hello all, i am in need of encouragement, as i get none from work. i was a float nurse at a small local hospital for a year. i learned a lot while i was there, but there was only so much to learn because it wasn't a trauma center and a majority of the pts were in the geriatric population and i basically saw the same things over and over again. i decided to branch out and get a job in the emergency department at a level one trauma center.
i feel as though a made the biggest mistake of my life and wanna quit nursing all together. my orientation was three months. the way this ed is broken up is that there is a main ed, non crit pts, a peds ed, an urgent care ed similar to a walk in clinic and the trauma/crit ed. i have been on my own about 3 wks right now and it has been nothing short of a disaster. there is no team work. a lot of laziness. tons of favoritism. i have been relugated mainly to the main ed which is fine, but i always seem to get pts that don't belong in that area. i thought i was doing a good job. my pts like me, i am pretty good at anticipating what the pts dx is gonna be. so i set up accordingly for the docs. the last three shifts have really had me not wanting to go back. infact i have been trying to get a job at my old hospital.
i know the day shift is busy and we just converted to a computerized system, but the things that i have been walking into. have totally left me disgusted. i take report on 5 pts. the previous rn has left me everything to do on these pts. out of the five, four had to be lined and labbed. some weren't even assessed and they had been there atleast four hours. no excuse. i let it go, did what needed to be done and that was that. the next night, i walked in and started off fresh. yet again i pick up 5 ppl immediately and have to totally work them up. as i am still pretty new to all this it took me a little time, but i knew who needed to be treated first etc.
about an hour into my shift the night manager tells me that i need to pick up my pace bc i'm to slow. too slow? the four other nurses on my side had 3 pts each and they were all admitted already. i was so upset, i took a minute to gather myself and tried to explain the situation and he didn't care. so i then pick up 5 more pts to get him off my back. still i was the only one running around like a chicken without a head.
noone communicates. i get a call from the or asking for report on my pt who was going for emergency sx. ummmmmm what?????? the er attending never even told me. he gave me the impression she was going home. so now i look like a jerk to the or. great!!!!! i rush to draw the type and screen, do the pre op check list and send her off.
at 630am some ppl feel as tho they don't need to pick up pts anymore. so yes i pick up the last two. i assess them, line/lab them and make sure that my relief has little to do bc i am giving off 8 pts to start their day. even if i was giving off just one i would make sure everything was done. i hate leaving things unfinished. it is not right and just plain lazy. i am in noway saying i am a super nurse, bc quite frankly i think i am a terrible nurse. the only thing i know i rock at is my relationship with my pts. they all seem to like me.
idk what to do? i am going to leave this job as soon as humanly possible. i go to work to work, not to socialize with my co-workers. i am there for my pts and their families bottom line. i try to make friends with the ppl i work with and they are so cliquey i feel like i am in hs. i cry everyday when i have to go in. sometimes i am made to feel like i am useless there. i hear people talk about me. i am usually a hot head, but i choose to ignore them bc again my pts matter, not these ppl who just wanna bash every new person who starts there. bottom line, one of the floors i used to float to at my old job wants me to work there.
problem is, as much as i loved the team work, my co-workers etc, i won't learn much, and will lose a lot of my rn skills bc it is a behavioral science floor. i am so torn. i love the work and learning in the er, just not the ppl i work with. i never realized that that is what can make or break you. it has broken me to the point that i want to give up nursing all together.
sorry for the extra long post, just needed to vent. thanks to all in advance!!!!! ; )
staff note: paragraphs have been added for easier reading.
You sound like a great nurse. I don't think you are experienced enough to be told to speed it up. I have always heard that the ER has a huge learning curve-worse than that of the floors. Plus it sounds like you have to pick up other peoples slack from the shift before. If I had a patient for 4 hours and none of the admit was done I would hear about it. In my facility if the patient comes up a half an hour befor the end of shift I am responsible for the admit data and admission history. I usually cannot get all of this done in a half an hour so I have to stay late.
Is there not some kind of guide lines as to who must have what done if the patient comes to you at certain times on one's shift? I mean having a patient for 4 hours and not doing any of the paperwork or labs, etc. sounds kind of fishy to me.
I know it is hard to speak up as a new nurse but it sounds like you are being taken advantage of by the previous shift. Some people will continue to take advantage of you until you speak up just because they can. Some people ar just plain lazy though I have no idea how nayone can be lazy as a nurse.
I really feel for you friend. it's not easy. As a new grad i'm struggling with my own issues. I really wanted to be a mom/baby nurse, but I got stuck on a med/surg floor and hate it. i just have to take it one day at a time. I know you are a great nurse! if you need to find another job, then do it. don't stress yourself out over it.
we all support you here on the forum! we all need support and eventhough we don't know each other, it's important to let you know we are behind your 100%.
About an hour into my shift the night manager tells me that I need to pick up my pace bc I'm to slow. Too slow? The four other nurses on my side had 3 pts each and they were all admitted already. I was so upset, I took a minute to gather myself and tried to explain the situation and he didn't care. So I then pick up 5 more pts to get him off my back. Still I was the only one running around like a chicken without a head...............At 630am some ppl feel as tho they don't need to pick up pts anymore. So yes I pick up the last two.....
