How to Deal with Stresses of Being a New Nurse

RNTOBE_1970 · May 17, 2011

Most important advice is to take care of yourself...take time to relax at the end of a long day.

AngelicDarkness · May 17, 2011

Think of every day as something new and shrug off the previous day. It is a learning experience. As a new grad myself, some shifts go well, others are a challenge (but my favourite because I love the rush!), and some... well just don't overthink them. My biggest flaw as a nurse IMO is going home and overthinking what I could have done, what I should have known, or what I forgot to ask. Keep a mini-pad on you for questions, and do write them down. I swear I tell myself I'll remember at the end of my shift, but I can tell you I remember about 10% of the time:).

I know it has beeen mentioned on the blogs a lot lately, but a journal will be your best friend. I love writing down things to research, or signing up for classes in the area (most of them are offered free through other health service representatives if you check the paper or online).

And always remember to have a day to yourself, relax and enjoy:)

In the end, a little nervous is a good thing:) From your post, I know you'll be the best nurse that you can because you're willing to learn, and you're excited! Best wishes with your orientation!:)

Brea LPN · May 17, 2011

1)If you don't know something, please ask. If another nurse gets snotty about it, remember she was new at one time even if she doesn't believe it.

2)Enjoy your days off.

3)Remember that you made it thru nursing school so you have learned alot but you are not expected to know everything. It's not possible to fit it all in school.

4) Observe all you can during orientation. While in orientation, think of as many scenarios as you, such as a fall, ask whomever is training you what to do in those situations.

5) Nervousness means you want to do a good job, which is a great thing.

Best of luck to you!!

Brilliant Dreams · May 19, 2011

1) You are going to mess up - acknowledge it now - so you wont be shocked later

2) You will be slow - guarenteed - dont let anyone bully you... You are new - you should be slow

3) Keep lists of everything... I keep lists of patients who refuse meds, narcs I give out, room #s I need to return to and why, etc... This way if I miss something while I am passing medications or forget to get something done - every hour or so I can check my list. PLUS it is great if you forget to chart something - it elimates a lot of extra searching bc you will already have a narrowed down list.

4) Befriend a nurse - someone who will not roll their eyes at you when you have a question.

5) Dont feel bad for asking a questions... And taking notes....

Florence NightinFAIL, BSN, RN · May 19, 2011

During night shift when you have some downtime - browse through all the resource binders in the unit and take notes. Orientation is the only time you have to take a good look at those binders/books/notes so use it well!

Don't rely only on your preceptor to learn something - ask questions and learning opportunities from the other nurses. Make sure they are not busy first though!

Help others (without them asking) and they are more likely to help you.

Don't take things personally - some people get stressed out easily and unless they make it obviously personal - don't worry too much about curt responses and grumpy attitudes.

Some people have a dry sense of humour and are labelled as rude. Don't use rumours to make up your mind about someone.

Spend even half an hour looking up meds/procedures/surgeries/nursing skills when you get home.

And best of all:

Try showing up half hour to 15 minutes early if you can before every shift - getting a head start on report and organizing your day before the shift starts sometimes really helps!!!

SunshineAnytime · Aug 5, 2011

I'm a recent new grad. Just started my job on Wednesday. These tips are great!! Thanks for posting them.

JRP1120, RN · Aug 6, 2011

These tips are great! Please keep them coming! I start my first job this Monday! Excited but getting nervous! Thank you all for your input here; I always learn so much! :)

shoegalRN, RN · Aug 6, 2011

My advice:

PLEASE be patient with yourself! This was so hard for me to do. You will not pick up everything on the first or even the second try. You have just graduated from nursing school and you are in the real world now. This means things are a lot DIFFERENT than what you have been told. Embrace this. Remember you are not super nurse and nobody is expecting you to be. Give your own self a learning curve.

Do NOT compare yourself to other nurses, especially experienced nurses. You are brand spanking new, do not worry about "why can't I get an IV on the first try like her", who has been doing IV's for years. Focus on your own journey. Comparing yourself to others will only make you more self conscious.

Do NOT participate in gossip sessions. You do not need to look down on another nurse to make yourself feel better about your nursing skills, or lack thereof.

When you go home at the end of the day, look things up just like you did in nursing school. If you had a procedure you had to do and never heard of it, let alone done it before, look it up. Same with meds. Look up diseases and their pathologies, as well as treatments. This will help out so much when you come across this again in the future.

Do NOT be afraid to ask questions. Keep a notebook with you to write down your questions and answers to them. This way you won't have to ask the same questions over and over. If you ask the same questions more than twice, your preceptor can use this against you and say "she is just not getting it, I've answer the exact same question for her 5 times already".

