When you have done all you can and it still seems not to be enough.

[BlearnRN]

So I have a question. I am a new grad basically. Sometimes when I give report to another nurse I try to tell them all the info on the pt I can. Sometime I don't remember everything or it isn't written down on the sheet I keep. So sometime I get yelled at example for today " You should know how much or if the pt has voided" Granted I know I should know that but after a day like a had today that was at the bottom of my priorities. 3 of my 4 pts are having seizures and the doc are either sending them for tests or messing with their meds or both. Then the new resident is putting in the wrong orders. So that means I have to chase after her and ask " Do you really want this seizure pt to go on a tilt table" etc... I could go on but that is a short version not to mention 3 of them I would say had a high acuity. Anyway I get so intimidated and down on myself when I don't remember things like that especially if they were having a problem with urinating the other day. Am I ever going to have it together? I just feel so forgetful and so "new" at times.

[jjjoy, LPN]

It's hard when you're new to know when you need to listen to the feedback you're getting from the other staff and when you need to let it just roll off your back. As time goes on and you get more comfortable, you can with more confidence tell yourself that this or that person is just impossible to please and that your performance meets standards.

There's also the uncertainty from the side of the experienced staff working with a newbie. They might be more likely to grill the newbie than another colleague because they know from experience what to expect from their old colleagues. For good reason, they aren't comfortable yet accepting an unqualified report of "the patient is stable" from the newbie who may or may not be adept at their assessment skills.

However, there's a difference between asking "Do you know if... ?" and scolding "You should know this...!" It's mighty hard for a newbie to learn how to prioritize when from their perspective they're getting equally negative feedback for everything from not picking up on a patient's turning bad to not having the exact urine output on a stable patient. And if the reason the newbie didn't get the urine output recorded was because he/she was rightfully addressing a need of higher priority, it gets even more confusing! Because if the newbie tries to explain why this or that wasn't done, they may get slapped down by a curt "I don't want to hear excuses. Just get it right next time." It leaves one's head spinning as they try to sort out what they did wrong... which may have been nothing! There's nothing inherently wrong about not knowing everything or not getting everything done, especially as a newbie!

[pattymac]

My favorite reply to people like that is: "I can't wait until I am as perfect as you...how long does it usually take?"

Don't let them get to you. I'm glad you care enough to want to improve.

Hang in there....you'll do fine.

[leslie :-D]

i do think it's important to know if a pt has voided.

regardless of her complaints, it's never acceptable to be mean.

one of the most important lessons a new grad needs to learn, is the art of being assertive.

you're going to need to know how to assert yourself with your colleagues, the md's, your pts and their families.

there is an art to giving report.

i've tried it many different ways and finally decided to report on systems by exception, i.e.,

neuro: pt lethargic. md aware

cv: pt hypotensive and tachycardic. md ordered...

gi: abd distended, bowel sounds decreased, output of t-drain, 100mls. no bm x 4 days.

gu: foley output 400mls, cloudy, dark urine.

etc.

i find this way organizes my thoughts and events of the day.

anyway, as others have suggested, do not let anyone talk to you w/disrespect.

wishing you better days ahead.

leslie