RosieD

Is it just one, or all of them? If it's all of them, the issue might be you in some way... When I was an aide, there was one nurse who always seemed stressed out, she always was sort of freaking out, didn't have time for anything (and then when she DID have time, she didn't round on patients to preemptively avoid anything, she sat in the conference room and always fell asleep. Poor dear, she had 3 young kids, and was always exhausted at night, but still.) We were super busy unit, it was pretty awful. But, this was the only nurse who would call me to do something that a patient had asked her to do personally- like, she would be giving a med, and the patient would tell her they had to use the toilet, and she would call me instead of doing it herself when she was already in the room. We had a HUGE unit, and I would often have 20 patients, so that was a problem. That said- if you are having a real problem with one person, talk to them! Tell them you want to talk, maybe get you both a cup of coffee, get someone to cover for you guys for 5 minutes, sit down and talk. Give her a couple of examples of things she does well, then tell her what your concerns are, and ask her what's going on. If she's having trouble doing her job, maybe you or someone else could help her organize. If she's seriously just sitting around, then maybe she doesn't know how important she is to you. Tell her you need her! Try to give her encouragement- praise the **** out of her when she does something right, even though it's just something that's what she should be doing without being asked in the first place, just like you would with a toddler. Also, there might be times when she is really busy too, and you're sitting down charting or taking a quick chat break. Sure, you notice when she's being a little turd, but you wouldn't notice when she was busy, as she'd be in a room with a pt. Maybe once a night or so, call her when you do have a second to breathe and ask HER how she's doing and if she needs some help. Try that for 4-5 shifts with her, at least. Ask the charge nurse for some confidential advice, and try phrasing it like, "I've talked to her about it, and I wonder what we could do to help her improve"- that way you're not trashing her, but still alerting the charge to the situation. If things DON'T improve, then yeah, full-on complain to the charge and the manager, but be fair and give real examples. Lastly- sometimes the best way to get people to help you is to get to know them better personally- take a few minutes at the beginning of a shift to ask her how things are going, ask about her boyfriend, school, whatever, find something in common, whatever. Making someone your friend is the easiest way to get them on your side.

Wow, harsh, guys. I'm a new grad. I live in a place where there are more new grads than there are positions, and you are not by any means guaranteed a job. I'm not averse to working on issues that I might have, of course that's part of orientation, and I'm willing to discuss them- it's just that, although the talk is of moving to a different unit, and that IS what they say they try to do when things don't work out early in orientation, I AM AFRAID of what it will mean to have that information on my record. I would not be able to easily find a new job if I left. I did come to this forum for advice, and everyone did say to quit... however, wouldn't it also be difficult to get another job after quitting or getting fired mid orientation? It seems, from what I see on this forum, that situations like mine are common occurences in nursing, but I still can't imagine having to explain this to another hospital. Would getting let go look so much worse than quitting? Lastly- I expect this hospital to stick by me through the orientation process, and I hope they will stand by what they say about moving us if there is not a good fit- they said many times in the beginning that they understand that sometimes a preceptor or a unit is just not a good fit, and that's okay, and they will move you. If I expect them to stick by me, then I think I should give them the chance to follow through with that. I don't want them to quit on me, so I don't think it's right to quit on them. It's not over yet, so we'll see. But, you're right, I'm new, I don't know how these things go, I'm just hoping for the best, knowing that I am a darn good nurse, even though I'm new and going through this foolishness.

Oh, and I just can't imagine that this will have anything to do with the board. This sort of thing happens all the time, they wouldn't be able to deal with it all! Not progressing in orientation is not the same thing as being an unsafe nurse. When you do the peer review thing, go prepared with SPECIFIC examples of when you asked other people if you could help them out, times when you were told you were doing a good job, etc. Ask what you have been doing well- there may be people involved in this meeting who don't know you, so don't let them only hear negative things. We aren't perfect. Neither are nurses who have been there a long time. Ug.

