take flight or stick it out in telemetry

[ineedavaycay]

Hello. Now I am a happy person. I am a people person and love caring for others and I never let anyone get to me. Being in psych for over 3 years has helped me overcome the most difficult of people. Before psych I worked in home care for 2 years.

I thought I landed my dream job. So much to learn.

Now I am about to come off orientation on a tele floor soon. The first month was difficult, I cried and just thought I couldn't do this but still learned so much. Then I went on to night shift and my new preceptor helped me with a fast routine and taught me so much. But now I can tell he just don't want to deal with me. He has been condescending even on a personal level and he is extremely ocd. In the beginning his ocd was helpful to learn routine n how to do things right. I am relearning everything. It may be harder for me than a new nurse because I haven't been dealing with medical in forever.

One day I had someone else and I had no anxiety and had a great night. She is such a outgoing nice person. I felt free to talk to her.

and then after her I had HIM. It was the worst night ever. I wanted to cry n quit. Then I heard someone else talking negatively about me. Then I had an emergency. The night got worse n worse.

I cried in my car, at home and the next day I was a zombie from depression n confusion.

I don't know if this is for me. Is it the floor? Am I going to be able to handle this? Am I just dumb and forgetful? Should I tell my supervisor I can't handle?

Should I try for an ortho floor ? Or some other floor without such fragile patients???

I have 2 children and bills and a school loan to pay but am not happy. I feel incompetent and dumb.

[jadelpn, LPN, EMT-B]

Nights are tough to get used to. The start of any acute care job in an area that is not familiar is also tough. You have only been doing this less than a month. Psych and home health are who different ball games, so give yourself time.

Take what was given to you and you can use, throw the rest away. When you are your own primary nurse and you continue to practice, you will find your niche.

With all that being said, I am more prone to psych. The thought of cardiac is daunting, is OH so not my thing, and I just don't find it an enjoyable part of nursing. Could it be that you are just not that into cardiac?

Don't cry in your car and get all worked up about other people's issues/ocd/foolishness. Go in, do your thing, and leave. Take a look at if, with your experience, cardiac is a good fit for you. It may be if you LOVE cardiac (

You have been a nurse for 5 years, lots of experience, think about where else you may want to go/do if this is not happening for you.

Best wishes

[ineedavaycay]

Thanks for your reply.

I really wasn't sure what I liked. I figured let me get in whatever I can and learn and see what I may like. I really liked the fact I can learn so much on this floor. But I feel that the rapid responses are extremely stressful and throw me off. And an emergency, someone who is tachycardic at 150 and needs your full attention and everything involved in that.....is giving me a heart attack! They throw me off. There has been 2 nurses who quit since I've been there. It's a ton to deal with.

[PacoUSA, BSN, RN]

I'm going to go ahead and answer your question of "Is it the floor?" ... It quite possibly may be. But at the same time, it could also be complicated by the fact that this is your first real experience on a medical acute care unit. You were a psych nurse and a home health nurse for the last 5 years. Telemetry is definitely a brand new animal for you, and the patients you will encounter are unlike any of those you will have ever seen (home health possibly would have seen typical patients there but not as sick or else they would be on a tele unit). I'm not surprised that you are having a tough time at it, it's a new environment and a different style of nursing than you are accustomed to. In some respects, you're probably feeling like a new grad all over again. And maybe a prior poster is correct, maybe this is not a specialty for you? I can tell you this tho ... Sounds to me like you have had some awful preceptors! That can make or break your experience. My preceptor on orientation was more interested in courting his future girlfriend by text than overseeing my orientation on the unit, and another nurse opined that he clearly let me go on my own sooner than I was ready. So in essence my training was trial by fire.

I am a telemetry nurse, have been so far for my entire three years of nursing, and I agree that it can be stressful because you never know what's going to turn on a dime. A walkie talkie patient can suddenly collapse with VT or an a-fibber can suddenly go RVR. This is why they are being monitored, and this is why we have to be vigilant and act fast. But I should say, you have to want to do this kind of nursing, it's not really a specialty for the weak of heart (pun intended). I say give it some more time and stick with it for at least 6 months because it does take a while to get it. With your background, you really do need more time to absorb the acute care setting. You have worked with relatively stable medical patients your whole career, so it's no surprise that you would get unnerved with a rapid. The experience with those comes with time. By the way, what kind of ratios do you have? If it's high, that can only add to the stress.

