Another feeling stupid thread... Need encouragement

Nurses New Nurse

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I am so mad at myself. I have beating myself up all weekend. My husband has to be sick of me saying the same things over and over again. I hate being new! I hate it. I am a brand new nurse. Graduated in February. I've been on the floor 2 weeks right now doing postpartum (mom & baby). I feel totally stupid and incompetent. I hesitated posting here because I am very aware that cyberspace is really a small place and is not as anonymous as people think, but I really need encouragement so here goes. Oh well maybe my coworkers will anonymously post words of support (or advice or a smack upside the head or whatever it takes for me to be a good nurse.) My assessments suck! I am completely embarrassed for missing things (and I think my preceptor thinks I'm stupid now). I have been playing Taylor Swift's Shake it Off all weekend to get my brain back on track. I am mostly sucking at assessments. Of course that may be because I haven't had much opportunity to do anything else. I have done head to toe assessments, but my school did a lot of focused assessments too. I missed tons of things I should have been covering in a head to toe assessment, but I didn't think of asking. I forgot some obvious steps in my assessment that I should not have missed. Also I can't hear heart murmurs on newborns to save my life right now (working on that). Struggling with telling what's abnormal on newborns in head to toe assessments and hearing "you know what normal looks like" though doesn't help because I guess I realized this week that NO I don't know what normal looks like! I'm a brand new nurse. So, what I did all weekend was look at pictures, tons of pictures of newborns, variations of normal, and abnormal. I listened to heart murmurs until my head hurt (and still not sure if I can recognize one). My husband assures me that I just graduated from school and I should be making mistakes right now and that's why I have a preceptor. All that being said, I want to do a good job. I don't like looking stupid. I don't want my preceptor to think I'm incompetent. I don't care if she thinks I'm good at this point, just not that I'm a complete moron. I don't think they orient a lot of new grads on this floor. Please gals and guys support, encouragement, tips for doing better with assessments, tips for not looking like a moron. I'm doing fine with skills and medications thus far. I don't think my time management is horrible, but assessments need serious work and that I know is the biggest part of nursing. I really, really want to do a good job. I want my third week on the floor to go better than the first two. Thanks.

Lev, MSN, RN, NP

4 Articles; 2,805 Posts

Specializes in Family Nurse Practitioner.

Deep breath... I wouldn't do anything different from what you are already doing other than talk to your preceptor (if she's the receptive type) about your struggles. You've only been on the floor 2 weeks. 2 weeks. Hardly enough time to be competent.

Specializes in NICU, ICU, PICU, Academia.

Be open and honest with your preceptor. It's been two weeks- you are just getting your feet wet. As long as you don't continue to make the same mistakes over and over again- you'll be fine.

And as for murmurs- it takes time. As in sometimes you have to listen for a full minute in order to pick them up. Little hearts beat so fast!

Postpartum RN

253 Posts

Specializes in Postpartum, Med Surg, Home Health.

First of all, congrats on landing a job in OB so fresh out of school!! It's my dream to be in OB, and I have been a nurse for over 6 years and still have not been able to attain my goal 😁

Only 2 weeks, don't panic over it, it will get better! It takes practice practice practice to get better with your assessments, it will come with time. As for listening to the babies heart for murmurs..I would suggest making sure all other sounds are off, close your eyes and calm your breathing, and just listen for that lub dub lub dub...pretend for those few moments that is the only thing in the world going on at the moment..sometimes on adults their heart sounds can be so muffled and difficult to hear, so I need to make sure that all the noises and thought processes in my head stop and I am only listening...!

