Brooke13-RN

I agree with the other posters. I'm a new nurse too only 3 months out and I am finding night shifts to be both challenging and rewarding. There is so much going on and I don't feeling like I am missing out on procedures, doctor interactions, or assessing skills. I'm sorry that the night shift nurses give poor reports on your floor, but let me tell you I've heard some pretty interesting ones from days. It has nothing to do with the shift that you work, it's the kind of nurse you want to be. Lazy nurse come on all shifts. Some of the best nurses I have come across work nights. You have to develope your critical thinking skills in a hurry becuase there isn't the abundance of the extra people to run things by. I am curious about what procedure you are expecting to do on days that wouldn't be done on a night shift. I'm on a busy med/surge floor and just the other night I put in 4 IVs, dc'd a CVC line, administered blood, and reinserted the NG that my confused pt pulled out. I'm just saying give nights a chance and if it's not for you look for a day position. Just please don't think that because a nurse works nights they don't use their skills or knowledge. I oriented on days for 6 weeks and I can honestly say that I learned more about nursing in the first 2 weeks on nights because I had the time to focus on the pt. Anyway good luck with your new career.

Hi eveyone, I've finally had a couple of good nights at work. And let me tell you the other night wasn't easy. We had 3 teams and we had 7 admissions in the first 2 hours. Busy med-surg/oncology floor. I just took one thing at a time and checked things off my list. I actually got done with my chart checks on time and was ready to clock out and had everything done. Well almost, I started thinking today that I might have forgotten to give a 6am med, but I'm not sure. It was 2 days ago already so not much I can do about it now. I think I gave it, I'm pretty sure that I did. I had it checked off on my things to do list, but I just can't remember going in the pts room to push it. I guess I'll find out tomorrow when I go back to work. I'll check the MAR to see if I gave it. Hopefully if I didn't the next shift caught. It's was a q 6 hour med. I do ask the day shift before I leave if there are any problems to call me. Oh well. But not getting off topic, it felt really good to get done with everything and handle everything. I'm only a couple of weeks off orientation and still feel out of control most of the time. I did get some flack from the two other RNs because they let me know that I did have the easiest group of pts, and so on. But I did have 3 admissions, 2 units of blood, and lots of meds. I just found while they were sitting around getting upset about all the admissions and being short staffed, I sat in my corner and worked and I think that by staying out of the politics of it all and taking things one thing at a time helped. I Guess I just wanted to say thanks to all of you who have been so supportive. I know that I'm still going to have a whole bunch of bumps, but it felt fantastic to finally leave work knowing that I did better. I guess there is hope. Thanks for listening. ~B

Hi, I did look for someone else to help me get the IV in. I asked all the other nurses on the floor and my charge nurse was the one who agreed that we could let it go until morning. Firstly the lady was getting upset because of my failed attempts and secondly because her arm was still swollen from the other IV and we thought maybe if that went down we could find a vein. It was the only arm that I could use. I didn't leave the other site in. I never do that. If it's bad I remove it right away. "and it doesn't matter if she previously left you an admission-its not a "you did it to me so i'll do it to you" type of world" This never even crossed my mind until I was driving home and thinking about her attitude. I felt horrible leaving the things behind. I never mind carrying on where day shift leaves off. My point was that they always seem upset to carry on where we leave off. But I would never have the "you did it to me so I'll do it to you attitude."

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Hi eveybody, I was almost able to leave work without any issues this morning. I didn't make any mistakes last night and was going to ready to walk out the door at 7:30 this morning. But at about 7:15 I found that one of my pts IVs blew. Now normally I wouldn't worry about that except that I had a hard stick a few hours before and decided since she wasn't getting any meds until after lunch and she was HL to begin with I would let the day shift have a crack at her. It wasn't that I didn't try to get, but I refuse to try more then two times. So, when after report I told the on coming RN that I wasn't able to get either IV she got really huffy with me. I felt bad enough as it was leaving two IVs for her to do first thing in the morning. I apologized multiple times and I just felt really bad. Then I was driving home and realized that last week she had left a whole admission for me and I mean a whole admission. The pt had been there since 3pm and they hadn't even gotten vitals on her. She didn't have any problem with handing it over to me. Where does this double standard come from. Why does it seem that days has a free pass to leave stuff for nights, but nights can't leave anything for days. We are busy people to. Thanks for listening and letting me vent. I just felt bad for leaving things and kind of upset that she gave me all this attitude about it.

