2018nurseandbeyond

Hello all. A mixture of a vent and just self-reflection. I have been a sub-acute rehab nurse for a year for my first ever year of nursing and then transition to med-surgical nursing (orthopedic-tele specialty). So while I feel like I've gain a lot of skills and learned a lot, I don't feel as I am comfortable with myself as a nurse. We have our one-year nurses, some extremely confident, breathing in their own skin. Everyone says " after a year you feel better," but it's rounding that year mark, and I still feel uncomfortable when things that are out of my normal tend to stress me out. I like the floor I am on it just very heavy, we'll have to transfer, discharge and accept report admission sometimes all at the same time ( as you know, I can not be everywhere at once, and someone will ultimately be first and then last). I like ortho. I like the acute. While I pick up on things or follow my nose on intuition on things there are still things I feel like I shouldn't be confused about. It feels as though people perceive me as someone with three heads, dumb. I tried to fake-it-till-you-make-it confidence, but it felt more like I was being a know-it-all-newbie, so I chilled out, but I feel at a cross-roads. Example 1: we had a patient who had been sustaining a high HR, and I felt concerned, performed an assessment, reviewed her chart to see if the MDs addressed it ( which they have) but even then, the tachycardia makes me uncomfortable. the pt's case prevented us from pushing any time of beta blockers to control their heart rate due to the fact they weren't responding to a fluid challenge with continued low BPs x1 day. I assess, do a BP on the patient and it's normotensive, if not a bit high. I run it by my charge nurse to call and see if I could get something ordered for the patient and she agrees. The PA doesn't want to order anything and tells me to just watch it. I write a note. Hours later the patient is now reporting chest pressure. Their heart rate is still sustained tachycardia. Their blood pressure is still normotensive. Now there is symptoms. I ask my charge nurse, but, unsure, " She's uh, complaining to chest pressure and pain in her hip, I have morphine for her?" "I would call the PA before you give it," But she seemed exasperated, annoyed I had to run it by her. It doesn't help I have a stutter when I get nervous, so I feel extra incompetent. Now we give a IV betablocker, the pressure in their chest is resolved. But now it's stat EKG and troponins. Everyone looked at me like I was an idiot. the CNA was speaking rudely to me like if I "allowed" this to happen. I didn't say anything, she doesn't know that I spoke and assessed my patient and I find it petty, but I did feel a bit ganged up n. --- example 2: Patient was a post op day 1 and as I received report it was noted the patient was due to void. I told the patient they needed to pee and asked if they were uncomfortable or full ( denies). Come around an hour later, my aide put the patient on a bed-pan, nothing was on the bed pan however the entire bed was saturated with pee, we had to do a total bed change ( fine with me, the patient peed!) My charge nurse asked me if the patient voided. I said, well, I don't have the amount because the patient's bedpan was empty but the entire bedsheets were wet with urine. She's not distended and I was going to bladder scan her but it was obviously urine. My charge nurse asked me so many extremely confusing questions infront of everyone and I was so confused. She looked at me with three heads! I was confused myself by what she was askin and she seemed in disbelief in my assessment skills and I felt like I was doing something wrong. -- On the bright side, many nurses come up to me and ask them to help when they need it. Though the frequency has lessened: Covid19 burnt me out, turning heavy patients as a small women with no muscle is quite difficult now. Whenever a new nurse approaches me with a question, I am hesitant than the others. Some with prattle off confidently. I've been told it is a good quality of mine but I feel like I go overboard and come off as very unconfident ( which I am). I tell them, as much as I am flattered to help explain certain ilks and ilms, I am still new like them, I joke and call it " the blind leading the blind". I refer to them to our most experienced ( approachable too) nurses to run it by and remind them if they haven't don't manuals or assessed something before bringing it up ( as I know how it feels to feel like everyone thinks you're stupid/incompetent). I review policy with them or show them where it is if it's an amendable issue. Considering I had a very bad experience I respect my license and my peers, I tell the new-hires that they worked very hard for their license and shouldn't go running to the first person they see, feel it out, their charge RN and nursing education is an excellent resource. It makes me feel weird when people approach me, like I don't know if I should be flattered or scared that I'm the only available "experienced" nurse ( I'm absolutely not). Either way, I stutter majorly, my face shows it all--no poker face here. I feel socially I am awkward too, so I miss social cues, though I've been told I have great bedside manner ( so far? I have put my foot down on patients who were outright rude) soo I feel like I get annoying, especially when lamenting how I want to be an experienced nurse with more years so I can feel comfortable in my own skin.

two most common one is infiltrations/phlebitis phlebitis - itis - redness. patient will complain of soreness at the site, it'll be red and warm and hurt if you try to flush it. best to take it out before it gets worse as ivs are a potential source of infection. infiltration - a keen eye to ivs is if the skin starts to get "tight" and cool to touch. infiltrations are now graded ( atleast where I am) as incident reports/sentinel events on a I-IV scale. Infiltrations can be minor, or huge, with pitting edema. Sometimes infiltrations need hot or cool compresses depending on the component in the IV. interstitial, im dumb I never heard of this, or forgot about it from nursing schol.