Is there someone involved in your orientation who is not your preceptor and not someone working on your unit? If possible, you should have someone to be your advocate at any meeting that might occur. Do you have documentation from your preceptor about goals met/ things to work on- anything to show that you were making good progress in some areas? What about your interview- is there a recruiter who was impressed with you? Obviously they wanted you enough to hire you, and orientation is something that takes some people longer than others. Does your hospital sometimes move new nurses to another floor, if the unit you are on originally is just not a good fit? Is there a union? Focus discussion on how orientation is a time to learn, and you are there to learn. Maybe your preceptor doesn't have the same teaching/ learning style as you do. Maybe your personalities clash. That should mean a new preceptor, maybe on a new unit, not being fired. Good luck.

You absolutely can do it! There were several girls in my class who were pregnant when we graduated, 2 who were SO CLOSE to term on the day we walked! You said it yourself- you know you can do it. That's all that matters. Depending on when you deliver, you may be able to take a week or even two off and make up clinical time after or even before, and your professors will be flexible if it happens during exams. If you can, get papers written or even exams taken EARLY as you approach your date. Like others said, at the very worst, you'll miss a semester and start right in again the next semester with the class that comes after you. Good luck, and congratulations!

Well, I jumped through the hoops. I did. I wrote about some things that I think I could work on, and also mentioned some things I was good at. I am under the impression that the DON thinks I have exhibited a pattern of ridiculous behavior, and does not realize that it was actually one day's worth of things, which were very much influenced by other people/ circumstances. I did write an apology letter to the manager of the department, which I am only partially sure was appropriate. I mostly focused on how much I enjoyed working for the department. I am so angry. My only hope is that this place is NOT the big, nameless, faceless hospital (although it is a big place), and they really market themselves as a place where they will work with a nurse through orientation. Hopefully that means they will stand by their word to transfer us to another unit if there is not a "good fit". There isn't a union, obviously, athough I wonder what good that would have done me as a new employee? The nurse in charge of all of orientation is amazing, I trust her, but I also know that the nursing shortage is a myth in our part of the state- they don't need me. I am still supposed to be in next week for some general orientation stuff, but I am very concerned. I can only hope that our conversations so far mean that I am still considered a valued employee. Damn it. I am so upset my cheeks and fingers are numb. I am not letting this make me hate the hospital- this is a wonderful place, and I am proud to work there. Either way, if I get transferred to another floor or if I get let go, this experience will remain as one of the most painful things that has ever happened to me, and it has really smushing what little hope I had left about enjoying nursing. Why is it like this?

I'm glad to see someone posted the recommendations stating that the smallest gauge in the largest vein is the best thing for the pt. I guess part of the idea is that blood should be able to flow easily around the catheter when it is in place; obviously it's not good if the catheter is wedged so tightly in a vein that it impedes blood flow. That said, I think that 18g IVs are EASIER to put in in many situations! Really! They feel big and awkward going through the skin. But, I find it easier to push the needle + catheter into a vein once I see the flash with an 18 than a smaller needle- with the smaller ones I think I am more likely to puncture through the vein, especially with very curvy veins. Policy is always the guide, though, for your institution!

I am new to nursing, and I am terrified that I will be in the same boat soon. I'm doing everything I can to prepare and organize, but I'm afraid that it will not be enough. Ug. To get this far, and still find it this hard. :) Tough, huh? Hang in there, honey. We may have trouble with a few aspects of nursing because of ADD. But, the way I think, because I have ADD, I truly believe it makes me a better nurse- I See connections between things easier than others, I'm used to paying attention to lots of stuff at once (as long as it's relatively interesting :)) and I know tons about psych meds and what it feels like to be misdiagnosed! The way I think makes me more empathetic and helps me see patterns that I think are harder for non-ADDers. We just have to find crutches to help us get by with the usual problems like organization and speed, or find jobs where the patient load is different. We can do it!

