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 Pediatrics, ER.

Don't let them make you cry! It isn't worth it. No one is perfect and everyone is human. I work in a community hospital ER and have between 3-6 patients at any given time. I've been there for almost 4 months, and I recently had 2 head bleeds to transfer out and a stroke activation at once, plus a 4th stable patient. It gets CRAZY. You CANNOT know everything. If I had to give report in the middle of that and a nurse tried to take a bite of me I would've told her to start with my left buttcheek. It has to be even more stressful learning trauma. Airway...Breathing...Circulation....Labs? It's pretty far down the list, unless there's something glaringly wrong or you're giving medications that are a direct correlation. I usually give report with the patient chart open and scroll through. It helps me focus on what the pt came in for, what we've done for them, tests they've had, meds they've been given...then if there's a high risk drip we go to the bedside and do a line reconciliation. I find doing walk rounds makes you freeze more because you're trying to recall from memory about that pt in front of the patient while the patient is distracting you with other questions.

Nursing is a lifelong learning experience. The day you know it all is the day you should find a new career. The nurses who eat you for lunch now are the same nurses someone else ate for breakfast when they first started. Just remember how it makes you feel and break the cycle in a couple of years when you're raising your own nursing babies. :)

My first thought was maybe three days of intense rest might be in order. Amazing what a rested body and a rested mind can accomplish. Hang in there.

Specializes in Rehab, critical care.

I'm a new nurse in the ICU, as well, so I feel your pain. There are days where I feel on top of my game, and others where I feel just like you. All we can do is our best, provide good, safe care, and be confident in the knowledge we do have and trusting our gut. You can do this! Not all nurses are going to be kind, just the way it is, so just suck it up for now, and even if the not-so-kind ones call you out on something you should know (like labs), then just try to better yourself for next time. The stable lady wasn't your priority at the moment, so it's understandable and not always possible to know it all, but it's good to at least try b/c the ones we think are stable may not be in 10 minutes. I think the PP had it right....she probably wanted to know why she was still there and not transferred down to the floor or just likes to know everything about her patients (I'm one of those people too lol, but I don't make people feel dumb if they don't know; I know how hectic it is, I don't know everything either (that's for sure lol) and I'm quite capable of looking them up).

I usually just take a few minutes at the beginning of my shift after I've received report to look up their labs, and that helps me know their baseline, and plus, then I can call the doc to notify them if they look like they're trending down to get replacements ordered before they're in the gutter. Who am I to offer advice, though? lol. My time management sucks sometimes right now, working to improve that, but I try to focus on my strengths, too (probably would help your confidence, too, if you focus on all that you do right!) Have you found anything that has slowed you down? I know what 2 things slow me down now, and so now I can work on those areas (but I'm sure it's more than just the 2 things I am aware of lol).

We're here with you! It's stressful, and can take a toll on us if we internalize the stress and not take care of ourselves and learn to leave work at work. I think that will get better with time as we build confidence, and trust that we made the right decisions, etc after leaving work and build rapport with our co-workers.

Specializes in Oncology; medical specialty website.
Nurses eat their young, always have, and always will. It's party due to envy (you may be prettier than they are, or rebuke their advances), partly job security fear (they can fire tham and hire new grads cheaper), and other reasons, and I'm sure we all could name a few?

I didn't see any nurse eating going on here. I have no idea where you were going with the "rebuke their advances" remark.

Why is it whenever someone is having a problem with their job, it's a;ways the fail of the seasoned nurses? Maybe the OP just isn't suited for ICU and would do better on a med-surg floor. Maybe she just needs more time to adapt to the job.

Decades of nurses graduated and started working; there was not the level complaining and accusing older nurses of "eating their young" like there is now. Have we raised the next generation to be unable to handle criticism/negative feedback? Nurses new to the profession should expect negative feedback; they're new to the profession and are going to make mistakes. Mistakes must be addressed...people's lives are at stake.

