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

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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

    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
    xtxrn likes this.
  2. 35 Comments so far...

  3. 2
    Poor honey! I can't give you advice (I'm still a student) but I'm feeling your discouragement and frustration through your words. I do hope this will get better. Thinking back to first months and first year of my previous jobs I was always unsure, insecure, ****** at myself for mistakes...this is normal when you care! Its clear you have the desire and concern. Decide to learn from these events and stick with it.
    pockunit and opossum like this.
  4. 11
    Sounds like a NASTY assignment for an ICU anyway. It gets better. I would bet the nurse wasn't asking you for the medical reason the patient hadn't been transfered to a floor, rather, it was a "what the heck is she still doing here" second guessing the doctors kind of question. My standard reply is " because her physician ordered her here and hasn't changed his mind" . As to lab quizzing, it's an old game to make the new nurse feel like a failure. "I haven't a clue, and didn't have time to look them up since they didn't have an impact on my immediate care." is always a fair answer. I could see if you were doing STEMI care on a reperfusion and didn't know your last enzymes, but as much as I'd like to know every lab value on every patient I have, I sometimes just settle for keeping them out of the body bag for my shift. I am not seeing the whole picture, so the nurse following you may not have been nit-picking, but more often as not, questions during report are more an attempt to make you doubt yourself than they are a real need for information. My advice, keep a card on each patient. As things come up that are something you want to pass on in report, make a note of it at that time. Make blank spaces for any labs you expect and want to follow-up on. Ask yourself before you start : what is this patients biggest problem at this time, and what problems am I solving, or watching for over my shift? If you can get that far you are well on your way to managing your patients.
  5. 1
    Thanks for the words of encouragement; I'm pretty good at shaking off a bad day but this one just really got to me.

    suanna, you're right about the nurse asking about why the patient was still there; we often wonder aloud why certain pts are still in ICU! It just hit me at that moment: I never even asked myself that question the whole shift. I missed "the big picture" - most of the time I just figure it's because the MD didn't feel like rushing to transfer them up or whatever. I wouldn't make a big deal of it anyway unless we needed the bed...but yeah, I just didn't even think of it. I'm still so focused on the little things, like getting all my meds done on time, etc.

    vegasmomma, thanks again for the kind words...I've also felt like this in other jobs, feeling like I don't quite fit yet and that it's just a matter of time before I feel comfortable. But this...this is unlike anything I've ever done in my life. It's just so...difficult and draining! I sure hope it gets better.
    gingersnapsRN likes this.
  6. 3
    Smh I was thinking the same! seems like nothing is going right for me,my manager is also very supportive but I'm wondering how long that will continue? I have not one friend at work and the one person I did call for advice,ignores me now,I guess I complain too much lol But this site has really helped me and if you know any support groups for scared new RNs anonymous then let me know! lol We need our own special support group.
    Nursingluv101, nsue, and opossum like this.
  7. 2
    Oh, that first year is TOUGH!! Just ride it out one day at a time. I'm sorry this shift was so bad, but you have to do what you can to get through and know that will be enough. Hugs.
    sweetgeorgia and opossum like this.
  8. 0
    It will not get better, only worse as the economy gets worse, more paatients per nurse, sicker because already people can't afford their copays an deductibles so are prolonging medical care, meaning sicker patients, with more pressure to get them out, and so on.
  9. 1
    I myself am a brand new nurse. In fact I haven't even started my new job yet. However, I can tell you what I have been told. I was told the first year is awful. You constantly feel like an idiot that should have never been granted a license. It also doesn't help when the experienced nurses hound on you, however it seems to be a type of initiation for some nurses. Just stick in there, you know more than you think you do. And as you practice more you will develop your own routine and plan to find how you work most efficiently. When you're a brand new you are just trying to remember to give your meds at the right time. It will get better!!!!
    opossum likes this.
  10. 1
    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?
    opossum likes this.
  11. 6
    Quote from Karl Farmer
    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?
    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
    Last edit by ~Mi Vida Loca~RN on Jul 8, '11


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