I'm on night shift and I get a lot of, we got a new admission and we called the admission nurse. Well the admission nurse only works the 7a-7p shift so if they don't make it they don't make it. Now I don't mind if they got the admission in later, but I've had 2 instances lately where the pt arrives on the floor at two or three and it's now 7:30 when I get out of report and figure out that nothing has been done on the admission. No vitals or weights or anything. That's really my only gripe.

Hi, I'm so sorry that you had this happen. I failed my last semester course right at the end so I feel your pain. I found out I wasn't graduating the day before pinning. This is what my Mom told me and I think it helped. She said that I must not have learned something that I was going to need to know to save someones life. Just take things one day at a time. It took me a long time to get over failing my class, but I did and now I'm working on a busy med surg/oncology floor. I'll send good vibes that you get back into your class. I wish you all the best of luck in your future nursing career. ~B

Ok, so I made it a whole day without stressing, but now I have to go back to work tonight and I'm worried about finding out I screwed stuff up from the other day. I left with everyone doing fine, but I keep thinking about stuff. Did I remember to tell them this in report, ect. I guess that it shoud be a comfort to know that my pts. have excellent nurses that come in after me, but I still panic. I would hope that if I did something horrible they would call me and tell me. Oh well I guess I'll find out tonight. Now I just have to relax enough so I can sleep and not work myself up before I go in again. Thanks again for eveyone's advice.

Thanks guys. While I don't have the Satan nurses to report off to, but they are more then happy to point out my mistakes to me in the morning when I come back. For example I had a med time wrong on the MAR. I heard the Aren't you lucky we caught it for you. We saved you from a med error. It wouldn't have even been a huge deal, I mean I think it was a daily suppliment that he would have gotten 2 hours early. But I understand that if they don't point it out I won't learn.

Congrats on making it this far. I think you are feeling exactly what all of us our feeling when we start. It is really really scary. It's great that you have worked as a CNA, I think it's going to help you with you organization. I had a 6 week orientation and have been on my own for 2 days now. I'm still scared before I go in because of the whole unknown element. What am I going to come across today. Just take things one at a time. Soak in everything you can over the next few weeks. I can't tell you if it gets easier because I still get nervous, but once I get there and get going on the nursing I can calm down and just do the job. Good Luck. I'm sure you are going to do fantastic.

I'm on a med-surg/oncology floor. I had 6 weeks of 12 hour shifts. So, actually 18 days before I was on my own. Felt like I could have used a couple more though. Been off of orientation 2 days and so far it's been going OK I think.

Hi everybody, So do you ever notice that it seems like you have to make mistakes to actually have things sink in. And the problem is the paranoia that you've made mistakes that you won't find out about until you go to work next. Of course working 12 hour shift means that you might not find out about them until you go back three days later. Does anyone else have this total paranoia about work when you aren't there. Everyone always says to leave your job at the hosp, office, whatever, but honestly how do you really do that. This afternoon I realized that I think I might have screwed up on an short stay admission from last night, it was the first time I had done one. I found the home meds already written out on our form, but didn't realize that it was something new that short stay surg. was doing. It was just written there on the home meds sheet we use on our floor and wasn't signed by anyone. I thought that it was something that short stay did when they came in incase of a admission. I went over them with the pt and doctor, but didn't rewrite them on our sheet, which I later found out that that was what I was supposed to do. When I got home today and read through my mail, which I was a day behind on, bam there it was. The new policy. So, now I'm dreading Monday when I go back to work and the educator points it out to me. When I get home I always wonder, did I check that med off, did I sign that paper, did I chart that pain level. I always try to double check and be very careful but then as soon as I leave I go, hmmm did I do this or that. My question is this something eveyone who is new is dealing with? Does it ever go away, the thinking about work constantly after you go. I even dream about work. Anybody else dealing with this. It's driving me crazy.

