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Nurses New Nurse

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I am a new grad on orientation on a telemetry unit. Although it's only been a month and some days, I can say that I DO NOT IN ANY WAY enjoy what I am doing. It hasn't come to dread yet, but that's probably right around the corner. I often think, "How will I ever manage this w/o a preceptor." It's a constant juggling act. When I give report, my preceptor(s) occasionally will throw in a tidbit that I didn't know, or didn't remember. Or, sometimes when I'm giving report to a nightshift nurse, he/she will ask something that I have no clue about, but my preceptor does, so they answer. This makes me feel like I am going to be a mess when I'm on my own. Thus far, I am told that I am doing "very well" but I just don't feel it. Sure, I'm doing well with tasking, but who can't do that? People have told me that I am too hard on myself. I just want to provide good patient care, and be a competent nurse. I do not want to be the nurse that people hate to follow. I guess I just feel like after almost 2 months I should be more "with it." I have let everyone that I precept with know that I welcome any feedback/constructive criticism that they may have, because I want to learn/understand things so that when I am on my own, I am not a complete fool. In the beginning, my primary preceptor told me a few things that she would have done differently: priority things mainly. Overall, the majority have said that I'm doing well, but that I'm too hard on myself. I just cannot fathom doing this on my own.

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Welcome to the big scary. Being off orientation is a dreaded prospect but it will get better as you pick up various tips, learn the routines, and quit quadruple checking yourself. Every new job has a learning curve, esp nursing and no one expects a new grad to be the best nurse on the unit. You said it yourself, the first priority is safe pat. care, as long as you keep that in mind you will be a good nurse.

Other things to keep in mind: preceptors tend to be the best nurses on the unit, so they should know more than you at this time. Also, think of your first year (at least) as a continous education process. Instead of beating yourself up over things, think of what you learned during each shift. As far as the on-coming shift, just make sure that all the physical things are done before shift change, then do your charting. That way, the next shift isn't already behind the curve when they start.

I have been on five very different units (tele/step-down, Peds, surgical, Level 1 Trauma ER, and currently at a level III ER) and at the end of each orientation I had the "Oh, Boy" feeling. It has lessened each time, but it is still there.

Hope this helps.

MajorDomo

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Priority setting is probably the hardest skill to manage, and you won't do so just out of school in a few weeks. Maybe in a year. You are nervous and wanting to make a good impression and take superb care of your patients. It just does not all come together at once.

Tele is a rough unit to get oriented to. Lots to know, lots to watch for, and those heart rhythms can sometimes mimic each other. The tecnological part of our work is astonishing, and you've worked long and hard to get to where you are.

Keep going one day at a time. Keep asking questions of your preceptor, and if they answer for you ask for clarification. You're new and it's the preceptor's obligation? honor? to welcome you to this profession in a way that won't have you running for the next Real Estate or Mortgage Broker class that comes your way.

Do something for yourself. Do you have good stress outlets? They are important. Read, exercise, dance, hug you cat/dog/godfish/SO/any willing child.Do something with friends not from the hospital; go to movies and make good use of your your time.

Above all, ASK FOR HELP (nicely) when you need it. The eye-rolling charge nurse will be there -- they always are -- and the ancillary help are there to help you too. Those who nurse from the desk do the bare minimum. Hang in there. It does get easier.

