New grad job anxiety and feeling completely lost...

[kaygbean]

Hi everyone,

After starting my first nursing job just this last week, I feel totally lost. Everyone keeps telling me that this feeling is to be expected but I am worried that I am going to hurt a patient or having my license taken away for making mistakes because I truly feel that I am learning nursing skills and practices all over again.

I started a job at a skilled nursing/short term rehab health center where I have around 25 patients. I have oriented for 3 days and tomorrow is my first day "alone" but there will be another nurse there if I have questions. I am absolutely terrified.

This facility uses paper charting and I have little experience with that and since charting i so important, I don't want to do a poor job.

The med passes was getting better my third day but I am SO SLOW because I don't want to make mistakes and I feel like if I didn't have the nurse I was following there to help me with other things that were happening during the day, I would have never gotten ANYTHING done. I am SO SCARED I am going to make a mistake during a med pass and seriously hurt someone. So scared.

Also, I have NO idea about the paperwork aspect of this job. It seems like everyone is always dealing with paperwork, calling doctors and filling out more paperwork and trying to find the papers to fill out and dealing with ADMISSIONS and DISCHARGE paperwork all while trying to do med passes, check blood sugars, give insulin coverage, ETC ETC ETC.

I feel like I have no time to do accurate head to toe assessments on any patients and that scares me also.

It's the little things too that are freaking me out, things that I feel I should know from nursing school. Like experience with IV's and PEG tubes and trachs. Those are all things I barely have experience with and am now expected to know how to do.

I am just so scared. Is this how I am supposed to be feeling? I honestly wonder if I can handle this.

[littlerayofsunshine, BSN, MSN]

First of all - take a deep breath and try to relax. Only 3 days of orientation and then you're on your own? That's pretty rough. . I'm a relatively new nurse too, just over a year and on my second job. I'm on a med-surg floor at a big hospital and we had 6 weeks orientation on the floor. I can imagine how nervous you are.

My advice would be to take your time with med pass - you will make mistakes if you rush. Ask other nurses how they organize themselves, they may have some good tips. Do your head-to-toe as you're passing morning meds. You will be slow at first but get better as time goes on. Make/find a good brain sheet for yourself. It will be tricky with so many patients, but it will help you to be sure you don't miss something important.

When doing something you're unsure of- trach suctioning, tube feeding,etc., - ask another nurse to watch you the first time. You can also do research online (youtube is great) at home to get a general idea of how to do it. Did your school provide any online resources? We had ATI and they offer good videos showing many basic skills. It's totally expected that you will be nervous and scared. I'd be worried if you weren't a bit scared.

The best advice I've ever received is that nursing is a 24-hour job. You WILL NOT be able to finish everything on your shift. Take to time to prioritize tasks - dressing changes, tube flushes, etc. Ask others if you're not sure what is most important to do. Delegate to your CNAs if you can. They usually do the ADLs. You must focus on the things that can't wait until the next shift. Try to cluster activities as much as possible. If you have a treatment or something to do w/a patient- try to do it when you are in the room passing meds.

Don't beat yourself up because you are slow and don't know it all. Nursing school does not prepare us to do it all. You should use your nursing process and critical thinking to do the best job you can. Ask for help, be open to suggestions. Better to be slow and late than rushed and make mistakes.

Get a good night's sleep, eat a good breakfast. Eat during your shift and try to stay hydrated. Take breaks if you can. You will think better if you take a few minutes to relax and regroup throughout your shift.

Good luck! Let us know how it goes.

[kaygbean]

Thank you for your supportive words...

Yesterday (my first shift "alone") went okay. My preceptor came in to help me out for the beginning of my shift but then left after a couple of hours. I didn't have to ask her many questions but a lot of things are still worrying/bothering me.

This is going to sound bad but I am mostly worried that I am not going to have any idea what to do if a resident/patient is starting to go downhill. I'm not sure how to get things ordered there and if I need lab tests, etc, I don't know how to go about it.

This facility uses all paper, no computers at all so there is paperwork EVERYWHERE and it is very confusing for me.

Also, like I said before, I am really worried that I am going to harm a patient. There is literally no time to do much else but pass meds and I don't see many nurses doing head to toe assessments, at least not as in depth as we were taught in school.

But yea, I had off today and tomorrow as well and go in Wed, Thurs, Friday but she said that my preceptor will be there which makes me feel A LOT better.

I just hope this anxiety and constantly worrying before and AFTER I get home from work goes away...eventually.

Thanks again :)