Has anyone felt like this soon after being off orientation?

  1. I have been off orientation for one week so far. First day was pretty overwhelming. I had three patients that were all new admits. Two came to the floor close to change of shift and one came to the floor shortly after change of shift. I felt I was running around a lot and asking the charge nurse questions almost every second. The difficulty was that I was not used to getting admits who came either from home or from ER and those were the admits I got on my first day off. When I was on orientation, the only admits I've recieved were from the recovery room. I felt like I was running around the floor like crazy to try and get things settled before I was finally able to sit and chart. Plus felt like I had to ask the charge nurse questions every second. In the end though, things came together. Second night off, I only got assigned two patients...both of whom I had the previous night. This time I felt the assignment was a bit too easy...even with some unexpected occurences with one patient (low urine output and an elevated temperature). I had time to give explainations to the patients and tend to the unexpected occurances pretty much on my own, had time to read about the past medical histories, etc. and managed to give report and leave earlier than usual when my shift was over. I felt really good about it. Third night off though, started out relatively well. Had three patients, discharged one...and then got another new admit from the ER. From that point on, I just felt overwhelmed. I really don't know why. The new admit patient was a total care patient, latex allergies, and with multiple needs which I have not done before such as catherization and certain types of dressing changes. Really felt like I was running around like a chicken with its head chopped off for the shift trying to get this patient settled in and tending to my other two at the same time. In doing this, I almost made a med error. I was supposed to give this one medication by IV push to a patient, but as I was drawing up the medication, I noticed I accidentally took out the wrong vial. It was a really good thing I caught the mistake that early on in the game when the medication was nowhere near the patient. So all I had to do was waste the wrong vial and get out the correct one instead. I felt change of shift did not go as well. I left way too much of the admission assessment for the day shift nurse to do, and one patient was on call for the O.R. Transport came right at change of shift, and I didn't even think to get the patient prepared earlier on in the shift. It was a fustrating night. Even though none of the patients were put in danger, I felt there was so much I could have done to make the night go smoother. Anyone have days when they felt like I did?
    Last edit by hica19 on Dec 13, '06
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  2. 10 Comments

  3. by   CarVsTree
    Yes, that sounds about normal. It gets better, I promise. You did great btw!

    Oh, and you did NOT make a med error. You had a near miss. Great job at catching that. That is why we're supposed to look at the med 3 times.

    Again, give yourself a pat on the back (and perhaps a bath or glass of wine).

    You're doing great.
  4. by   RN BSN 2009
    You're doing great!! You'll get the sixth sense and the hang of things pretty soon. It just takes some time to get into the circulation.

    Keep up the good work
  5. by   stressgal
    Yep! Just keep moving on. It will get better, then every once in a while you'll have a day that will totaly knock you on your ...,,, well, you know! I'm in an ICU where the thought is to give the new person the toughest patients so they gain experience and the other nurses will know the newbies can handle things when the going gets tough. I'm the newbie so guess who I get. It really has been a great learning experience and each day I improve a bit more. Hang in there, you can do it!
  6. by   meannana
    one day at a time and each day you will get better
  7. by   AliRae
    My first day on my own was in February, and I remember it absolutely vividly. I was taking care of a little guy with a trach, and the first time I suctioned him, I thought I was going to faint. The attending wanted to send him home, but something told me he should stay. I got in a fight with the attending, and ended up in tears in the break room. Pretty much wanted to quit right there. But the little guy ended up staying, and it turned out he stayed for another 2 weeks with a pneumonia. I ended up getting very close with that family over the months, and was privelaged to take care of him again the last weekend that he was with us before we took him off his vent and let him pass away. I told the dad that weekend that the first day I took care of his son was my first day, and he said he would have never been able to tell. The moral of that long story? You're doing better than you think. Keep your head up.
  8. by   tamari07
    hica19, you just described my week ! This is my first week off orientation and I feel the SAME way. My first two days on my own weren't bad... I really can't complain, but I still felt overwhelmed! Yesterday I had four patients, one total and three "walky talkies". I work on a neuro unit so unfortunately our patients are impulsive and like to wander. So you have to have eyes in the back of your head. Anyways, I was pretty caught up, but I knew everything would happen at once: I was getting a new admission (95 yr old confused in resp. distress), my post cardiac cath patient would be back to the floor (freq. vitals, dsng checks.. .not to mention I've never had a post cardiac cath pt... I work NEURO!), and my other patient was coming back to floor from MRI... plus I had to start and IV in my other patient and hang her vanco... whew!!!

