funsizedliv

I have been in the same boat for the last 2.5 years(not counting school). Its like a recurring nightmare, I have had 3 jobs since graduation, and it is always the same. I think I am doing great at first, then one thing leads to another and I feel like I am sinking slowly towards failure. Most reciently, I thought I had gotten most of my major issues with time management and organization under control, but then I got written up yesterday because a patient complained about something from weeks before (one of those behavioral patients who seem to want to steal nurses licenses) and just before that information, I snapped at a patients daughter who decided to get in my face because her fathers dressing hadnt been changed yet. I went home bawling my eyes out terrified of not being able to do my job despite people telling me I am a good nurse. I sometimes dont want to do it anymore, but I lack the skills of anything else. at least your management wants to try to help out. with me I finnaly voiced what was wrong on my unit that was dragging me down, expecting some type of advice, and they had no answer for me. just looked at me with a sad look. I say go with your gut, while your management is working with you, look for other jobs, find something that seems to suit you better.

For me, My first job was a nightmare. There was no support system, which did not help the fact that I was a new nurse with ADD and no real experience in the field. My second job was much better, the fact that I did have a little more knowledge of the job helped me stay on task. I also had a great mentor who was just as much as a spaz as me (lol) and that helped me learn to make the ADD work for me. I was the only nurse who could get everything done during my shift, and I thank the ADD for that, because I could be doing one thing, while instructing my CNA's about something that needed to be done, and giving my co-workers my lunch order. Unfortunately, that job didnt last and I was laid off, but it did give me a lot of confidence as to what I was good at. As for the medication, that mostly gives me the energy I need to get through the day. If I get bored, I fall asleep.

I agree, on my old floor, I knew which people were pretty stable with their BP's and I usually didnt check it unless something was going on. But after a med error involving a cardiac med, I just wanted to be extra careful while on a new floor. Plus the person who I was checking recently coded (that was an interesting story, involving me running up a couple flights of stairs with a large 02 tank, but thats for another time). I am still waiting for the DON to let me know whats up. I contacted regional HR and she told me she would look into things for me. But so far, nothing. luckily, I did get a job callback yesterday, so I may not be doomed.

I have done everything they have asked, and tried very hard to please everyone. I didnt just tell them to go screw when they tried to help me, I did what they asked, They made an unfair judgment based on a small amount of info (about 15 minutes for a med pass today, not including the other issue)

So, since my last post https://allnurses.com/general-nursing-discussion/nervous-over-possible-370981.html I have done the re-education that was ordered, and had one full day on the alzheimers unit (with no orientation to anything or anyone). So today, I had my second day on the floor. I was determined to make things go smoother, showed up early, made a checklist of tasks. I was pumped for a good day. So the staff educator came upstairs to pass me off on insulin administration, which went fine. Shortly after, A woman who is from the corporate office (hired to make sure we are up to state regulations before state survey) came up stating she had to watch my med pass. So I was already a little behind since there are 17 feeds on the floor and the nurses have to help out, which I dont mind, but it throws off my day (which I am still adjusting to since ITS MY SECOND DAY) So trying my hardest during my med pass to do well, when the lady realizes that I still have a lot more to go and I am already out of compliance for times (22 pts with most meds at 9am). So she goes down to the DON, who has the floor manager shadow me for the rest of my pass. I of course was flustered by this because she was changing the way I do things.(she thought it odd that I would take a pts bp before giving a bp med even though there were no parameters!?) So I got done at a reasonable time for my second day, an hour off of course but I'm still learning the ins and outs of the floor. So after lunch, the floor manager says she has to take the keys to the cart, that she will be doing the pm med pass, and I have to meet with the DON and the woman from corporate at 2pm. 2pm rolls around and I go to the DON's office. At that time she was giddy since she just recieved word that we did not have any deficiency in nursing from our state survey. that glee went away as soon as she said "she didnt know what to do with me" that my med pass did not go well. What the corporate woman found as 'bad' was the fact that I didnt do my med pass 'like everyone else'. I dont flag the pages in my MAR if there is an afternoon med, I use my census sheet because that is what works for me. I explained that being learning disabled, I have to do things the way they work for me. No one ever told me that I Have to flag pages. They said it was an option (when I got hired), but no one said it was the law. I also was informed that it was 'bad' that I didnt take my med cart down the hall with me. The flaw with that is, I kept my med cart where all the pts were, in the dining room, I had no need to drag it down the hall. I also reminded them that it WAS ONLY MY SECOND DAY and I was still getting a feel for the floor. their recomendation: another suspension until further notice, she will be contacting HR and they will decide if her reccomendation for termination is a good one. I just cant believe it, I feel like I was set up.

