Absolutely incompetent...not so sure "it gets better".

Nurses New Nurse

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Just finished my last 12 hr shift this week...I'm sleep deprived and I've been bouncing around between Med Surg and ICU. A brief background: I graduated in 2010 and it took me 9 months to land this job, which I've been working for about 3 months, only a couple of weeks on my own between 2 depts. I did my immersion in a trauma stepdown unit and the ICU where I work also includes stepdown - mostly medical.

Today, I simply wasn't on my game. I had two pts, including a transfer up to MS, as well as a fresh GI post-op in addition to my stable lady w/a GI bleed. Not a problem, I thought...nothing too complicated and I've encountered these kinds of pts before. The day was kind of busy, I felt a little out of sorts because I hadn't worked ICU in a couple of weeks. Everything went alright I guess, although I did make a med error that I told my supervisor about. I also needed help hanging blood, but it all got done. Except some of my charting :uhoh3:

When night shift comes on, a seasoned nurse took over my stable lady and asked me a couple of simple questions about her labs. Turns out I didn't really look at her Kardex all day because I was so busy getting my post-op set up and hanging blood, or helping the stable lady with toileting, that I didn't look at the big picture going on: why was stable lady here? Did her troponin peak? What about her H&H?...this is all stuff that I...spaced. I just didn't think of it. I didn't think about what the "plan" for her was...and I feel like a total failure. The seasoned nurse was understandably annoyed at me and I felt like a piece of garbage. Another older nurse had asked me at shift change why stable lady was here in ICU. I just blinked and said, "I don't know. I should know this." Her reply was "Hmph."

I'm starting to wonder if nursing was the right career choice...this is a second (or is it third?) career for me and I suck at it. I truly do, I'm not just saying that. I need to have a heart-to-heart with my manager, who has been extremely helpful and supportive. Most of my coworkers are supportive, for which I am truly grateful. But I'm just afraid this isn't going to "get better" with time...I don't know if I'll EVER get this.

You know how Dan Savage started that whole "It Gets Better Project" for LGBT youth? Do we need to start one for new nurses?

Does it get better if you start out the way I'm starting out??

Thanks for listening...:redpinkhe

Specializes in Emergency Dept. Trauma. Pediatrics.

At my facility the preceptor gets the "easier" patients while precepting and 2 dollars more an HR while precepting.

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I agree with some of these posts that US new grad /nurses do drain the experience nurses more, BUT we have to gain experience from somewhere we don't know what we don't know and we need help learning.

I can say that as of now after 2 months in a hospital i don't feel good at this piont. mainly b/c i'm not sure how much i should know right now. I was pulled off orientation early which scraed the **** out of me but having done 2 weeks by myself i have had to be strong although i have cried almost every shift hahaha.

I will never forget being new like some nurses do. but then on the other side of that coin i have had some awesome nurses.

i'm just at that point "will it ever get better b/c i can't cry every night at work b/c i'm almost 40 yrs old for goodness sake hahahaha. Help me!!!!!

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I agree. They "prepped" us for the world of nursing...but didn't let us in on the joke that bed-side nursing in the real world...is NOTHING like they taught us. It took me at least 3 weeks to not say "that's not how they taught us in nursing school". I graduated in May...and if I would have known what I knew now...I may have never chosen this as my profession. I do not feel like I am doing the job I signed up to do. I feel really apathetic and sad about the world of nursing....

Ia

I agree with some of these posts that US new grad /nurses do drain the experience nurses more, BUT we have to gain experience from somewhere we don't know what we don't know and we need help learning.

I can say that as of now after 2 months in a hospital i don't feel good at this piont. mainly b/c i'm not sure how much i should know right now. I was pulled off orientation early which scraed the **** out of me but having done 2 weeks by myself i have had to be strong although i have cried almost every shift hahaha.

I will never forget being new like some nurses do. but then on the other side of that coin i have had some awesome nurses.

i'm just at that point "will it ever get better b/c i can't cry every night at work b/c i'm almost 40 yrs old for goodness sake hahahaha. Help me!!!!!

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Shiner1,

we could be twins right now hahaha

i feel so stressed when i'm at work that i don't give very good patient care which REALLY bothers me. I'm lucky if my assessment is longer than 10 minutes.

This isn't nursing to me....

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HA! I am sooo glad you have time for assessments! I normally start tossin' meds right when I walk in the door. The E.D. looooves to give us new patients at shift change. I'm lucky if I can even see them before the assessment starts. I feel completely blind-sided....

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Just fyi...I've been holding bags of ice to my ears during my shift because my B.P. is up so bad. *****?

