Two steps forward.....

Wish i could help, but it is the same for me. "Seat of the pants" nursing due to understaffing due to capitalism.

I feel the same way....I've worked four days this week. Two days were good days...I felt somewhat competent, eveything was pretty much done on time, and I had time to have meaningful interactions with my patients. The other two days were horrible.....one of those days was today and I questioned my own sanity for wanting to become a nurse!

You are not alone!!! It will get easier (at least that's what I'm told!)

I'm in the same boat as you guys.....

Some days I feel like I'm great at my job, informed, being compassionate etc...

and then the next day, I'm running around from the SECOND I take report to the exact moment I report off to the next shift...and in between those times, I feel misinformed, rushed, incompetent, and unfocused.

I decided I'm going to start a "Positive" journal... write down every situation where I've felt confident and have made a difference.... in an effort to stop dwelling on the negative.

Hang in there, we'll make it through, and siiiggghh at how nervous we were, 20 years from now!

"I decided I'm going to start a "Positive" journal... write down every situation where I've felt confident and have made a difference.... in an effort to stop dwelling on the negative."

That's a great idea. Also, i go over the events, good and bad, on my day off so that i can either avoid and learn from mistakes and re-inforce what worked. There just isn't time in the moment (or in the 12.5 hours!!)

You took the words right out of my mouth! That is EXACTLY how I feel after almost 2 months on my floor. I am going to be on my own starting next week and I am really nervous....my preceptor is great and says to just hang in there on those bad days, you learn more than you think from those experiences.:nurse

I feel the same way as well. I've been on my own for 2 months. The hardest part of my day is now giving report at the end of the shift when I am dead honest about what I wasn't able to get to. I get rolled-eyes and heavy sighs. I am getting the silent treatment from one night nurse because we hand off our admissions, no one stays to finish an admission, you hand it to the next shift. I gave her and admission that was 80% complete last night. I hustled to get that 80% done. I gladly take admissions from the previous (day) shift, but our night people act as if we should stay and finish every last detail. Some of the 'seasoned' night nurses act as if we were sitting around all evening. My unit had a highly dysfunctional family return to the floor this evening causing chaos. I still feel incompetent - I blew the vein of a young patient, I still suck at IVs. Thanks for starting this thread - and giving me a chance to rant.

Really...

I've been on my own for a month now. Since that time I've taken six patients, at the insistence of my preceptor and nurse manager - BUT - the night charge nurse has been assigning me 7 and 8 patients, and I've tried to reiterate to her on more than on occasion that I am only supposed to be taking six patients until I am comfortable with that number (I'm still not).

This week I went in and was assigned seven patients. I tried talking to the charge nurse who was not at all kind about it. I accepted the assignment, knowing fully that it was my own choice - albeit a desperate one. I went home in tears.

The next night I had six patients and the night was an absolute breeze - easy group of patients. I had time to review charts, pull together a decent report, do the MARs in record time... it all went so well... AND I was able to help the oncoming shift with a few things - running to Central Supply before I left, making their day a bit easier. I left with not only a smile, but a shred of confidence that I've been lacking for long, long time - and a HUGE smile.

I talked with my nurse manager again about me having 7 patients. She expressed concern and said that I should only be taking 6 patients. I told her that wasn't always the case. She told me I needed to be sure I was telling the charge nurse this. I let it go. That evening I was assigned *8* patients. It was awful. Several of the patients I already knew and a family member kept telling me how rushed I was in comparision to all the other nurses on the floor (who had their share of patients) - that was hard to hear. I simply told her I was busy (I was) and was just working on getting the evening work done. The other patient was an angry, belligerent man who was on the call light all night long - and telling me taht I didn't know how to read orders, that I was a time waster, that I didn't get his needs met appropriately and that I didn't know what I was doing.

At that point, I didn't... I had 8 patients and it was just too many after one month being on my own... Many of my patients are total care, Neuro checks on one every two hours, seizure precautions on the other, Neuro's four on another, charting, assessments, MARs - you get the idea.

So - by the end of the shift, the oncoming nurse - bless his heart - took ALL my work from me and finished it. All the errors - for example, I told him a patient was due for dialysis that day, the oncoming nurse expressed that he didnt' think so, and so, I figured he was right since he'd had that patient before - not so - I was right and before I left the floor, the patient was being taken to dialysys and the oncoming nurse was appropriately frustrated. There were other things like that, too...

Bottom line - I took too many patients - and yet - if I refused - how would I escape retalliation? Then again, I need to protect my license.

