Last day of orientation!!!!!

  1. Hi everyone,

    Well last night was my last day of orientation and I have to say that it didn't make me feel any more confident about being on my own. I was doing pretty good until about 4 when I realized that I still had 8 IV meds to give, pumps to clear, 4 charts/mars to check, and report to tape on 13 pts, yup 13 pts. Plus I had to finish up the admission on the man that came in and couldn't give me any history so I had to go through his old charts. I was only 30 mins over with the paperwork.

    My preceptor ended up coming to the rescue at 5. I had asked her to pretend like she wasn't even there so that I could get a feel of things on my own. We had been doing that for the whole week. But to be honest she usually had to step in sometime during the night. It's not usual that we would have 13 pts, but there were only three teams of 1 RN and 1 LPN. They couldn't get anyone to cover the census.

    So, now I have the weekend to think about my first day flying solo. I start Monday. My preceptor isn't working that night, but there are 3 experienced nurses and they have helped me out in the past so I'm pretty sure I can go to them with questions. Plus, with four RNs on we shouldn't get any more then 10 pts a piece.

    I'm just pretty terrified about all this. I'm really scared that I'm going to miss something important, or not call the Doc when I'm supposed to, or just get so far behind I don't get the work done before the next shift. My floor is a really busy post surgical/oncology floor, so I have to make sure everything is on the up and up.

    I just needed to vent my worry I guess. I feel like I could use another 4 months on orientation, but well I have to fly solo sometime. They seem to think I'll be fine. That's all I hear, I'll be fine. So I guess I'll just keep telling myself that. I'll be fine. HOPEFULLY. Thanks for listening.
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  2. 10 Comments

  3. by   suzy253
    Quote from Brooke13-RN
    there are 3 experienced nurses and they have helped me out in the past so I'm pretty sure I can go to them with questions. Plus, with four RNs on we shouldn't get any more then 10 pts a piece.
    I just needed to vent my worry I guess. I feel like I could use another 4 months on orientation, but well I have to fly solo sometime. They seem to think I'll be fine. That's all I hear, I'll be fine. So I guess I'll just keep telling myself that. I'll be fine. HOPEFULLY. Thanks for listening.
    I know how you feel. I'm a new RN and off of orientation & on my own. The first day, knowing I was to be mod leader, I was soooooo scared. But as the days went by, I got the hang of things better and better.
    And there's your answer right there as you posted it

    'there are 3 experienced nurses......................'
    You will never be alone. Have faith and confidence in your abilities. You can do it! I still ask questions a lot and ask for help with a procedure I haven't done or am not that comfortable with, and all the other nurses have helped me out quite willingly.
  4. by   Brooke13-RN
    Thanks Suzy. I think I'm just so nervous. I get nervous going on the nights when I will have a preceptor and the idea of being on my own with my mod is terrifying. I'm just scared that I'm not going to get everything done. I haven't been able to as of yet, my preceptor always ends up stepping in at one point or another. I'm already kind of starting to freak and I have two days to worry about it. There is just so much to get done and do and I don't really think I'm fast enough. I'm just scared right now. I just need one successful night.
  5. by   RNKay31
    wow, congrats to you and wishing you the best.
  6. by   Brooke13-RN
    RNKay, Thanks for the congrats. I wish I was feeling it though. I've been a nervous wreck all day because I have to go in tomorrow. But then I'm a wreck most days before I have to go in. I'm just so scared that I'm not going to see something or do something that is going to keep my pt safe.

    Then there is the fact that I haven't been able to get everything done. It seems like I sink the closer to 6 I get. The problem is I don't know where to pick up time. I think I'm just too slow. It takes me a lot longer to go through the charts and MARs. Then it seems like every night my preceptor has to point something out to me that I messed up on. Yet, they think I'm ready to be on my own. I wanted to scream no, let me have one more week. But then after that week is over I'll want another. I know I have to get out there and do my own thing, I just wish I had some more confidence. I'm just scared I'm going to hurt someone. Oh well. Here I am rambling again. Thanks for listening everyone.
  7. by   Slobgob
    "Then it seems like every night my preceptor has to point something out to me that I messed up on. "

    "Something" connotates that its closer to 1 mistake than 10 mistakes per shift. I have to say that the latter is my trend. I still have 1 month left on orientation, but i'm pretty sure I make 10-12 errors per day.

    Let's see, how about last shift?

    1) Didn't give the 18:00 Coumadin till shift report, got it pointed out to me by the noc shift nurse.

    2) My CABG pt used his IS once all shift, when the orders call for 12 times in 12 hours.

    3) Gave my patient 2 Senna... and he already had semi-loose BM.

    4) Blew two IV sticks on veins the size of a bus.

    5) Snipped a piece of skin while cutting the sutures (placed tightly) when I went to take out the TLC.

    6) Let my patient go 10 hours without urinating even though she was getting fluids, and didn't question what was wrong.

    7) Gave 40 Lasix IV, 40 K-Dur PO at the same time with a semi-low K.. here comes PVC city... had to wait that one out.

    Yeah, it was a bad shift... usually not that bad... but all of these situations worked out okay, and I can't stop thinking that my preceptor had to use her special nursing powers to make sure my patients were all safe...
  8. by   jjjoy
    Thanks for your honesty. Some folks might say you should have done or this or that, or why wasn't that done... which is perhaps valid... but I get annoyed with vague or useless advice like "you need to work faster" and "don't make that mistake." It's one thing if you don't realize that you need to work faster or you don't realize that you made a mistake. But I know I was keenly aware of my faults in those areas and felt like I was being scolded for falling off a bicycle while learning how to ride (don't fall! be sure to balance!... ugh, yeah, would if I could!).

