New Grad-First Day in the ER--Feeling Overwhelmed and Foolish

amyinga · Oct 20, 2013

I've done ER for 12+ years, mistakes you made?? that's just because your nervous, not because you don't know! Don't worry! I promise it WILL get better. We ALL had to start somewhere and learn the steps to becoming good in our field. Keep your chin up and TRY not to let these "mistakes" get you down and frustrated, plus after you pop out that baby your emotion will get better :)

Sippie · Oct 20, 2013

It sounds like you just had a bad case of nerves. It does seem like you have a good preceptor. You will do better as you gain confidence and get used to how things are done. Getting a job in ER right out of school means they must have seen something in you that told them you would make a great nurse. Just take it a day at a time and don't beat yourself up. Someday you will be an expert and have a student that is nervous and insecure and you can tell her about your experience.

amyinga · Oct 20, 2013

and to make you feel better, I had been a nurse 3+ years when I was working in the OR at this time and was placing a foley in a pt and for the life of me could not figure out why the doctor scrubbing in was laughing at me. Well, I had the pt frog-legged so to speak so I could put the foley in, well the pt was a MAN!!!! LOL... I felt real dumb, I was just doing it out of habit as most of our pts that day had been women.

ThePrincessBride, MSN, RN, NP · Oct 20, 2013

Well, you ARE six months pregnant. Cut yourself some slack.

DavidDudley · Oct 20, 2013

Not bad for the first day. I think your main problem isin't your mistakes, but its your mindset about your mistakes. Mistakes aren't bad, their how we learn.

Editorial Team / Moderator · Oct 20, 2013

Oh, and here's something you should do: bookmark this post and come back to it about a year from now. You'll have a good chuckle and realize how far you've come. :)

That Guy, BSN, RN, EMT-B · Oct 20, 2013

Good job newbie! That sounds like a good first day to me. I notice this a lot with the new people to the ER. They want to function like the seasoned ER folk, and you wont for awhile. Its the truth, and it is frustrating at times....and it is ok. It takes time and it takes a lot of mistakes. I know I had plenty the first few months. Chalk each one up to a learning experience. And the nerves do go away after awhile.

tigerRN2013 · Oct 20, 2013

You are not alone! I spent my whole orientation making mistake after mistake, but I learned lots and don't make those mistakes anymore. Be patient with yourself; it gets better.

chatty-cathy · Oct 20, 2013

Sounds like you just have a case of the nerves and you are doing just fine! Be gentle with yourself hun. The first day on any new job can be overwhelming let alone a busy ER. These are all minor things that can happen to anybody so try not to forget to breathe and have fun. A little humor goes a long way, I have been known to have butter fingers myself :)

Don't worry, your taking on a big challenge as a new grad which is doable so just take it one day at a time and things will get easier. I'm 5 months in now as a new grad in the ER and I still say I'm rusty from nursing school :)

melmacrn · Oct 20, 2013

I can't thank you all enough. I've been wiping away tears the entire time I've been reading your replies and wish I could hug every single one of you. I love the idea of keeping this post and going back to it in six months or so--just to see how far I've come in my position. I think I have had the mindset that they expect me to perform like a tenured nurse in the ER and I need to be realistic with myself--that is not going to happen. I really need to stop being scared of everything and just relax. I need to allow myself to make mistakes. And I definitely need to stop worry about what might go wrong (ex: what if I faint, what if I do it wrong, what if I look stupid, what if, what if what if..). It's the "what if" attitude that is really bringing my confidence down. I also need to stop worrying what other people are thinking and just worry about myself.

You have all been so helpful. Thank you so much.

Ruby Vee, BSN · Oct 20, 2013

I was so excited to start as a new grad in the ER. After three days of training (not ER directed, just hospital orientation) and taking two ECG/rhythms classes, I was introduced to the person I'd be with for floor orientation. I was so excited and felt like I would be comfortable with this nurse since she has a fun/outgoing personality. I am so eager to learn and want to be a great nurse. Unfortunately, my first day did NOT go as planned and I feel overwhelmed and completely foolish. I feel like they're already regretting their hiring decision with me.
I did my school preceptorship (64 hours) in the ER back in June and then took NCLEX in August, so I've been out of the clinical setting for about 4 months. Everything that could have possibly gone wrong (with the exception of killing someone) went wrong. Mistake, after mistake, after mistake. Things I was comfortable with as a student.
Here is a summary of my day. During all my experience in clinicals, I never left upset. I was crying the entire way home and cried for a good hour after getting home. I'm so overwhelmed and I feel like I'm letting the department down. I also feel like they just expect me to know how to do everything, and I don't. I just really need to get these feelings out.
1. Foley: My hands were sweating so bad, I couldn't get my sterile gloves on. I finally got them, but it took forever. Then, I was blank on what to do with antiseptic and even blank on what the syringe of lubricant was! I hadn't seen a foley kit since first year (I had done lots of straight caths throughout clinicals--just not foleys). I finally got the catheter in, but I was embarrassed.
2. I couldn't start an IV if my life depended on it! During my preceptorship, I was able to start them and take blood without assistance. It's like I completely forgot how to even do the steps. Plus, the person I'm with does things completely different than the person I precepted with over the summer which is frustrating.
3. Glucometer. Yeah, doesn't get much easier than doing a glucose reading...wrong. She asked me to find out what his blood sugar was and I was so excited, like "finally! something I won't mess up and can look competent at while doing"...While the machine was reading the results, I pulled the strip out (not even thinking!!!!), so of course, got an error message.
4. Went to connect IV tubing to the IV....couldn't figure out why it wouldn't go on...oh yeah, because I forgot to take off the cap. She teased me on this one and I smiled, but I was feeling so stupid.
5. Almost forgot to swab the IV port with alcohol before doing a saline push, but the trainer caught it and tried handing me a alcohol pad...that I dropped on the floor, so she got me a new one.
6. Put like four of the stickers for ECG on incorrectly because I couldn't figure out how to count the intercostal spaces. I've never done these before.
7. Was asked to reconnect a patient to monitoring...forgot to hit start on blood pressure cuff and didn't hook up the leads.
THIS IS ONE DAY!!!!!!! I FEEL SO FOOLISH. It looks even worst seeing it all written out. Any past experience you've had or hope you can share would be so greatly appreciated right now. I hate feeling this way. Plus, I have ACLS training next week and I'm terrified of that as well.
Did I mention I'm 6 months pregnant? Yeah, I'm just a wreck, lol.

Any new grad who isn't feeling overwhelmed on her first day is extremely foolish! That said, none of these were end of the world mistakes. And believe me, no one expects you to know much of anything your first day! Relax, take a deep breath and be glad your preceptor has a sense of humor.

Guttercat, ASN, RN · Oct 20, 2013

Most of us felt like bumbling bumbles for a while. Give yourself a break. You're not going to feel comfortable for a while.

Concentrate on making sound, clinical judgments. If you have common sense, your coworkers/superiors will note that, while realizing that the hands on deftness comes with time and practice.