Am I doing the right thing? New nurse getting butt kicked - page 4

by j_tay1981 12,824 Views | 58 Comments

I am a new male RN, BSN. I graduated in August of '12 and started at my job on a neurology/med-surg unit. I never really wanted to do med-surg, but many nurses told me that it is a great place to start because you can hone your... Read More


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    i'm also a new nurse, still struggling... at peak times, i would get so stressed out, but i started some subtle deep-breathing exercises, positive thinking/imagery, and basically told myself that being stressed makes everything WORSE, calm down, etc. it's been helpful. also, if you tell your co-workers- the very ones you're afraid of alienating- why you're snapping, how badly you feel about it, and ask for their help- you might get the understanding you really need.

    if the patient ratio is too much for you (we all have our limits & comfort zone), why not consider OR? it's a much more focused environment, although with stresses of its own.

    bets of luck to you!
    multi10 and j_tay1981 like this.
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    I've found that educating myself was a key in feeling more comfortable. After a little over a year of practicing I've gained a lot more confidence and rarely get nervous before work (unless I'm being pulled to ICU.. I'm only leary of going there because last time I had to take 3 patients and felt mildly overwhelmed since I wasn't oriented to work there). I learned from other nurses and mistakes I've made things that I knew but didn't really piece together. Looking at lytes can paint a picture of symptoms. Subtle changes can speak mass amounts of importance. Calling doctors gets easier when you start being able to guess what they'll say or make realistic recommendations of what you'd like an order for. Recognizing symptoms and acting on your instincts makes you feel great if you're correct and teaches you something when you aren't. Skills that seemed daunting become more routine. Knowing how to prepare someone for a test and educate them regarding it becomes easier.

    Post its are of daily use to me. I use one per patient to write down any important events from my shift and anything happening that day (tests, labs, consults, drips.. Etc..). It makes report much easier since I just stick them note to the patient summary sheets we use.

    I also attempt to chart as it happens or at least make a note on a paper towel or alcohol pad and stick it in my pocket. I'm terrible at remembering times so it helps me immensely. I still ask plenty of questions as do other nurses. I feel great that many times I'm the one they ask and I actually know the answers.

    You'll get there. Give it time and don't give up. Even though it sounds like you have great ratios (on my cardiac/icu step down we take 8 each), it can still be overwhelming depending on what's going on. Get your year and go from there. Good luck!

    ~ No One Can Make You Feel Inferior Without Your Consent -Eleanor Roosevelt ~
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    I actually got home from work a few hours ago. I was a delayed start due to a low census that stated to pick up later in the evening. Tonight, there were a few times where I called the doctor regarding a patient's pain and asked for an uptick in morphine frequency for pain. From my past experience (albeit limited in time) I knew what to ask for from the HCP that would be reasonable. He agreed with my request and the patient hit the analgesic she needed.

    So, I guess I'm saying the learning and acclimation is occurring for me. Small steps are still steps, right?

    I hesitated to divulge what my floors' ratios are; I know they are low and I didn't want my posts too sound too whiny (apologies if they do). To me, however, they are still a bit of a handful.

    Interesting idea: going into OR nursing. As a tech, I worked in preop/PACU and got to see a great deal of patients before and after surgery. Likewise, surgery clinical where usually my favorites. I always loved A&P!

    Thanks for all the advice and support! Please share whatever else you'd like!
    canoehead likes this.
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    OP, you've received great advice here and you are cool and kind enough to acknowledge that we are paying attention. You're already way ahead of the game. I can only speak from experience about nurses and nursing. For example, one of the strongest and most capable men I know switched careers to become an RN.
    I asked him, "What is your favorite part of being a nurse?" He replied, "Driving home from the hospital." Huh!? That kind of shocked me because he had worked so hard to become a nurse. I asked, "What's your least favorite part of being a nurse? He replied, "Driving to work. Me: "Wow."

    Today he no longer gets sick in anticipation of going to work. There are other joys in his life. Make no mistake: Floor nursing is horrible but you will eventually find a method of coping.

    Maybe someday Nursing conditions will be restored to when we nurses had manageable work-loads and Management provided us with what we needed and had realistic expectations of what one human being can accomplish in one 8-hour (or 12-hour) shift.

