dadweeb

Hello all, I need some advice. I have been reading posts on this web site for several years, there is almost always someone with a similar story where I can draw comfort/advice from. I have worked in an LTACH for three years and was searching for a hospital position. I was fortunate enough to get a position on a Med Surg floor. Administration has been very generous with the orientation period, I have been with a preceptor for over 6 weeks now. I believe they are giving me one more week. There are some good days, but most days I leave feeling inadequate and close to tears. I know I am a good nurse, but I am overwhelmed with 6 patients, constant discharges and admissions, one PCA on the floor most days which leave us to do the vitals and sugars. The phone provided by the hospital never stops ringing for patients wanting to go to the bathroom, wanting PRN meds, water/food, beeping IV machines, telemetry calls, family wants to discuss plan of care...and list goes on and on. Meanwhile, we have to chart in real time (almost impossible!). Labs need to be evaluated, doctors mention orders which they never enter into the computer so they are called for telephone orders, and the docs expect the nurses to read all of their notes. Since I am fairly new, I don't recognize the docs when they come in and end up calling them after they leave (pisses them off to no end!). Please tell me it gets better...I struggle every day with time management and providing good care to my patients. How long does it take to get "used to" the pace? Do you ever get used to it? Even the seasoned nurses verbalize how anxious they are the night before their shift!

I know this is an old post, but this is exactly why I go allnurses.com; the emotional support. I am in the exact same situation at this time. I have been in an LTACH for 3 years and was told "if you can do this you can do anything". Yeah, not so much. I have been orienting for 6 weeks now (three 12 hour shifts per week), and most days I feel like a complete idiot. I am constantly overwhelmed with the expectations. The ratio is 1:6 with constant discharges and admits. One PCA for every 12 patients, if we are lucky. Most days its one PCA for 12 patients and if there are 20 on the floor the nurses are responsible for their care. You all know the drill. Fall risks, up to bathroom, incontinent patients, isolation patients, orders to check every 15 minutes. AND the docs expect you to read every note they write. The portable phone never stops ringing, whether it is a patient asking for water or telemetry tech telling you the leads are off again (for the 12th time!). Administration expects you to chart in real time, how can you do that?! and not stay after your shift ends. UGH! I know it takes time to adjust, but I feel like crying at the end of every shift. My preceptor is an excellent nurse, but she expects everything done the way she does it and feels every other method is wrong. I need someone to tell me that this will get better.

The instructors treat you as adults. If you want to know something ask a specific question. As to the reading, this semester you will have to do a lot of reading it does get lighter as you get further. Lastly, as to nursing skills, you should go to youtube and find videos of people performing the skills and it will help you tremendously! Lastly, most nursing programs spend the first few semesters weeding out the weaker students who don't belong in the program. Don't let yourself be one of those! Make friends with 3rd and 4th level nursing students, most will be happy to give you a few hints as to how to get through the semesters ahead. Good Luck!