triageyoda

Hi friends, I need some help. I have been working for a triage company for 2 years now that only pays $20/hr and in one of the large US cities with high cost of living. We don't get paid for being on call, nor do we get any extra for holiday. We get a $2 bonus for 5pm friday through 8am monday. I really need to find a telehealth job with a realistic salary for this expensive part of the country. Has anyone worked for FoneMed, Medcor or CareNet? I am due to interview with one one Monday and what I have read so far from other nurses is scaring me. It might be better to get paid less and not get run into the ground... Any advice?

I really need some advice if anyone can help me figure this out. I interviewed for a position at a local hospital coming from a doctors office. The position I was hired for was a step above what I applied for, but I eagerly agreed to take it on because the departments are very similar. Today was my 12th day on the floor (8 hour days) I am supposed to be on Orientation for 6 weeks. All of the women are very experienced and very fast and my preceptor changes every few days. I have noticed 2 women in particular that have serious attitudes about my skill level. Eyeball rolling, huffing and puffing, pulling things out of my hand, everything I do is wrong.. right down to the number of seconds I apply skin prep, where I place items in the patients room, etc. Yesterday one of the ladies very blatantly asked for a private meeting with my boss right in front of me in order to air her grievances about my performance. She then proceeded to send an email up the chain of command telling this manager what she didn't like about my work. I watch theses ladies whisper to each other about me as if I weren't standing 10 feet away. They correct me in front of patients. I got tired of the games today and I finally asked my supervisor if there was something I needed to know because I'm not stupid, and she proceeds to tell me that I am moving way too slow, that I am not meeting anyone's expectations, that I am way behind compared to where most people are at this point in Orientation, that I should be operating far more independently by now, etc. Ok. I feel so intimidated by these aggressive personalities that it is hard for me to concentrate. How am I supposed to know that I'm behind pace if people are running to supervisors and directors and not me? No one told me at day 3, 5, or 7 that the pace was that bad. Now all of a sudden I am 2 weeks behind where I'm supposed to be? Now I really feel stupid! Also when my supervisor receives this feedback shouldn't she come to me and tell me right away to help me make these corrections instead of just sitting on this info and dropping a huge bomb on me only after I pull it out of her because I know what BS smells like? Again, this is my 12th day on the floor. These ladies have been doing this job 9-45 years. They knew I was coming from a doctors office. I don't understand how I can be running independently at this point if I feel so intimidated that I have lost all of my confidence and can't even sleep at night. My supervisor also proceeded to tell me today that her experience tells her that if I am this far behind I can't catch up and am probably not a good fit for the position.... I am so confused. I thought I had 6 weeks to learn and grow. Can somebody please explain to me what I should be reading between the lines? My interpretation is that they have already decided they are getting rid of me and I am beside myself. I just can't believe this is happening after only 12 days on the floor. Up until this weekend I thought I was working towards a goal at the end of the 6 weeks and now they tell me I suck??? I work so hard and try so hard I'm really confused and hurt. Pretty sure my "meeting" this Friday will be the boot. Anyone have any ideas on how to salvage this? I don't even know where to start as far as communication is concerned. I feel like only my skills can speak for themselves at this point but somehow I have to be able to lock out the intimidation that is going on or I won't get my confidence back. Help! near tears and don't know what to do!

Thanks so much for the feedback and encouragement! Yes, we also only use the AC for a CTA or port power injection and also avoid areas of flexion related to thrombosis, inconvenience, and length of patency. I am left handed and seem to have trouble with patients especially when they are in the bedside chair. If I am restarting a right forearm and applying traction with my right hand from underneath, those faint veins disappear on me. I like the idea of using the thumb as a marker I will definitely try that. I have also started looking for a freckle, etc. Can you still get good traction in these areas by using the two finger spread technique lateral to the site? I've been trying it but find that on the older skin especially I still run into occasional bunching up. I think its really just practice at this point. I like being able to feel where I'm going if I can't see it, so when I go to scrub, and look back and the vein is gone I freak out because now all I see is an arm, a blank canvas where I know I saw a vein a few seconds earlier! I really don't want to just stab blindly so I'll feel and re-clean, but then I'm not sure about the depth at that point...

