I had a shift the other day in my old, crazy hospital based ER. They are not short many day shift nurses anymore; however, they have filled those positions with non ER nurses and several new grads. I was a floating and helping out when the charge asked if I could help one of the new grads prepare an intubated patient for transport to the ICU. I walk into the room and she is absolutely freaking out. She immediately asks me what the amount of the medication she has on the pump.
I asked her before looking at the pump, "Did you use the library on the pump?"
"Umm, my preceptor did it." She's being trained by the charge nurse who also has a full load of her own patients.
I look over at the pump and told her, "No, she didn't use the library."
"Yes, she did."
"No, she didn't." I was taking my critical care booklet out of my pocket when she turned and left the room to get the charge nurse.
I turned to the tech, "Where did she go?" The tech shrugged.
I walked out of the room to see that she was standing next to the charge who was on the phone dealing with another problem.
"Would you come back in here? I'm trying to help you. How much does the patient weigh?"
She ran back inside the room and told me.
While looking up the medication, I asked her if she gave report. She did, but she said she didn't know the answers to many of the questions the ICU nurse asked in report.
I told her how many mg/kg/min the medication was running. She then ran outside of the room again and stood next to the charge nurse to ask her if that was right. By that time, respiratory showed up to transport the patient. Normally, the nurse should have packaged up the patient by that point so the RT doesn't have to wait long for transport. She was nowhere near ready. I got the patient ready for her. She came back into the room and I asked her what the hell was she doing. She said she wanted to check with the charge nurse about the medication.
The new grad had a bottle of extra medication with her. She asked what she should do with it. I told her she could send it with the patient and document that it was sent with the patient to ICU. I guess she didn't like that answer because she ran out of the room to the charge nurse who was busy with a patient. At that point I felt like slapping her. The RT rolled his eyes and sighed loudly. I told him that I would transport the patient to ICU because at this point, the patient would be here forever.
She ran back into the room and looked completely frustrated. I understand how she could feel that way, but hell, she had people helping her and she didn't trust any of them.
I told her to calm down and I'd transport the patient which she said she would do without my help.
What a cluster. I think new grads can start in the ER, but they really need a strong preceptor program and a dedicated teacher. These kids are going to make some major mistakes and hurt someone.
They already have had one of the new grads leave because he said he wasn't cut out for the ER due to its incredible stress and pace.
I wonder if this nurse will do the same.