The funny thing is, I keep thinking to myself, "who is really going to put up with my patients besides me?" That is why I always had the same side of the unit, because I could remain calm despite insanity. Plus, I consider myself tech support on the floor, fixing the gadgets and helping the unit manager find things on her computer. She did say once "what would we do without you?" and I said (joking) "you would all be screwed!" lol. I have re-orientation this morning, then I am going to the third floor where I will have my med pass observed for two weeks (I wonder how long that will last), then once weekly for a month, then once a month for a while. I am still looking for something different, and have applied other places, but I am going to try to make the best of it. I am just a little bit bummed out because I consider the staff on the second floor my friends, I have worked with essentially the same team for a year, and I don't adjust to change easily (meaning I dont enjoy it, I can figure things out quickly though).

so, I just had my meeting. those days I had off will count as suspension without pay. then tomorrow I have to redo orientation with the staff educator. then they are transferring me to the alzheimers unit. they think that since my current floor is so crazy right now and since I'm a fairly new nurse, the alzheimers unit will be good to help me learn assessment at a slower pace. I actually started out on an alzheimers unit when I graduated. but I dont know if i will be staying at this facility.

So I just noticed that I had a voicemail from 9am (for some reason my phone didn't ring or vibrate and it was in my pocket) So I will be meeting with the DON at 11am. Dont know what is going to happen, and I'm pretty nervous. Ill try to update afterward.

Because another nurse would cost more, it all comes down to that. What I love is that they spent a huge amount of money to put in new carpets, security cameras (probably some hidden ones too!) and a new fancy sliding glass door, when they could have added more staff and fixed the actual broken things before the state came.