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If any of you new grads (and even for a couple of years, though it decreases) felt like you had it all together, you'd be scary. :eek:

Nursing school teaches you how not to kill someone on purpose. That's it. The rest is OTJ training- and it kinda has to be that way- there's just SO much to learn- and not everybody is going to need all of the same information. You decide what you need based on where you work.

It does get easier- but even dinosaurs have off days; don't let the slip in lab work throw anyone- it happens; you got the patients to the next shift in one piece- that's worth a LOT more than knowing a couple of labs. :up:

(and yes, I know this is an older thread :D)

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So happy to know tht what i'm feeling is normal, i won't throw in the towel just yet.

Just seems that everytime i go to a new floor where i haven;t worked i get so anixious and have a melt down haha i cannot go to work everyday and cry hahaha one older crabby charge nurse said i can;t believe yu are crying your patients are easy what wrong with you... of coourse i never said anything i just said i'll b fine this is normal for me when i go somewhere new. not to mention i got report an hour late and i as first admission. Today is my day off so i;m happy

thanks for all the nice wordds it really does help.

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It gets better!

I just finished my first year in PICU and honestly, I felt like a world class moron for the majority of that year :eek: I dreaded giving report every shift because the more seasoned nurses will make you feel like crap if you miss something or make a mistake. I had one who wrote me up for the pt having D5NS hanging instead of D51/2NS. Yep, definitely my mistake because I admitted the pt from the ER, where they started the IV fluids, and when she got to the unit the resident added the standard orders for D51/2NS. When I clarified after the fact, the resident didn't care, but it was my mistake. I don't think it was a write up worthy thing, but oh well. I am SO vigilant about double checking all my fluids since then!

That's the thing though, every single mistake I've made, has been an "ok, I'll never make that mistake again" moment for me. It is a very steep learning curve, but it does get better.

I finally rounded that corner just a few months back. I'm not scrambling to finish everything I have to do before the end of my shift, I don't spend the days after thinking of all I did wrong (usually), and I have confidence going into report, and now I know who the "bully" nurses are and ignore their attitudes during handoff ;)

I never doubted it was the place for me, but I'll admit I cried at work a few times because other nurses were treating me like I moron, and I worried that I'd never been seen as someone who knew their stuff or ever feel confident again. Prior to ICU, I'd always thought of myself as very smart, people have always told me I am, I did great in nursing school, etc... but again, it's a steep learning curve but if you keep learning, and push through the hard parts, eventually you'll find yourself in a place where you hit your stride. :heartbeat

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I can tell you that you are not alone! I am feeling like a big incompetent fool! I was a CNA for over 30 years wanted to be a nurse my whole life and now that I'm there I wish I was back being a CNA. Life was simple then!

I have been a nurse in LTC for 3 1/2 months now and still feel like an idiot! Not only that but I am having so much anxiety I can hardly think! I am sure the other nurses think I'm an idiot too!

I know that all new nurses go through this but it doesn't make it easier. From what I hear no matter how long you are a nurse there are times when you feel stupid and miss things. I guess we have to give ourselves a break and move on to the next day, trying to learn and get better.

Hang in there and know you are not alone!

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Specializes in Neurosciences, cardiac, critical care.
It doesn't have to be this way. Not all places are like this and if being a new nurse is so bad I highly doubt the experienced nurses are "envious" that they can't be a new nurse again.

OP I am sorry you are having such a bad experience. Hopefully the time flies and once you are no longer considered a new grad you can try and find a better position or a better hospital. Don't give up and believe in yourself. You will gain more confidence and your skills will get better and your time management and so on. Everything you are feeling are echoed all over these boards by other new grad nurses that are working. :heartbeat

Second this. I'm really sad your co-workers aren't supportive of you. Is there anyone there that's willing to help, or at least listen to your concerns about no one else being willing to?

I feel the need to debunk. srsly . . "prettier than they are"... "you rebuke their advances" .. LOL - the Y chromo strikes again. As for the hiring new grads at lower salary - not in this HCAPS environment. Reimbursement is now tied to patient satisfaction & outcomes; higher levels of experience/expertise have a proven ROI & new grads are seen as a detriment to the bottom line that far outweighs any salary savings, especially in light of the salary compression among staff nurses (experience is not well rewarded).

I think the primary reason that experienced nurses dislike working with newbies is very simple... it increases their workload and job stress. The 'oldie' not only gets all the complex/difficult patients, but also has to prop up the newbie. They would much rather be working alongside people who can hold up an equal share of the load. Over time, this becomes a huge irritant and major source of job dissatisfaction. Eventually, experienced staff begin to lose focus on the (new grad) individuals involved and only see the impact it has on their own lives. It's not fair, but it's human.

Yeah, I have to agree with this as well. From what I've seen so far, the older nurses get frustrated when us newbies ask them questions that we could figure out by thinking or looking for 30 seconds. I try to not ask where anything is until looking for myself for at least a couple of minutes.

