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Newbie4567's Latest Activity

  1. Hey ya’ll, Over the past week or two, I have been the unlucky recipient of multiple heavy assignments. A lot of random emergencies have been happening on my shift, and naturally I have needed to rely on my team to support me during those situations. I’m a newer nurse, and I have always felt that my coworkers look down upon me because of it. I started in the ICU and no one has been shy about sharing their concerns about my lack of experience. Even though I feel I have been improving, it feels like no one else sees that except a few coworkers. With these emergencies, I’ve noticed that some of my coworkers will come into the patient’s room and do things to “help” without communicating with me directly. For example, I had a vented patient who was dysynchronous with the vent and decompensating. I was literally unable to leave the room for two hours. I was in the process of bolusing Fentanyl, per the provider (who was outside of the room)’s order. Another coworker walks in, logs me off of the COW and starts signing out and pushing meds. I asked him what he was giving my patient and he looked at me like I had two heads and said “we’re pushing roc!” like it was obvious. While I appreciate the help of my coworkers, I also feel like I should at least be informed as to what my colleague was doing to my patient. More recently, I had a patient on continuous dialysis that started to alarm for an unusual alert. As I was trying to troubleshoot using the machine’s directions, I called for help as I had never seem the alarm before. Neither had most of my coworkers, so my admin charge came into the room. She’s a domineering person and has a tendency to come off in a condescending way. She also hasn’t been at the bedside in YEARS. While the dialysis alarmed, the patient’s pulse ox (which had been reading 98% ALL DAY) suddenly had a horrible pleth and was reading 68%. The patient’s voice had been hoarse and unclear all day, in relation to her mental status. I knew my patient was probably fine, but my charge started to freak out and completely took control of the situation. She applied a NRB, suctioned her and had us boost the patient and said “we need to focus on the patient’s oxygenation right now” and “She’s so hoarse!!” in an incredibly condescending way. The way she said it was like I was a first year nursing student who didn’t know a thing. As soon as we applied another pulse ox probe, the pleth improved and her oxygenation was 100%. While I appreciated her help, I felt like I was more than capable of addressing a pulse ox with a bad pleth and ultimately my concern was more with my dialysis circuit, which was failing. After the situation was under control, I saw her standing outside of the room talking to my manager, which made me feel like she was complaining about the way I had handled the situation. Afterwards, she came up to me and was saying “this is ridiculous, the patient looks horrible, where are the doctors” and reiterating concerns that I already was planning on addressing during rounds (the doctors were rounding on another patient down the hall). I even emphasized that once the patient was settled I was going to ask the doctors to round on her next, by my charge didn't seem satisfied. I’m just frustrated overall because I think I would have been able to take the lead in that situation and my charge didn’t give me the opportunity. While I appreciate her help and concern for my patient, I knew my patient was okay and purely the victim of a bad reading. My dialysis was at the risk of clotting, which would have been a bigger safety risk overall. I feel like she (unintentionally) made me look bad by not allowing me to guide her care.
  2. Newbie4567

    Leaving the bedside

    Maybe it’s the COVID, maybe its the stress of being a new nurse, but I am considering leaving the bedside after my two year contract is up. So, If you are an RN who’s left the bedside, what career path did you choose and why? Any regrets/advice for others leaving the bedside?
  3. Newbie4567

    New Nurse Advice Please

    Hello there, The first thing I want to say is: BREATHE. It is going to be okay. You got this. You passed the NCLEX. Your hiring manager chose you because she believes in you. Trust me, if she really felt like you weren’t a good candidate, she would not have chosen you. Next, the first weeks of your orientation are going to be the basics. Assessment, organization, planning care, medication administration. All of these things are going to become easier with practice. I understand you’re afraid that you’ve forgotten all your skills, but it WILL come back to you when you review. I would practice your assessment skills on a friend or family member. My basic assessment (as an ICU nurse) is: -Neuro: assess orientation, movement of extremities, as pt to smile and stick out tongue for facial droop. Check pupils. Assess for pain. -CV: feel radial and dorsalis pedis, ask about palpitations/numbness, tingling. listen to heart sounds, assess temperature of skin, capillary refill, and edema. If on telemetry, assess rhythm. -Respiratory: lung sounds, ask if feeling short of breath, verify amount of o2 patient is receiving -GI: listen to abd sounds, THEN palpate abd. Ask about pain during palpation. Ask about last bowel movement. Assess feeding tube/tube feeds. Ask about nausea/vomiting. Gu: assess foley (if one is in place), perform foley care if possible, assess NEED for foley, assess color and quantity of urine if possible, review I&o’s in chart skin: verify status and stage of all wounds, perform wound care as needed. Sometimes, I assess wounds later in the day as this can be very time consuming. Remember to specialize your assessment to your patient! For instance, perform a more thorough neurological assessment on a patient who recently had a stroke. Lots of educational websites are available to review lung sounds, heart sounds, and CV rhythms. I would review the most common medications you will see on the floor. Trust me, no one expects a brand new nurse to remember every single med they are given. I would review common BP meds, diuretics, pain meds, blood thinners, anti-arrythmics and seizure meds. Ask your preceptor about the formulary available to nurses at your hospital, or download a medication administration app. Feel FREE to call pharmacy about a medication route, dosage or timing that you are concerned about, for example if a new NG tube has been placed on a patient who failed their swallow eval, can they still take their scheduled chemotherapy pill crushed? As for organization and planning care, that will just take time. Utilize your resources and your preceptors. Ask about hospital specific care bundles. What does your hospital do to prevent CLABSI? CAUTI? Falls? Is there a rapid response team? Review the signs and symptoms of sepsis (essentially...high temp, low bp, and high HR). And don’t be afraid to ask questions. From one new nurse to another, you got this!
  4. Newbie4567

