Rantings of a young new ER nurse.

[DaretoDreamRN]

I am a new nurse. I graduated in May 2006 took my boards and started working in the ER soon after. I personally do not think working in the ER is rocket science. I don't know it all and I am not afraid to ask questions. I would rather ask questions than kill a patient.

I just got off orientation like two to three weeks ago and I have to say it has been challenging. Not the work...the people. The work is hard and some days I want to cry but I just realized that even experienced nurses feel that way some days ( so they told me). It might not just be as bad as I would feel because I am a newbie. There is so much I don't know but I am so willing to learn. Some nurses are just big gossips....They sit around and want to discuss how that new nurse will never make it cos she is soooo slow and stupid or how this experienced nurse is sooo lazy and should not be an ER nurse. Some of these "gossip clicks" have only been nurses for like 2 years or at the most 5 years. I just act like I don't hear cos I'm sure the day I am not working, I will the new topic.

People tell me that I have to learn to tell the techs and the secretaries to help me cos I cannot do it by myself and I am kind of trying to get used to that. I try so hard to prove myself that I can do stuff. I feel uncomfortable because I don't want them to think I am a lazy person and I'm always asking for help because I do not know how to do it. I have to admit that the times when I do ask the techs to help me do a work up with me for a chest pain or something else or so they are always willing to help. There is this particular secretary that just really ticks me off. While I was on orientation if the Doctor had additional orders my preceptor will tell me to tell the secretary to put the orders in while I go gave the meds. Each time I would ask her she would give me an attitude about how I need to "learn" how to do it and she was busy (reading a magazine or on her cell phone)...by the way I do know hot to put the orders in. I would be so frustrated that I would go put in the orders in and delay giving the meds and my preceptor will be mad at me. Other nurses told me that she does have an attitude regardless but she dare not disrespect them like that.

People must have noticed that I like to do things by myself because my preceptor actually made a week where all I have to learn how to do was delegate to people. Anyway four days ago I had to draw two set of blood cultures and hang Avelox for a patient with pneumonia .My hospital has a narrow window period (couple of hours) where the blood cultures needs to be drawn and the antibiotics need to be hung. I was going to draw the blood and I just stopped by to tell the secretary to please help me put the orders in and she started with her attitude again telling me that I have to learn how to do it and that she was busy (doing nothing). I told her I was going to go draw blood and hang the antibiotic and I was really busy too. She just kept on going on and on and there were like three nurses there including the charge nurse. The secretary said that well she saw me hanging around doing nothing so I should have the time to put the orders in. I asked the charge nurse if she saw me standing around and the charge nurse said no. The secretary then said "Well You need to stop your yapping around and go do some work. Didn't I say I will put the orders in?" there were three nurses standing right there. I was in shock for a second....then I just walked away.

I was trying hard not to cry at work... when I got to my car, I just had to cry. Maybe I'm just to sensitive..maybe I need to be way more assertive. I didn't know nursing would be like this...I didn't know at all.....

[LZRN]

First of all you need to tell this person to kiss your *** and stay in her pay grade! Second, I'm new in the ER too, just do your best, learn a little more every day and you'll get better and faster! You will soon the the ER master!

"The secretary then said "Well You need to stop your yapping around and go do some work."

LizzieJ said:

I am a new nurse. I graduated in May 2006 took my boards and started working in the ER soon after. I personally do not think working in the ER is rocket science. I don't know it all and I am not afraid to ask questions. I would rather ask questions than kill a patient.

I just got off orientation like two to three weeks ago and I have to say it has been challenging. Not the work...the people. The work is hard and some days I want to cry but I just realized that even experienced nurses feel that way some days ( so they told me). It might not just be as bad as I would feel because I am a newbie. There is so much I don't know but I am so willing to learn. Some nurses are just big gossips....They sit around and want to discuss how that new nurse will never make it cos she is soooo slow and stupid or how this experienced nurse is sooo lazy and should not be an ER nurse. Some of these "gossip clicks" have only been nurses for like 2 years or at the most 5 years. I just act like I don't hear cos I'm sure the day I am not working, I will the new topic.

People tell me that I have to learn to tell the techs and the secretaries to help me cos I cannot do it by myself and I am kind of trying to get used to that. I try so hard to prove myself that I can do stuff. I feel uncomfortable because I don't want them to think I am a lazy person and I'm always asking for help because I do not know how to do it. I have to admit that the times when I do ask the techs to help me do a work up with me for a chest pain or something else or so they are always willing to help. There is this particular secretary that just really ticks me off. While I was on orientation if the Doctor had additional orders my preceptor will tell me to tell the secretary to put the orders in while I go gave the meds. Each time I would ask her she would give me an attitude about how I need to "learn" how to do it and she was busy (reading a magazine or on her cell phone)...by the way I do know hot to put the orders in. I would be so frustrated that I would go put in the orders in and delay giving the meds and my preceptor will be mad at me. Other nurses told me that she does have an attitude regardless but she dare not disrespect them like that.