You didn't mention anything about your mother assessments, how are those coming along? You will do great, relax, ask lots of questions; also maybe go into the nursery when you have some time and listen to all those babies hearts, and ask the nurses which ones have a heart murmur so that you can try to hear it!

mvm2

1,001 Posts

Would it help to make a check list of what you have to do in an assessment and keep it in your pocket so that you don't forget anything. I believe if you just find a way that makes since to you and do the assessment the same way each time it will become second nature for you eventually and it won't be a problem

Also don't be so hard on yourself. Take the afternoon and write a list of all the POSSITIVE things you have done these last two weeks and then get a hug from your family

enuf_already

789 Posts

I second the deep breath! It's too early to panic. First, you recognize your weaknesses and are doing something about it. Good for you. Stupid people don't realize what they don't know so you can throw being stupid out of the equation right now.

If you like your preceptor, tell her that you like how she does her assessments and you would like to watch her do one on baby while she talks out loud and you write it down. Ask her what abnormalities are normally caught at this stage and how those babies presented. There is no harm in saying you want to make sure that when you are off orientation, you are a fully contributing team member and right now you are concerned about making mistakes. If you have a unit educator, they would also be a great resource.

Hang in there! It will get better. Just remember to breathe.😀

tsm007

675 Posts

First of all, congrats on landing a job in OB so fresh out of school!! It's my dream to be in OB, and I have been a nurse for over 6 years and still have not been able to attain my goal ������

Only 2 weeks, don't panic over it, it will get better! It takes practice practice practice to get better with your assessments, it will come with time. As for listening to the babies heart for murmurs..I would suggest making sure all other sounds are off, close your eyes and calm your breathing, and just listen for that lub dub lub dub...pretend for those few moments that is the only thing in the world going on at the moment..sometimes on adults their heart sounds can be so muffled and difficult to hear, so I need to make sure that all the noises and thought processes in my head stop and I am only listening...!

You didn't mention anything about your mother assessments, how are those coming along? You will do great, relax, ask lots of questions; also maybe go into the nursery when you have some time and listen to all those babies hearts, and ask the nurses which ones have a heart murmur so that you can try to hear it!

Just as bad! I totally forgot to turn the patient over to assess her episiotomy! I checked the bleeding and fundus. I don't know why I didn't remember I needed to do that. I think it's partially because on my own kids postpartum they didn't turn me because I was intact so I just totally forgot that step. I feel like an idiot. I guarantee I will NEVER make that mistake again though. I have done maybe 1 day of postpartum in school. That and I listened to lung sounds and heart sounds last. (That part I don't care about. I don't always do things literally head to toe, but I go in the order that makes the most sense for the situation. However, since my preceptor wants to see head to toe I will do it in that order during orientation.)

I also didn't ask about headaches, check reflexes or clonus either. In my head I was thinking those were only relevant for pts with a history of PIH or preeclampsia. I read up tons on labor because this was a labor position, but I didn't use diligence in reading up on postpartum. I totally forgot about the fact that preeclampsia can show up postpartum. All these things I should have known and it was kind of like a head smack/duh moment when I thought about how I missed these after the fact!

I am sure I will not make these mistakes again, but trying to figure out how to redeem myself in the eyes of my preceptor now. I am sure she won't hold this against me forever, but I really want to do better.

tsm007

675 Posts

Would it help to make a check list of what you have to do in an assessment and keep it in your pocket so that you don't forget anything. I believe if you just find a way that makes since to you and do the assessment the same way each time it will become second nature for you eventually and it won't be a problem

Also don't be so hard on yourself. Take the afternoon and write a list of all the POSSITIVE things you have done these last two weeks and then get a hug from your family

Totally redid my brain sheet again and don't care if I look dumb it has all the things I could think of that I needed to check. I even made a list for postpartum education and a cheat sheet for things I need to teach since there were none on the floor. I figure she hasn't seen me do education yet I can at least nail that one! I'm usually really good with patient education.

tsm007

675 Posts

I second the deep breath! It's too early to panic. First, you recognize your weaknesses and are doing something about it. Good for you. Stupid people don't realize what they don't know so you can throw being stupid out of the equation right now.

If you like your preceptor, tell her that you like how she does her assessments and you would like to watch her do one on baby while she talks out loud and you write it down. Ask her what abnormalities are normally caught at this stage and how those babies presented. There is no harm in saying you want to make sure that when you are off orientation, you are a fully contributing team member and right now you are concerned about making mistakes. If you have a unit educator, they would also be a great resource.

