Lunar

Hey! Thanks for asking. I finished out the month with two other preceptors that gave me rave reviews and I am now on my own and absolutely loving it! : ) I think back to that initial talk with the manager and I was so devastated because there had been no indication. I went into quite the panic as you could see from my posts here. I don't mind sharing that I shed a tear or two in the privacy on my own home. lol It seemed like the end of the world to me. But I stuck it out and was determined to prove that little &*$(# wrong. lol I'm soooo happy now and love being on my own. I continue to learn everyday and absolutely love it! Thanks again for asking, and again, thanks for all the advice and encouragement and support from everyone. : )

Sandnnw, Didn't think you were being mean at all. I am extremely open to advice. : ) Thank you. I owned/managed a business in my past life before my husband left. DO NOT want to go to med-surg... that is not for me. I love the ER. BAT = Brain attack team as in stroke. I explained the scenario that has brought up this issue for me in an earlier post if you'd like to go back and read it and I'd appreciate input. I have never been one to stand around, I'm running constantly. We are a very busy ER. As for mistakes I honestly haven't made any... for me it's been more learning to speed up for better time management and I've made great strides in that area since I have started. Honestly I feel my biggest problem is my confidence which I am working on. I know I am a good nurse. I just need to be more proactive which I am now working on. I was treating my preceptor with the same respect I gave my nursing instructors and I believe I feed into her power trip. I think there will be worlds of difference with my new preceptor. She was who I started with intially before the shift changed. I am going to prove myself over the next 4 weeks... or die trying. lol Thanks again for all the input and support. Working 3p-3a today. Wish me luck! : )

Thanks for all the good wishes. I feel it went very well. They loved the "plan" I proposed and I had a great day. Looking forward to next week starting with the other preceptor. Found out today that the other novice that had been with my preceptor is going through the same thing. I'm really thinking the preceptor was on a power trip. The other novice and I are going will both be with different preceptors. Yea! I'm off to bed to start reading ER manuals. lol Thanks again everyone! : )

On my way out door to turn in plan only have a sec. BAT = Brain Attack Team. He was having a stroke. As far as possibly not letting on about a lackluster performance... if I was giving one there was never a word said to me, never a word prior to finding out they were extending my orientation. Never a notation in my clinical folder, no one ever talked with me. I was put on the May and June Staffing Calendar. I was set to go. Then... the week before I was set to be on own... when I verified w/ manager... this is the first I heard. I had gotten feed back that I just needed to speed up but that would come with time; that I needed to stop second guessing myself cause I was doing a good job; that I was doing better than I thought; that I was right where I was supposed to be. (these all were comments made from different nurses I worked with). Got to run... wish me luck...giving her my "plan". I'll keep you posted. Thanks for all your support. : ) Say a prayer for me at 0700 please!!! : )

Thanks again for all the input and support. You all have no idea how much this has helped me. I know I have a long long way to go. In answer to some of the earlier posts, no I've not made a med error (knock on wood); I am now up to the 4 rooms (5 when you get the psych block), which is the norm unless we are understaffed. Initially my assessments took too long but I have streamlined those (was used to doing a full head to toe from school and time on floor). And yes I have requested to have my original preceptor, who was absolutely fantastic and a great teacher. The sacrifice is she works 7p-7a which my body had a hard time with but now it seems worth the sacrifice The specific incident that was brough to my attention happened about a month ago. It was during my first BAT. A gentlemen came in completely asymptomatic other then "worst HA of life". He went downhill in about 15 minutes. On the way to CT he began gagging and my preceptor said we needed to turn around and go back to room as he was loosing his airway. Doc had to do immediate intubation and it was not an easy one. He went from htn to becomming extremely hypotensive and had to hang a levophed drip. He ended up being flown out. It all happened extremely fast. Once we got him stablized my preceptor told me to leave the room and find a computer to document everything because the flight crew would be arriving shortly and we had to print out a summary for them. That is exactly what I did. While I was out documenting, manager came by and pointed out to me that if I were a primary nurse without a preceptor I would not be able to leave the room and come out to doc. I would have to stay in the room and oversee pt and document. I acknowledged that fact and kept on documenting. When it was all said and done I complemented my preceptor and told her what a good learning exp it was for me and that I was in awe of her quick response. I told her I had never had that experience before that I didn't know that I would have known to turn around at that point. I was being honest. Those are the two incidents that have been brought up. I left the room to document and I didn't know that he was loosing his airway. Like I said it all happened so fast and I don't know that I definitely would not have known. I was in the back of the bed and she was in front of bed. I could not see the patient, she could. I made a statement that I probably should not have made. So that is what the manager is basing her decision on.

RN-Cardiac!! Are you kidding me? Apologizing for it being a long reply?? That was exactly what I needed. Thank you, thank you, thank you! I hate to admit it but I have felt so beat down since my conversation with the ER manager, and have felt so alone... your reply was a breath of fresh air for me. The fact that you took to time you did to answer me means the world to me. Your right trying to "define" critical thinking, let alone trying to write a plan for it is very frustrating. I know I am a good nurse and don't believe my fears are unfounded. My mistake was expressing them to coworkers. Won't make that mistake again. I loved your car scenario and will definitely use your advice. Thank you again so much for showing me a random act of kindness. You never know how such things can touch a person's life. : )

Thanks so much for your support and input. Problem with getting the book is I need to turn in a plan for myself by 700 tomorrow morning. I live in a rural area and I'm sure the only way for me to get the book in online = won't have it today. I will definitely look into book to use as my own resource... at this point I am still in need of input for how you write this "plan" I have been working on it for the better part of today, searching on the net as well. No where can I find clear cut suggestions. Everything I find says a nurse needs critical thinking... but no where does it say how you improve upon it. UGH But I am determined!