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GiVE YOURSELF TIME. I have been out of school for about a year, and at first I almost hated it, primarily out of fear. Fear of mistakes, lawsuites, codes, angry doctors, intimidating family..... everyone told me to give it 6 mo to a year. I thought, whatever, like that will make a difference. But, the money is good and I was in school for a long time so I just prayed with my husband before every shift and stuck it out. To my suprise at about 6 months I started to feel O.K. about work. now at almost a year out I am feeling like I am really good at this. Night before last when I worked things were crazy, we are full and it was me and another rn and an lpn from the medical floor on my tele/stepdown floor. I helped out the lpn when her pt's sats were falling, did her iv pushes, and ran to her pt's room and then helped her interpret the rythem and call the md when her pt had a 26 beat run of v tach that looked a little like torsades, that morning when the other rn's pt started to crash i stayed over and assisted with a femoral central line and transfer to icu and the family member put her arm around me and said that she remembered me taking care of her mom a week or two ago and how her mom calmed down when I would whisper in her ear about the procedures and what were going on around her, the night before that I assisted my old Preceptor(an awsome nurse) to program and calculate a dopamine drip. my other pt's family looked at me when I walked in to the room at the begining of shift two and said, We are so glad you are his nurse tonight. As I read this back it sounds a little like I am tooting my own horn, but that is not how it is meant. I still have bad nights when I feel like the dumbest nurse on the floor and I have no clue what is going on with my pt, but this is meant as encouragement from another new nurse that It really does get better. If you spend much time on this site you will find the posts about how much some people say they hate nursing, just understand that they probably have had a rough few shifts and need to vent to other people who understand, and the other half are just burnt out. I still have some rough times at work, but I just pray a lot and let God put me where and with who He wants me, and to guide me, and it always turns out O.K. It is fine to feel overwhelmed sometimes (or at first all the time!) because you are helping heal and save peoples lives. You Can Be Good At This And Enjoy Your Job.

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Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.

Your preceptor knows these things because she/he has time to find them out while your juggling things. More than likely when they are on their own they don't know these things either.

Sooner or later it will all fall into place for you. Give it time. Also, realize you don't have to stay there forever.

Is it true you do not in in any way enjoy what you're doing. Is there not one positive thing? Do you like people? The patients? Making a small difference in there lives? Getting a paycheck? If there is not ONE THING (which you said in capital letters above) you enjoy about your job, that is indeed sad. But my guess is you're letting the negative overshadow your thinking and need to clear your head a bit and think differently.

There is so much about my job I loathe. Dwelling on all that stuff will make me depressed. Some days I barely have a handle on things, so I know the feeling. Good luck to you.

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Give it more time. One month, you're still a newbie. One year, and you're still a newbie. In any setting it usually takes a good 1-3 years before you're truly comfortable.

Never stop asking questions, even after orientation. If you look, you'll see even the most experience nurses consulting on situations.

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Listen to what corrin has said. I agree w/her post. I am a new nurse (4 mos. on med-surg/tele floor), just finished orientation. I do not feel "alone". I have the support of all the nurse's on the floor and am able to ask questions all day long. I make sure I use all my resources, and if a pt is going for a test, and I'm not sure of what they will need to be (npo, consent signed, or whatever...), I call radiology or whatever dept is doing the test. I learn something new every 5 minutes, it seems. Just jump in with both feet. Approach ea. day with a positive attitude and know that you are never alone. It gets easier every time I work. My time management skills have improved tremendously, and I just know at the end of my shift, I AM GOING HOME!!

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Hey, I was a new nurse orienting on a telemetry unit also. I started at the very end of January 2005. I felt exactly how you felt in the beginning. I was told by my manager that it could take up to two years for a new graduate nurse to feel competent on a critical care floor. I feel like I learn something new everyday. I never thought I'd know as much as I know now 11 months into it. Hang in there. Soon you'll start feeling more competent. I was just like you. If you would like, I've created a journal called NIGHT SHIFT about my days at work. Feel free to read it.

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Your preceptor knows these things because she/he has time to find them out while your juggling things. More than likely when they are on their own they don't know these things either.

Sooner or later it will all fall into place for you. Give it time. Also, realize you don't have to stay there forever.

Is it true you do not in in any way enjoy what you're doing. Is there not one positive thing? Do you like people? The patients? Making a small difference in there lives? Getting a paycheck? If there is not ONE THING (which you said in capital letters above) you enjoy about your job, that is indeed sad. But my guess is you're letting the negative overshadow your thinking and need to clear your head a bit and think differently.

There is so much about my job I loathe. Dwelling on all that stuff will make me depressed. Some days I barely have a handle on things, so I know the feeling. Good luck to you.

Ok, ok :), I don't dislike everything about my job. Sorry for the capital letters, at that moment, I felt they were necessary to convey what at the time I thought were my true feelings. When I did my post, I was still "coming down" from work. I love my patients--err, some of them :). My dayshift co-workers have been quite helpful as well. Thank you for helping me put things in perspective. You're right, once I clear my head, and take a step back, it's not that I dislike what I am doing. I think as one other person posted, the "dislike" stems from fear. Thanks for responding, I needed that.