Hang in there! It will get better. Just remember to breathe.������

Going to do that! I really want to get this.

Mavrick, BSN, RN

1,578 Posts

Specializes in 15 years in ICU, 22 years in PACU.

OK, let me get this right.

You are a brand new nurse, as in, just out of nursing school, not been out awhile and messing around in other jobs and just now got the job of every student nurse's dreams.

You have been on orientation for 80 whole hours, or would that be 72 if you work 12 hour shifts, and you want your preceptor to think you're a good nurse.

Well, I gotta tell ya, your expectations are your problem. You seem to be doing great as a new nurse, making mistakes, learning, asking questions, but you are NOT a good nurse. Realistically speaking you probably won't be for another year or so. Ain't it just awful being human and all. Expert practice is rumored to take 10,000 hours of repetition, so you got time to catch on.

The fact that you want to do well has driven you through nursing school and to getting a respectable job on a post-partum unit in a hospital but that same desire can drive you (and your lovin' husband) crazy. Now you must nurture the little baby nurse growing in your brain. Learning stuff for the first time, finding your toes, missing your mouth, falling down and getting back up.

Please, please allow yourself to be a great orientee. Let your preceptor teach you her way. You can always modify it later when you have a better way. Dial down your expectations to what is reasonable for a new grad. Listen to the feedback you're getting from your preceptor and continue to make progress.

Enjoy your weekend and if you're a mom, HAPPY MOTHER'S DAY!

I started on L&D as my first job about 9 months ago and felt the same way. So-first of all, you are NORMAL! We all go through it!

This is what you do:

1. Ask questions anytime you are unsure. Try not to ask the same question twice, if you need to write the answers, that's ok! A good preceptor expects the questions!

2. make yourself a good brainsheet, and use it!

3. List steps of what to check on a 3x5 index card. One for mom, one for baby. Use it like a check list--it won't take long before it is second nature, but until it is, use it every time you go in to assess.

4. Get hold of other new grads where you work, or some of your classmates and form an informal support group. I did this, and trust me, you have no idea how valuable it is to have others who are going through the same thing to vent to. Once you have solid proof that EVERYONE feels the way you feel, you will start to be ok feeling that way. it is the smartest thing I ever did!

5. celebrate your accomplishments, because even if it doesn't feel that way, every day you are learning something and that REALLy is an accomplishment!

Long around the 6 month mark, I suddenly realized that I no longer felt like a stupid, incompetent dolt! it was a wonderful feeling! I still don't know everything that I need to know in order to do my job perfectly...but it really truly is going to get better! So wear your badge with pride, and understand that they wouldn't have hired you if they didn't have a heck of a lot more faith in you than you have in yourself. This is the first time you have done this, but it isn't their first time. Trust them to train you, trust yourself to learn and you will do great!!!

Specializes in Obstetrics/Case Management/MIS/Quality.
First, you recognize your weaknesses and are doing something about it. Good for you. Stupid people don't realize what they don't know so you can throw being stupid out of the equation right now.

The quote above is very true. I've seen it time and time again with new nurses that I have trained in OB. The fact that you recognize what you don't know is a great first step. The dangerous nurses are the ones who think right out of the gate that they know exactly what to do, all the time, and do not question themselves ever. I would take an orientee like yourself any day!

You are very new in the orientation process and so I would suggest being gentle with yourself. Take the great advice that other nurses in this thread have offered you. I especially like the comment of getting completely quiet to hear the baby's heart while trying to discern a murmur. If necessary, and if mom allows, bring the baby into a quiet nursery and close your eyes and just listen for a few minutes at a time. Of course, make sure that mom doesn't get the idea that something is wrong with her baby! Don't want to scare a new mommy!

You will do fine in time. I have no doubt, because you show a genuine desire to be a fantastic and skillful nurse. Best of luck to you!

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