Help on adjusting to being new grad

  1. I am a new grad on a tele floor, I have been there 6 months. My problem is getting the fact that I don't know what the more experienced nurses know and that I am still learning. I don't feel like my patients are getting what they need, because I am still in the "task oriented" phase of nursing and not able to see the full picture yet. I feel the nurses with more experience are better able to care for patients than I am and I don't think it is fair to the patients. I have a wonderful group of nurses that I work with and they are all extremely helpful and supportive, as is my manager and our nursing education department. We have an RN residency program that meets once a month and they come around and check on us new grads. I could not ask for a better place for my first job. I know the problem is all mine, but any advice on how to deal with this adjustment would be helpful.
    Thanks for any advice!
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  2. 6 Comments

  3. by   llg
    It sounds like you have a good understanding of the situation. Now, you just need to learn to accept it.

    Some people in your situation would blame everybody else -- finding reasons to criticise their coworkers etc. for finding out that life as a nurse is not always perfect. At least you have the good sense to realize that you are in a good situation with supportive people who are treating you reasonably.

    As far as "how to deal with it goes," here are a few suggestions off the top of my head. I hope other people will add to the list.

    1. Notice that your coworkers are not perfect and that they do not give perfect care every day either. (I think you can do that without without being overly harsh in your judgments about them.) You may have built them up so much in your mind -- put them on too high a pedastal -- that it makes you feel more inadequate than you actually are. It's kind'a like parenting. Nobody is the perfect parent: you just hope that you are a good enough parent so that your kids don't get really screwed up. Engage them in conversation about how you feel and ask them whether or not they feel that they have practiced perfectly most shifts. They will probably tell you that they feel they are not perfect either. Hearing them discuss their imperfections may help you feel more comfortable with your own.

    2. This goes along with #1. Don't set unrealistically high goals for yourself and your job performance. It's OK if you have to stay a little late or take some of your lunch break or whatever to get your work done. Everybody does that sometimes: most people do it regularly in the early parts of their career: doing it doesn't make you worse than everbody else. It's OK if you sometimes say or do the wrong thing as long as nobody was seriously hurt by it. etc. etc. etc.

    3. Focus on patient safety first. The other stuff is great, too, but can often be missed without too much harm to the patient. As long as you kept them safe and didn't actually hurt them, you did OK for the day.

    4. Reflect back on all that you did not know ...and on your lower skill level ... during the first few weeks on the job. Identify all that you have learned and the improvements in your abilities over the last several months. That should help you feel that you are moving in the right direction. Set some modest, realistic goals for the next few weeks so that you can continue to see yourself developing in your nursing abilities.

    5. Remember the old serenity prayer to help you with the acceptance part: "God, grant me the ability to change the things I can change, to accept the things I can not change, and the wisdom to know the difference."

    I'm sure there are other ways to help yourself that others will contribute to this thread.

    Good luck,
    llg
    Last edit by llg on Jan 11, '07
  4. by   AliRae
    Don't be afraid to ask questions. 6 months or 6 years of experience? Doesn't make a difference. We're all still learning. (I say "we" especially because I still think of myself as a new grad ... been at this a whopping 15 months.) Learn when to say "I'm not comfortable doing that" - it's better to ask for help than to do it wrong or do something to hurt a patient. Admit your mistakes. Not only does honesty earn you respect, but others will most likely end up learning from your stumble. Remember how your preceptor did things, but don't feel like you need to do everything exactly the same way. Look around- look how the experienced nurses organize themselves and perform tasks, and form your own hybrid system. Once you make your first med error, stop and breathe. It was pretty much bound to happen, and now you're past it and you can stop dreading it.

    Write things down, especially when they're good things. It's easy to get overwhelmed with the magnitude of what you have to learn, so hold on to the moments when you can think "YES. This is my calling, and this is why I do this job." I'll never forget the mother of my patient on my very first day off orientation. We were chatting, and she looked at me and said "I can tell you love your job. You're doing what you should be doing." I held onto that with both hands when I got into a fight with the attending later that day about my other kid, and was able to stand my ground and do the right thing for my patient. Be proud of yourself when you do things well.

