I Feel like a bad nurse. Feedback please

[Soliloquy, MSN, APRN, NP]

This is my 2nd week on my own and I feel like i'm a god awful nurse. Most days I barely have time to really read the charts for the plan of care (and I can hardly read the doctor's writing most times) and by the time I need to give rounds, I feel like an idiot when the doctor asks me things because all I can give is, "I don't know". Many times I don't see the big picture of the patient and I feel really incompetent.

The other thing too is even though I get all the tasks done for the patient on my shift, I feel bad because sometimes I miss things. Like sometimes I miss a patient's labs, or recently I missed that some medical orders weren't initiated from 2 days back. Granted I didn't admit the patient but I took care of the patient all shift and I felt so guilty that I missed it all this time. I keep wondering if I'm going to be written up or lose my license or get fired for something like this at some point.

I was told by my charge nurse that I need to be more assertive but sometimes when I'm doing SBAR with the doctor, I really don't have a recommendation and I really would like to know what to do. I guess I can be more clear and direct so I'm going to try harder with that.

The truth is, I don't feel very empowered and confident as a nurse at all! I'm always afraid that the next time I go on my unit will be my last and so I'm always scared inside. I'm scared because I don't always know EVERYTHING there is to know about my patient. I don't know all their labs or all their vital signs up to the minute or what medication they'll be getting at 10pm when it's only 1pm on my shift and so I feel bad because I don't know all there is to know. Many times I'm not even 100% sure when to call a rapid response. I've read the various reasons one can call a rapid for but it's never that clear cut in a real situations so I'm always using my judgement and I don't feel confident with that.

Feedback please! If anyone has anything they can help me with.

[mc3, ASN, RN]

Oh my gosh! this is only you're second week and you think you should know all the answers?? Give yourself a break! You're still learning! Confidence will come with time, as most anyone here will tell you.

((hug))

mc3:yes:

[cardiacfreak, ADN]

This is only week 2! Give yourself a break. Here are just a couple of tips...come in early and look up your patient's labs, meds, and diagnosis. I always look at the MD's history and physical and try to read over their progress notes. See if someone on your unit has a "cheat sheet" to help keep information organized.

It gets better, believe me. Just hang in there!

[hikernurse]

You're exactly where I would expect you to be at this point! Give yourself some time. When you do something well--even something you might not think is a big deal--give yourself credit. That will help build confidence.

Also, finding a few unofficial mentors to run thoughts past would help. Most nurses are happy to help a less-experienced nurse.

As far as the recommendation part of SBAR, it doesn't have to be an entire care plan, it can be as easy as recommending a physician assess the patient in person or giving fluid. You'll find that there tend to be typical issues on your ward. I am a NICU nurse and a common order would be a CBC, CRP and CXR. Other units might find that giving fluid is a common response. I guess my point is that with experience you'll get to have a pretty good idea of what needs to be done.

I promise it gets easier! It won't be all that long before you look back and can't imagine ever not knowing what you don't yet know now .

[Soliloquy, MSN, APRN, NP]

Thanks guys

I know I'm being hard in myself but I feel like the other nurses are doing a much better job and sometimes the doctors come down hard on me for some things. I'm usually the first person to come on for day shift, and I try to look over everything but sometimes I just don't know what to report or ask about in terms of labs. Potassium, rbcs, wbcs, pt/inr, and mg I look at but sometimes I miss orders and it just seems like the entire day is ruined.

I like the suggestion about reading the doctors h&p on the comp(see? I didn't even think of that!) I'll try that tomorrow. I have a system and I get out on time but I'm always worried about what to do during a rapid response or if I'd have a code blue situation and then they'll be looking at me like I killed the patient. :/

[cardiacfreak, ADN]

Thanks guys

I know I'm being hard in myself but I feel like the other nurses are doing a much better job and sometimes the doctors come down hard on me for some things. I'm usually the first person to come on for day shift, and I try to look over everything but sometimes I just don't know what to report or ask about in terms of labs. Potassium, rbcs, wbcs, pt/inr, and mg I look at but sometimes I miss orders and it just seems like the entire day is ruined.

I like the suggestion about reading the doctors h&p on the comp(see? I didn't even think of that!) I'll try that tomorrow. I have a system and I get out on time but I'm always worried about what to do during a rapid response or if I'd have a code blue situation and then they'll be looking at me like I killed the patient. :/

Lol, nobody will think you killed the patient. I remember my first code, I couldn't even remember what they were admitted for! It gets easier I promise. Just take a deep breath and say to yourself,

'I CAN DO THIS."

[TheLiftedButterfly]

I haven't started hospital nursing yet, I've only done Home care & School nursing. With both of those positions I had a considerable amount of anxiety each new case or assignment I took. Keep an eye out for diagnosis, medications and nursing interventions associated with these disorders and emergency interventions. After work, do your research. Read up and keep learning. Proper knowledge helps build confidence. Watch as many youtube videos as you have to and open up as many old textbooks or drug books necessary. Bring your drug book to work, read it during lunch, whenever you can. KNOW about your drugs! A prepared nurse is a confident nurse. Time and more experience helps as well. People know you are new but the key is to always think twice about an action and if you don't know the correct answer ask your supervisor. Your supervisor will be happier you're safe rather than sorry. Try to remember everything they tell you the first time.... GL

[seaghost]

I just recently started having suggestions for doctors and I've been working 5 months haha. You have to hear some before you can give 'em... yeah?

[Kaltia]

After you summarize the situation just say is there anything else you want me to do at this time? You don't have to suggest anything

Also ask the others if they're missing orders. Computers systems can be a pain and if theirs a quirk that's not letting orders through that shot to get fixed

Hugs you'll get there