I'm different from all of you in that I love cardiac! ❤️❤️❤️ ... My goal is to advance later into critical care, a CCU or maybe in ED. And different from all of you is that I hate psych! LOL! I never have and likely never will. I once had a psych pt transferred to my unit because he had to be on dialysis. His primary psych dx was schizophrenia, and at times he seemed like a time bomb, I did not like dealing with that at all. I would not be happy just working with someone's disabled mind, I prefer fixing other failing organs. I mean I know psych pervades every nursing specialty, I just can't work with psych being the primary nursing focus. Besides, I love scrubs 😝

That's the beauty of nursing, there is something for everyone as individual as they are.

Sent from my iPad using allnurses

[GuEsT78]

Perhaps the big question is whether this is an adjustment/poor supervisor/orientation issue or a genuine mismatch between your personality and this new job. The former could go away over time. The latter never will.

We can't tell which this is from far away. Is there someone at the hospital that'll help you sort this out, perhaps your former supervisor on psych or a wise friend that you've worked with and knows you well?

-----

A friend of mine wasn't a nurse, but was in a similar situation to yours. She had been a customer service representative for a large credit union. Because it paid better, she moved into a position screening people for loans. She hated it. An extremely helpful person, she'd been a great fit for customer service. She wasn't a good fit for her new position, where she was expected to be critical of people, to look for potential problems, and to turn down loans applications.

I couldn't imagine her boss not being delighted by the work she'd done as a customer service representative, so I encouraged her to talk to him about her troubles. When she did, he not only let her return to her former and much loved position, he let her keep the raise she'd gotten.

------

People do differ in ways that make for work incompatibilities and that is particularly true of nursing. Someone who loves the high stress of a CCU or an ER may not adapt well to a psych or orthopedic unit where far more patience is required and vice-versa. ER is all adrenaline rush. Psych may mean weeks to see even a tiny change in people.

I know when I oriented on days as a Nurse Tech on a medical unit, I hated all the busy work that involved. Nothing I did seemed to matter much. In most cases, all we were doing seemed to be helping kids get well a tiny bit faster and with a tiny bit more comfort. I thought about quitting. The outcome, a well child, was never in doubt.

Then orientation ended and I went on nights. There I discovered what the hospital had not told me (perhaps deliberately). I was assigned to a cluster of rooms on that unit caring for kids with leukemia and sharing my slot with a third-year nursing student. Within hours I feel in love with that work, so much so that I recently wrote a book, My Nights with Leukemia, to encourage nurses to consider pediatric oncology.

Why did I love it? Because there what I did mattered enormously. I could literally make a life and death difference in the lives of those children. And because over the space of weeks I got to know those kids very well—something that would not be true of an ER—it had a special meaning. The work was high stress, but it also brought with it a high sense of fulfillment. That was a perfect match to my personality.

People differ. Some people are broadly adaptable, able to work almost anywhere, and some aren't. There's nothing wrong with having a more focused personality. Not being able to do some things well means, in most cases, that you'll do other work exceptionally well. As you move around into different areas of nursing, you'll learn that. This isn't a disaster. It's a learning experience.

Also, keep in mind that, while it never feels good to tell bosses and potential bosses "I can't do this...," showing that you've got an awareness of your limitations can be a plus with the hospital administration. It spares them the painful duty of starting that sort of conversation, particularly since you can suggest alternative assignments.

You're asking the right questions about your fit on the unit. You need to settle on answers before the potential frustration for you and them gets out of hand. If you can adapt, then adapt. If you can't, then that move to Ortho makes sense. I imagine it's also a unit where patience matters more than coping with outlandish levels of stress. I later worked with teens who'd had orthopedic surgery and patience was definitely a plus in caring for them. I had to keep reminding myself that, when I walked them to the toilet, I had to move at their speed not mine.

[ineedavaycay]

Thanks for your reply. My first preceptor said it's going to take me awhile. She said the same things. The ratio can be up to 1:7. The only reason I liked psych was because of the children. I think the cardiac is very interesting. I really don't mind constantly doing work, the time goes by fast. But some of us stay 2 hours extra because it was so busy. Someone told me the census is down in the summer so stick it out. I'm going to see how it goes when I go in this week. Hopefully I can suck it up and ignore negativity.

[ineedavaycay]

Wow. Thank you all for your responses. They are tremendously helpful. I am so glad I posted.