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Hey, I was a new nurse orienting on a telemetry unit also. I started at the very end of January 2005. I felt exactly how you felt in the beginning. I was told by my manager that it could take up to two years for a new graduate nurse to feel competent on a critical care floor. I feel like I learn something new everyday. I never thought I'd know as much as I know now 11 months into it. Hang in there. Soon you'll start feeling more competent. I was just like you. If you would like, I've created a journal called NIGHT SHIFT about my days at work. Feel free to read it.

Thanks for your post. I look at my co-workers who have been nurses for 2 years. I am so envious of them. I think just starting out is a bit overwhelming, as I'm sure it is for everyone. I would like to read your journal. Is it something that's posted on this site? I will look around for it.

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If your preceptor is caring and attentive, if the nursing skills you are observing and learning take into consideration the principles of aspesis and nurturance, then count yourself lucky.

I spent about 5 weeks in a tele internship. I loved the patients. I loved the nursing. I loved the science of sick hearts and medications. I felt I was doing pretty well.

But I kept getting told "you should know this" (and now I know they were full of it); I kept seeing really, really poor technique (we would have been failed for doing what they were doing); and I felt bad watching the poor patients being treated roughly.

I'll not go on anymore about that. That was my experience, and I am so glad it is not yours!

Relax, enjoy, you'll get it. It sounds like you have what it takes. Your patients will appreciate you.

Remember, you don't have to do it all by yourself, all alone. You can ask questions, you can ask for help.

Soon you will be offering help to other new grads and wondering what the heck happened, how did you become so competent!

Hang in there....

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GiVE YOURSELF TIME. I have been out of school for about a year, and at first I almost hated it, primarily out of fear. Fear of mistakes, lawsuites, codes, angry doctors, intimidating family..... everyone told me to give it 6 mo to a year. I thought, whatever, like that will make a difference. But, the money is good and I was in school for a long time so I just prayed with my husband before every shift and stuck it out. To my suprise at about 6 months I started to feel O.K. about work. now at almost a year out I am feeling like I am really good at this. Night before last when I worked things were crazy, we are full and it was me and another rn and an lpn from the medical floor on my tele/stepdown floor. I helped out the lpn when her pt's sats were falling, did her iv pushes, and ran to her pt's room and then helped her interpret the rythem and call the md when her pt had a 26 beat run of v tach that looked a little like torsades, that morning when the other rn's pt started to crash i stayed over and assisted with a femoral central line and transfer to icu and the family member put her arm around me and said that she remembered me taking care of her mom a week or two ago and how her mom calmed down when I would whisper in her ear about the procedures and what were going on around her, the night before that I assisted my old Preceptor(an awsome nurse) to program and calculate a dopamine drip. my other pt's family looked at me when I walked in to the room at the begining of shift two and said, We are so glad you are his nurse tonight. As I read this back it sounds a little like I am tooting my own horn, but that is not how it is meant. I still have bad nights when I feel like the dumbest nurse on the floor and I have no clue what is going on with my pt, but this is meant as encouragement from another new nurse that It really does get better. If you spend much time on this site you will find the posts about how much some people say they hate nursing, just understand that they probably have had a rough few shifts and need to vent to other people who understand, and the other half are just burnt out. I still have some rough times at work, but I just pray a lot and let God put me where and with who He wants me, and to guide me, and it always turns out O.K. It is fine to feel overwhelmed sometimes (or at first all the time!) because you are helping heal and save peoples lives. You Can Be Good At This And Enjoy Your Job.

Your first three sentences are precisely how I feel. I know that I am still very new to nursing, and that there is no way that I am going to know everything...ever. But for some reason, that gets lost when I'm in the moment. I get frustrated with myself. I think I need some activities outside of work. When I'm not at work, I'm at home, or occasionally shopping. I work out 4-5 days/week, but I do that at home. I think I just need a hobby or something other than work and coming home. Thanks for posting.

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