    New Grad to ICU

    I started in the ICU in July after graduating in May 2019, as part of a residency program. I would definitely recommend working as a CNA while you’re in school to develop those connections. On my unit, our “techs” are all certified EMTs or critical care techs so there may be additional requirements for working in an ICU while in nursing school. Be ware: there are a lot of older nurses that do not believe new grads should be in the ICU. When you land your position, DO NOT let their attitude discourage you. You can and you will succeed.
  5. Newbie4567

    I don’t fit in, and my coworkers think I’m an idiot

    Thank you for responding. My evaluation with my manager ended with him telling me that I was doing a good job, but you’re right. The fact that he was even considering if I was right for the role terrifies me, and the only real reason he provided for me was that I wasn’t as social as the other nurses. I feel like I’ve been given a lack of constructive feedback. There is one nurse I really admire, who is really nice. She precepted me one day, when one of my mains called out and she went out of her way to teach me and talk to me about how things were going. I just wish I had had that kind of support from my own preceptors. It's worth a shot to talk to her. I’m trying to look at myself and my performance. I really think I say the stupidest things at work, without stopping to think. It makes me want to socialize even less. I can really see myself getting out of here when my contract is up.
  6. Newbie4567

    New Grad Worried I Forgot Everything I Learned in School

    I would go over basic assessment and neuro assessment skills. Do you have a friend/partner you could practice on? Definitely review the 5 rights and safe medication administration. I’m also a new nurse, four months off of orientation in an ICU and I can tell you the first few weeks are focused primarily on reviewing those basic skills, as well as organization and planning. You will learn A LOT, very quickly, but it will be okay in the end. Good luck!
  7. Hey ya’ll. I’m a new nurse, I graduated May 2019 and started in my current job in August. I was hired into an ICU, and even now I feel like I don’t fit in. I feel like a giant fraud, a failure, and like I come across as a moron to everyone I interact with. I always did well in nursing school, and I graduated with honors. I worked in a high acuity floor as a tech for a year before starting in this role. I felt as prepared as I could be, but from day 1 my coworkers have made it abundantly clear that they don’t believe I should have been hired, purely off of my new grad status. This came from everyone, from regular staff nurses to the nurse educator to my own preceptors. Orientation went badly. My two preceptors were on two different planets with what they expected from me. One, quite frankly, was lazy and didn’t seek out opportunities to teach me different skills. The other was overly intense and helicoptered me, giving me no room to grow on my own. He also made disparaging comments towards me when he was frustrated. For example, “You’re just like a boy! You don’t look for anything on your own!” and once when I expressing concern about a patient, he rolled his eyes and said “you say that about everyone”. At the end of my orientation, he blindsided me and told my manager that I wasn’t ready to be on my own. He had never given me that feedback, just that he felt I was doing well. Going into work every day, I always felt so anxious about everything on my plate, everything I had to remember, and the stress of my preceptors that I didn’t put in much effort to make friends. I really wanted to, but I was so overwhelmed that I couldn’t even focus on it. I’m a naturally shy person as well, and it was intimidating initiating social interaction when all of my coworkers are best friends. Despite being shy, I’m usually good with making friends. I try just to be as nice and helpful as possible, but no one seems to want that from me. Since being off orientation, I feel slightly better, like there are some nurses that I could consider myself friendly with, but the vast majority seem to have this disdain for me. No one is friendly, no one is kind, people roll their eyes when I ask them questions. Even when I try to be helpful, my coworkers just seem annoyed by me. Everyone gossips, and I’m always afraid that one stupid thing that I say is going to end up spreading around my unit behind my back. One time, a coworker texted me at home to tell me about a small, inconsequential mistake I made. This person went out of their way to make me feel bad at home, about a small mistake that I had never made previously. Even my manager, during my evaluation, said “We weren’t sure if you’d be a good fit into our family. Like does this girl even talk?”. The only nurses that I seem to get along with are in the pool. Everyone else has a palpable dislike for me. I’m stuck here in a two year contract and I really wanted to make this job work. I can’t even explain how grateful I am to the few nurses that are nice to me, because they’re keeping me from feeling terrible all the time. What can I do? How can I help myself?

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