4th week orientation, 1st melt down

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    So, today was my 1st day of my 4th week and it was sort of a bad day. First of all, we had to wait forever to get SBAR from the night nurses and our first doctors rounds were at 0730. I hadn't even got to assess the patient and the doctor was asking questions I didn't have answers to. I felt like an idiot. Later that day, I was called by a skilled facility to get report on another patient who was to be discharged to there, which I didn't know about, so I again felt like an idiot. Then to top it off, another nurse's patient needed an NG tube inserted so they asked me to do it. It was my very first one but I needed to get the experience so i agreed to do it. While I was trying to insert the NG, I started to meet resistance after a few inches. The patient started to cough and was very uncomfortable. I pulled it back and saw there was blood. My preceptor told me to try again but the same thing happened. I felt very incompetent and started to feel the tears well up. She told me to try again but I told her I felt very uncomfortable with the procedure, especially since I kept meeting resistance and the patient was bleeding. My preceptor took over and I went into the pt bathroom and started to cry. I couldn't hold the tears back...so again, I felt like an idiot. She told me to take a break and compose myself. I did, but I still felt bad. I felt bad about the whole day. I felt very insecure of my abilities, and very embarrassed about crying at work. I'm hoping tomorrow will be a better day. I hate feeling this way :'(
  2. 8 Comments so far...

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    Sorry you had a rough day. Hang in there, it will get better. I think tears are like a pop-off, the pressure builds and builds til it needs to be released. NGs are uncomfortable to insert as the nose is very tender, but the vessels are also very fragile so it's common to see a little blood. No worries!
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    (HUGS) it happens...I was in your shoes last week. Sometimes a good cry pulls it all together. Trust me, EVERYONE has their moment, regardless of their experience, at least that's what everyone tells me, and I have seen.

    Hoping tomorrow will go better!
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    Thanks for your reply...it made me feel a little better. I just wish my preceptor would have told me that. I'm still angry at myself for crying tho. She is the only one who saw me cry, as I tried to hide it and compose myself in the break room. I have this feeling that she told other nurses about it because of some looks that I got later on in my shift. Maybe I'm wrong and just being insecure...I really hope I'm not being talked about...this is not how I wanted my orientation to go. *sigh*
    Hoping to get better sleep tonight so I can go in tomorrow with a fresh outlook and better attitude.
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    Ahhh...you learn that self care is the best thing. If people were giving you "looks" *shrugs*, no worries...don't let your feelings get you trapped because you are new...I remember "no one can make you inferior without your consent"....keep your communication open with your preceptor, and your supervisor...if you are in a nurse residency coordinator, you can reach out to them as well. I did the same for my previous week.

    Keep us posted!
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    Hey friend: As a night-nurse, let me just say sorry for your troubles getting report. A lot of things happen right at shift-change, as you can expect. Next time, try and see if the night-nurse is still available to talk to the Physicians. As a courtesy, most of my friends and I will stay a little late to talk to MDs so that the day shift can get their things sorted -- After all, we've been here for a whole shift and know the patients well, you're just coming on and might not even have labs yet.

    Next, let me also say that it gets better, you'll progress with time and confidence. When there is down-time, continually ask to start IVs, insert NGTs, put in Foleys. Get your hands dirty with some wound care too. The more experience you get, the more confident you'll become. You made it through nursing school, you graduated, you earned that license. You have it within you to be an incredible care giver, all you have to do is go for it!

    Once you get into a rhythm, you'll be able to better accommodate to changes in shifts. Ask some of the other newer nurses how they made the transition, it's always very fresh in our minds. Finally, I would add that b/c you didn't get report yet, you shouldn't feel bad about not being able to talk to those doctors. Sometimes, physicians can seem intimidating and condescending, but just be confident and forthright and say, "Doctor, the previous nurse is yet to give me report for this patient, I will find them for you so they can speak with you." If you can't immediately spot them, look for one of the charge nurses, they can usually take the physicians off your back and may be able to even give the provider the info they're looking for.

    Keep your head up, you're learning, you're working, you're growing in your role. Congrats at your work so far, don't be so hard on yourself! I had a little break down this weekend, so they still happen nearly a year after you start on the floor, you just have to keep on keepin on, friend.
    Last edit by kChoRN on Mar 19, '13 : Reason: Word Correction
    Sun0408 likes this.
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    BTW, NGTs aren't always easy and not everyone is a good candidate to try on. In my school, we did them on eachother -- We had good anatomy, prep, etc. Don't let a bad insertion upset you, they aren't always easy. I was helping a newer nurse start one the other day and neither of us could -- MD couldn't either when he tried (surprised us both that he tried in the first place...haha).
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    Thanks for the kind words. Today was a little better except for the fact that I had family members that were trying to tell me how to do my job today. A daughter decided to tell me time after time that she was in the medical profession since she was a veterinarian and was very overbearing. It was a bit intimidating. Tomorrow will be my last orientation on days.. YAY! Then I start on nights on Sunday. I will have 2 weeks of orientation on nights then I'm on my own (night shift forever)... Been a night shifter as a CNA for 12 years. Can't wait to get my night groove on again!
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    Oh hah, look -- Nights will be better to start out as a new grad. Fewer family, physician, and management causing nerve issues around. You'll find your rhythm quickly again! Best wishes, friend!


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