    Anyways... of course, as it always does, everything happened at once! Got my post cath patient, ten minutes later got my new admit, then my mri patient came back. So I'm running around insane trying to figure out what I need to do first. Everything is important, everything needs to get done.. I was just confused on what to do first. Fortunately I have an extremely supportive team. One nurse started the IV for me and hung the vanco, the charge nurse got my new admit settled in, and I could go check on my post cath patient and make sure he was stable. So it all worked out... though I did have that deer caught in headlight look. I think its just going to take time to learn time and priority management... that's one thing they can't teach you in nursing school.

    Just keep your head up... know you're not alone... I understand completely... good luck
  9. by   RN 4 U
    Quote from suemom2kay
    Yes, that sounds about normal. It gets better, I promise. You did great btw!

    Oh, and you did NOT make a med error. You had a near miss. Great job at catching that. That is why we're supposed to look at the med 3 times.

    Again, give yourself a pat on the back (and perhaps a bath or glass of wine).

    You're doing great.
    I am still in orientation and i feel a bit like she feels. I have been feeling out of control, almost made a med error, caught it and everything was fine.I just want to thank you for praising us new nurses even when we feel that we are out of control and failing miserably. It makes me feel good when even if i feel that i'm doing bad that someone like yourself, more experienced recognizes the things that i am doing well at and encouraging me along the way and to tell me that feeling this way is normal, but realizing that things will get better.
  10. by   nysnurse
    I hear you. I am 5 weeks off orientatation ( I work 2 nights a week in med-surg) and was told I was ready to float to another floor. Needless to say - I was given 7 pts (3 in isolation, 2 pts on the other side of the unit, 1 a new admit that was hallucinating all night long). The staff was not very welcoming and I left feeling like I really don't want to do this. We have no mentoring program. I feel pretty alone myself with no support.
  11. by   hica19
    Thanks everyone for sharing your experiences. I am now 3 weeks off orientation and things have gotten better. Still ask a million questions though, but everyone said it's much better to ask a million questions than not asking and making mistakes. I really don't know what I have done, but I've had two patients who seem to really like me. Whenever my shift was about to leave, they ask me if I were back the next day and if I were, they request that I take care of them again. One patient did a 360 degrees turn for the better the next time I took care of her and I got to discharge her to home and before she left she left me a vase of really beautiful flowers. And I had another patient whom I had taken care of the last 5 times I worked. I also got to discharge him to go home the last time I worked. He and his family left me two presents. I just love it when I'm able to take part in making patients feel this good. It was just really hard working Christmas day. Less patients around but then there were also a lot less staff around for help. The ones that were around were are also really busy themselves. Felt bad that I couldn't provide the care that I would have liked. I got a patient load that I've always been getting since getting off orientation, but this time I had to balance CNA work with nursing work. But I know all I could do is try my best. No med errors, no patients were put in danger.
  12. by   AliRae
    Quote from nysnurse
    The staff was not very welcoming and I left feeling like I really don't want to do this. We have no mentoring program. I feel pretty alone myself with no support.
    Is there anyone you've felt any warmth from? Our unit doesn't have an official mentoring program, but it's kind of understood that you have a "bond" with the person you precepted you (especially if you start as a new grad like I did). They put me on the same weekend as my preceptor once I was finished, and she was always there to answer questions. I would encourage you to try and find someone that you can use as a "buddy." It doesn't sound like the easiest thing in your work situation, but even an unofficial mentor like that can make a big difference.

    Keep your chin up- we've all been there. =/

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