struggling with med surg expectations

[sleepdeprived1]

I recently transitioned from psych inpatient nursing to med surg. I quit my job in psych - working there for a year as a new nurse. I didn't want to lose my nursing skills and wanted to be involved in more acute medical care nursing. I applied and got hired on a busy medical surgical unit of hospital and although this is my fifth week of orientation, I have only had 10 days on the actual unit. The other days were for trainining,equipment,and computer classes... I feel that I am doing my best to improve and catch on quickly (it does take me a little longer to learn things , im not a "see one, do one, teach one" type of person and I don't feel that is safe practice anyways.

Well, my last week of 3 days training were kind of "rough" and did review at home iv pumps, computer charting, etc..this week when I came back to work I felt my confidence was up more at ease, although I guess I still appear nervous to others. I have been given 3 patients to care for and I am still falling behind. It seems like multiple issues keep me distracted and have been late on administering medications today.

My NM called me in her office and spoke to me about how she feels that maybe this is not the right fit for me..etc..bottom line is it sounds like I am going to be fired UNLESS i can prove that I can take care of 4 patients next week without issue. I just feel that 10 days into orientation is so short with such high expectations. I am NOT one to give up and I continuously strive to manage my time better and prioritze.

I am scared for next week. I need to be able to take care of 4 patients without issues or late med administration. I understand NM perspective but really had to hold back tears and choke it up to finish my shift. I was hurt to hear that other staff had "concerns" on if I would make it. I don't feel like I am getting enough feedback until now -that it seems too late. I was also given a "checklist" for orientation with weekly reports on my progress.

I have yet to see a written eval or check off on anything. It is basically sink or swim. and I have been sinking. I feel that they think I am "sinking" because I ask a lot of questions. If I have not done a skill since clinical and/or only read in textbook I want to ensure safe practice and barely feel like 10 days is sufficient for me to practice as RN on unit.

While I am hurt that others (not only nurses supposedly) are saying im less than adequate I am also saddened that I quit my previous job and will probably be fired next week unless i can care for 4 patients on my own without any issues. I just don't understand how healthcare is safe anymore with this mentality/demand on nurses. It is expected that I will be off orientation in 2 more weeks. (6more days, which would give me a total of 16 days orientation on a busy med surg floor-is this typical???-in psych i had 30+ days...)

[lynds80]

Thanks Esme..if given another chance I will use these..I was sent home today and told that this unit was not the right fit for me and that I wasnt making enough progress yesterday i had 4 patients and struggled some and then got an admission which i still struggle thru the computer admission process.and trying to remember my other pts. i still have my preceptor had me go to first patient room in morning administer all meds for time do am assessment and do all am charting on these in room then go to pt. 2 and do same and so on...well by the time i get to patient 4 its a little late and then expected to go to patient discharge meeting which im forever late for or miss..sounds easy but maybe still a bit slow with charting entire am shift assessment...thought itd be better just administering meds doing am assessment noting abnormals to chart..after all meds in on time then going back to chart but then id prob. be behind too ..oh well..in the process of finding right fit for me..obviously 15days med surg training wasnt enough or too chaotic for me

Sorry to hear it didn't work out for you. Chin up something g better is out there for you!

[Esme12, ASN, BSN, RN]

Thanks Esme..if given another chance I will use these..I was sent home today and told that this unit was not the right fit for me and that I wasnt making enough progress yesterday i had 4 patients and struggled some and then got an admission which i still struggle thru the computer admission process.and trying to remember my other pts. i still have my preceptor had me go to first patient room in morning administer all meds for time do am assessment and do all am charting on these in room then go to pt. 2 and do same and so on...well by the time i get to patient 4 its a little late and then expected to go to patient discharge meeting which im forever late for or miss..sounds easy but maybe still a bit slow with charting entire am shift assessment...thought itd be better just administering meds doing am assessment noting abnormals to chart..after all meds in on time then going back to chart but then id prob. be behind too ..oh well..in the process of finding right fit for me..obviously 15days med surg training wasnt enough or too chaotic for me

I don't think they were fair to you......you went from a new grad to psych. Going to med surg is like being a new grad all over again especially since you never worked med surg. I think they should have been reminded that you never worked med surg and needed at least 30 days.

The way hospitals act these days makes me sick. I'm sorry ((HUGS))

[SnowboardRN]

That makes me so sad that they treated you that way. :-( I have been a nurse for two years in a SNF and then started working on tele. They gave me ten weeks of orientation, and i didn't start taking on 4 patients myself until the 7th week! (full time training) Just don't be too hard on yourself, it sounds like their expectations were not reasonable at all

[lynds80]

That makes me so sad that they treated you that way. :-( I have been a nurse for two years in a SNF and then started working on tele. They gave me ten weeks of orientation and i didn't start taking on 4 patients myself until the 7th week! (full time training) Just don't be too hard on yourself, it sounds like their expectations were not reasonable at all[/quote']

Wow! I had 4 PTs by 3 wk of orientations and no na's.. That means I would do all the RN work, aide work ( brief changing, q2 turns, sugars, weights, vitals, all my own lab draws). And this was a midnight shift. I couldn't handle it all. I had literally 3 diff jobs to do. Needless to say I left my anxiety was through they roof... Too much for a RN let alone a new grad...

Don't be to hard in yourself their loss! I hope you find something soon!