I learned during my time as a travel nurse that if you don't speak up about it at times like this, when its happening, then you'll become the donkey of the unit and find yourself in these situations day in and day out. What makes it worse is, managers will turn a blind eye to the improper assignment making and turn the ones who abuse you into heros. "Look at Sally, all her I/O's are done and she remembered to fill out the belongings sheet someone else missed. Why can't you do it too?" Nevermind that Sally had four patients and I had eight.............the eight worst patients on the unit to boot.
Unless you put the problem of improper assignment of patients in the lap of your manager (where it should be), it'll continue and you will never get any credit for carrying more than your fair share of the load. I often brought up the poor patient assignment making to the manager in the middle of, (sigh) another meeting about some obscure piece of paperwork no one does that I missed (but I was expected to because "You are a travel nurse and expectations are different for you.") I would conclude the meeting with a very calm tone but my meaning/point was as follows:
"I do understand this (tongue in cheek) paper is very improtant to you, I don't deny it's usefullness to the pt. care process (tongue in cheek so hard I am bruising my mouth). Unfortunately, I am unable to get to it due to the workload placed on me by your unit. I not only take the most patients, but I take the most acute and most disgruntled patients. Quality, with assignments like this, is bound to slip no matter how much I exert myself. If you wish for me to pay more attention to details such as (the form no one else does) I will need your cooperation with a more fair pt. assignment. Otherwise, I can sit here and tell you I am going to do it, but the reality is, it won't be done."
Some managers got the point and got on the charge nurses about assignment making. Some insisted such staffing practices did not take place on their unit (to which I always responded "Sure they don't, sure"), but they stopped worrying about (the form) not being done. One, yes, only one, called me out and said I was lying and said she was not renewing my contract. I giggled to myself as I recalled I had already booked my next assignment and resigning me was already off the table.
Completely agree. If you do not stand up for yourself, other nurses will have no problem letting you do their work for them. They also are totally ok with letting you take the fall for their mistakes. This happens at my work to the new people all the time and I work in a nursing home. One of my friends says she wants to be a nurse because it was inspiring how I used to be shy, quiet, and a bit of a doormat, then after I became a nurse I began standing up for myself and don't let people get away with treating me like crap. :) I just got sick of being blamed for everything and doing more work than everyone!!!! One way NOT to advance in nursing is to play a martyr or doormat. I hope this doesn't hurt your feelings. I know you want to do well, want to learn everything you can, and want to seem capable. You may have to forcefully stand up for yourself a bunch of times to get the point across but once you do, people will be a lot less likely to try to walk all over you. But the longer you let yourself be used this way, the harder it will be to get it to stop. And it's hard to get your supervisor to stick up for you because all they care about is (most of the ones I've worked with) that the work gets done. They don't care if you do 75% and Nurse Sally does 25%. And if Nurse Sally gets only 15% done you'll be blamed because you are new.
You don't have to be mean about it. Just state the facts. I have Pt A who needs xy and z. Pt b needs this. I'm doing that. Then, when you are maybe done earlier than the other nurses, offer to help. That way they are more likely to offer to help you when you need it.
I urge you to try this and stick with it for a while before switching places. You will find this everywhere. It's part of nurses eating their young. You can do it!!!!!!! And then just remember this when the time comes around that you are the seasoned pro and there's a newbie around.
In some places of employment, some people just want to see others struggle and fail. I just came to a conclusion this is a part of life. Everywhere you work there are going to people who are in certain favoritism groups. These people also hang together when they are off from work. I know some that takes vacations together. You have choices and options. You can either stay to work or leave. I know can find something better and less stressful. What specialty would you like to work, if it is the ER you may need to find a different ER? Good luck.
Lets give this poster a break guys! She's a relatively new ER RN and as we all know it does take several years to become comfortable in a level one trauma center. Add in the new computer system and you have a recipe for added stress for the nurses and providers.
To the OP: It does take time to develop organizational skills. There is nothing wrong with saying "no, I can't take another pt until I get theses three or four worked up. I can't provide safe care if I take another pt." Since you have just been off orientation a short time, do you have a mentor or someone you can trust to go to with questions. Believe me, even with many years into nursing, I still ask questions. However, if you feel that you just can't do it or the environment is too caustic, get out. There is nothing wrong with telling the manager that the unit is very closed to new nurses and that is the reason that you aren't staying.
Again....everyone, cut these posters some slack. Have you never had a very frustrating moment or day or shift or week or month???
About an hour into my shift the night manager tells me that I need to pick up my pace bc I'm to slow. Too slow? The four other nurses on my side had 3 pts each and they were all admitted already. I was so upset, I took a minute to gather myself and tried to explain the situation and he didn't care. So I then pick up 5 more pts to get him off my back.
