted to the way things are done in each pretty well. When I got back to my own unit to work for a night (or in some cases like last night... part of a night) I feel a bit out of place. My unit does not normally have CNA's and usually just the one that is Unit Secretary 4 days a week. The RN's are pretty self sufficiant as a result and we have had some issues with know who should be taking VS and such, but that has been worked out. So I thought anyway.

Every unit has been very positive toward me and seems to be very appiciative that I am there and pretty much lets me be on my own to determine what I need to get done. I sit in on report so that I know who is on strict bed rest, has a foley, on strict I&O's, etc...

I'll try to keep this simple (honestly, I WILL try). On Tue. night I was left to work on my unit in FC. I was very excited about working with my own crew again and tried to anticipate their needs from I remembered needed to be done. I took vitals on the pt's I was allowed to (L/D and NS seems to be off limits for some reason) when I came on after report was done. I have always been in the habit of charting (done on computer) as soon as I am done and I report anything out of the norm or any needs I cannot meet of a pt to the RN I am under for that peticular pt. They usually just shrug their shoulders at me and say, yeah, I know and don't appear to be concerned, which is fine, I am just the messenger and I understand that. I cleaned equipment after deliveries, put together charts, helped care for a NS full of gagging babies (can't figure out what was up there, must have been something in the milk :wink2:), called new borns to admitting, set up the circ room for an AM circ, did a couple of hearing screens and a midnight weight, got a newly post-partum mom up the first time & also changed her bedding, prepaired a room for an early am C/S, ordered labs on NB's and delivered the cord blood etc... I think you get the picture. It really gave me a good feeling to have the RN's coming to me saying, "Oh, you already did that?" or simply finding me doing what they were going to tell me to do. I felt I had anticipated their needs and that was best way for me to be helpful on a floor not used to having a CNA. Apparently work performance was not seen be the RN's in the same way.

When I got to work last night I was first floated to another unit and one of their RN's was floated to mine. Around 11:00 I was to go back but nobody informed me of this until after 11:15. I was helping an RN get her hourly BS and VS on a pt with the Dr. present waiting for the results, then I charted it before going to Family Care. While I was writing down the patient load and finding the information I felt I would need from the cardex I was handed a list of things I would be doing and at what time I would be doing them from one of the RN's. It felt strange, kind of like I was someone off the street that had never taken VS or I&O's before and was in need of direction for some reason. It also had on the top a message saying that I would do hourly checks on all pt's and chart it. I felt this was too much! I could not find a good reason for me to open every door during the night and look at patients on a unit such as ours. PP mom's are usually stable patients, I can not chart on or care for Laboring moms or the new borns (their rules) and they were doing their checks anyway (were they not?). I was answering call lights and doing their VS and I&O's as well. But... I did it. I was told to by my RN's and that is what I did. When I was finished doing VS on all pt's I was passing the nursing that had a very upset baby in it and no RN so I went in to calm the NB. Not 2 minutes after I went in there one of the RN's came in and said, "if you aren't done charting you shouldn't be in here holding babies. I'm just worning you because there has been a lot of drama about things not getting done or charted." I used this opertunity to ask questions and find out the reasoning behind the list. It would seem that they RN's didn't feel I get anything done the night before except hold babies in the nursery and the statement was even made that "everytime we look for you, you are nowhere to be found" this was from a nurse I have worked with all of 3 times since I started there and simply isn't true. If I am going to be leaving the floor I ALWAYS tell someone. I admit I smoke but it does not effect my work. I have maybe 3 cig. in a 12 hours shift and NEVER if there are things needing to be done! During the night I also found out that they feel I am taking up an RN spot on the schedule and that leaves them short handed. One even mentioned to me that it must be tough and that I must doubt myself on everything since I haven't passed the NCLEX yet. I responded with, "No. I don't doubt myself at all. I just need to figure out the NCLEX, but I think others here do and that's a hard one to swallow". She responded with, "Well, I'll be honest with you. I do that. Since you never worked on nights as a GN we just think, how scary is she? Why can't she pass the NCLEX". I will add that I have a lot of respect for this RN because she will actually talk to me as if I am older than 2 years old and is up front with me at all times. Now my boss wants to talk to me.