jjjoy thanks for that. Your right that does seem to be how it is. I guess it all takes experience and that's what they keep telling me, but I think sometimes people forget it. Lisa, I survived last night. I started off 9pts, but then at midnight I picked up 2 more. Census changed. I did all right because I didn't have too many unexpecteds, no admissions or discharges last night, we had a full house. But I did have to call the Docs a couple of times, one was for a post surge who after 5 hours still hadn't voided. Said he couldn't. I bladder scanned him and then ended up calling the Doc because he had 800CCs in. But to be honest, even though I knew this was wrong I still asked another nurse if she would call for that because I didn't want to screw up. And if it makes you feel better I cried the whole drive to work talking to my Mom on the phone. I know what you mean about the resources. They are all so busy too. I was doing my chart checks and they were saying can we help you. But really what could they do. They had 11 charts to check themselves. They are my pts, I have to get it done, which to my surprise I did. I think. I'm sure I missed something that my nurse educator will get me on tomorrow. She once found that I forgot to initial the MAR on the bottom, even though I signed it. You have to put your initial, print your name, and sign each sheet of the Mar at the bottom. Oh well. Take some deep breaths today and tell yourself you can do it. When in doubt I always think of the Water Boy. Rob Schnider yelling you can do it always makes me smile. I had to compose myself a couple of times last night when I started getting behind because I felt like a failure. I was behind, but then I just kept on going one task at a time. And this morning I got to leave at 7:35. I don't know what to tell you about the emotional stuff. I do notice that when I have to go right back I feel better then when I have to go back after a couple of days off. The day before I cry most of it and want to quit. Then I go in and feel better until I have to go back the next time. I think for us right now it's just the fear of the unknown. Not knowing what to expect when we get off those elevators. I have nightmares even about work. Hang in there and let us know how your first day went. I know how you feel about the driving yourself insane. Hang in.

RNKay, Thanks for the congrats. I wish I was feeling it though. I've been a nervous wreck all day because I have to go in tomorrow. But then I'm a wreck most days before I have to go in. I'm just so scared that I'm not going to see something or do something that is going to keep my pt safe. Then there is the fact that I haven't been able to get everything done. It seems like I sink the closer to 6 I get. The problem is I don't know where to pick up time. I think I'm just too slow. It takes me a lot longer to go through the charts and MARs. Then it seems like every night my preceptor has to point something out to me that I messed up on. Yet, they think I'm ready to be on my own. I wanted to scream no, let me have one more week. But then after that week is over I'll want another. I know I have to get out there and do my own thing, I just wish I had some more confidence. I'm just scared I'm going to hurt someone. Oh well. Here I am rambling again. Thanks for listening everyone.

Thanks Suzy. I think I'm just so nervous. I get nervous going on the nights when I will have a preceptor and the idea of being on my own with my mod is terrifying. I'm just scared that I'm not going to get everything done. I haven't been able to as of yet, my preceptor always ends up stepping in at one point or another. I'm already kind of starting to freak and I have two days to worry about it. There is just so much to get done and do and I don't really think I'm fast enough. I'm just scared right now. I just need one successful night.

Hi everyone, Well last night was my last day of orientation and I have to say that it didn't make me feel any more confident about being on my own. I was doing pretty good until about 4 when I realized that I still had 8 IV meds to give, pumps to clear, 4 charts/mars to check, and report to tape on 13 pts, yup 13 pts. Plus I had to finish up the admission on the man that came in and couldn't give me any history so I had to go through his old charts. I was only 30 mins over with the paperwork. My preceptor ended up coming to the rescue at 5. I had asked her to pretend like she wasn't even there so that I could get a feel of things on my own. We had been doing that for the whole week. But to be honest she usually had to step in sometime during the night. It's not usual that we would have 13 pts, but there were only three teams of 1 RN and 1 LPN. They couldn't get anyone to cover the census. So, now I have the weekend to think about my first day flying solo. I start Monday. My preceptor isn't working that night, but there are 3 experienced nurses and they have helped me out in the past so I'm pretty sure I can go to them with questions. Plus, with four RNs on we shouldn't get any more then 10 pts a piece. I'm just pretty terrified about all this. I'm really scared that I'm going to miss something important, or not call the Doc when I'm supposed to, or just get so far behind I don't get the work done before the next shift. My floor is a really busy post surgical/oncology floor, so I have to make sure everything is on the up and up. I just needed to vent my worry I guess. I feel like I could use another 4 months on orientation, but well I have to fly solo sometime. They seem to think I'll be fine. That's all I hear, I'll be fine. So I guess I'll just keep telling myself that. I'll be fine. HOPEFULLY. Thanks for listening.