So I haven't posted in a long time. Since my first thread, I have graduated, worked in a crappy job for 6 months, and since leaving there, I have been at a facility for one year this week. So this is what I am worried about: I found out that I had made a med error five days in a row, ( I didnt check the dosage listed on the pill card). I was taken of the schedule for sat, and sun., and asked to meet with the DON on mon(holiday). She was not in on monday (my normal day off). I arrived to work on tuesday and was not on the schedule. I am terrified that I am going to get fired, is that likely? backstory: I work on an acute rehab floor. We had been pretty empty for a few months, but there suddenly was a surge of admissions which really threw us off. Many having some pretty serious issues, one even being returned to the hospital for elevated potassium that the hospital missed (he seemed the most healthy out of all of my pts). Several of my patients require A LOT of nursing care, I have two MR patients, one is non-verbal and has bolus GT feeds, I have one psychotic patient on dialysis who is 90 years old and not doing well, yet refuses to sign a DNR, I have a woman with expressive aphasia who now has a GI bleed, A pt with hepatitis B+C with 4x daily blood sugars and behavioral issues, a 80yr old new gt patient with recurrant aspiration pneumonia running a temp of at least 100.0 for 3 days, and lastly, one with PTSD and severe anxiety who, despite 'wishing she were dead' for needing one, requests an enema every morning, and those are just the heavy ones. For my end of the unit, I am one nurse to 18pts, I have two CNA's ( who arent allowed to do much more than AM care and toileting per the facility). I am responsible for all treatments, meds, and skilled notes on 17/18 of them. There is a charge nurse (who I consider my mentor) who has every intention of helping, but she is so bogged down with orders that she cant get away from the desk. We also have a new MD and a team of NP's that work with him. One NP comes in daily to take off some workload from the MD. This new doctor has most of the patients on the unit, approx 30pts. For some reason, they stopped giving the other two MD's (one being the medical director for the floor, the other is the former director) admissions. Well once this NP came in, instead of checking patients and ordering things, she began overhauling how we do things. She even hijacked our part-time unit clerk, keeping her on the floor at all times (and now she has no time to do medical supplies, her primary job). So this made a mess of everything and caused confusion for the staff. We finnally started getting the hang of it though after a few days. So she wants: VS and weights as soon as she arrives on the floor. (of course this is done before meds anyway, but my cna's havent done vitals at this facility, and its like pulling teeth to get weights done.) So When I arrive on the floor in the morning I (personally) have to: take VS on all 18 patients, make sure weights are done before breakfast (the 11-7 shift wont do them) get report, count, check the breakfast trays and help pass them out, check the bm book, check the apointment book, then I can start my med pass. Then, once the NP arrives, she tears through things, bombarding us with questions that I usually dont have the answer to, then gets really annoyed with us and 'throws us under the bus' to the DON. Then I can finish the rest of my work, but I havent been able to get done on time for a few weeks now. I have so much to do and so little time (I have never taken a lunch break since I started BTW), that I have to rush through everything, and having ADD, I already dont have a good attention to detail all the time. (not to mention it is really hot on the floor, I sometimes think they are doing a study on our behaviors related to intense temps.) On thursday we had staff meetings, the State had just done our survey, and then returned to investigate problems they found. After the meeting I attended, the DON asked me and the charge nurse to stay behind. She told us what needs to change on our floor and that we are not up to her standards of quality at that time. She even told us to change our handwriting becaus its 'too loopy'. She said she was trying to motivate and not push people out of the facility. (she told me that I was going to be the death of her). So later that day It was discovered that I had been giving a patient too much digoxin for five days. He was supposed to get 0.125mg but was getting 0.25mg. I checked his AP before each dose and held it on the day that the error was discoverd since his AP was 55. The NP was looking at his labs and discovered he was in dig toxicity, she asked my nurse manager to investigate. When my manager asked about the med, it clicked. I knew that the dose ordered was 0.125mg, but the med I had was 0.25mg, I had been rushing through the meds and I never got to check the dosage on the pill card. (the pharmacy also never sent the correct card, and the old one was never removed from the cart). So I felt terrible, cried my eyes out once I was home, and was worried sick about the patient. (I found out this morning that everything is ok and he is out of toxicity). It was all my fault, I am the primary nurse and missed this error for days. (there was only one other nurse who gave him the med on the weekend, but I dont know if anything happened with her). So on friday (my day off) I was very nervous to return to work on the weekend, expecting the worst for the patient. But at 7:30pm on Friday, I get a call from a coworker (turns out to be the nurse who trained me a year ago), telling me that the DON called her from home, and decided to take me off of the schedule for the weekend, and wanted to meet with me on monday. (monday being a holiday and my normal day off). So before ending the conversation, the nurse passing on the message wished me a 'good little vacation'. I didnt know if she knew what had happened on thursday so I just shrugged it off. So now, again with the waterworks. Fearing that I will be fired I prepared for my meeting with the DON. I listed what I need to improve on, where I need help, and problems on my work floor that directly affect my work. I also posted my resume online and applied for jobs just in case. Monday comes, I call work and leave a message for the DON to call me when she wants to meet up. (it was a holiday so she didnt come into work that day, as I expected. ) So, no call back on monday. Tuesday (today) arrives. I get ready for work and prepare myself again for my meeting with the DON. I get there, and my name is off the schedule. The DON is not in yet, but I happen to bump into my floor manager. I tell her about the weekend (she seemed blank expressioned so I couldnt read if she knew something or not). I asked about the patient, and she informed me that he was fine, back to baseline and the med was d/c'd. So I asked her to have the DON call me when she see's her so I can meet with her. That was at 7am (its now 8:42a). I am hoping that I was given the weekend off because the DON recognized that I was overworked and that led to the med error, but I fear the worst, and that I will be out of a job. (they reciently have 'cleaned house' and escorted staff out of the building, the charge nurse I work with thinks she and I will be next) Any thoughts are appreciated.

Definitely sounds like ADD to me. I used to get the same way with all tests, I just did not have the ability to take my time and I felt the need to be the first one done. If someone passed in their test before me I would get nervous. I also have generalized anxiety which I knew about and was treated for years before the ADD diagnosis. But If you really want to know more about ADD and symptoms and get some tips, I greatly suggest the book "driven to distraction". It was given to me by the executive director of the nursing home I worked at when I graduated nursing school. He heard I was having trouble with my ADD and it turns out, He had been struggling with severe ADD for years, and he was very successful in life. He credits a lot of it to that book. It really explained a lot and gave me the answers I was looking for and more.

Thanks for your support. It's helpful that there are ENCOURAGING people, let alone nurses, out there.

