1yr new RN and feeling increasingly insecure.

Specialties Cardiac

Published

I graduated in Dec 08 and have been working since then on a very busy 60 bed Cardiac Tele unit. Initially out of school I had the expected insecurities, but had been feeling more and more confident in the last few months. Over the last month or so I have been becoming increasingly insecure in my abilities and knowledge. Nothing has happened that brought this about. I just don't feel that I know when a patient's change in condition or vitals is serious, and when it is no big deal. I'm scared every shift that I'm going to miss something or underreact to some detail. The unit I work on is fantastic. The nurses are very supportive of each other and I can always bounce things off of them. However, we also act as a step down unit as our ICU and AMCU are generally full and we get patients who need a higher level of care (such as my recent 70/30 B/P on dopamine gtts). I don't know if my new insecurities are coming about as a I'm growing from more of a task based nurse to a role based nurse, or if I have just been out of school long enough that I feel that my knowledge is fading. Did/does anyone else feel this way? Any tips?

Thanks!

Jen

iluvivt, BSN, RN

2,774 Posts

Specializes in Infusion Nursing, Home Health Infusion.

Hi Jen,your knowledge base should be growing along with your experience.....SO...you need to examine your insecurities and try to figure out from where they come and work on them. You really have not been out of school that long and though you are more comfortable...I am certain you are still having new experiences every day. The mindset I have always had is that it is MY responsibility o keep learning and growing....so I NEVER have stopped learning. So make certain you are hooked up with the nursing journals and internet sites you need to stay current. Never let something slide by you..IF you do not know something..LOOK it up as soon as you get the chance and right away if you need to use the info to make a clinical decision. The key to feeling experienced is knowledge and of course your experience and others. I also learn from my co-workers experience. Just making that commitment will make you feel better....also maintain god working relationships...b/c you said it...YOU are not alone......one brain is GOOD ..more is better. Know how to use your resources..and then USE them. Things will get better if you are committed and continue to work hard...no it is not easy..but you sound like you are in a good place on that until...just hang in there

nursej22, MSN, RN

3,810 Posts

Specializes in Public Health, TB.

I think your observation about moving from being task based to role based is probably a large part of your insecurity. You may be realizing just how you don't know and how much more there is to learn. This is a great time to start attending some conferences; you will have an opportunity to grow your knowledge base and obtain some affirmation about just how much you do know.

It sounds like you work on a great unit. And I don't think its a bad thing to be a little insecure because it keeps you vigilant; I've seen complacency nearly kill a patient when a staff person got lazy.

It may help to talk to some one you trust at work about how you're doing--a co-worker, a CNS, your manager.

lsad78

19 Posts

I wish I had some good advice for you...I, too am in this same situation...I am coming up on 2 years as a nurse...I work on a unit similar to yours and have a great supportive staff around me but lately have been feeling not so confident..I agree with your statement about, "growing from a task based to a role based nurse"....I also feel every nurse has a "bad run" sometimes...Lastly, I agree with the comments about increasing our own knowledge base...I am looking into going back to school..ugh!...Best wishes to you...Don't be too hard on yourself.

Agnetha

5 Posts

Specializes in Cardiology.

hi jen,

i can understand how you feel but it sounds like you're being a bit hard on yourself. it would be wonderful if we could spend a year on a ward and know absolutely everything - but unfortunately that's not the reality. we have to be patient and build up our knowledge base in different situations - from the routine to emergency situations. how we do this varies from nurse to nurse. one of the aspects of nursing that make it such a satisfying profession is that no two days are alike. so i suppose what i'm saying is there is always an element of uncertainty in every day. it's finding the 'tools' that work for you in order to build up your own experience and knowledge, that will bring your stress levels down. personally i have found talking out my uncertainties with trusted colleagues has been invaluable. i have learnt many 'coping strategies' this way. when you open up to people you find that they experience their own uncertainties and lack of confidence. that's the benefit of having good team relationships and knowing the skills and expertise of the people you work with, so that you can depend on each other and support each other. no one knows it all!

stay positive & patient with yourself. keep open to learning. keep sharing with your colleagues. let us know how you get on.

i

icunrse

3 Posts

Specializes in Cardiac/ICU/Med-Surg/Geriatrics.

I can understand your feeling of still being insecure. When I graduated a intensive 2 yr program (we were thrown on the floor week 2 of school), I didn't feel comfortable for about 2 yrs, when all of a sudden...it clicked. You don't think you know anything, or retained anything, when all of a sudden, when you have an emergency...you are rolling and doing everything right. This is not saying that codes go smooth. They never do. You will always question what you did, what everyone else did. That's healthy. You are supposed to review codes to make sure proper ACLS protocol was followed, (that never happens where I work, but there is a committee who does review them). Keep doing your work, read up on medications, procedures, diagnoses that you don't know about when they come up on your patients, and it will all click. I promise. I was in your shoes about 13 yrs ago.

LisaFis

9 Posts

I am a new RN also and haven't found that trusted coworker. I am constantly thinking about what I don't know, what I haven't seen and will I be able to handle it when it happens to MY patient. I hate when I ask other newer RNs (2-3 years ICU) how they felt when they started; trying to gauge my own feelings of nervousness, insecurity, lack of confidence etc.

I haven't found that person on my unit who says "yeah, I was scared ******** and I made it. With the support of my coworkers I had all of those first time experiences I learned from all of them and I am here to tell you you will too"

Nothing nearly as positive. So damn frustrating-the unsure, insecure and scared feelings I have. More often you'll hear "Well that was textbook ACLS, do you have your algorithms memorized?" Holy crap I passed ACLS with flying colors but that's not real time, real life. I pray every time I am going in to work that I will be able to handle what comes up. It takes it's toll on your spirit, at least it is on mine.

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