    It can be very confusing. "You should've done X Y and Z" usually said with a scolding or condescending tone. But when trying to explain the combination of details that determined the call in that specific case an experienced colleague will find it too difficult to explain and say "You'll get it with more experience." How can someone say I "should've" done something that they admit that only experience can truly teach?

    I guess I get frustrated when I've done the best with my capabilities, handled the situation and then be told it was "wrong." Wrong to me says that I could've done better, but the reality as a newbie is that I COULDN'T have done better. Oh, well, next time, right? In health care, no two situations are identical, so it generally takes several experiences to learn how to handle different things.

    You also hear "this was late", "you should've done this" "why isn't this done yet?" "you forgot that" "have you done that yet?" "that's too slow" all day long, day after day. Then, when you're on the verge of a nervous breakdown, convinced you are a hazard to your patients, that you just aren't nursing material, ready to run away and never come back, suddenly you're hearing "it takes time" "you can't do everything all the time" "you're only human" "you can't expect to get it all right away."
    Last edit by jjjoy on Oct 23, '06
  9. by   RNLisa
    Quote from Brooke13-RN
    RNKay, Thanks for the congrats. I wish I was feeling it though. I've been a nervous wreck all day because I have to go in tomorrow. But then I'm a wreck most days before I have to go in. I'm just so scared that I'm not going to see something or do something that is going to keep my pt safe.

    Then there is the fact that I haven't been able to get everything done. It seems like I sink the closer to 6 I get. The problem is I don't know where to pick up time. I think I'm just too slow. It takes me a lot longer to go through the charts and MARs. Then it seems like every night my preceptor has to point something out to me that I messed up on. Yet, they think I'm ready to be on my own. I wanted to scream no, let me have one more week. But then after that week is over I'll want another. I know I have to get out there and do my own thing, I just wish I had some more confidence. I'm just scared I'm going to hurt someone. Oh well. Here I am rambling again. Thanks for listening everyone.
    Brooke, I feel the same way exactly! I am on my own tomorrow for the first time. I have an upset belly and just feel like puking. I have been ok the past 2 days I had off, but today, I have been a nervous wreck as all I can think about is tomorrow. I am dreading the 30 min. drive there in the morning, and coming in to see my name (without a preceptor) on the assignment board with how ever many patients I end up with. It is only an 8 hour shift tomorrow, but still am nervous as heck. I know I have done everything during my orientation, and I am so scared that tomorrow I will get one of every skill I didn't get to do on orientation. I know my manager said there will be resources to help if I need it, but they all have their own patients to worry about. I am feeling so much like I am making a huge mistake being a nurse. I am questioning my skills, critical thinking, and judgement. Will I overlook a lab? Will I miss a critical piece of an assessment? Will I forget to give a med? Will I give a med that I shouldn't have? What if? What if? What if?? I feel like I am actually driving myself insane right now.

    ANY WORDS OF ADVICE? ANYONE???
  10. by   Brooke13-RN
    jjjoy thanks for that. Your right that does seem to be how it is. I guess it all takes experience and that's what they keep telling me, but I think sometimes people forget it.

    Lisa, I survived last night. I started off 9pts, but then at midnight I picked up 2 more. Census changed. I did all right because I didn't have too many unexpecteds, no admissions or discharges last night, we had a full house. But I did have to call the Docs a couple of times, one was for a post surge who after 5 hours still hadn't voided. Said he couldn't. I bladder scanned him and then ended up calling the Doc because he had 800CCs in. But to be honest, even though I knew this was wrong I still asked another nurse if she would call for that because I didn't want to screw up.

    And if it makes you feel better I cried the whole drive to work talking to my Mom on the phone. I know what you mean about the resources. They are all so busy too. I was doing my chart checks and they were saying can we help you. But really what could they do. They had 11 charts to check themselves. They are my pts, I have to get it done, which to my surprise I did. I think. I'm sure I missed something that my nurse educator will get me on tomorrow. She once found that I forgot to initial the MAR on the bottom, even though I signed it. You have to put your initial, print your name, and sign each sheet of the Mar at the bottom. Oh well.

    Take some deep breaths today and tell yourself you can do it. When in doubt I always think of the Water Boy. Rob Schnider yelling you can do it always makes me smile. I had to compose myself a couple of times last night when I started getting behind because I felt like a failure. I was behind, but then I just kept on going one task at a time. And this morning I got to leave at 7:35.

    I don't know what to tell you about the emotional stuff. I do notice that when I have to go right back I feel better then when I have to go back after a couple of days off. The day before I cry most of it and want to quit. Then I go in and feel better until I have to go back the next time. I think for us right now it's just the fear of the unknown. Not knowing what to expect when we get off those elevators. I have nightmares even about work.

    Hang in there and let us know how your first day went. I know how you feel about the driving yourself insane. Hang in.
  11. by   Tweety
    Best wishes.
  12. by   ursulanursula
    Hey Brooke.

    You are doing great, hang in there & you will start to feel more confident & competent the more shifts you get under your belt.
    It has really helped me to read about your experiences. I am starting a new job in a couple of weeks & although I have been an RN for 3 years, the job is in a new area & I am nervous that I won't be "ready to be on my own" after my 6 orientation shifts. I think "deep breaths and telling myself I can do it" will save me.

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