When I worked on the units, I would make time to wash my hand at regular intervals thoroughly. I would make time to regularly dis-infect my medication cart over and over in the case of accidental cross-contamination. Hopefully, it's better for you; we ran out of sanitation wipes, regular hand-sanitizer and gowns. everyone had to use their disposable gowns for days. it was rough.

Absolutely. I worked on the pandemic when it hit my state bad. I self-isolated, kept 6 feet apart and wore a mask covering around them. Separated my eating utensils from the group and kept my toothbrush somewhere else. The PPE we wore at my hospital was booties, a Tyvek suit, an N95, mask, goggles and a hair covering. I'd put on a surgical gown (cloth, you know the ones from PACU) for extra protection. double glove, take off my dirty gown after sanitizing it, and then taking off the first pair, hand sanitizing the gloves and then sanitizing my Tyvek before taking off the gloves to wash my hands. When I left the unit, I'd disinfect my Tyvek suit, take virex and scrub the bottoms of my shoes thoroughly with bleach. leave virex on my stethoscope for 5 minutes and other things. and then wash my hands for 20 minutes. When I get home I scrub myself down and self-quarantine as much as possible. I was one of the few people, SO FAR, in the entire hospital, to not get +covid.

hi all, ive moved to a med-surg unit. I've been a rehab nurse for one year, and I want to know what kind of things to expect in difference between rehab and med-surg. I am pretty insecure about myself and especially since a lot of nursing co-horts think rehab is "nursing home" or "not real nursing"... at my rehab center I've done PICC line dressing changes, hung IV abt, do insulin sliding scale, change wound vacs, do a lot of wound care, assessments, start ivs. I'm not so good at wound vacs, but I am good proficient at PICC lines and decent at iv starts. My med pass consists of patients of 12-25 depending on staffing ratiosand as a charge RN would be doing a lot of charge responsibilities. i just want to know since i am very insecure in myself, i feel like the educators respect the nurses straight out of nursing school rather than me as if i been "tainted" any tips to "prove" myself as a goo dnurse and maybe stop being so sensitive?

How would you feel if your unit manager tells other co-workers that you are doing things wrong so they tell YOU when you come up to said unit manager multiple times to ask how one is doing, but they continue to say your performance is fine? I feel like I am being borderline bullied: So far I've been told at work a lot of falsehoods: 1. Specific charting that is only supposed to be during days and evening shifts to finish up for nights, that if I did, would be fraud. 2. Told to sign off on receiving medications I did not receive and therefore reconcile because nights are the "easiest shift" ( I just write if the medication has been on unit from the rec-form or if we have the card, and no long sign it as my unit manager requests me to do as it would be fraud). 3. Told to put in consults from other MD as orders without the authorizing primary care provider's consent, being told it is "fine". 4. Have my nightly audits thrown out, things I am required to do for my workplace suddenly disappear. 5. Hear rumors that my unit manager told other workers I've "written them up" for things I had no idea about or even spoke about at all. 6. Told false protocols and things about our unit. Such as our private rooms can house TB patients ( false). 7. Scolded for not "picking up after myself" when day shift leaves pizza boxes and don't clean up after themselves. I don't feel obligated to clean up after other people's messes in the break room. I don't know how to feel. I feel so frustrated. I've brought this up to my supervisor, albiet in the heat of moment. She thinks I am just in a personality conflict with the unit manager

thank you again for your support everyone, im rereading the comments because again today SUCKED. i came in feeling strong but left like a sad, sad pitiful pup. god. got yelled at for leaving a psych consult not filed, i was working on auditing 5 new admissions on my unit, weights, ambulation, did the glucometer restarts, i didnt get the chance to file everything. i came up to the nurse and nicely asked if the place is still dirty, she yelled at me NO! i asked her, " what is it you would like to be changed about this place so I can work on it?" and she explained it to me and i felt so frustrated i guess no one sees the work you actually put in... just all your mistakes :(. just gotta keep doing better. morning report was brutal i feel like i got ganged up for being a fresh piece of meat.

thank you guys i cant believe the amount of support i feel from this... its been paralyzing me for my weekend off!! ive been so stressed that im "weird," "paranoid" "anxious" and "lazy"...means so much

Worst day ever, I felt like I was getting into it with all my staff members. CNAs getting upset with me when I delegated to them. Following advice to -tell- not -ask- with patient concerns ... I mean I'm misses-unfair etc etc. Especially with their scope of practice and facility protocol... I feel like my new full-time co-worker doesn't think I am competent and whenever I do hands on assessment, or nursing based skill with her everything falls out my head and I feel -extra- incompetent when she criticizes me for sloppy work or doing things differently? Today was especially bad, had 2 rapids where I was assessing and I felt... Just bad. Sloppy. No one liked me. I was a ***, and I was incompetent. 4 more months until I hit my year of nursing... I'm just burnt out and crabby over my co-worker politic drama and pt. Complaints as a charge nurse... Wanna go part-time but life isn't doing it... Or new job ?

