New Grad Discussion Thread

lagalanurse · Jan 21, 2013

Congratulations!!!

I am somewhat struggling with an overwhelming sense of responsibility that I have never felt until now. I second guess myself on every little thing I do. I'm in the ER and did my senior preceptorship in the ER and I was also a tech. So I am familiar with the unit. I was supposed to give Fentanyl the other day and freaked out cause the pt only had a systolic of 102. :-( I know it's a huge responsibility to have the RN behind my name, but I didn't expect to "freak out" this much!!

Good luck to you. It's been a long road but I know it's worth it!

%63theend · Jan 21, 2013

I'll start :)

The Good: :inlove:

My favorite part of the job is providing compassion. I like calming rattled nerves. I work night shift so I have a little more time to do this than my dayshift peeps. Not a lot more, but a little more. Sometimes I honestly just make time where there isn't any. For example, tonight I had a patient with new diagnoses of diabetes. He came in for something else and the ER found his high blood sugar. He was so worried he started having palpitations! I printed out a bunch of hospital "care notes" about his condition and I sat down and tried explaining it to him. I made a pretty good jumble of my explanation and realized I have work to do on breaking down patho to layman's terms. But eventually I think I started to make progress. But then I decided to just pull out my phone and youtube a video about it. We watched about a 4 minute video about diabetes and I learned how better to explain it and the patient got the info he needed. I reassured him that taking care of his body will help prevent him from having the scary complications he has heard about. We talked about medication, diet, and exercise. One of my favorite moments I've had in the past 4 months.

I've learned I like surprising people. The hospital doesn't have to be a bad experience. I had a woman who's husband informed me it was their 50th wedding anniversary and they had to cancel their party because of the hospitalization! It happened we had a retirement party earlier that day in the break room and we had balloons and cake. Voila, with a swift thought came a little deed, and in a few moments time they were having an anniversary party in their room. They both laughed and said they'd never forget having cake and balloons on their anniversary in the hospital.

I've learned I really like wound care! The weirder the better! I get nervous packing them because I HATE hurting people in pain!!! But I like doing it and figuring out what is used for what and when and how much... It's different every single time, I swear. If it were a bigger field I'd possibly consider doing something with it down the road.

I've learned the things that cause the most anxiety turn out to have the biggest reward when they are mastered. I have always been TERRIFIED of PCA pumps. I have NO idea why. I just get serious anxiety about things I don't understand and I've never really had a lot of exposure to these guys and they are not user friendly! I now have zero problems checking the settings on one and I am pretty sure I could set one up by myself the next time I have to do one. Of course I'd still get another nurse to verify the settings afterwards as is the policy! I used to be terrified of drawing blood from central lines, too, but now I find it kind of an interesting little procedure. I get a little rush from being able to do it all by myself

The cons are many as well and I go back and forth between liking my job and hating it LOL!!! So to be balanced I guess I will share my dislikes as well.

The Bad :poop:

I dislike the hospital management busy work. There is a constant influx of BS meetings we are required to attend making our 3 days 4 more often than not. There is a huge amount of ppw and projects we are required to do ON OUR OWN TIME! I do not get paid enough for this. Esp considering I am so exhausted on my days off it is all I can do to recover. My poor house is falling apart. My kids miss me! I don't have time for hospital ppw BS.

I dislike whiny people who think I am the housekeeper and have no other patients and exist to straighten the clock on the wall (true story) and clean up their bedside trey as in putting their mints in their pants pocket in the drawer when they are 100% mobile and capable.... People don't have any idea how many other patients I have and how serious there issues are and yet I am getting calls about ice. Why don't they call the tech??? I swear the patients don't have any idea what the techs are for. Not that I mind doing anything and everything for the patient. I just don't have time when there are 6 of them and only 1 of me!

I love and hate night shift. I love the pace. I love the other nurses and the techs. They are nicer and more laid back than dayshift peeps. I hate what it does to the rest of my life. I'm tired. A lot. But I also feel like I can practice nursing "safer" at night b/c of the pace so I feel it is better for me at this stage. I pretty much think all nurses should start on nights... I feel like I learn better b/c there is less interruptions. Esp. from family members!

And the Other

It is different from how I expected because I NEVER in a MILLION years thought I'd work nights. I have small kids and the schedule is crazy. But they put me on nights and I said "I'll bloom where I'm planted" and you know what? I am. There's more busy work/ppw management crap than i could have imagined. There's a lot more guessing than I'd like. Don't know how to do a procedure? Ask the charge. She doesn't know how to do it? Well we're on nights so that means googling it. I like to have hospital approved fact sheets handy but there isn't such a thing. Everyone depends on finding someone else who has done it before and hopefully they know how to do it right... That's frustrating.