B/C I don't like whining without a potential solution in hand, I am looking for advice/validation. Here are my observations and plans:

1. I feel woefully uneducated to handle this. I spoke with human resources last week and HR told me that there is an internship program at the hospital. I told her I didn't realize there was one and would it be possible for me to participate. She said she didn't tell me b/c the floor where I work has a "negative vibe" and that she wanted to bring in more positive energy to the floor - that would be me. Now I find I am not elligible for an internship and that, yes, HR should have told me about the internship opportunities there. Had I not been so new to the nursing industry and had I actually known about internships, I probably would have asked, but, bacn then, I didn't know what I didn't know.

2. I need to change something - 8 patients (for now) is too many. I may either transfer to a different floor or may go to a different hospital altogether.

3. I may go back to school. I feel that there are a lot of things I didn't learn in nursing school (classroom or clinical). I think a lot of that has to do with my lack of experience (of any kind) in the medical environment - and that I'm a mid life career changer.

The other night was an eye opener for me... How my work in nursing has gone from "it's all about patient care" to "I can handle 8 patients" - without regard to the patient, but rather, the primary focus being on *ME* surviving the night with all patients breathing in the morning. That's rough, folks, when it gets to the point of me not seeing my patients as human beings. Something has got to change and it's got to be me.

Once again, advice is appreciated. Oh, please understand that I am extremely hypersensitive - I already feel like I've been beaten with a sledge hammer - I'll try not to bite anyone's heads off.

Take care,

Shawna

slangdell- i feel your pain. i am interested in what seasoned nurses may respond to your quandry. itoo am a career changer and it blows my mind that with very little training we are put in situations such as what you describe. i have to say that there maybe and by maybe i mean hopefully will be--a floor or hospital out there that actually trains new nurses, not throws them to the wolves so to speak. to any seasoned vets out there---is every floor like this? they don't care much that you dont feel fully educated and prepared they just need bodies to get patient care DONE.

what would you be going back to school to study? just curious.

is this how hospital nursing just is? because from what i have seen, major changes need to happen in nursing. god bless all of those who continue to work in such dire situations. i also think it is harder for 2nd career nurses but htis is just my opinion. most of us come from places where there if there is dysfunction its not so evident. the way drs. talk to nurses and the like...it blows my mind.

anyhow i would suggest finding a different fit. life is too short. what keeps you there money? other positions offer money. time? time is of the essence and wouldntyou rather spend it learning not just doing? experience? every situation offers experience.

look we all know floor nursing is hard but i have tos ay that if it feels that rotten, why do nurses stay???????

The general culture in nursing tends to be "if you can't get it done, then that's *your* problem". I'm hoping the new wave of second career new grads might feel more empowered to help change this. They have worked in other fields and may be more confident in their overall abilities (outside of experiential skills that can only be gained with time and exposure) as opposed to believing it when managers tell them it's *their* deficit. They have previous professional work experience and expect to be treated professionally and may be less likely to accept the type of disrespectful communication that too often goes on on a nursing unit. And with the high cost of many ABSN programs, if their graduates are dissatisfied with the outcome of their education, they might be more likely to make their dissatisfaction known, as opposed to traditional students who are often made to feel *just lucky* to have the opportunity and they'd better *keep their head down* if they want to make it through.

Anyway, this has gone a bit off topic from the OP. I feel for you and hope you find a way to make it through. Maybe later you can help fashion a better transition for new grads.

Thanks all for saying that you're mid-career changers. I'm a mid-career changer too! Some say "Re-tread nurse". I was never a nurse's aid, just my ABSN program, and bam I am hired. At first I felt unqualified even to give report to my nurse's aids, but I value every one of them, and treat them with utmost respect, and ask them to show me and help me and I admit I was never an aid, and they've come to respect that. I have trouble dealing with physicians with an attitude, I can usually always deal with upset patients/families, but I can't deal with poor (egotistical/arrogant) behavior from physicians. There are positives and negatives about bedside nursing, though the negative things may drive me to another area within healthcare, maybe a masters, maybe something that values my BSN.

I'm getting that it's pretty normal for new nurses to feel completely inadequate, and to feel badly when giving report and getting eye rolls and sighs for all the things that didn't get done. I think, for me, I'm getting to the point where feeling off kilter doesn't feel quite so uncomfortable anymore, and if someone wants to have an attitude because I wasn't able to get to something, it's their problem.

I went through a stage when I first started working, where I really felt that my patient assignments were inappropriate for my licensure and experience (brand spankin new LPN). I had to advocate for myself on many occasions, reminding my charge nurse of things outside my scope of practice, and getting help from others when I needed it.

I am so thankful that I have such a supportive group of people to work with. The culture on my unit is one of mutual respect and teamwork. If not for that, I would not have stuck it out after those first few horrible months.

The more I read here about new grads getting teams of 7-8 high acuity patients and unsupportive and downright toxic work environments, the luckier I feel.