Disappointed.

I have always wanted to be a nurse. After working as a CNA for two years, I finally graduated RN school in December. I work on a busy Med/Surg floor in a small, community hospital. I was very excited to start working as a nurse, and I thought I knew what I was getting myself into... I am working on the same floor I worked on as a CNA, so I'm in familiar territory, however the role is much different. I have no time to have a real conversation with any of my patients, no one is available to help me with taking them to the bathroom, changing diapers, etc. Our medications administration times were just changed from 1h before, after to 30 min before, after.. so all of my medications are always late now. I always have 5 patients, and most of them are from nursing homes and require total care. I have seen quite a few dangerous things going on around me, and yet no one is being punished for their actions. I feel like I am in a dangerous position and am fearful of my license. I LOVE being a nurse, but the facility I work in makes me HATE it more every day. I need 8 more months of experience to have a full year. I'm scared to move somewhere else because I'm a new nurse. Any advice??
Why would they change the parameters on the med pass? That seems rather dumb. Do they write you up for it? Personally, if it were me, if they didn't write me up, I wouldn't worry about it and be happy with getting them passed within 1 hr before/after. As for it being unsafe, if it is as bad as you say, then I would start applying elsewhere.Are you unionized? You can usually file an unsafe staffing report if you are. If not, and you can't find a job, I would just stick it out for now. Document, document and do the best you can.

What shift do you work? Can you give an example of the dangerous things you have seen?It's true, the roles of CNA and RN are very different. While you can understand what it's like to be a CNA because you have walked a mile in those shoes, a CNA cannot understand what it's like to be an RN because they have not walked in those shoes. Do you think the CNAs are doing their best, but just stretched thin like you, or do you think they don't really understand how much you rely on them to perform their assigned job duties?Like you, I worked as an RN on the same floor that I had worked previously as a CNA. It seemed like the CNAs all thought that since I had been a CNA, I could handle their workload in addition to my own. This made things much more difficult than they needed to be.Another thing to consider is that real world nursing is so very different from nursing school. We learn things the "right" way when we are nursing students, but then once we hit the floor as new grads, we have to learn survival strategies, which may deviate somewhat from the way we were taught in school. Now that does not mean we should put patient safety on the back burner; to the contrary. Patient safety is always the most important thing. It just means that sometimes, you find different ways of getting things done than you were taught in school.Document like your life depends on it. Your documentation is what will cover you should something go wrong that is out of your control. Patients and families who are not happy with their hospital stay, even if it's for something as stupid as taking too long to bring jello, will *always* blame the nurse. Make your patients and their family members like you. Patients and families seem to care more that their nurse was nice, friendly, likable, than whether they received their medications on time, whether mistakes were caught and averted before they could happen, whether they were kept safe during their hospital stay, etc.Even if you don't have time to really have conversations with your patients, you can make them feel like you have all the time in the world. Always take a couple of deep breaths and compose yourself before entering a room. Make eye contact. Sit in a chair at their level. If you do these things, it doesn't matter if you only spend thirty seconds doing it. Their perception will be longer.Not sure what else to tell you. The first year is always tough, but things usually get better after a while.

This is the exact reason why I am not going to settle LT for this type of hospital nursing. I had most of my clinicals on a floor like this, and by the time it was over, I wasn't even so sure I wanted to be a nurse anymore.

Does your facility have a compliance hot line? Is the CNO approacable? As for your license, you are not responsible for what others do. You can call Joint Commission hotline and they may do a survey. The State probably has a hot line. Everything must relate to patient safety, not how hard you have to work. If you find another job somewhere else, take it. All that stress is unhealthy.

As a new grad nurse, you do feel disappointed and overwhelmed. There is such a big difference in how you feel during clinicals compared to how you feel when you're out there on your own with 5 or 6 patients especially on a busy med-surg floor. I worked ortho/medsurg for one yr and I had to leave because it was physically and emotionally draining. Floor nursing is not for everybody but pray and ask God to help you to hang in there to complete a yr and put in for a transfer to another unit that you think you may like or try another type of nursing work. I love being a nurse and I know you do too, its' going to be alright and it will get better as time moves on and you become more experienced. I wish you the best.

Becoming a nurse after being a CNA can be disappointing. I remember feeling the same way you do, that I no longer care for the pts directly in a very private way. ie dressing, changing, bathing etc. The above posters gave you some very good advice about how to feel more connected. You will not spend the amount of time you did as a CNA but your time is more focused on what's wrong with the pt. You are listening with a nurses ear and knowledge. You will delegate things to do for the pts to the CNA's like repositioning or a back rub. If you want to find 5 minutes to do those things for your pts you can. Also, you will get faster with the med pass. That will leave you more time for pt care if you want. Give them a minute or two while you're in the room. Calm down it WILL get better! And, yes, I'd stay in one place for the first year. For better or worse, what you learn there will serve you well.

The 30 min requirement has to do with the "standard of care" being required to keep hospitals getting approval to take care of medicare/medicaid patients. Our facility is pushing back against this.

Quote from BhavanaThis is the exact reason why I am not going to settle LT for this type of hospital nursing. I had most of my clinicals on a floor like this, and by the time it was over, I wasn't even so sure I wanted to be a nurse anymore.

Any co-workers you can talk to and be assured of confidentiality? It sounds like a lousy situation, I hope you have some support somewhere. A co-worker would be ideal, might be able to give you some help, feedback, or at least comiserate. Two months isn't long, I hope you can hang in there. Maybe another floor or shift would work better for you? I wish so badly to help you because when I'm a patient, I want a nurse who's bothered by all those things you mentioned, not a nurse who doesn't care. Wishing you every day better than the previous.

To all of you that commented, thank you so much for your kind words of encouragement. Just knowing I'm not alone makes me feel much better! To StarGazer, I work days 7a-7p. An example of an unsafe incident actually happened Thursday, the night I wrote this. A patient who wasn't even assigned to me was getting aggitated because she couldn't go outside to smoke. Her primary nurse (who wasn't do anything at the moment) asked me to check on the patient, and I did, even though I was admitting 2 other people at the same time. I managed to get the cigarettes, but the patient backed me up against the wall and grabbed my arms. She twisted my wrist (she has Alzheimer's, and didn't even know what she was doing). Being that she's 80 years old and suffers from dementia, I didn't feel like I could fight back. I pressed the call button and 10 minutes later someone answered. I yelled for the primary nurse (who was also the charge nurse) and she never came. When the patient got tired and finally let go of me, I ran to the nurses' station and found that nurse sitting there... I filled out an incident report and notified my supervisor. Had the lady been any bigger or stronger she would have broke my arm. That's only one unsafe incident. There are more!I really appreciate all the sweet comments. It feels good to know that so many of you have been in my shoes! I am praying daily and asking God to get me through this time and send me to a better place. I have learned to be a great documenter, probably documenting way more than I need to. I make sure that I spend every available second with my patients. They are the only reason I'm there!

Sounds like a lazy charge nurse needs a swift kick in the asterisk. Go ahead and do it, tell her I said it was OK. Just blame it on me!

Stick it out while you look for another job, but try to stay there 12 or 18 months before you make the move.