I'm coping one day at a time. One week at a time. One month at a time. Each shift that passes I celebrate that it is over and I got to go home. Each week that passes I tick off a week further and a week closer to the month marker. Each month that passes? Holy cow that's serious. That's another notch in my belt. Another feather in my cap, hard-earned. I give myself a big ol' attaboy (attagirl rather) and smile and think how did I manage another month?? Then I dream about what my future career plans are and how I am even closer than I was a month ago. Once in a while I look over my notes from when I started and laugh at how much I now know by heart and realize I've already come so far. Each shift brings experience.

Even tonight I ran to a rapid response for a pt that WASN'T mine! I thought to check his blood sugar! I was the first one to think of it! It turned out to be fine but I was proud I helped! I brought the crash cart! I knew that's all I was capable of at the time, but it was something. I did a little something.

Anyway, all of this isn't to toot my own horn about all of the milestones I've reached or great things I've done. Trust me, for each of these good stories there is a hundred more of how I've given meds late, forgotten to chart something, didn't assess something the first time in the room and had to go back again, and then again, and then again, before doing it! There are a million times I've had to be shown how to do something. Once. Twice. Three times. You get the picture. This is just a little way to encourage me, and hopefully some of you, and also to just share. We're all new some time. This is me being new. How is it for you?

Altra, BSN, RN · Jan 21, 2013

See also the new grad forum:

First Year After Nursing Licensure

:)

nurseprnRN, BSN, RN · Jan 21, 2013

The patients don't really know the difference between the nurses and the techs. Hell, a lot of healthy people on the street can't tell you that. :)

Good attitude will take you a loooooong way. A very refreshing post. Way to go, Robinelli.

%63theend · Jan 21, 2013

Thanks! Maybe because I haven't gone to bed yet after working all night, I couldn't find a new grad forum, even when using the search function LOL!! I should probably drop off my kids and go to bed instead of hanging out with them playing on here! Definitely will make note of this for future reference!

See also the new grad forum:
First Year After Nursing Licensure
:)

%63theend · Jan 21, 2013

To Lagalanurse,

Absolutely. It worries me not knowing everything. If I haven't given a med before I look it up on an app on my phone. I don't have time to read EVERYTHING about the med though so it is helpful only to some degree. I also make a habit of calling pharmacy A LOT about things. I know all the pharmacists by name and voice now. I KNOW they know me!!!

I've never given fentanyl, I just looked it up. I had forgotten all about that med. Thanks for the reminder!

I think it is this kind of thing that is the reason nursing school harps on you- if you make a mistake FESS UP! Because we can't know everything so the important thing is to monitor our patients and know when to get help from others to intervene. Something that occurred to me the other day is the importance of knowing if the pt has a working IV. It may be INT'd. It may not have been flushed on your shift. What if that pt has an allergic reaction and needs a stat IV push? Prob a good practice to flush all IVs at start of shift. Add it to the rounding. Something I've been thinking about. Anyway, yes... we have incredible weights on our shoulders. To me I really feel like if something goes wrong with the patient I should have prevented it somehow. Like I have to be clairvoyant! I'm all over the place with this post. I really should go to bed LMBO. At any rate I am just trying to say I agree with you, hang in there, the fact you care and thought to second guess something in THE BUSIEST of places in the ER means you're going to make an awesome nurse!!!! In fact you already are one!

JustBeachyNurse, LPN · Jan 21, 2013

Thread moved to first year after nursing licensure to elicit further response and support other new grads. Congratulations!

%63theend · Mar 7, 2013

Just a quick update! I'm only 9 shifts away from hitting my 6 month milestone (April 1)! Wow it has gone by so fast! In many ways I still feel like a brand new grad. There are lots of procedures I've still never done, several I've only done a few times and still need help with, day-to-day forms I have trouble finding, things like that. But in many other ways I'm really starting to get comfortable! My time management skills have increased exponentially over the past few weeks. I'm finding I'm adding literally hours to my shift to do other things like spending more time with the patients and charting more accurately. I occasionally prepare forms for dayshift if I have enough free time. I rarely forget to assess something the first time in the room now. I'm getting less nervous about seeing vital signs out of whack. I'm starting to understand if the patient looks good it's not time to panic but to make a plan. I'm less nervous. Others are coming to me (sometimes) to ask my opinion on what to do with THEIR patients. I feel more confident. And to top it off I finally got a good schedule for the first time this month and have consecutive days off. I'm looking forward to seeing how that works for me. I'm also sleeping easier during the day and able to "flip" my days and nights with more ease. It's starting to all come together.