Advice please!

[RNurse2]

I have been working at my first job for four a little less than four months now. It's a busy med-surg floor. I had a pretty lengthy preceptorship compared to some I've seen here, but I don't think it was very good. I don't know though because I don't have anything to compare it to.

Anyway, I'm really really struggling with time management. I feel so guilty when giving off going report because I either have to leave things hanging for the next nurse to do (while I spend an extra hour or two catching up on charting) or because I don't know about things concerning my patients when asked such as particular lab work because I haven't had time to look. I have read to try brain sheets, but things change throughout the shift so much that I don't think another sheet of paperwork would be that helpful for me. We have SBAR sheets for each pt when we get report and then I have a sheet that I put notes on of things I need to remember to do or chart. Not to mention I really don't have time to try to get much organization going on because I can't come in more than 5 minutes early and my work phone is ringing with fires to put out often before I'm finished getting report.

Then there are discharges and admissions and often having to work without an aide. Then there's all the tasks that pop up for me to do that are new to me that I have to stop, track someone down and ask them to help me (they are busy too and I know they will soon be sick of it). Add to the top of that the other stuff the company mandates such as hourly rounding grids in the room etc.

I am so overwhelmed. I cry a lot. I want to be good at my job so bad but feel like a total failure! I think it may be normal but I don't know. I see my coworkers getting off on time and even having time to chit chat sometimes and I am jealous of their abilities. If what I am feeling is normal for a new grad, I think I want to be abnormal.

[PA_RN87, BSN, MSN, RN, APRN]

This could easily be me right now. I'm on a medical-oncology floor finishing my 5th week of orientation and I feel like I'm drowning. I have horrible anxiety and I feel incredibly pressured to be "wonder nurse" right away. My worst fear is that I'll be fired for not being "wonder nurse." I'm so stressed all the time, and it's taking a toll on my physical and mental health. Everyone keeps saying it will get better, but I feel like I'm being judged for making mistakes or running behind. I've been told that "nurses eat their young," and I'm finding that may be more true than not.

I tried a nurse's brain sheet for the first time the other day, and I really feel like it helped me to organize my day, thoughts and remind me to chart certain things. I'll be tweaking and altering it as I find out what works and doesn't work, but it seems to help me keep organized, and my day seemed to go a little more smoothly.

I wish you all the luck, because I truly understand how you're feeling. I was 2 steps from quitting the other day because I felt like I couldn't cut it. You aren't alone, and I'm glad I'm not the only one who feels this way and struggles with the same types of issues. If I wasn't so concerned about preparing for graduate school, I'd be perfectly happy to work in a physician's office, school, or other "less intense" environment, but I want this type of experience to move forward with.

I've literally been surviving by taking it one day at a time. I have an incredible support system at home, and I try to focus on the good days when they come. I spent all of today on the internet researching others' experiences, and we're not alone. I've attached the brain sheet I'm using (and tweaking).

NurseBrain_6pts.doc

[Tammy121]

I feel the same way!! 6th week on orientation on step down cardiac floor. I feel like an idiot when I give report. I try my best to keep organized with all that went on throughout the day for the main purpose of change of shift report. Change in meds, doc orders, etc. Because I have felt stupid about forgetting these things during report, it has made me develop a habit of writing them down on my "rounds report" (which is the sheet we get that summarizes what is going on with the patient... Not sure if every hospital uses them or calls it that).

Anyway, what I do to organize, which is working for me, I use the rounds report throughout the day and that is where I write all my information. I get to work 45 early, print out all rounds reports on my patients, highlight important info, then look up labs. If I have time, I look up radiology tests. I also find extremely useful doctors reports because that gives you a quick snapshot of the patient plus the patients history. On the front of my rounds report I have several boxes, one contains the labs, another box is for my assessment, another box is for vitals and another for blood sugars, and a box for "to do" throughout the day to keep on task. On the back of my rounds report, I write shift report on the top, on the left i write shift reports assessment, on the right is a box for "open" procedures, on the bottom is for doctors orders and med changes. So I have everything I need for that one patient all on this rounds report that I carry around all day and update throughout the day. It's working for me and took me 6 weeks to figure out! Ugh. It still needs perfecting but I feel really good about it. It keeps me organized.

I love reading these posts because I feel so inadequate everyday at work, I beat myself up for making stupid mistakes. Like I don't know what it is but I can't keep all these details in my head like my preceptor does. I am improving though. Just taking one day at a time.