Act confident. Even if you are shaking inside, keep a poker face. This will help develop confidence along the way. However, don't confuse this for arrogance or being unteachable. If you do not know something, you still have to ask, but do it in a confident way.

Do sit down with your preceptor at the beginning and end of each shift and develop a list of short term goals that should be accomplished during the shift. This could be you handling two patients on your own, plus taking an admit, or you calling the doctor on your own. At the end of the shift, ask for feedback to see if those goals were accomplished. Keep the line of communication open between you and your preceptor.

Do NOT take things personally. If you get constructive feedback from your preceptor, do not take it personally. Instead, look at it like a learning opportunity to make you a better nurse.

Do keep a positive attitude. Be a team player. Use your resources. Relax and try to get the best learning experience you can get.

Do not get discouraged if your preceptor gets the hardest assignments on the unit. It's because they will be learning experiences for you. It's best to have the sickest pts while you have someone with you, then when you don't.

xtxrn, ASN, RN · Aug 7, 2011

Something I used to tell new grads....

If you don't have time to do it right, when will you have time to do it over? (not sure who said that first- wasn't me!!)

You will get the time management stuff down as you go- make little goals (even tiny ones if that's where you need to start... every step makes progress to the final destination).

There WILL be cranky nurses... it's NOT you- they're generally cranky with everyone

This is all a process, not an event (another unoriginal phrase), and a marathon, not a sprint :) You're going to be doing this for decades, more than likely... consistent growth lasts longer than infrequent bursts

turnforthenurse, MSN, NP · Aug 7, 2011

As a brand new nurse myself, here are some tidbits of advice:

* You will make mistakes - everyone does! So don't sweat it.

* You won't be expected to know everything right off the bat - nursing school prepares us with a baseline knowledge of nursing, but you don't learn how to BE a nurse until you start working. With that said, ASK QUESTIONS! No question is a stupid question. As a new grad, you should have a lot of questions - I fear for those who don't. I'm a new grad and I always have questions. Even seasoned nurses with 4+ years of experience still ask questions. Also, ask the doctor questions! Usually they are receptive to your questions (I work night shift, so when I call them at 0330 I try to get to the point when talking to them instead of asking a bunch of questions, unless it may impact patient safety or something)

* Calling the doc IS scary at first and will be scary for awhile. Just remember SBAR and always have your patient's chart in front of you. Thankfully all of the doctors I have worked with so far have been very pleasant, but some can be rude. Don't take it personally. Just remember that you are trying to do what is best for your patient and it is their job to be on call AND they are getting paid a lot of money to do so. If you are ever unsure if you should call the doc (or who to call), ask another nurse! If your patient looks bad, you can always call rapid response, too. They can give you a second/third/fourth/etc opinion (because sometimes docs don't always answer their pagers!)

* If you are EVER unsure about ANYTHING, ask! Or look it up. I carry an IV drug book, regular drug book and another book called The Manual of Critical Care Nursing with me. I will still look things up when I get home, or at work when I have some downtime.

* If another nurse or doctor is going to do a procedure, ask if you can watch or better yet, ask if you can do it yourself! (within your scope, of course...you obviously can't do a chest tube insertion but you can assist with one! :lol2: )

* Sometimes you won't be able to chart until much later in your shift - hopefully not at the end. You will start to become good at remembering things, but I always keep a piece of paper in my pocket along with my "brain." as I do things, I write it down AND the time that it happened. You might not be able to chart that 400cc's of urine you dumped at 0100 right away. Whenever you have to call the doctor about anything, always note the time when you called them, what it was for and what you were told. Some examples:

Lab calls you to report a critical lab value: Ammonia level of 90. Pt has end-stage liver disease and this to be expected; however, you still need to report it. "Called Dr. ____ at 0600 to report critical ammonia value of 90. No orders received."

"Called Dr. ____ at 2100 about holding Lopressor because pt HR is 57. Dr. ____ said that was okay."

* I work night shift, and our labs usually come back between 0530-0600. Unless it is absolutely critical and the patient is in distress (such as a troponin of 2.59, chest pain and ST-segment elevation), we usually wait until EVERYONE'S labs come back, ask who needs to talk to the doc and when they call, pass the phone around, that way the doctor isn't receiving 5 different pages. Doctors really like this. Of course that isn't always possible. But just a thought!

* Try to leave work at work - meaning when you come home, just don't worry about it anymore. I still have problems with this and have woken up from deep sleep in a panic because I forgot to chart the patient's response to some PO Benadryl I gave at 0630 :lol2: Since it was PO technically the response shouldn't be documented until 0730, but I was still freaking out! Just over little things like that. I have asked my coworkers and I have been told they have all had similar things happen to them.

SNIXRN · Aug 7, 2011

People before paperwork. By managing your day, it will help reduce your stress. Good luck :)