People must have noticed that I like to do things by myself because my preceptor actually made a week where all I have to learn how to do was delegate to people. Anyway four days ago I had to draw two set of blood cultures and hang Avelox for a patient with pneumonia .My hospital has a narrow window period (couple of hours) where the blood cultures needs to be drawn and the antibiotics need to be hung. I was going to draw the blood and I just stopped by to tell the secretary to please help me put the orders in and she started with her attitude again telling me that I have to learn how to do it and that she was busy (doing nothing). I told her I was going to go draw blood and hang the antibiotic and I was really busy too. She just kept on going on and on and there were like three nurses there including the charge nurse. The secretary said that well she saw me hanging around doing nothing so I should have the time to put the orders in. I asked the charge nurse if she saw me standing around and the charge nurse said no. The secretary then said "Well You need to stop your yapping around and go do some work. Didn't I say I will put the orders in?" there were three nurses standing right there. I was in shock for a second....then I just walked away.

I was trying hard not to cry at work... when I got to my car, I just had to cry. Maybe I'm just to sensitive.. maybe I need to be way more assertive. I didn't know nursing would be like this...I didn't know at all.....

[LDJRN]

lizzie, congrats and welcome to the wild wide world of nursing! it's true, every nurse does have those days...I don't think they ever stop occurring. is this unit clerk your age or older than you? if so, I had this same problem with my uas/cnas at first. sometimes, people feel like you shouldn't be able to tell them what to do for whatever reason. in my experience, they tend to stop behaving that way when you "prove" yourself to them. it was very hard for me to delegate at first, because I tend to avoid confrontation at all costs, and my aides were aides that I worked with prior to getting my license; but I realized that I couldn't do my work + everyone else's and stay healthy and sane. I've just always thought "we're all adults, you know your job, I shouldn't have to tell or ask you to do something you should already be doing". it took me a while, but I think with more confidence, comes more assertiveness. and you know "fake it, til you make it" is actually good to live by, now. just make sure you don't cross the line between assertive and aggressive. good luck!

[ukstudent]

You will be eaten alive in nursing if you keep with the "please would you like to help me" attitude. Being nice works with most people but not everyone. That last week of orientation when you had to delegate was trying to teach you to be assertive. Next time you have orders that need to be taken off, give the orders to the secretary and and say " these orders need to be taken off asap", leave them with her and walk away. No please or can you. In every area of nursing people have responsibilities to carry out for smooth functioning. Dr's write orders, nurses carry them out and secretary's take them off. Start acting like the other nurses around you. Do you see them asking her if she has enough time to take off their orders? Because, I am thinking that they don't do that, it's only you. If just tell someone to do the job that they are hired to do is not easy for you, please think about you patients. You are not helping them by delaying treatment so that you can play at being secretary, your a nurse, advocate for your patient.

[Medic/Nurse, BSN, RN]

People treat you they way that you allow them to. Do not allow this secretary to treat you this way ever again. Tell her your expectations and then follow policy if she continues to be abusive.

It took some work, but I vowed that I would not work in any environment that left me in tears! I may shed a few from the occasional heartbreak that I witness, but I'll not be reduced to tears from other staff. No exceptions!

Vow to start today - I WILL NOT ALLOW MYSELF TO BE TREATED IN A MANNER THAT IS UNPROFESSIONAL/RUDE/DISRESPECTFUL BY ANYONE. I do not treat people poorly and expect the same. Include everyone: RN, MD, TECH, AIDE, SECRETARY, PATIENT, FAMILY, ADMINISTRATION. This takes some practice and will test your ability to control your emotions, responses, reactions and diplomacy. Worth it! - If you plan on staying in this field.

* First, patient care will not suffer because the "order" does not get put in before the labs/medications are given. I would never delay necessary care until I had the order in the computer.

* Second, the secretary seems to be "pushing" you. Bottom line - It is HER job to put in orders! I can/will put "orders" in when I NEED to, but I will care for my patients first. But, her JOB is one of administrative task support. I'm all for being nice, but nice doesn't seem to be working for you here. Actually, its kinda working against you!

No discussion on what you are doing or what she is doing (but you can bet that if her cell phone use and recreational reading are interfering with her ability to do her job, it would simply be a WRITTEN administrative issue - EVERY TIME if necessary).

Example:

YOU: "There are some orders on this chart that need to be placed in the computer."

Simple. Direct. No further conversation necessary - you may thank her when you get the chart back if you want.

This secretary chose this method with her prior communication/issues with you. There is NEVER a good reason for the treatment that has been heaped on you.

As to your practice of trying not to delegate. I felt the same way at first and found myself near drowning at times. Now, when I work, I work on team building! Patients always benefit!

And I always let my "team" know just how valuable they are!

