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I need some advice. I am a new grad....I have been working for three weeks (about 8 shifts) and I am feeling very lost. I am working on a gyne unit that has lots of general surgery and medicine patients. I had 5 buddy shifts that I worked with an RN ( I haven't written my registration exam yet) I am casual so I get called in for most of my shifts. I got called in for four night shifts. I was assuming I was going to be acting as an LPN because on nights there is one registered nurse and one LPN per team ( each team consists of 16 patients usually). When I got there I found out that I was not the LPN I was the "registered nurse" for my team. I objected to it of course because I had not been trained as team leader and I am very new. They told me that I would be fine and that the other nurse on the other team would be there if I needed assistance. My first night went okay but I didn't get a break because it took me extra time to keep up. My second night two of my patients went bad and we had to call in a CCA and the respiratory team. I guess there were orders for q2h urine measurements on one of my patients and I thought that my LPN was taking care of this for me but she wasn't. When the doctor got there the next morning and found that this hadn't been done (urine output was very low) he yelled at the day staff and wrote up an incident report to go in my file. The other staff on my unit think that it is unfair that a new grads like myself keep getting thrown into these situations because we are short staffed and there isn't anyone else to cover the shifts. I feel like working as a new grad with 16 patients to care for is risking my license. I need to know if this is just cold feet because I am new or if I have a valid concern. I am afraid that maybe I am just not going to be a good nurse and maybe I have chosen the wrong profession. I did very well in school and all of my clinical rotations but when I had a patient load then it was only max of 6 patients to care for. I need some advice about what I should do. Please if anyone has anything for me I would really appreciate it. :bluecry1:

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Wow, that is incredible to me. IMO, that is 100% WRONG. I would never want to be in charge of a team of 16 pts and other LPNs as a recent grad.

I hope things get better for you. Good luck. You are not a bad nurse, just in a bad situation.

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Specializes in critical care; community health; psych.

I'm not a nurse yet and may be out of my league here, but it doesn't sound to me like you picked the wrong profession. It sounds more like you landed on the wrong place of employment, or at least the wrong unit. I'm hearing that orientations last for months for some new grads. To be sending a grad nurse just three weeks out of the starting gate to be team leader sounds like a train wreck waiting to happen.

Hindsight is always better, right? You have the right and the duty to refuse any staffing situations that could compromise patient safety. You got snookered. Some staffing managers will tell you that working with chest pain is good for you. Anything to get a credentialed body to fill an empty slot. Your first instincts to say no were correct.

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it really sucks that you've found yourself in this predicament... but there's definitely a few things you can learn from this experience:

1) NEVER assume that someone else is doing your work for you, even if you delegate it to them... i once asked a Nurse's Aide to remove a pair of TED stockings from a pt. who had pushed them down to her ankles... the aide said she'd take care of it... i went in 4 hours later to do a CSM/pedal pulse check and what do i find but those stockings STILL around my pt.'s ankles... the poor pt.'s ankles were swollen but there was no apparent problems (pulses were intact, cap refill brisk and no numbness/tingling)... i was so mad... not only at the aide for not following through with her promise, but at myself for not checking sooner...

2) you need more orientation days if you're not comfortable with your scope of practice... i know it's hard to turn down shifts... and when they call you in, people aren't always aware what you've been orientated to... speak to your manager and let them know how you're feeling...

3) if your manager isn't supportive of you, i would suggest looking to another unit that offers a better orientation...

as a side note, in my experience, orientations here in Canada are extremely short in comparison to most i've heard about in the U.S.... in fact, i've never heard of an orientation here lasting past 2-3 weeks for any new hire, unless it's in a specialty area (ER, ICU, etc)...

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Specializes in PCU, Critical Care, Observation.

16 patients???? That is insane! Cover your butt - perhaps it's time to find someplace new to work.

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Run, run, run from that unsafe environment, do you want to lose your license?

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Just wondering... are you even allowed to do that considering you don't have your RN yet? Isn't it just a case of 2 LPNs covering these 16 patients which leads me to wonder what the law etc.. is on that? Still ignorant student, please educate me on this...

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Specializes in Med/Surg, Ortho.

NO NO NO,, this place is asking you to practice without a license, and thats illegal as all heck. As a new grad who hasnt sat for your exam yet you CANNOT take a teamleader position and be solely in charge of those patients. There has to be someone who is working with you(on that team)that is licensed as an RN. There are guidelines that most states have through their BON that dictates how a nurse graduate practices while license pending. FIND OUT. Go to your state's BON on the internet(look for things stating "under direction/supervision of a licensed RN). Go to your nursing school, they should have gone through those guidelines with you before graduation. Then take the info back to your facility and demand that you only practice within those limitations until you pass your boards.

This place is asking you to become inelligable for your license if the BON finds out. God help you if something terrible happens.

At least this is how it stands in my state, doubt it is much different in many others.

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I went in to work my last night shift tonight and it went well but I notified my manager that I wouldn't be working anymore night shifts until I got my registration and until I got enough orientation shifts that I felt safe taking care of that many patients. She tried to tell me that my feelings of anxiousness were just because I was a new grad and that "this is the real world of nursing take it or leave it". I told her that I felt my feelings were valid and that I was not only worrying about my safety but the safety of the patients. She wasn't too happy but that's okay because I feel confident in my choice. The funny thing is the other staff on the unit 100% back my decision and told me that they have been telling her for months that it isn't safe to put new grads in that position nor is it fair. The staff said they would back me and that they think I should go to the union about the whole situation. Anyway....I am feeling much better and I really appreciate everyones input. I don't feel so useless anymore. :)

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I went in to work my last night shift tonight and it went well but I notified my manager that I wouldn't be working anymore night shifts until I got my registration and until I got enough orientation shifts that I felt safe taking care of that many patients. She tried to tell me that my feelings of anxiousness were just because I was a new grad and that "this is the real world of nursing take it or leave it". I told her that I felt my feelings were valid and that I was not only worrying about my safety but the safety of the patients. She wasn't too happy but that's okay because I feel confident in my choice. The funny thing is the other staff on the unit 100% back my decision and told me that they have been telling her for months that it isn't safe to put new grads in that position nor is it fair. The staff said they would back me and that they think I should go to the union about the whole situation. Anyway....I am feeling much better and I really appreciate everyones input. I don't feel so useless anymore. :)

Good for you for standing up for yourself!!

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Good for you for recognizing the dangers of being in that situation. Sometimes nurses will just go ahead in a situation they don't feel comfotable in. Which leads to bad outcomes! I know when I started at the hospital after graduating, I was on orientation for 8 weeks with a preceptor and boy was I glad!

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Specializes in Med/Surg, Ortho.

Kudos,, way to stand up for yourself and your soon to be license. Ya dont want to screw something up before the ink is even ON the paper ;)

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