gearheadfly

I'm a new grad (BSN), hired for ICU, and I have finally had enough of my hospital. For the first two months, I was shuffled around to other floors and units with at least 15 different preceptors who were constantly asking me, "Why am I orienting an ICU nurse?" When I finally got to the ICU, things were slightly better as I had two primary preceptors, one of whom has advocated for me as best she can. BUT, in thirty shifts I have had over ten different preceptors. Once I had the same patient three days in a row, but a different preceptor each day. Every day I would be chastised for caring for the patient in the way the previous preceptor had shown me. Yesterday I worked with the preceptor I like least. She is impatient and snotty. She hates explaining anything, so she will huff and roll her eyes and tell me to "go finish your charting" while she draws labs, initiates tube feeds, changes dressings etc... (everything I need to practice!). I had one patient who should have been a 1 to 1, but I was assigned him and another less acute patient. My preceptor said (huffily), "Since you are going to be on your own soon, I'm just going to stand back and let you do everything today." I guess that might have worked, except that one hour after my shift began the MD's d/c'd fentanyl and ativan on my heavy patient (vented and with etoh withdrawal), who then proceeded to flip out and (even in restraints) yank his foley halfway out and kick me in the head while I tried to prevent him from throwing the lower half of his body over the bedrails. My preceptor then takes over and decides that she is going to do everything for this patient since I am obviously not competent to be left on my own. I, however, will still be in charge of charting, giving report etc... on the patient, whose SBP has dropped to the 60's btw. Meanwhile my other patient's family is having a meltdown about some unsatisfactory interaction they had with an MD in the ED when dad was admitted. I am trying to help them out, care for dad, and not give them anything else to write complaint letters about. When I finally got around to doing GRASP on my patients, I realize that my first patient's score is 23(!), which means that he should never have been part of a paired assignment. My preceptor is giving meds that I can't even find MD orders for and gets pissed when I tell her that she needs to chart on all of that stuff. At the end of the day, my preceptor tells me basically that this is what I can expect to deal with and that I should have been able to handle it all by myself (even though she couldn't!). I know from experience that none of the nurses on my unit would have taken that assignment; the first patient was a 1:1 all night. The only reason that the charge nurse gave it to me was because my preceptor was a half hour late as usual that morning and wasn't there to speak up. Although I have not had problems of this kind with any other preceptor, I have finally had it with that hospital--their disorganization, their randomness, and their unhealthy work atmosphere for new grads (I'm not the only one going through this). I am starting to look for another job. But what am I? I'm set to start working on my own in January. I'm not technically a new grad anymore, but I have virtually no experience (the training program and preceptorship at my hospital is a joke). Do I apply for positions as a new grad? I can't be negative about the job I have now in interviews, but what do I say when I am asked about why I'm leaving? Has anyone else ever been through this? How did you handle it?

John 123- I live in Berkeley, CA. I think you were too hasty in turning down the job at Kaiser Hospital Oakland. I've spent plenty of time in that area, and I would hardly call it "high crime," at least compared to anywhere else around here. It's very close to Piedmont Avenue, which is rather upscale, with some excellent restaurants and cool shopping. Housing in Oakland is also relatively inexpensive compared to the rest of the Bay Area, so you would be able to make your money go farther living there. Maybe you should take a trip to CA and check it out before you make any major career moves.

There are couple of rude people on my unit, but I've been through so much crap already that I'm now of the "bring it ON!" attitude. I've discovered that I can say almost anything to anyone as long as I plaster a big old smile on my face. One morning I heard the nurse I was supposed to be giving report to making fun of my last name as she tried to pronounce it off the assignment board. She was repeating it over and over to the charge nurse and saying, "Who the H*LL is that???" The charge nurse could see me standing right behind this woman, and I could see a look of panic on his face as he tried to signal my presence to her. When she finally turned around to face me, I said brightly (ENORMOUS SMILE ON MY FACE), "That the H*LL is ME! It's pronounced *****, and I am ready for report when you are!" I heartily enjoyed her embarassment. I have found that laughing when people are trying to bring you down really throws the jerks off.

I'm a new grad and was hired August 20 for a job in the ICU. Since the critical care training program did not start until mid October, my manager told me that she would place me in the cardiac procedure unit to orient until that time and sign me up for the various orientation classes I needed as a new hire to the hospital. Well, the first month went very poorly. When I showed up in the CPU, nobody was expecting me, nobody knew why I would be placed there, no preceptor was available, etc... I wound up taking an eight hour tour of the hospital with a nurse who obviously had better things to do than to babysit someone's mistake. The next day, I had a preceptor, and we took one patient. The day after that, I had a different preceptor, and we took two patients. The following day, I had the first day's preceptor again, and I was scheduled to take four patients alone (including two new admits and a discharge) with the preceptor shadowing. I told the preceptor that I didn't think I would be able to handle it, particularly since I didn't have my own access to the Pyxis for meds. She was angry and basically then took all the patients herself with me shadowing her and pretty much begging to be shown how to do anything. After that week, I was sent to the TCU, where again nobody was expecting me or knew who I was. They sent me back to the CPU, who sent me to the ASU and so on and so on. I must have oriented one or two days in every unit and floor of the hospital. After I spent one day in the ICU shadowing a very unhappy nurse, the assistant manager there decided that I needed a definite plan. I was to begin training night shifts in the TCU that next day and to stay in that unit until my critical care training started. When I showed up at 11 that night, nobody was expecting me in the TCU. I couldn't help it, after a month of the same, I started to cry. They sent me to the CPU, where, remembering the three days I had spent there a month before, I actually fared pretty well, taking a full load of (mostly sleeping) patients. The next night, the TCU was ready for me (sort of), and I had a preceptor. I've been working nights there for the past three weeks, and I haven't had the same preceptor more than three days in a row. I am so miserable that I cry every night before I have to go in to work. Every time I show up, the charge nurse looks irritated that she has to find someone for me to work with, and the person I'm assigned to looks positively burdened to have to work with me. On top of it, most of the nurses in the unit are all from the same country. Although I speak Spanish and Russian as well as English, I (and nobody in my family) would ever dream of speaking those languages in front of people who did not understand them. I don't think that there is the same custom in these nurses' culture as, all night long, they speak their language around and over me as if I weren't even there. Although I'm surrounded by people, I have never felt so lonely. Last night I felt so nervous about going to work that I couldn't stop throwing up and so I called in sick. I've never called in a sick day at any job before in my life. All of my previous (non-nursing) employers have loved me. I never missed a day of school and graduated near the top of my nursing class. Now I feel like the biggest, dumbest, most unwanted loser. I'm trying to hold out until the promised critical care classes begin in twelve days, but I dread even going in to work tonight. Are all hospitals like this? Is this what everyone goes through? At nursing school, I was led to believe that there was a system to training new nurses, but I have received nothing resembling a systematic training. Should I look for a new job? This hospital pays the best in my area and has fantastic benefits, but the nurses here seem more unhappy than in any of the other places I rotated through in school.