Scared.....No Nursing?

Sunshine.nurse · Nov 25, 2018

You have been give some great feed back. =) Probably stings a bit to hear though, it would me if I heard that from my coworkers' about my work. However, best advise, Put your pride and hurt feelings aside-- LEARN from what you are being told by others, and ask that supervisor for details of where your assessments went wrong. And READ your facility's policies and procedures manual.. memorize it. If what the nursing supervisor is telling you differs from the clinical policy.. ask for clarification from the DON. Clincial policies are your facility bible! State scope of practice is YOUR Professional BIBLE, but the clinical portion on what a nurse is expected to do in a particular situation is your daily working bible during a situation. Then FIX what you are doing wrong! It is the ONLY way you're going to survive. No one is ever perfect... not even that nurse with 20 years experience you probably work with..lol You are the ONLY one that can control how fast or slow you work. You are in fact a baby nurse. You will get faster. NO ONE is expecting you to be 100% perfect with your routine down pat. But It is YOUR responsibility to stop and do the focused assessments needed when they are need before calling the doc. Hell, call your supervisor for "a second set of eyes" if you are unsure about what you are observing. It is their job to be that second set of eyes... and it also helps relieve some pressure off you if their assessment is wrong. Remember to document "Charge Nurse at bedside. Or Charge nurse made aware," when they give that second assessment. If meds are late because of another patient's emergent situation, well, your meds are going to be late. Just make sure CN is aware. Remember to BREATH... I did subacute rehab for 7 years, it was a hell that'sfor sure, but it did get easier. All you can do is the best you can. You are only one person. And don't let anyone see you lose your sh*t while on the floor. (I balled at my med cart within the first 30days of being licensed. Looking back, I shouldn't have...I survived.) Subacute is a world unto itself. And nurses in general are usually not nice to their young at first. Good luck!!!!

Sunshine.nurse · Nov 25, 2018

Sounds like you need to find ask the individual providers what specific information they want when you calk them on labs. Or you can keep a running log of the info asked by provider when you called, and use it to help with future calls. PT/INR.. always the current coumadin dose. Write it on the lab results sheet.

bevtag · Nov 28, 2018

But then some labs we call on to give a heads up and providers aren't asking for a full assessment...

It made a doc really mad when I did that. The doc has to put a puzzle together with the pieces you provide. They don't remember the specifics on all their patients. Since you are his eyes and ears, do an assessment before you call regardless. cya

BBP42 · Nov 28, 2018

I remember working at a nursing home where we had to call several different MDs regularly for labs or change in condition, and there was one everybody dreaded calling because he always asked for a ton of information that others didn't and had no patience for waiting if we had to look something up. I learned to line up everything possible before making the call - their chart open to last set of labs, MAR open to their med list, vitals written down, etc. because he was impatient with me once and I never wanted to go through that again. We have all been there. The issue seems to be more with seeing the big picture in order to anticipate questions and that will improve with time and experience. I have seen more than one new nurse who really wasn't bad driven out by similar situations and that is a shame, because if support and education are provided facilities would end up with better nurses and less turnover. I am glad to hear your facility seems to be willing to manage this situation the right way. Don't be discouraged, you can do this if you are open to the advice and training they seem willing to give you!

RNinheart · Nov 28, 2018

I think you need to concentrate on patient safety and on what is really going on.

Daisy Joyce · Nov 28, 2018

If you keep getting dinged for the same things, that's what you need to concentrate on.

Also, your self confidence has been taking a beating, so make sure you're also taking care of yourself.

You're not bad or stupid because you're struggling. You just need to improve in those areas.

dream'n, BSN, RN · Nov 29, 2018

Remember that as a RN you are not only collecting and reporting data, you are also ASSESSING that data. The assessment (critical thinking) part seems to be what you are missing. When calling a lab result to the provider think about what that result may mean...ie: high Potassium level, what does that mean for this patient and what s/s should one look for? Look up hyperkalemia and assess the client for those s/s. What are their previous levels and why was the lab ordered to begin with? Are they on any medications that could be involved in the elevated level? On dialysis? After your investigation of the data, then call the provider with all the information.

I know it seems alot at first to think about with one lab result, but that is critical thinking. That is ASSESSING the data. You will get quicker and it will get easier over time as you gain experience and it will become second nature to you.

Florida Sun RN · Nov 30, 2018

I feel your pain. Four and a half years ago I got my RN. I worked my tail off in nursing homes and rehab facilities. I was told the same thing. You're too slow, no time management, incompetent, don't know how to do an assessment!

the following is another comment I recently posted:

I became a nurse due to a tragedy and I regret it. I will say it ... nursing sucks. Not everyone is cut out to be a floor nurse. Seasoned nurses make you feel inadequate, units are cliquey, managers run you ragged and working nights is the pits if you aren't a night person. If I could do it all over again, I would get a certified medical assistant certification and see how you like primary care and working in a doctor office. I'm currently working in primary care because it is better for me. It is an environment I strive in. Floor nursing isn't for everyone. Get out now while you still can. There is always other areas such as physical therapy or radiology. Whenever I hear someone wants to go to nursing school- I tell them DONT do it.