    Have something other than nursing that you love to do. Whether it's music or swimming or paint-by-number, you need something on the other end of the spectrum to keep you balanced. Leave work at work. It's so easy to dwell on things, but after your 12 hours are over, it's best to leave it at the door until you're back on the clock. (I'm bad at this, so my policy is that I'm allowed to think and cry while I'm driving home, but for me it has to stay in the car.)

    Stop. Breathe. Smile. Hold your head high. You've a part of what I feel is one of the most important professions out there today ... Welcome!
  5. by   incublissRN
    OP,

    I have those same feelings. I graduated May 2006 but I was unhappy on the cardiac medical unit I was on so I transferred to a cardiac recovery unit in November. I am off orientation next week and am getting very nervous! I feel like I just graduated in November.

    Whenever I have a bad night I stop and think about all the things I've learned in the last 12 weeks. It's going to take a long time before I feel like a competent critical care nurse. It's great that you work with supportive, experienced nurses. Whenever a patient of mine looks funny or I can't figure out what's going on I always discuss it with another RN that I trust. That is all that is expected of me at this point...I might not know what's going on but at least I can tell something is wrong.

    If I had a bad day and was complaining that I didn't do anything positive for my patients the nurses that I looked up to would say, "Are your patients alive and breathing? Then it's a good day."

    I try to think of positive statements to say to myself whenever I feel like my night is falling apart, it helps with my self confidence. And like AlieRae said, find a hobby. My friends bought me paint-by-number for my bday!
    Last edit by incublissRN on Jan 11, '07 : Reason: typo
  6. by   GrnHonu99
    Quote from elfinM
    I am a new grad on a tele floor, I have been there 6 months. My problem is getting the fact that I don't know what the more experienced nurses know and that I am still learning. I don't feel like my patients are getting what they need, because I am still in the "task oriented" phase of nursing and not able to see the full picture yet. I feel the nurses with more experience are better able to care for patients than I am and I don't think it is fair to the patients. I have a wonderful group of nurses that I work with and they are all extremely helpful and supportive, as is my manager and our nursing education department. We have an RN residency program that meets once a month and they come around and check on us new grads. I could not ask for a better place for my first job. I know the problem is all mine, but any advice on how to deal with this adjustment would be helpful.
    Thanks for any advice!
    Frusterating isn't it..to feel like you have the ability to be a great nurse but knowing that you just need more experience. Im in a similar situation. My hosp is awesome, I couldnt have asked for a better place to work. All my co workers are great, supportive. My environment is conducive to learning. We have educators that circulate on most nights just to help new grads..

    However...I still feel inadequate...i just need experience and there is no book i can read or class i can go to to hurry that process...in school it was easy, if i werent doing as well as i would have liked then i would just study more...

    now, there isnt anything i can do but just keep truckin through...everytime i have to call a doc or when they round, i try to preapare myself, think what questions can they possibly ask me...never fails that no matter how much i prepare they always come with something where i have to say...i dont know. sigh.

    it will get better. every night i learn something new.
  7. by   elfinM
    Thank you for all your wonderful advice. It will all be helpful! I also did start up my Yoga again to help focus. Thanks again.
  8. by   hica19
    Thanks so much everyone as well! I'm in exactly the same boat as you all...new grad for 2.5 months...on my own for about a month or so. Some days I felt myself really progressing. But then there are days when I feel myself hit a stumbling block and things get rough. Like for today...things started out well...but then I got a new admission and things started to escalate out of control for me. It's mainly because there were a lot of skills that I had to do today that I've never done before...i.e. changing a PCA dose or flushing a NG tube. And because I've never done these before, I had to ask, which took up a lot of time. As a result, I was way behind on my charting and stayed over an hour later to finish up, and even then, things weren't as good as I would have liked it.

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