I first posted on this thread almost a year ago exactly. I was failing out of nursing school at the time. Well, I ended up working my butt off and passing and graduating. So I got a job at a nursing home, it was the only job that was offered to me. I was excited and thought it would be perfect for me because repetition is the best thing for me to be successful. I started just after passing the NCLEX, and everyone was very encouraging. Several of the staff told me that they were impressed with my work and were surprised that I was a new grad. Well, they decided that they would cut my orientation short since I was doing so well.(or because it saved them some money..). I had one week of orientation which included passing meds and documenting. Nothing on admissions/discharges, or any desk work like calling the MD's and getting orders. So with my minimum of training, and complete lack of experience, a few mistakes were made because no one bothered to show me what I was supposed to do. My boss knew that I have ADD, and that I would need some extra help at times. She agreed to help out, as she does with everyone, and she suggested to me to stick with one task until its finished and not get pulled away so I didnt forget to get back to my task. None of my mistakes were serious, no one was ever put in danger, and I never caused harm to any of my residents. It was more like I would get some lab results in and get pulled in seven different directions before I get to call the doctor, and once I get back to the labs, its past 3pm and its too late to report anything. After some of my incidents, my boss would tell me that she would want to talk to me, or she and the ADON would have a meeting with me to figure something out. I would approach her, and ask about the meeting, but these meetings never happened. She would be too busy. So fast forward to the present. Yesterday one of my residents needed his PSA levels drawn. The lab never showed up, but before I left for the day, I left a message with the lab that we needed that lab drawn and it was a stat order. So I get to work this morning, the lab was still not done, but the girl from the lab was there and I asked her to draw the stat lab because it was needed for his urology appointment that morning. So I inform my boss about the lab issue, she is upset with the lab and tells me to make sure I get the results. I call the lab a little later, and the results are not in, but they tell me that they will do it right away. I check the fax machine shortly before the resident has to leave, and still no results. I mention this to my boss, but she doesnt say anything. Too busy. Later on in the day, my boss asks if I got the results to the doctor. I told her that they never sent them. She wanted to know why I didn't call the lab. I honestly didn't think to call again, since they said it would be sent out STAT. She said I was going to be in trouble with the MD since I didn't send the resident with the results. So I call the lab, get the results, and make sure the MD is notified. This is where she asks me if nursing is what I thought it would be, and "what is going on with me" since I'm making mistakes. She said she cant keep covering for me and checking to make sure everything was done right. I haven't been working there for 4 months yet, and my boss tells me that she doesn't think its going to work out with me working there. After all the time she was sympathetic and said she would help me. She said that I have made too many little mistakes, and now its coming up to her having to fire me, though she says she doesn't want to. I told my her that I made an appointment with the assistant director of nursing to see what we could do. She said that she feels its too late for that and she doesnt think this is the right fit for me. I bawled my eyes out for the whole ride home. I love this job, and all of my residents, not to mention the damage to my self esteem. I have to worry about not being able to hold down a job because of my ADD. I feel like I'm trapped in the same nightmare that I was in during school. I thought I had finally succeeded at something, but then failure crushes me again. I am terrified that I'll never be able to support myself because of this, I just rented an apartment with my boyfriend because I thought I had some job security, but that flew out the window.

I Just graduated in May and got my license a few days ago. While in school I was applying everywhere, but the only place to get back to me was a LTC facility. I interviewed right away and it seemed great. The staff was very friendly, and it was familiar because as a teen I worked in the kitchen there. When I told people that I wanted to work there, many nurses and fellow students turned up their nose and seemed disgusted that I wanted to work in LTC. Some were very supportive and said that I should do what I'm interested in. My clinical instructor also thought it was an excellent place for me to work because the stability of it would keep me organized. I get aggrivated when other nurses say I should work in a hospital. I havent been able to get a single interview at a hospital, and I already have worked as an aide on a med/surg/telemetry floor for the past year and have come to hate the way it is run. Not a big fan of hospitals at the moment. I actually just called the facility this morning to let them know that I had gotten my license and would be thrilled to work there. They were excited as well, and I'm going to get everything squared away on Wednesday!

Yeah, its tough. There were several students who returned to the program with me, and a lot of them are having some difficulty. I almost failed again because I forgot to take a test. But after failing one time, and coming back from a zero test score, has made me pretty much fearless. I feel that I have been through so much crap in this program, that I can take anything that they throw at me. its coming down to the wire, today was the last class day before the final on Monday. Just two clinical days left, which the teacher has been giving me a hard time, but I can handle that. Just keep up the hard work.