Hi there. I just started on the IV team at a hospital. My previous background was Infusion in an outpatient setting where all of my IV's were AC's and hand. My new facility likes to place a lot of forearm and inner arm sites for patient convenience or because by the time we get called for a re-start the patient has nowhere left to stick. I am having a lot of trouble seeing and hitting the Median and Cephalic veins in many of our patients. Either I can see it and it blows, or once I apply traction it disappears on me and I can't touch it again after cleansing. I can hit them all day with my eyes closed if I'm going for the AC or hand, but these particular ones are really giving me a run for my money trying to transition from OP to a hospital setting where I'm now dealing with a patient in a bed, I am now standing up, the patients are often dehydrated and have been stuck all over and have blown sites, etc. I need to master this last technique before I can be cut loose on the floor. Does anyone have any good advice? I'm really getting stuck on the fact that once I feel it and clean I can't touch it anymore and I don't always know where to go back to and I am consistently under or on top of it and I notice that my traction in these areas is also not the best. I just can't eyeball the angle like I can on the hand and AC's.... help please!

Sheesh. And I thought $30 was low...

I think this poster must be using the Protective Plus IV Catheters which would possibly explain the clicking sound they would hear at the time of threading and pull back possibly???

I think this is a very normal reaction for new RN's these days unfortunately. It's exactly what I went through. Nursing school does nothing to prepare us for the real world and once you start getting your own patients it takes time you get your flow and learn things like like prioritization and time management. The stress can be absolutely overwhelming. All of a sudden you feel completely inadequate and lose all self confidence and feel totally stressed out all of the time. Let me assure you of a few things. First, take a deep breath. It is not you. You have been thrown into an environment with a lot of responsibility and when you are on your own and realize that it can be scary. A license alone does not make any of us experts. I can remember getting to that exact point where you are now. I had a hard time getting everything done and prioritizing. I was not able to get the help I needed out of the CNA's and ended up doing all of my own ADL's plus assessments, meds and charting, which always made me miss lunch and go home late every night. I cried every day and had panic attacks driving to and from work. I think I even remember calling my husband from the car one morning begging him to let me quit and just turn the car around and go home! So no you are not a failure and no this is not abnormal. In the past nurses used to have one semester to one year interning at a hospital and running a floor before they even got out of school so that they could learn exactly how to juggle these issues. Now they crank the students out with very little floor time. So... how can you survive it? It honestly just comes with time and experience and it will get better, but you have to give yourself permission to have a learning curve. Don't be so hard on yourself. You have to remember that yes we are nurses and we tend to give our patients our everything, but this is a job and you leave it at the door when you go home at night. Also it's not a race, don't compare yourself to others who have been there forever. You focus on yourself and what you know that you have been trained to do. Remember that you survived nursing school. You passed the NCLEX, you earned a license with tears, sweat, and many sleepless nights, and the hospital picked YOU! They would not have cut you loose on your own if they thought you were incompetent. Have confidence in yourself! When I was in clinicals I used to carry a notebook and highlighter with me. I would constantly jot notes of things I needed to prioritize and get done right away and highlight the ones that were super important and then cross them off as I went along and put a time beside them that I had to have them done by. Also, It IS also okay to say no (obviously not to your boss or supervisor) , but learn how to communicate when you are already overloaded or say I'm sorry I can't get to that just yet I have something more urgent I must get to first and then I'll be happy to help... Learn how to delegate. Use those CNA's. If you can find great ones team build with them and don't let them go! Do something nice to show them your appreciation. And finally don't be afraid to offer and ask back for help. Team players can be found on any floor. I hope these suggestions help. Hang in there. It does get better. I also treated myself to a massage once a week. I didn't need therapy or meds, this is a very fast faced environment now and inpatients are sicker than ever before. Give yourself the credit you deserve and it will come in time. Good luck and let us know how you are doing! :)