Will It Always Feel This Way???

[cute_cabbage2005]

I started my nursing job as a new grad nurse on a cardiac unit that is intense and fast paced. I have been on this floor a month. This job has been EXTREMELY stressful and overwhelming.

My training has started off on the wrong foot. I have had 2 preceptors. My first preceptor was good nurse but a horrible teacher with 2 years experience. I spent the first few days listening and watching her slam things around, complaining, and flying off the handle at the littlest thing. I think having to train me and do her job at the same time created a lot of stress for her. After 4 days I couldn't take it anymore and switched.

My current preceptor is a more patient nurse with 15 years experience but her skills seems a little sloppy. Lately she has been showing some stress. Normally she is good at showing me things, but yesterday, she was having a bad day and "dumped" 2 patients she didn't want for me to deal with on my own.

Patient #1 was grumpy, non-compliant with end-stage cirrhosis and cardiomyopathy on a heparin and Primacor drip via 2 separate IV ports. He was suppose to be transferred to CCU to be monitored during the drip but ended up staying on the floor. He kept getting out of bed even though he was told to stay put for the duration of the drip. His IV pump kept beeping non-stop. His thing was giving me the hardest time over EVERY little thing I asked him to do. It was totally exhausting. Patient #2 was a newly admitted from ED with ETOH intoxication with altered mental status and late stage cirrhosis. His ammonia levels were elevated. He had a bloody Foley. He had bruises and skin tears all over his body. He was a mess. He kept drifting in and out between awake/sleep...so it was difficult to do an admission data report on him.

Both patients had ascites and both had bad veins. Someone from the STAT team to start the IVs. The ETOH patient's abdomen got really huge and distended. I couldn't get my preceptor to look at it. She said was too busy (with a discharge) to help me, so she told me to get the charge nurse to look at it. The patient had an NG tube in which very little content was being suctioned out from it. The charge nurse ended up calling the STAT team. The patient ended up getting a paracentesis which had caused his distended belly.

Even though the patient was stabilized I cant help but feel what I didn't do (because of my inexperience) that could have hurt him. I've been restless and haven't slept for days because of the scenario of that episode plays over and over in my head. I felt that my preceptor somewhat abandoned me when I needed her help. I also felt very inadequate. I have a feeling that the charge nurse is probably thinking the same of me even though she hasn't said a word to me. This incident has affected me so much that I feel like quitting.

I have 3 more weeks of orientation on this floor before I move on to my next assignment. The nurses on this floor get 4 patients. I'm only working with 2. I'm having a lot of mixed feelings going on inside of me.

My current preceptor keeps saying that she cant take it anymore on the unit and wants a transfer. I feel like I have no support on this floor. I have to be careful of what I say and do on this unit because it may escalate into a rumor. I can't help think that I'm getting the short end of the stick on :cry:my training here. I dread going back to work and my stomach's is constantly in knot. Has anyone had or is having an experience as bad as this? I've been told to give it 6 months....but at this rate I don't know.....

[leslie :-D]

you were given 2 sick patients.

end stage liver disease, is not easy to deal with...esp as a new nurse.

it affects physical and mental status.

the resultant encephalopathies from increased ammonia levels, makes caring for them even more challenging.

ascites will respond somewhat to para/thoracentesis but only temporarily.

it sounds like your preceptor is burning out or highly stressed...

which gives you little support and guidance.

while you feel you're drowning, believe me when i say you are learning.

always remember your abc's, first and foremost.

and effective communication.

go to the cn if preceptor isn't receptive at the time.

write thorough nursing notes.

and take those deep breaths.

you can do this.

and you will be so glad you did, sev'l months from now.

wishing you the best.

leslie

[CHATSDALE]

so far you're swimming and not going down for the third time

you woll survive this and while i can understand the problems with the preceptors asking for a third one at this stage might not goover well

if yo feel like you have too then do it, if yo believe that you can ride out the next three weeks that would be better

and this is probably the par for the course on this floor

request othro or pedi anything but here

[jessiern, BSN, RN]

You will get into the swing of things. It takes some time to get into the grove. Learn how to assess and patient, and learn how you like to do things.

Trust me, it does get better. If you cont to feel you are drowning, might be worth considering transfering to a less intense environment for the time, until your feet are good and wet.

[MissERN]

no, it won't always feel this way!! i've been a nurse for 7 months and now i love my job...but it wasn't always like that. i'm so very sorry that you are having a difficult time! please know though that you are not the only one who has spent many nights awake replaying the day! i did the same thing when i first started. i would leave work and question so many of my decisions...it's really scary when you are new and don't have experience to make decisions that you are very confident about, but it does get better.

i would encourage you to sit down with your manager and talk about your concerns. maybe there is someone else who might be better suited to be a preceptor. that can make all the difference in the world! i had to do that during my orientation, and it was so much better when i had a preceptor who would help me learn. you are not alone, and i understand what you are going through. i'm sending you a hug and i'll pray that things get better for you! hang in there and i hope you can find a preceptor who is perfect for you!

[Scrubby]

If you honestly feel that you cannot cope with a patient because of inexperience and are not safe in your practice then you need to be a patient advocate. In this situation i would be notifying whoever is in charge that i require help as i do not have sufficient knowledge or experience to perform safe patient care. If i do not receive this help then i will write up an incident report to cover my own butt, and to hopefully make someone out there take notice that the staffing levels where i work are dangerous and something may finally be done about it.