Hi, I actually did the oppisite of you. I started on days for four weeks and now I'm on nights my perm. shift. I think they are both busy in different ways. On days like Slobgob said you have everyone trying to get a piece of you. I remember just getting out of report and the case manager wanted to get a report on the pts from me. You also have PT, OT, and transpoters tying up your pts. You'll probably spend half the morning looking for your chart and then the Docs arrive and sit there with them. Then you have the orders to deal with. Not to mention on days you have to worry about diets, baths, family, and did I mention all the new orders. You've been on nights so I know that you have a handle on that. I would expect you to be busier on days for sure, but I think that has more to do with all the extra people demanding time with your pts. For me I'm a night person, but we get the crazy nights like this last one for me. 10 pts, 2 discharges, and 3 admits all before midnight. You'll figure out what is best for you I think. I hope that you like days. I bet you won't miss waking the Docs up at 3 am. Good luck with the change.

I don't have any words of wisdom, just that I wish you the the best of luck. I find it hard to believe that this place would fire you without even asking for your side of the story. That is just incredible. I'm glad that you are going to seek legal help if you need it. It sounds like you were in a difficult situation to begin with with the wife and you handled it wonderfully. I'm sorry that you are being treated this way.

Ya, I'm in Golden Key. I've never really participated, but I do get a lot of news letters and invited to different functions. I'm not sure if there was a fee or not, but if there was it was a one time thing. Go to their website if you still are concerned. I think it's one of the earlier honor societies, meaning I think it's for 2nd or 3rd year students. Hope this helps and congrats on being invited. ~Brooke

Thanks Tweety. I'm sure your right no feedback is good feedback. I'm usually pretty sure of myself about things, but I just feel out of my element. traumaRus, 10 is out of the norm for our floor I believe. What they told me in my interview was that the max would be 8, ha ha...I believed her. But it's 8-10 pts to 1 RN and 1 LPN. We have team nursing. I guess the whole house was full though and they had people overflowing all over the hosp.

Hi everyone, Well I'm on week five of my orientation on a busy med/surg floor. I have two more weeks to go. This was my first week on my regular night shift. While I like night shift so much more then days just for the fact that I can keep up with the charts and pts, I still feel overwhelmed. My biggest problem is that I haven't gotten any feedback from any of my preceptors or nurse educator. We are supposed to be doing weekly evals, but everyone is too busy to sit down with me. I've even offered to stay late to have a sit down, but that's not happening. It's just that the floor is so busy that no one has time for things. I guess the kicker for me was my last day on day shift. I had worked with this one particular preceptor for 4 weeks. Towards the end I was taking 6 pts, being primary on them and minding on my preceptors two pts as well. The last day I was kind of sinking, but I managed to tread there until the end and was maybe 5 minutes over. When I got to the break room I found that she had just left and didn't say anything to me. Not a hey good luck on nights or anything. I hope it doesn't sound like I'm whining, but I'm going to be on my own in 2 weeks and no one has said hey you need to work on this, or you are doing well with this. It's not that I haven't asked or went to my nurse manager for input. But things get busy and meetings I set up go by the wayside. I'm just frustrated I guess. I know there are things that I need to work on, like organizational skills and being more comfortable with the docs. I almost had a panic attack last night when I needed to call and get an order for nausea meds. I've just never called a doc at 3am before. But I made it through. I guess I feel like I've been left to my own devices completly. I just really need someone to tell me how I'm doing. I'm just so tired of the it's going to take you a year to feel comfortable. I understand that completly. I just want to know how I compare to other new grads and what I need to work on. Is that too much to ask? I feel like my nurse educator is upset with me because I haven't taken the whole team yet. I did happen to run into her this morning and she asked me what I did last night. It was my second night and I was working with a nurse who had never had an orientee. We had 10pts with 2 discharges and 2 admissions. Well I told her that we kind of worked together I didn't have a designated number of pts, but I give all the IV meds, did 7 of the 10 assessments, 1.5 of the admissions, both discharges, all the chart checks, all calls to the docs, taped the entire report, and anything else that came up. The only thing she said was well so you weren't actually team leader. That's all the feedback I got. I said no, but I did do all that I just told you. And her only response was you really need to be the team leader. I just wanted to scream and tell her then to put me with a preceptor who would feel comfortable handing the reins over. Next week I guess the normal preceptor is coming back from vacation. Oh well. I've just had some rough shifts and am feeling sorry for myself I guess. I'm sorry for the vent I just needed to get it out. Thanks for listening. ~B

Thanks for the responses. I am very thankful that it wasn't anything life threatening. I know that this is not a mistake that I'm not going to make again. I need to just slow down. So, hopefully I got this type of mistake out of my way, and can start my career on a better foot.