Your manager told you that you needed to pick up your pace, how did taking on 5 more patients do that?? I would have consentrated on the patients I currently had and left the rest for the Nurses who had less patients. But then, I don't work the ER so I really don't know the routine used there. Sometimes if you try to do too much at one time, co-workers don't see it as you trying to learn or help out, they see it as you trying to "show-off" by being better than them. While this is not always what is happening, it is what they see. Is it possible to that there is any of the Nurses that you can talk to about this?? Good Luck & God Bless
Really?... you old farts need to put on your reading glasses. Oh, that's right, I forgot to get mine... OK, I'm back. LOL.
(return)
To be a good listener for someone who is very down, you need to accommodate a little.
(return)
You gotta realize that fussing about this kind of stuff when the OP is so upset, is a lot like Erick's example of the NM who just has to have that belongings list...
You sound like a very competent nurse who happens to work for a fast paced trauma center. It takes time to learn the ropes and feel comfortable in your new surroundings and new position. If this is really what you want to do, please don't give up just because things are hard.
Everything can become a learning experience, and every experience is there to teach you something. It seems like there is a vast amount of knowledge to be had in the trauma center, and it is definitely not a place for the faint hearted. You can do this if you really want to, YOU just have to believe you can do it! Hold your head up high and know that every day you strive to be the best nurse you can be!! :redbeathe
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
BECAUSE WE WANT TO HELP AND IT'S HARD TO READ AND YES I AM SHOUTING! I can't help if I'm struggling to gain the ins and outs of a thought process from the OP that could easily be fixed as paragraph form!!!!!!!
This is not, NOT too much to ask to hit the gosh forsaken enter key, takes one second. GEEZE!
Deep Breath..........change the txt size on your computer and scroll from the top of the page 3-4 sentances at a time......it really helps.:)
Us old chicks have a hard time with the font sometimes:lol2:
To the OP..........You poor baby:redpinkhe........the ED can be an intimidating place. Mostly from the staff. They are a hard core bunch of very strongwilled, opinionated, and sometimes jaded individuals. They have seen it all and delt with it...................they can be very intimidating. Unfortunately, the ED is one of those places that tend to eat their young. The behavior boarders being called a hazing type of initiation. Some staff have the tendicies to feel it is their job to put you through the paces to be sure you belong. Is it right no, does it happen, yes. Everyone is watching you to see if you "have what it takes". From your post YOU DO!!!!!!!!!! Take a deep breath stick with it you will thank yourself in the long run. Give it a year. Talk to your manager and tell her some of the issues. That ED Doc should have told you about the OR:mad:, if he had done that to a seasoned staff he would leave the conversation without limbs attached.
They are testing you to see if they can trust you and can you hold your own. Is it right ? NO, but in a fast paced critical enviorment there needs to be trust developed over a peroid of time. They will back off, eventually........in the meantime, Smile,be polite, but don't be a carpet! stand up for yourself.....politely. Level one's are really hard core and they are accustom to people comming and going and making sure the residents don't kill anyone every 6 months. You sound like you are doing fine......have a good cry now and then and move on! I can remembeer when I started to the ED there were weeks I would cry every night on the way home from an inner city ED.
There will always be those "old" ED nurses who are too hard core and sometimes lose compassion. I can usually spot them from the parking lot. I have always loved the ED:redbeathe.......You are never canceled,you are never floated,and now matter how miserable a patient can be you know that they probably won't be there tommorow......the go home, to the floor, or to heaven (or hell). Stick to your guns.........they will eventually lighten up. If they don't you now have a years experience at a level 1 trauma. The ED world is now at your feet!
Paragraphs PLEASE! Most people will not bother to read your post as it is. Nurses are supposed to be able to write like professionals. Paragraphs, punctuation, spelling and grammar still count in the real world of professional employees.
A letter of application sent to me in the format used in the OP would go directly in the trash.
Wow. This thread is mostly about why her essay is not divided into pragraphs. Yes, I find paragraphs easy to read but she probably forgot to write in paragraphs. People forget things. No one is being mean, they are helping her so next time she posts she can use paragraphs.
.......in the meantime, Smile,be polite, but don't be a carpet! stand up for yourself.....politely. Level one's are really hard core and they are accustom to people comming and going and making sure the residents don't kill anyone every 6 months. You sound like you are doing fine......have a good cry now and then and move on! I can remembeer when I started to the ED there were weeks I would cry every night on the way home from an inner city ED. 
sistasoul
724 Posts
You sound like a great nurse. I don't think you are experienced enough to be told to speed it up. I have always heard that the ER has a huge learning curve-worse than that of the floors. Plus it sounds like you have to pick up other peoples slack from the shift before. If I had a patient for 4 hours and none of the admit was done I would hear about it. In my facility if the patient comes up a half an hour befor the end of shift I am responsible for the admit data and admission history. I usually cannot get all of this done in a half an hour so I have to stay late.
Is there not some kind of guide lines as to who must have what done if the patient comes to you at certain times on one's shift? I mean having a patient for 4 hours and not doing any of the paperwork or labs, etc. sounds kind of fishy to me.
I know it is hard to speak up as a new nurse but it sounds like you are being taken advantage of by the previous shift. Some people will continue to take advantage of you until you speak up just because they can. Some people ar just plain lazy though I have no idea how nayone can be lazy as a nurse.
Hugs to you