How can I handle the stress and anxiety?

[olliebear]

I'm a new grad nurse and just got off orientation last week. I work on a very busy med/surg floor and had great preceptors for the most part during orientation. Although I felt nervous about being on my own, all of my preceptors said that I was doing excellent and that I would be fine.

Well, I do love my job, my co-workers and my patients. I love interacting with and caring for my patients. I am generally a very positive person and I usually am able to remain calm and focused when things get busy. But I've had a rough week and I'm really feeling it. I'm absolutely terrified of making mistakes. I'm frustrated because I'm having a hard time trying to get to know my patients and understand what is going on with them as much as I would like because there are so many tasks to be done.

I had 5 patients this week that each had a long list of tasks that needed to be completed. I was getting slammed with calls from doctors, the OR, echo, speech, and tele within the first hour of getting there. I had patients needing to get ready to go for procedures ASAP, a patient with psych issues, a pt actively vomiting, and several of them all needing antibiotics (with some of them not being available because pharmacy didn't bring them up on time). The doctor didn't mark the surgical site on one pt and needed to be called down to do it. Then, 3 of my patients got discharge orders all at 5PM so I had to get their transportation all handled, their paperwork completed, had to track down doctors to get them to sign scripts, and had to go over their paperwork. One of my patients became extremely anxious and pushy and I ended up forgetting to DC her PICC line before she left - I had a hard time falling asleep that night because of that mistake. I wanted to cry and I still feel absolutely awful about it. I told the charge nurse but she didn't seem too concerned and said she would look into it. Is it not as big of a mistake as I thought it was?? I'm still going crazy thinking about it!! I feel like I should be written up for that! Then I had pts coming up to be admitted for those rooms right as my shift was ending!

And then the next day was also crazy! Again, one of my pts needed to be ready for the OR by 8 but was also needing IV antibiotics and pain meds. I had a wound care nurse that came by right smack in the middle of med pass needing help with one of my pts, which ended up taking 30 minutes. The night shift nurse didn't give meds that should have been given before she left for two patients, so I was scrambling to give them before they were too late. Oh ya and the night nurse also didn't bother to order a pump and channel for one of them that needed antibiotics as soon as I got there. My CNA was getting upset with me because I needed 5 minutes to give meds to one of those patients (he had a very irregular heart rhythm) before I could come in to help her move another one of my pts. I was giving IV pain meds almost every hour and most of my pts were getting IV antibiotics throughout the day. I had diabetic patients that needed insulin. Then, again at 5 I got discharge orders for one of my pts and was told that the ambulance would be there in THIRTY MINUTES to get them so I was again scrambling to get everything done for that pt. As I was getting ready to DC that patient, one of my pts who needed abx removed his IV, another one got an order for IV abx STAT, and then I noticed that my other pt was showing signs of septic shock which needed to be addressed immediately.

My coworkers try and help when they can, but they are also so busy that it is hard to get help sometimes. I'm sooo afraid of making mistakes and I really just am trying my best to provide the best care that I can give. I study on some of my off-days which helps with understanding conditions, but I want to be able to understand more about my individual patients. I try to come to work early to read up on everything but I commute and the parking situation isn't best there. Can anyone offer up some advice? I'm so worried about making a mistake and I feel like a failure sometimes at the end of my shift.