Hi all- I need some advice. I recently got a job at a hospital that I wanted to work at VERY MUCH, and got placed on the step-down unit I requested. I was assigned to a preceptor who did a good job teaching, and things were going well. I was told that I was doing a good job and I felt comfortable with my progression. I was moved around between several different preceptors over the next 4 weeks due to staffing issues. On the last day I worked there, I was assigned to a preceptor I had not worked with before. She was telling me what to do every 30 seconds, and telling me to drop what I was doing to do something else before I had any time to finish it (and this is not because I'm new and slow, nobody would have had time to do it :)). This went on all day, and was quite distressing. I made several attempts to fix it, very politely letting her know that her constant direction was making it difficult for me to organize my work- and I promise this was not just an issue of her trying to teach me priorities or being extra vigilant with a new person. 8 hours later, I was not so chipper. I was frustrated and I'm sure that frustration was showing some in my behavior- never in front of a patient of course, but I don't think I was being perfectly sunny with her. I had a very difficult time getting things done in a timely manner ALL DAY because of the constant interruptions. Long story short, I was called into a meeting with supervisors and told I was doing a bad job by my manager- He said I would still be an employee but would be moved to another floor. I was devastated, and pointed out that I had received good feedback until now- He told me I must have not been listening. Seriously. I understand that if you burn bridges in an area, whether it's your fault or not, it might be wise to cut your losses and move to another unit. And, maybe I wasn't meant to be in that area anyways. So, I am trying to forgive, forget, move on, and make a new start. That's all going good. Well, good-ish. So. I had to make an appointment with a higher-up, who had not met me and who had a list of "issues" printed up from my unit. This list included a few things I could work on, but mostly was out-of-context ridiculousness. She had not actually spoken to anyone from my unit, she had just received this memo, and from it she seemed to have come to the conclusion that I was a very serious problem and maybe should be discharged. Wow. We talked, I was positive, admitted to having some failings in my communication skills that day (we all do sometimes of course), and detailed some ways I could work on that. I felt like I couldn't defend myself- anything I argued would be further proof to her that I was a poor team player who wouldn't accept responsibility. So. Then there was another meeting with someone who was supposed to be an advocate for me, and that went well, and he really did support me, but we all still were in agreement that I should move to another unit. However, I need to write a detention-type essay about everything I did wrong, how it negatively impacted my unit's teamwork, and all the things I would do to improve myself if I were to be kept on. I also am required to write apologies to all my preceptors for my bad behavior to "tie up loose ends and bring closure to relationships". I do not owe apologies to my preceptors. Two of them were totally uninvolved, and I had apologized to that ill-behaved preceptor on the day in question several times, and tried to fix the working situation. Anything to make it better. I don't think the DON understands the situation fully, but I don't feel like I am in a position to argue. I was EXTREMELY careful and tactful when explaining that I felt, while I would love to work on some of my own problems with a new preceptor, I felt like maybe the situation had been blown out of proportion. I delicately pointed out that although the preceptor had the impression that I was a bad, obnoxious person, I was not actually so. I admitted that it is definitely possible I gave her the wrong impression of me, and that I would examine myself and work on my communication style. My advocate agreed that it was most likely exaggerated and that the preceptor had got me wrong, but that doesn't change what I have to do. So, here's the question, finally- I understand that sometimes unfair things happen and you have to suck it up, and maybe later I will find that it's all for the best. BUT, I don't want this to go on my record as a huge blemish, nor do I want any new manager/ preceptor I have to think I am a bad egg. I was doing okay with the forgiveness and moving on until I was required to detail all my failings in these notes. I am being asked to admit to being a bad team player, which I have NOT proven to be (this was not a large enough inquiry to ask people for GOOD things about me, apparently). If I don't take responsibility, I won't be doing what they ask, and if I do I'll be bad-mouthing myself on paper and in effect agreeing with their view of things. Even though many nurses had good things to say about me, my supervisor is only focusing on the bad, and making it sound like it was a pattern of terrible behavior, and not just the last day. I don't know what to do. I do NOT want to go to another hospital, I am HAPPY at this one. I already have agreed to go to a different unit (if they decide to keep me, which I guess is all but certain), but I just don't know how to go about fullfilling their requirements without admitting to problems that I don't have- they want some serious details! I am going to write the stuff, I need to keep my job, and I want to work for this company- but how do I do it without damaging myself, and how do I forgive and move on? Thanks! -Rose