Shiner1,

we could be twins right now hahaha

i feel so stressed when i'm at work that i don't give very good patient care which REALLY bothers me. I'm lucky if my assessment is longer than 10 minutes.

This isn't nursing to me....

Just curious, what do you need to assess that would take over 10 minutes? My school drilled our a!s to be able to do a complete head to toe in under 7. Unless I'm doing a super-focused exam listening for murmurs or doing a stroke scale or intense neuro w/ cranial nerves/reflexes, it doesn't take more than 5 mins.

It gets better!

I just finished my first year in PICU and honestly, I felt like a world class moron for the majority of that year :eek: I dreaded giving report every shift because the more seasoned nurses will make you feel like crap if you miss something or make a mistake. I had one who wrote me up for the pt having D5NS hanging instead of D51/2NS. Yep, definitely my mistake because I admitted the pt from the ER, where they started the IV fluids, and when she got to the unit the resident added the standard orders for D51/2NS. When I clarified after the fact, the resident didn't care, but it was my mistake. I don't think it was a write up worthy thing, but oh well. I am SO vigilant about double checking all my fluids since then!

That's the thing though, every single mistake I've made, has been an "ok, I'll never make that mistake again" moment for me. It is a very steep learning curve, but it does get better.

I finally rounded that corner just a few months back. I'm not scrambling to finish everything I have to do before the end of my shift, I don't spend the days after thinking of all I did wrong (usually), and I have confidence going into report, and now I know who the "bully" nurses are and ignore their attitudes during handoff ;)

I never doubted it was the place for me, but I'll admit I cried at work a few times because other nurses were treating me like I moron, and I worried that I'd never been seen as someone who knew their stuff or ever feel confident again. Prior to ICU, I'd always thought of myself as very smart, people have always told me I am, I did great in nursing school, etc... but again, it's a steep learning curve but if you keep learning, and push through the hard parts, eventually you'll find yourself in a place where you hit your stride. :heartbeat

My hospital really tries to stress that a "write up" isn't to assign blame- it's to fix systems within the institution that are broken. Hopefully that's how yours (and mine lol) really works. Re: the importance- depends on your pt. If it's an ICP pt, then yeah- an isotonic solution is going to increase ICP. The D5 1/2NS (hypertonic in the bag, hypo in the body) is what we normally use for maintenance fluids. But really, probably not a big deal. Glad to hear your handoffs are going better- I've also tried to learn who I need to know a ridiculous number of irrelevant details for and who just wants to know the pt is still breathing. :uhoh3:

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Specializes in ED.

Opossum- can totally relate!!

Except, my fellow RNs in the ER are great and very helpful. I KNOW I am a weight around my preceptor's neck, and they do not change the acuity of Pts for her - I am in the trauma bays when she is, and the easy district when she is, so I am learning to handle it all and I am lucky she remembers and laughs with me about her first year in the ER and her silly but emotionally overwhelming mistakes.

Just this week I decided I need to focus more on my reports - I try to get ready an hour before change of shift and then I look up and it is 5 of and I still feel discombobulated..... :-(

The worst, most embarrassing shift report grill I got was actually from a newish RN who has been there maybe 1 year and a 1/2. She asked me all the labs on a Pt and all the whys and whens and I was a stuttering idiot, she offered no encouragement, gave me nasty "looks," I asked "Why are you rolling your eyes at me?" She says "Whatever." I cried the whole way home, not just from her nastiness but more from my knowledge that indeed my report was lacking and she is the last person I want to expose my weaknesses to!

When I give report to the experienced RNs they are very helpful, we'll do walking rounds, and they help me answer the questions I don't know, they are not out to "get" me but to teach me. It's something I like about the ER atmosphere - I never feel alone and I can always ask for help without feeling like too much of an idiot. I will be forever grateful to these experienced nurses.

I also gave a really sh*tty report to the MICU one night - it had been an intense high-acuity shift, and the MICU alerted us to the bed being avail at 10 mins before shift change and I was frazzled and disorganized in my thinking and she asked me at one point "Did you just come on, do you know this patient?" Ugh, I wanted to die. Another moist ride home.

My preceptor and the nurse educator keep reminding me how much more I know than I did 8 weeks ago - but it is very hard to find the positives because each shift brings so much to learn and so many fresh horrors that overwhelm me! I am just trusting the process - everyone says the first year sucks and I am finding that true. Everyone says things get better after a year so I am betting on that too!

Keeping a lid on my negative self talk is helping too. When I focus on my mistakes and mutter criticism (curse!) at myself and call myself stupid I set up a whole negative spiral that just leads to more mistakes and disorganization. I am trying to shake stuff off quicker, learn from the mistake and move on.

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