Hey everyone, first and foremost I've been a lurker here for a while and decided to finally join and post. I'm a new RN/new grad (May 2011), and finally landed my first job in December 2011, in the ER. It's been rough, not gonna lie... if i may explain briefly and get your advice from you wonderfully experienced nurses out there.
New ER RNs/new grads are given a 20-week orientation at the hospital I was hired at. We started off for 3.5 weeks on a med/surg floor and started in the ER in January 2012. We're in week 14, but I've had some issues arise that I've hit a brick wall at and almost feel targeted and compared to other orientees, some with some nursing experience, some without.
For the past few shifts my preceptor has been letting me go off on my own for the most part and letting me manage 4-5 (out of a 5 pt assignment area) pt's on my own based on acuity. Our area has mainly level 3-5 pts, while more critical are on the other side of the hallway. I haven't had any real criticism from her other than if the day was good or bad, and that I have been making significant improvements, and don't be afraid to get into the room with a critical patient. She was pulled into a code in a different area and left me to manage our assignment on my own which she said I did pretty well at.
Now, I'll be the first to admit I've had my fair share of mistakes over the last 8 weeks I've been down there (first med error that was caught in time before administration, screwing up telephone orders from a Doctor and getting yelled at by the ICU nurse for it) and some others, but nothing directly harming to a patient. I learned from my mistakes and know they won't happen again. But that's not the reason for this thread and my long rant (i apologize, thanks for reading this far!)
The other day I was brought into the Education Director's office (a woman whom i had never met) with my clinical coordinator. The conversation I was lead to believe we were having (as told to me by my clinical coordinator, it was a "3/4 the way there check-in") turned out to be waaaay different. They told me I'm behind where I should be at this point (I should be managing 5-6 stable pts they say, when the max number I've had to work with was 5 this far). they also said there have "issues" and that in 6 weeks when I come off orientation they're "afraid I won't be safe," and that apparently my perception of how well I'm doing is wrong. They say that I'm "struggling" according to my preceptor and that I'm "scattered" with the pt care needs, without specific situations other than the med error and botching the orders, and a pretty nasty write up from the nurse I was working with one day (my preceptor was out sick) because her and I butted heads for a better part of the day- where she twisted what I said and instead of talking to me about the day wrote a very demeaning, rather nasty review of the day.
The Nursing Director of the ER pretty much bashed me as well, saying she "always sees me behind the desk" and that I haven't made any improvements since we last spoke 3 weeks ago. When I spoke to my preceptor later (in tears nonetheless) some of the things i told her they said she stated she denied, saying there are things we do need to work on but that I'm improving each week. She told them (in the meeting we had with the ER Nursing Director) the skill is there, just time management and priority is what we need to work on.
The ER I work at is rated one of the best in the country, 97% pt satisfaction, but unfortunately is more concerned with the numbers than the staff. The nurses are understaffed, sometimes we don't have any techs. Some of the people I work with, while they are good nurses, some can be very demeaning and down-putting, even some of the Doctors. They've had 16... that's right... 16 RN resignations over the past year because of they way they treat their staff, and a high turnover rate for new nurses who get their year and get out of there.
So, the whole reason for my rather long thread... they're giving me 4 work days to improve or they're moving me off the floor IF there's a job opening someplace else in the hospital, and if not they're not letting me finish the 6 weeks or give me an extension.
My response: challenge accepted.
So i guess the whole idea of this is... any advice for fine-tuning priority and time management the next four days? I love being in the ER, I love emergency medicine (I've
been an EMT for 6+ years), but I feel like I'm being targeted without a true reason behind it other than I'm "not where I should be" and minor errors that everyone I believe makes and can make. A fellow orientee who has nursing experience, and worked as a tech for 4 years is being pushed to come off orientation early because they had two more nurses resign, while they're telling me I'm behind.
Advice? A shoulder to lean on? Am I wrong to look at it this way? I'm up for hearing anything you wonderful people have to offer. Thanks in advance.