Ask around with the other nurses on your unit- have them tell you the story of the first time they made a med error, the first time they made a mistake that they felt responsible for/ guilty for/ like an utterly worthless excuse for a human for. They all have stories. And remember, while it is certainly possible to make stupid mistakes, especially as a new nurse, MOST mistakes at hospitals are NOT because of one person's mistake- they are usually errors that involve a lengthy chain of things that could have gone wrong and did, or a problem that has occurred over and over again, which is a sign that there is a system problem that needs to be considered- like, for instance, med errors when you have two concentrations of a med available on a unit, with very similar labels. That's an error waiting to happen. But, like a previous person said, you may not be doing as badly as you THINK you are doing. Keep talking to your preceptor, or other nurses that you trust and work closely with. Tell them your concerns. Admit mistakes and near mistakes, and they can tell you how to avoid them. DOn't worry, we all do it :)

omg, I had a little old lady who would NOT keep her fingers out of her bum one night- she was on the bedpan, she WAS going, but I guess at home she uses digital stimulation daily to alleviate chronic constipation- that's fine, and apparently quite common, but it was very not necessary when she was in the hospital and on a bedpan, and GOING, because she'd had a suppository! There was poo EVERYWHERE! I believe my first reaction was a judgmental, horrified "STOP THAT!" Poor lady. It was funny, it was sad: it was tragic. She was confused. It took a lot of time to clean up. I understand your feelings, which are not evil, but things that many of us think all the time at our jobs. No worries. Be grossed out, and act with love. :)

Oh, honey! What a fear! LOL Well, the truth is, poo is gross. It's normally kind of gross, and at times it is shockingly, appallingly, filthy gross. But, it's OKAY. That's my general response when people ask me about how I can do a job like that- "Yeah, it's gross, but that's okay." Usually patients don't seem to mind- I suppose it's the acceptance that right now you can't do it, and you need some help. But sometimes it is hard on people, like 20-something patients or your little old ladies who are upset because they "don't want to be a bother". I always tell those ladies that one of the wonderful things about being human is that we are there for eachother when we need help. And the big kicker- if our situations were reversed and I needed help, I bet they would do the same for me. But it's true, sometimes it's super gross! Sometimes you can smell it in the hallway 20 rooms away! Wow! That's gross! But, what are you gonna do? Give your patient the love you've got to give, fix them up, and laugh to yourself (or a good nurse pal) about how you thought you would pass out. It's okay. You get used to it very, very fast. :)

wow, you guys. i live in grand rapids, mi, and we are all starting at $21.62 and hour. that adds up to around 40k before taxes, give or take depending on your vacation allowance. all the hospitals in town are giving or are about to give a $0.60/ hr adjustment based on comparisons with other hospitals in our state, which is about an extra $1,000 per year. because i live in a city, the cost of living is higher, but the surrounding hospitals in smaller areas pay less, including those outlying hospitals that are part of a major health care system. you can make $2 and hour less, working in the same position for the same company, just 1/2 an hour away. i made $11 as a nurse aide, and our unit secretaries made more than $15. i understand that the cost of living is much higher in ca and some areas on the east coast, but it feels kinda harsh to see how much people are making there! i have been trying to work out a budget, and when i add in student loan payments, car insurance, 6% to the retirement fund, and all the necessities like groceries and health care, i can't afford to get my own rented apartment. and i don't even have a car payment! making this much money feels great, even when i see how much taxes are taken out. but, you know when people ask you what you do and you tell them you are a nurse, and they tell you how awesome that is and how smart your choice was because you will always have a job and all that? well sometimes that really gets to me, because people seem to assume that nurses make a ton of money. i have at times told people what the starting wage is (because i don't know, i suppose to a lot of people that is a ton of money), and everyone has been surprosed- they thought we made much more. also, the whole idea of a nursing shortage- people always bring that up, and job security, but in reality, when i go home after a day spent working incredibly hard to just get the basics done, i feel terrible because i did not have enough time to give as much care as i feel my patients deserved. some days it's not as much as they needed. (not just because i'm new- it's the other nurses too). and, it's not because there's a shortage and my floor doesn't have enough nurses- my floor is fully staffed, they are not trying to hire more- we are that busy because where we work they think that 7 patients is an acceptable load. shame. all that said, there is a huge variation in pay. i got loans from the state of michigan that i don't have to repay if i stay here, so i will happily stay. and i love my state. one major difference though: unionized hospitals in the area pay significantly higher wages. that's definitely something to consider.:)