That at being said, I felt like I could make a better floor nurse if I had a BSN. $10k later, I'm still not good enough. (I graduated BSN in May) I'm still searching to find my niche and I believe it's in a doctors office without the 12 hour shifts, no nights or weekends and a better quality of life. Sure you won't be making $30 but it's what you need to figure out for yourself. Going to nursing school and getting in this field actually has ruined my life so far but I'm trying to continue to find a way to make this work.

jd81pn · Nov 30, 2018

I wish I really knew. All I have ever been told through this nursing journey so far has been the underlying theme of "I'm incompetent". Really hard to find confidence/strengths in that

Did you ask the person who gave you that feedback? Did you ask how you should improve?

Sometimes, there are skills aren't for us but we're good at other skills.

I personally would ask my instructors/supervisors where and how I should improve. And how I should get there. But, I know that some people can be atrocious who want to destroy your self-esteem and confidence. I haven't met that kind of people in my whole life. I just heard stories. I think I'm fortunate I have clinical instructors who are really want us, students, to bring the best out of us. Yes, they can be very very mean if students repeatedly committing offenses (unprepared). They keep emphasizing that we READ and ask questions when we can't figure things out.

I do things that can put patients in danger and get myself in trouble. I learned to listen to what they have been telling me(us students).

Rise from those terrible feelings and move on. Keep going. Think this way, that person wants you to keep your license and keep you out of trouble. If you keep playing it in your head, you'll screw up over and over. You give yourself another chance. What I'm saying is that don't be too hard on yourself and don't judge yourself. Don't make your bad habits become your destiny.

jd81pn · Nov 30, 2018

Remember that as a RN you are not only collecting and reporting data, you are also ASSESSING that data. The assessment (critical thinking) part seems to be what you are missing. When calling a lab result to the provider think about what that result may mean...ie: high Potassium level, what does that mean for this patient and what s/s should one look for? Look up hyperkalemia and assess the client for those s/s. What are their previous levels and why was the lab ordered to begin with? Are they on any medications that could be involved in the elevated level? On dialysis? After your investigation of the data, then call the provider with all the information.
I know it seems alot at first to think about with one lab result, but that is critical thinking. That is ASSESSING the data. You will get quicker and it will get easier over time as you gain experience and it will become second nature to you.

Were drilled with this over and over what to do before calling a provider.

jennylee321 · Dec 1, 2018

Are people using the words "you are incompetent" or "you are not good enough", or are you telling yourself this? Because if that's actually the feedback they are giving you it is not at all helpful. If someone tells me I'm not good enough, what do I do to improve? Be "more good"?

Maybe sit down and think about the specific feedback you've gotten and write it down. Is there any specific feedback that you could use to improve on. If not you need to take that list with you and meet with your supervisor and ask them for constructive feedback other than "you are incompetent".

You are probably in a bit of a spiral of shame and negative self talk at the moment. So in addition to seeking feedback this is something to focus on because it's hard to get better when we are own toughest critic.

kbrn2002, ADN, RN · Dec 5, 2018

Hello All,
I have posted on here several times before, but in short, I am a relative new grad. Only a little over a year out of school. I have failed out of two med-surg orientations. I am currently working at a nursing home and it was going fairly well, up until recently, where again, I am being told I'm not good enough/my assessments are not up to par, I'm basically incompetent. I'm scared and angry..... Everywhere I turn, I am being told apparently nursing isn't for me. This is all I have ever wanted to do. So now I have a nursing degree and very little clinical experience to get into anything like informatics or..... So now I'm stuck. I don't really know what else I have an interest in. I don't know where to go next. I really don't want to be stuck at a desk job or sitting in front of a computer all day. I have a nice nest egg (financially) and I still have my job at the nursing home, (so I don't need to make a decision in the next couple of days) but I don't know if I will be staying. Any other suggestions on where I can turn to? I LOVE nursing. It hurts and breaks my heart to even consider walking away, but no matter what I try, I'm told that i can't do the job.

First, deep breath. As you say you are still employed obviously any issues you are having at work haven't given them cause to fire you. You are by your own admission a new nurse, you should expect to receive some measure of instruction and constructive criticism. As long as the feedback you are getting is geared towards guiding you to improvement this isn't necessarily a bad thing.

Now on the other hand, if your co-workers or even worse your superiors are seriously telling you that you are not good enough or calling you incompetent that is not ok. That is pretty much the definition of a toxic work environment and you would definitely be better off looking for a different job before your self esteem is so shot it has no chance to recover.