I just don't know what to do. I spent most of the night fighting back tears and doing everything in my power to not quit. I don't bring my personal problems to work (which are difficult and many at times) and I remain professional and try my best to give quality pt care and respect to all the RN's I work with.

I do know I need to get my license, I need to pass the NCLEX and then prove myself to them. I can retake it in Nov. but don't know if I will have the $335 to pay for it by then. The $8/hr pay cut was a huge set back. I am stuggling to just pay my bills on time now (have to find another $200 by monday even). AND... we have been trying to buy a home for the past 3 months as well and that has only added to the financial pressures. I am not a spring chicken. I have been in ugly situations with fellow employees before but this feels different. Nobody has ever treated me like I was not a quality worker and made comments to me of that nature. I guess I am like a fish out of water here.

I am sorry this is so long. I just really don't know exacty how to handle this. My boss can be a little scary at times and you never seem to know what mood she is going to be in on an issue. I am the new kid on the block so don't expect her to take my word over the others. I don't think my job is exactly on the line because she did send me an email today asking when I was going to test again. I am NOT doing it because she is pushing me to this time. I will wait until I am ready. (which my plan is the end portion of Nov.)

[rags]

Sorry I can't seem to edit my post (my browser shuts down when I try:angryfire) so please excuse the misspelled words and poor grammer. I should actually be in bed still but for some reason can't sleep :zzzzz ...

[Melina]

No wonder you can't sleep! First of all, I want to tell you that being a CNA is wonderful experience for nursing. I think we should all do it, if only for a summer. I can tell right away when I work with nurses who have been aides.

Second, I am so sorry you are being treated so poorly! I couldn't tell from your post if this treatment started after you took the NCLEX? The nurse you spoke with was probably right about the reason for the staff's behavior (not that it makes it right!). It would be nice if someone would approach you directly, but not everyone has good interpersonal skills. Are you assigned to a particular nurse? Can you ask her to discuss her concerns with you, so you can answer them directly? I can understand they may be nervous about having a "failed" nurse on the unit, but it isn't like you didn't graduate! Not everyone is good at taking tests, and the NCLEX isn't like most tests. Sometimes it just takes a couple of tries. I think it's really brave of you to stick it out. I wish I had more concrete suggestions, but I want to wish you well. Keep us posted!

~Mel'

[rags]

I never actually worked with the night crew until I was a CNA. I was actually on my last day of orientation (which is all days) when I found out I didn't pass the NCLEX. My next shift was the first time on nights.

Our hospital is not large (big for a small town but not large) we average anywhere from 3-4 pts to as many as 25 (most I've seen is 13) on a unit and when I work I am the ONLY CNA for that unit with up to 3 or 4 nurses depending on the pt count. The nurses usually have anywhere from 3-6 pts depending on the night and needs of the pts. The night in question there were 4 NB's - 4 PP moms - 1 delivery - 2 hyst - and 1 PED; 3 RN's and me.

I found out last night from an RN on another unit I get floated to that she ran into my boss and thanked her for allowing them to have me and she added that I "was a real life saver" for them. I found the timing to be a bit ironic.

Thank you for your words of encouragement. Sometimes that is worth as much as advise.

[rags]

As far as graduating. I am very proud of the fact that I managed to hold a 3.5 GPA all through my nursing school and college classes. I worked very hard for it and think that makes it all the more difficult to swallow not passing the NCLEX twice. Our school (an adjuct to the college) was very small (6 graduate nurses in my class) and we had one instructor though classes and clinical for two years. She spent a great deal of time teaching us to think outside the box and NOT be text book, task oriented nurses. Unfortutely the NCLEX seems to want just the opposite. I'm getting there though. Being a CNA is all about the "tasks".