Hi everyone, Well somthing I thought would never happen happened. I made my first med error. I thought that I was having a fantastic day today. I was staying on top of orders, calling doctors, taking and giving reports. Then about 3:30 went to check when my last pain med and nausea med was given to my pt, and realized that I gave my IM nausea med IV push. As soon as I realized this I reported it to my preceptor and promptly broke down crying. The thing is I told my preceptor about my error and she told me that we were going to have to tell my Nurse Educator. Well she had already left for the day so she told me just to bring it up with her tomorrow. That things like this happen and I shouldn't make myself sick over it. I was upset and wanted to take care of it now, file a med error report, anything, but she wanted me to wait until tomorrow. Saying that it wasn't that big of deal and all nurses make errors sooner or later and it just shows I'm human. I monitored my pt and nothing happened until about 7:30 when I was going home and she developed a rash. I asked her if she ever has any trouble with rashes and she says that she sometimes gets them from being in the hospital or tape. So, I called and had some cortisol cream ordered. I asked my preceptor if I had caused the rash but she said that it was hard to say and unlikely. It had been 6 hours since the error. I took some quiet time to myself to reflect on what caused me to make the order. First I was rushing and wasn't as careful as I should have been. Then I had written down from report that my pts meds had been switched from IM to IV, but that was only the pain med. So, this was a major learning curve for me. I can say I've rarely been as scared as I was when I realized what I had done. I just need something to be settled so I can put it behind me and never make the mistake again. I didn't feel comfortable not reporting it right then and there, but my instructor told me that we were going to wait. Thanks for listening. I just feel so horrible. ~B

Thanks everyone for the encouragement. I like the 3 round plan for the morning. I'm going to give it a try youngatheart. I guess that I can just take it one day at a time for the next couple weeks and then hope I get a chance to learn my routine once I get on to nights. Thanks again everyone.

Hi everyone, First off let me tell you that I am on day 5 of orientation on a med-surg floor, so I know there are still a lot of things that I need to learn. But Sunday was just a miserable day for me and I'm still thinking of things that I missed and needed to do. I took 3 pts with an LPN on my team. Plus I was doing any procedures that came up on the rest of the team for learning. I was doing pretty good I thought, getting everything done and keeping up on things. Then I hung a IV antibiotic and hooked my pt up to the wrong channel on the IV. I started up channel 3 to give the IV and hooked him up to channel 2. Nothing happened except the med ran onto the floor. Channel 2 wasn't turned on. Well I was supposed to call pharmacy to let them know I had an accidental wasting, but one of my pts had a emergency and I went to that and forgot to call pharmacy. I remembered today. So, then I was thinking about what else I probably forgot and this came to mind. It was 7:30 and one of the Docs came in. I was late leaving the floor just doing one last minute thing and he asked me a bunch of questions about how my pt was doing. So I was so happy with myself that I answered all his questions and knew what he was talking about. Then he said that he was going to go ahead and order a laxative for the pt. He was writting in the chart when my other pt started calling out for me. So then I went to take care of him and my preceptor told me to come on it was time to leave. So I just remembered that I didn't take the chart up to the desk to secretary to put the order in the computer. I was doing OK while my LPN was with me. She showed me more then my preceptor has shown me since I got on the floor. But then at 3 the census on the floor was low so they sent her home. I was on my own and I sure felt it. I'm just so frustrated that I can't keep up with things. I feel like the whole floor is moving in fast forward around me and I'm out of the loop. I keep missing when the Dr.s come on and new orders get written. I just don't feel like I'm catching on. I'm sorry if this post sounds like a huge whine, but I'm just so frustrated. I keep telling my preceptor and other nurses that I feel lost, but they only tell me that I'll catch on. I'm just so frustrated. I'm hoping that when I get to go to nights things will be better, I will have time to slow down a little. I feel like I'm on a dead run from the time I walk on to the floor until end of shift. I'm lucky if I get a 10 minute lunch break. I know that it's supposed to get better, but I don't know how to learn to make it better. How often in the day are you supposed to check orders from the docs? That's my biggest problem I think. I can get the assessments, procedures, meds done, but then I miss things. For example my preceptor asked me what time my pt was being discharged and I didn't even know that she was being discharged. Thanks for listening. I htink I just needed to vent my frustrations. I just feel lost. ~B