It is a tough job and I admire your fortitude taking on the ED as a new nurse. It does get easier, hang in there! :)

GOOD LUCK!

PRACTICE SAFE!

[UKRNinUSA, RN]

I had a similar experience to you, both when I was new to ER and then when I transferred to the ER at a sister hospital. In the first instance I took a lot from one particular EMT (which I tried to ignore) who thought she was a better "RN" than me. One day, I finally had enough and stopped being polite. I lost my temper and stood up for myself, shouting-"I'm sick of this *%$#@ &%^$@! -- you're the tech, I'm the RN, I'll be the one giving the orders. Got it ?"

She was really peeved, didn't talk to me for a while, but I was exhilirated and never had any more problems with her.

The next instance I had the same kind of problem but this time with the unit secretary, who had been there forever. The situation was a bit more difficult because she was related to just about everyone who was anyone in the hospital. I talked (ranted) to the manager about that one along with my frustrations about always getting the crappy assignments. This too blew over - after a while they accepted me and began treating me better.

Humans are more like animals than we care to admit - if we see a weakness we will jump all over it, if it can work to our advantage.

My suggestions are: get a self-help book/take a class on assertiveness and mention to your manager that you are concerned about the lack of teamwork from this individual and it's impact on ..........(choose your manager's/ hospital's favorite cause). Good luck.

[TennNurse]

My, I do believe that we work with the same unit secretary. Your not in Memphis, are you?? Like you, when I was in nursing school, I never dreamed how utterly miserable the secretary could make your job if she chose to.

You've gotten some good advice here, esp RE taking off orders. Putting the chart next to her and saying politely, "There are new orders to be taken off" is the best approach. It's best if there are witnesses, in case she complains about your attitude or denies that you ever gave her the chart. A polite "Thank you" in front of witnesses when she does take the orders off is also good- it establishes a good reputation for you if you ever do get into a situation where it's her word against yours. If you give her the chart and make it clear what you expect, and she does not do it, immediately report this to your charge nurse. If it happens again, write it up and give it to your charge nurse. This is an appropriate use of the chain of command, it keeps you from having to deal with it, and it will impress upon her that neglecting her work will carry consequences. Apparently this jewel requires some incentive to actually do her job.

From reading your original post, I think that shedding your good manners completely is going to be hard for you, and I don't think you need to be stressed out about that on top of everything else. Have you read that ancient work by Dale Carnegie, How to Win Friends and Influence People? This is an excellent book with very good advice on managing people. I also had a hard time delegating when I was a new nurse, and this book was very helpful in teaching me how to do it nicely, allowing me to continue exercising good manners without compromising my authority.

I have been in your shoes before, and I do feel your pain. Please feel free to PM me if there is any way I can help you. (((((((hugs)))))

[DaretoDreamRN]

she is like 10 yrs older than me..i know I have to be assertive...its just I'm new to it all...i work on friday and I'm going to work hard at it without being aggresive. I have to to survive....thanks so much for your help....

[jojotoo, RN]

You will be eaten alive in nursing if you keep with the "please would you like to help me" attitude. Being nice works with most people but not everyone. That last week of orientation when you had to delegate was trying to teach you to be assertive. Next time you have orders that need to be taken off, give the orders to the secretary and and say " these orders need to be taken off asap", leave them with her and walk away. No please or can you. In every area of nursing people have responsibilities to carry out for smooth functioning. Dr's write orders, nurses carry them out and secretary's take them off. Start acting like the other nurses around you. Do you see them asking her if she has enough time to take off their orders? Because, I am thinking that they don't do that, it's only you. If just tell someone to do the job that they are hired to do is not easy for you, please think about you patients. You are not helping them by delaying treatment so that you can play at being secretary, your a nurse, advocate for your patient.

This advice is right on the money. Stop worrying about who likes you and you doesn't. You have friends, right? Outside of the hospital? Don't be dependent on the people at work to give you strokes. If you get them fine, but if you don't - well, you weren't expecting them anyway.

[Mulan]

I think the secretary needs to be written up. She needs to do her job and keep her attitude and her mouth to herself.

[ND76]

My, I do believe that we work with the same unit secretary. Your not in Memphis, are you?? Like you, when I was in nursing school, I never dreamed how utterly miserable the secretary could make your job if she chose to.

Hahaha! You took the words out of my mouth! Do we all three work together? The whole thing sounds very familiar to me, the secretary, the preceptor on the cell phone, the gossiping co-workers, and the even the OP!!!

[Freedom42]

My nursing professor uses a book called "Holistic Assertiveness Skills for Nurses: Empower Yourself and Others," by Carolyn Chambers Clark. I'll be honest: I'm not wild about it, but I'm definitely in the minority. My classmates rave about it.

Clark offers a variety of scenarios and exercises to help the reader become more assertive. She does offer good suggestions on how to stand up for yourself without losing your temper or blurting out something you'll regret.

Good luck.