About a week ago, a patient NEARLY fell after the aide who was supposed to watch them walked off the unit without letting me or the other nurse know. I only realized they were about to fall when I was standing at the nurse's station and saw them half-way out their chair wheeling theirself to us. I was angry. This aide had been giving me a lot of trouble. Not answering call bells on the high-side, not listening to me when answering the bells. Being generally rude, rolling eyes, scoffing, ignoring me whenever possible. My supervisor was aware, I gave verbal warnings with my sup for the aide to realize they needed to stop. After they walked off the floor I decided it was finally time to write them up. They walked off the floor. Technically it isn't "my patient", but I am the charge nurse for 40 patients. So if the patient fell I would have to do assessment and the documentation surrounding that ( which is a whole lot). So they got written up with the support from my main, full-time supervisor and the unit manager backing me. The other nurse refused to write a statement and so did the other aide. They told me later it was " none of my business to write that aide up"; and " this isn't my patient, so it's not my problem." I was appalled and shocked. In the past, the aide who I wrote up was always so talked about poorly, by another entire unit and of other nurses. But I wrote them up because I was disgusted by the negligence that the aide portrayed. The other workers covered her, saying I was making it up and the other nurse refused to write a statement supporting my statement. Same with the other aide, who, ALWAYS complains about the aide who neglected the patient. Telling me, " Stay in my own business, and just let that man fall." I'm venting and angry because now I feel like I am being mobbed by that aide's "clique". I don't like being accused of being a ***-stirrer but it comes with the territory of being only here for 7 months--but I *CARE* about my patient. I do... and for this to be said to me after all of this stress... no support... just me being accused of "jumping the gun"... is... angering and insulting.

@JKL04 thank you

@jkl33 I am friends with the aide who needed to come back on break. I said, " Oh you seem upset by this let me text her so you can take your full break." It was an innocent statement. The aide is known to be mentally not right but everytime I tried to speak my side of the story to my sup the aide would come up and scream saying I am a liar and how they swore on their dead relatives I was doing everything to conspire against them. The supervisor said NO I wanna hear your side here RIGHT NOW, HERE--when I tried to pull her aside to speak to her in a quiet manner. While the orther aide was losing it and kept interrupting me. Then the sup said YOU ARE THE ***-STIRRER.

Charge Nurse, brand new and 20's. I've been breaking up assignments with one aide rotating with a higher amount of patients and it goes through in that way. So one day Aide 1 gets more and the other gets one less patient, and another day Aide 2 does. We've had drama on our floor that the aides weren't happy with so a lot of this is to create fairness. Which I was really proud of. I've been doing the culture of care requests which entail us doing group huddle ( nurses werent doing that for their aides prior to me accepting the job). I've been struggling with a few aides. This one aide flipped out on me last night where I feel at a lost because the Sup (per diem) sided with the aide. The aide was saying the second aide hasn't returned from her break so I said, " Oh let me text them, I want you to have your full break." The aide misconstrued that as me picking/favoring sides. She kept saying " This is why I don't work with her because you know how I feel about her. You guys know how I feel about her." I was quiet. She kept screaming that I was this and that and eventually the other aide started to fight her to defend me. I tried to break it up but the supervisor felt like I was at fault because I texted the aide to come back from break so the other aide ( accusing me) could take her full break for relief. " YOU are the ***-stirrer for this. You ARE playing favorite with aides." So basically. My name has been tarnished ( by this aide who says I am playing favorites). and basically. well. I asked my nursing educator to move me to the day shift because now I lack support.

older i nurse confided to as my mentor leaving unit for different job. said that i was the reason she got introuble for some things, claiming i "said things/accused her/wrote her up". devastated, as during that situation i 100% backed her up and reaffirmed that what other staff members accused her of wasnt true. told the DON of our facility she was an amazing nurse. she never told me she was leaving but she told everyone else who kept it a secret from me... and one person accidentally spilled the beans. not hurt she is leaving, brighter pastures in a stressful job. hurt by all these hurtful things that are being revealed from others of all the things she's said about me when she orientated me. like damn. still in my feelings but ill get over it...

thank you so much for helping me out @rn&run