I hope the newer nurses can keep in mind that questioning you about your patient isn't always questioning your abilities as a nurse. Sometimes (at least with me) it is your own fear of having performed poorly that makes you view questions and comments as an attack. I often question about certain labs or situations during report. It is because listening to the reporting nurse has made me consider certain things. I have never looked down on someone who didn't know the answer, but I do make a note to remind myself to check on it! :) I know there are some nurses out there who do carry mal intent, but try to ignore them. If it is the majority of nurses you are dealing with, try to find a new unit! I now appreciate when people question me and use it as an opportunity to learn. If it is truly an important and applicable question to the needs of my patient, I will remember to regard it the next time around! Even the most experienced nurses are learning something new on a regular basis!

Have we raised the next generation to be unable to handle criticism/negative feedback?

I could offer some experiences and observations in my management experience outside of nursing, in regards to this question. However, whenever I bring this up it immediately strikes many nerves. :D

Specializes in ICU/CCU, Med Surg.
I didn't see any nurse eating going on here. I have no idea where you were going with the "rebuke their advances" remark.

Why is it whenever someone is having a problem with their job, it's a;ways the fail of the seasoned nurses? Maybe the OP just isn't suited for ICU and would do better on a med-surg floor. Maybe she just needs more time to adapt to the job.

Decades of nurses graduated and started working; there was not the level complaining and accusing older nurses of "eating their young" like there is now. Have we raised the next generation to be unable to handle criticism/negative feedback? Nurses new to the profession should expect negative feedback; they're new to the profession and are going to make mistakes. Mistakes must be addressed...people's lives are at stake.

I agree...mistakes should absolutely be addressed. To be clear, I don't think I've experienced the "eating young" phenomenon from any of those seasoned nurses, even if I felt they were nitpicking at the time. If anything, they were pointing out the obvious or alerting me to a potential (or actual) mistake regarding pt care. I may not have liked their tone of voice, but whatever. It's not always about me and my feelings :smokin:

I don't expect to be handled with kid gloves...I think I just get overwhelmed. A lot. And maybe ICU isn't the right place for me...it's been 4 months since my original post and I can say things have gotten a bit easier. I definitely like ICU more than Med Surg; I'm just trying to find my niche and I think I'm having a tough time with the emotional/mental/physical realities of floor nursing v. nursing school.

I'm thinking I'll get there...eventually...

Oh gosh, did I write this? I, too, often forget to look at the big picture and forget to about my labs, etc. Unless I've been notified of a critical lab value, I tend to just forget about them since it always seems like I have so much going on. I've been called out a few times for not knowing why a patient was still in ICU and just this morning I didn't realize that a patient's K level was 3.0 and the nurse who was taking my patient was annoyed (rightly so) that I hadn't called in the result to the MD and got a order to replace her K. I'm three months in to my first job as a nurse and I'm not sure it gets better but just know that you're not alone.

I'm sorry to hear about your difficulty and your feelings of incompetence. However, you're just inexperienced and this is totally expected. It's hard to think to look at the "big picture," to know when to ask why, etc. Heck, "what IS the big picture" is a hard enough question to answer sometimes.

You made a mistake that tons of experienced nurses make--focusing on someone you felt needed your attention to the detriment of those who are lower priority.

Give yourself some slack. :)

this thread makes me shiver and anxious big time! and i just started my orientation. Yikes!

I know this is thread is years old but..... Did it ever get better? Right now I am in that position: feeling incompetent, frustrated, want to cry every shift, older nurses look down upon me, feel like poop, type of new nurse.

I am a new grad RN, I am on a CV surgery floor and I was fortunate to be back on the unit I had my consolidation at during my final year in school. I only had one shift before and the routine is slowly coming back to me but I still feel like I'm a student. I feel like the other nurses expect a lot from the new hires.

My preceptor is nice but I fear disappointing her by being incompetent. So like the previous poster, I hope it gets better and what's the best way to turn a bad experience into a good one? I haven't had one yet but I am just anticipating that day....

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