I've worked as an RN at night on a busy med-surg floor for a little over a year. As much as I love being a nurse, it has been an extremely difficult this first year! It seemed as though the first 6 months went ok, then I began to regress. The more mistakes I made, the more I lacked confidence in my actions.
There have been lots of errors I've made-mostly being unfamiliar with hospital policy, procedures, or with paperwork. More recently I made my first real medication error. Fortunately, I have never harmed a patient and have always been honest with my mistakes. I'm terrible with IV starts. I have made a lot of effort to improve my IV starts, yet still find myself frequently asking my colleagues for help.
I was just notified by our night Charge Nurse that she's writing me up up for the numerous errors made in the last few weeks including recent my recent medication error. She has reported everything to my Nurse Manager. In addition, she told me there is impatience brewing amongst some of the night nurses when it comes to helping me start IVs. She also stated a couple of day nurses think that I "don't get it" without specific complaints made. This CN reassured me that she thinks I have lot of potential, but I lack confidence. I respect my CN's decision because she's ultimately concerned about patient safety. I admire her honesty and concern. I have had a few meetings with my Nurse Manager about my performance in the past, and she will be speaking to me again about this writeup. I'm horrified to think about what's coming my way.
I never imagined that I would have such a difficult adjustment. I had a very positive experience in nursing school. I have a wonderful supportive husband, family, and friends. I get along well with the staff and I'm very open to constructive criticism. Always dreamt of being a nurse. I'm very concerned about patient safety and the direction of my career.
I am hesitant to be open with friends and nursing colleagues about my challenges at work. Feeling really hurt learning that some of my co-workers aren't being straight forward with me about their opinions. In the same token, I really enjoy many aspects of my job and don't want to give up when the going gets rough. I'm unsure about where to go from here or how to respond to my CN. Any advice would be greatly appreciated.
First off, you worked hard to realize your dream, you still need to fight to keep going! There is a lot of advice here, very interesting to read. To protect your job you need to ask for help. Admit your shortcomings but tell your boss you want to suceed. Can they help you improve? As a long time preceptor, my first thought is that the training program has failed you (assuming there is one). Maybe it works for most people but it didn't meet your needs. There are so many learning styles and ways of learning, perhaps their program isn't the best. By showing that you are willing to learn hopefully your boss will see that you are worthy of an investment in time and training. As others mentioned, ask if you can do some IV time in ER, GI lab, IV team whatever. I once was brought on the carpet for IV skills and had to be "remediated". Since then I've started well over 10,000 IVs and am the go-to guy here at my hospital. You should identify the weaknesses you have that you can work on yourself. Maybe your boss or you could find someone to mentor you. Come up with a strategy and stick to it. If you are getting written up, and ask for help, they would be a poor organization not to respond. Best of luck!
Specializes in Infusion Nursing, Home Health Infusion.
You need to take matters into your own hands now......read every nursing policy and procedure at your hospital and I mean every one. If you do not understand the rational for anything look it up!!!!. I would do this on my own time..this is your survival we are talking about here!!!! Ask to go with an IV nurse for training...if there is no IV nurse ask to go to a pre-op area or ER...make sure you are assigned a nurse that likes to teach..otherwise your experience will not be good..and yes they need to pay you for this..start every IV you can...read the steps on how to start an IV.....this is a skill that takes training and practice and I am sorry your co-workers are being a pain about this....Gosh I have started thousands upon thousands of IVs..and if I got upset about it....I would not have a job..they need to get over it!!!
sounds like you are having a really rough adjustment time. med/surg is physically the hardest work there is to me of all the areas that i have worked. i loved it but learned when to back off and make a change for a few years and then return. not everyone is designed to work med/surg and that is okay. hospitals have many different departments and units and each speciality is different. the pace and intensity is different in each area as well. usually by a year you know if med/surg is right for you.
i would advise one thing though. do not evaluate yourself as a nurse or yourself as a person by only the one area of experience. that would be too limiting and may clip your feathers just as you are about to fly. talk with your nm and cn and ask for a transfer. icu is more hi-tech but does more one-on-one patient care. ratio may be 1:2 but even so, there is a difference. the lines in icu are more often than not central lines, art lines, swans ganz lines. nurses do more line care tasks thained wonderful experiencen peripheral sticks.
there are just so many areas nurses can go into, please don't get down on yourself. you have learned a tremendous amount and have gained a huge amount of skills that you are not giving yourself credit for.
you have wisly recognized your weaknesses, now focus on what things that you do well at onthe floor. what do you enjoy doing? what job interest you. i would see this as a positive opportunity foe growth.
don't worry about the iv thing, experience give that. rome wasn't build in a day. consideer this a learning process, one of many on you walk in life. you will make it. look for what you are intersted in and good luck.
i just wanted to add that if the op has actually had a write up, they she may not be eligible for transfer. some facilities i've worked at have a policy where you can not transfer if you have had any sort of disciplinary action against you.
i agree with others that the op shouldn't beat herself up too much about iv sticks. i've been a nurse for 2 years and just now am working at a facility where there is no iv team or lab team. i wish those where skills i had, but i know they will come with time.
Thank you to all for taking the time to reply with such thoughtful advice. I have given everything here a great deal of thought. I agree that confidence breeds success. I have worked 3 nights since being told I was receiving a writeup and I've been trying to hold my head high. It makes surviving these shifts a lot easier. "Fake it til you make it?"... Very wise.
I should note that I was hired after my hospital shut their new grad program down. I've had to be pretty proactive and independent in my own learning. I had 5 days of general hospital/computer training and 7 weeks of floor training between 4 mentors. We float pretty frequently and I was first floated on my second week off orientation. Right from the start, I've had to ask lots of questions and do a lot of research at home to come as far as I have. I even enrolled in an IV therapy course across town to brush up on my skills. I will ask my manager if I can go to the ER for a day, as many of you suggested.
As far as hospital policies and procedures go, we have a book the size of two encyclopedias available at our nurses station. *Hard to know everything, but I've tried figuring out the most important stuff. I've read the employee handbook given to me when I was first hired. Not everyone sticks to the rules, so things become a little unclear. I will bring this up with my NM.
I have not signed my writeup or spoken to by my NM yet. At this point, I fear I will get terminated, since I am just past my year mark. This is not the first time I've been confronted for making mistakes. I've always struggled with time management, although I do feel that I've made good improvements. Trying to maintain a positive mental attitude. I really revere what I do as a nurse and will push to at least stay employed at my hospital. A few of you mentioned trying another floor. I am still pondering this. A mentor would make me feel a lot more supported. All great suggestions to try, if my manager doesn't fire me. Please keep your fingers crossed. **
nurse2033, MSN, RN
3 Articles; 2,133 Posts
First off, you worked hard to realize your dream, you still need to fight to keep going! There is a lot of advice here, very interesting to read. To protect your job you need to ask for help. Admit your shortcomings but tell your boss you want to suceed. Can they help you improve? As a long time preceptor, my first thought is that the training program has failed you (assuming there is one). Maybe it works for most people but it didn't meet your needs. There are so many learning styles and ways of learning, perhaps their program isn't the best. By showing that you are willing to learn hopefully your boss will see that you are worthy of an investment in time and training. As others mentioned, ask if you can do some IV time in ER, GI lab, IV team whatever. I once was brought on the carpet for IV skills and had to be "remediated". Since then I've started well over 10,000 IVs and am the go-to guy here at my hospital. You should identify the weaknesses you have that you can work on yourself. Maybe your boss or you could find someone to mentor you. Come up with a strategy and stick to it. If you are getting written up, and ask for help, they would be a poor organization not to respond. Best of luck!