I would really appreciate some input. This is the first time I'm posting so please forgive me if I'm doing it wrong. I'm a novice nurse, graduated last year and entered a 10 month orientation program at a local hospital. Novices started rotations through med-surg, tele, and then end up in home unit. My home unit is the ER and I have been there about 5 months. I was set to come off orientation and had been put on May's staffing schedule. My last week of orientation I ended up in the hosp so I was told that my orientation would be extended another week to make up for the week I missed. The last shift of that week I ran into the nurse manager and asked if I was good to go to start my own schedule the following week. She informed me that they were extending my orientation (but was not sure for how long) because they were concerned my critical thinking skills were not ready. This conversation happened in the middle of my 12 hour shift AND it was the first it had ever been mentioned to me and it had never been noted in my clinical folder. I put my big girl panties on and finished my shift. Honestly I did have a little cry in private but regained my composure and think that think I did a pretty good job. I called her back on my day off to pick up the conversation and let her know that I loved the ER, felt I had grown tremendously since I had been there, wanted to be a nurse there and would do whatever it takes. She countered with: she needed a timeframe from me on how long I thought it would take to develop my critical thinking skills and I had to write a plan and goals which are due Fri at 0700. I know I need to improve and grow but honestly feel that will come with experience. I am not making excuses for myself but have had issues with the preceptor I have had since getting on days and had been told months ago by the nurse running the orientation program that other novices had issues with this preceptor. I'm a new grad at 47 and my preceptor graduated three years ago and is 23. I hate to talk badly about her, I think she is a great nurse, but honestly don't feel she has what it takes to be a preceptor. That is not the issue I am facing now I am just extremely frustrating. What I am asking for at this point is any guidance with writing this plan. She did not give me anything to go on other than critical thinking skills. I do want to improve upon them but not quite sure how you write a plan for that. Other areas I know I need help on is delegation and confidence. I do believe part of the problem that this is stemming from is that I am the kind of person that wears her heart on her sleeve. I told my preceptor that I was going to be nervous when I came off orientation and started on my own (but I feel that is a normal fear). I just shouldn't have expressed it to her I suppose. And on one occassion last month I had my first BAT and when it was all said and done I complemented my preceptor telling her what a great learning experience it was for me that I don't know I would have known exactly what to do had I been on my own. UGH! Boy did that come back to bite me. Any suggestions for a plan?? I have a 4 week extension. Thanks for any help given. : )

I would really appreciate some input. This is the first time I'm posting so please forgive me if I'm doing it wrong. I'm a novice nurse, graduated last year and entered a 10 month orientation program at a local hospital. Novices started rotations through med-surg, tele, and then end up in home unit. My home unit is the ER and I have been there about 5 months. I was set to come off orientation and had been put on May's staffing schedule. My last week of orientation I ended up in the hosp so I was told that my orientation would be extended another week to make up for the week I missed. The last shift of that week I ran into the nurse manager and asked if I was good to go to start my own schedule the following week. She informed me that they were extending my orientation (but was not sure for how long) because they were concerned my critical thinking skills were not ready. This conversation happened in the middle of my 12 hour shift AND it was the first it had ever been mentioned to me and it had never been noted in my clinical folder. I put my big girl panties on and finished my shift. Honestly I did have a little cry in private but regained my composure and think that think I did a pretty good job. I called her back on my day off to pick up the conversation and let her know that I loved the ER, felt I had grown tremendously since I had been there, wanted to be a nurse there and would do whatever it takes. She countered with: she needed a timeframe from me on how long I thought it would take to develop my critical thinking skills and I had to write a plan and goals which are due Fri at 0700. I know I need to improve and grow but honestly feel that will come with experience. I am not making excuses for myself but have had issues with the preceptor I have had since getting on days and had been told months ago by the nurse running the orientation program that other novices had issues with this preceptor. I'm a new grad at 47 and my preceptor graduated three years ago and is 23. I hate to talk badly about her, I think she is a great nurse, but honestly don't feel she has what it takes to be a preceptor. That is not the issue I am facing now I am just extremely frustrating. What I am asking for at this point is any guidance with writing this plan. She did not give me anything to go on other than critical thinking skills. I do want to improve upon them but not quite sure how you write a plan for that. Other areas I know I need help on is delegation and confidence. I do believe part of the problem that this is stemming from is that I am the kind of person that wears her heart on her sleeve. I told my preceptor that I was going to be nervous when I came off orientation and started on my own (but I feel that is a normal fear). I just shouldn't have expressed it to her I suppose. And on one occassion last month I had my first BAT and when it was all said and done I complemented my preceptor telling her what a great learning experience it was for me that I don't know I would have known exactly what to do had I been on my own. UGH! Boy did that come back to bite me. Any suggestions for a plan?? I have a 4 week extension. Thanks for any help given. : )

Hey just wanted to let you know you are not alone. I was glad to see you posting my concerns as well. I just graduated last year and went right to an ER. I've been there 4 months and still feel extremely overwhelmed and question whether I can do this. I would definitely say give yourself more than 4 shifts to decide! There are days I love it... then days where I question whether I can do it. Like yesterday... get a septic patient from a nursing home going down fast with bp in the crapper, transport team showing up unannounced to take my 5 year old pt with an intussusception, (at the same time I might add) then I got slammed with two ambulances (all this happened in immediate succession) in addition to the pt I already had in my fourth room who was pretty stable with gi upset. I thought I was loosing my mind. I am at the end of my orientation with two weeks left to go. Thank goodness my preceptor was able to stay with my septic patient who was getting a central line put in while I tried to juggle everything else. I felt so inadequate and question all the time if I can do this. : ( I love it... but at the same time... just don't know if I am ready to be totally on own in 2 weeks. I am petrified.