    I hope to see that day in my lifetime.
    Last edit by multi10 on Jan 6, '13 : Reason: spell
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    I think new nurses are told to start in med surg because so many hospital specialties want a year of med surg an because it teaches you stuff that you used to get in clinical under the old fashioned hospital based nursing school. I did two years (part time) and was float, I floated between med surg, LTC and maternal newborn and dipped my feet in corrections nursing and mental health. Now I'm a maternal newborn nurse who's dabbling in school nursing. I will say this, the women who taught me my job 15 years ago taught me skills and organizational habits I use to this day. If you have good mentors it's a good experience, if your mentors leave you to sink...then yeah, med surg is a rocky way to start. Hang in there. One little tip I've learned...go and see all of your patients for a quick "Hi, I'm Autumn, I'll be your nurse tonight, is there anything you need right now?" If the answer is yes, assess and solve problem. if the answer is no? you go on to the next. Then you won't have the aid telling you somebody just vomited and someone else's pain is a 10.
    mind_body_soul RN likes this.
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    I graduated from nursing school in August of 2011. I have been working in LTC and in dialysis. I absolutely hated it most days , at least the LTC place since this was new to me. I have HORRIBLE gi distress. But I have learned that: 1. I am new , so I am not going to know everything all the time 2. that i shouldn't be embaressed to ask questions, which I do all the time. 3. to take it one day at a time. 4. i have to take xanax prn( this is very helpful).lol... good luck and give yourself a break , we all make mistakes and no one is perfect
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    Hey there,

    I am a relatively new med-surg nurse myself (1 1/2 years experience, counting my residency). My first year was HORRIBLE despite having had experience as a CNA in the hospital and as a home health aide in an AFH.

    I used to throw up before work.

    I used to cry after work.

    I would get out late every single day.
    I fantasized about leaving the field of nursing to become an apprentice chocolatier.

    And then...I don't know what happened. Something clicked. I stopped stressing out and spinning my wheels. I realized that no one is going to die if I can't fulfill every single patient request immediately. I prioritize the important things (pain, nausea, bathroom) and everyone else can wait! I learned there are diplomatic ways to communicate with patients so that they understand that you are doing the best you can. Example: "Sure Mrs Jones, I will get you some ice just as soon as I finish a procedure in another room. Thanks for your patience." or "I will be happy to discharge you just as soon as I get my new patient settled, can you give me 15 minutes?". Most people are pretty reasonable and those that aren't, well...too bad. You just can't take it on when you know you are doing your best.

    I still have awful days but it's a lot better now. I hope in time you will have a similar experience....the work may not get better but you will learn better ways to cope. Hang in there.

    (And as for snapping at coworkers, it's become a running joke on my unit that I need to eat throughout the day or else I get super cranky. I have a hummingbird metabolism, I can't help it. Just laugh at yourself and your coworkers will forgive you your short temper.)
    VegetasGRL03RN, Abby4031, multi10, and 1 other like this.
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    Yep, I remember those nights. It does get better!

    Once a more experienced nurse, sensing I was having a particular rough shift, told me that when those nights happen to always remember that by morning you will be a better nurse then you were when you started your shift. I found that to be true, and still have to tell myself that sometimes.
    multi10 and j_tay1981 like this.
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    I am 1 1/2 years out of school. I worked my first year in a med-surg float pool, but as of July, have been in SICU. I can definitely identify with having been extremely nervous before work for the first few months, and even after that if I knew I'd be floating to certain floors where acuity tended to be higher. Then, when I moved to the ICU, I might as well have been a new grad all over again. I'm actually just beginning to feel confident enough going into SICU at night without the nervousness that the OP speaks of. And it still hits me when I know we have CABG's on the schedule that day.

    Let me tell you though--it is like lifting weights. I use this example because it is a hobby of mine. You could say the same about running or anything else. Progressive overload. At first, benching 120 lbs was tough for me. But as more weight is added, the body adapts to lift more. I feel like the brain does the same thing. The more we learn and the more experiences we have, the more comfortable we feel. Sometimes, the worst experiences are the best because when you make it through a terrible shift, you realize... "Wow, I survived," and then the average nights suddenly seem a little bit easier.

    In the SICU, we had a bad 3 or 4 weeks where it seemed like every night, the worst was happening. Deaths, codes, etc. As a med surg nurse, I had only dealt with a rapid response once the entire year. I definitely wasn't ready for this. I was getting terrified to go to work. I questioned whether I could truly cut it in the ICU. But finally, things slowed down and the average nights were no longer scary at all. And the average situation that I would have found stressful before now seemed manageable next to that horrible month.

    So when you have the bad nights, just realize they teach you, and while you can't help but be stressed,make sure you learn from them and let them be confidence builders. And go where you want to work. This "You must work med surg for a year or so before going anywhere else" is a load of crap. I did it and still felt I was no more experienced jumping to the SICU than a few of my colleagues who were new grads. Disclaimer: Just make sure whatever you do, you get a decent orientation and have a good support system among other nurses.
    j_tay1981 likes this.
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    JottRN, thanks for this post. It makes a lot of sense. I've noticed too that surviving crappy nights makes the more mundane nights easier to work through.


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