New Grad Med Surg Nurse Freaking Out!

Nurses New Nurse

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Oh God, somebody please help me! I just started a job on the Med Surg floor and will have 6-7 patients per shift. I am working with a preceptor right now and having trouble juggling only 2 patients (I just finished up my 2nd week on the job). I feel incompetent because I have to ask a billion questions, am not used to the computer system, and freak out inside when talking to physicians about a patient. Just a general lack of confidence and experience I suppose. I feel like I will never get it down, am overwhelmed, and almost burst into tears at least once during my shifts. I am an extremely organized person, but really need some advice on how to best prioritize tasks so that I don't feel so overwhelmed. Did anyone else have this problem as a new grad, or am I unreasonably panicky/being too hard on myself? I never realized in nursing school how hard nurses truly work. Now that I am on the floor, I am convinced that my fellow nurses are superhuman angels!! :bowingpur

Oh man. I know the feeling. Let me tell you my story. I have been an RN 15 years. Most of those were in LTC and homecare. Never did med surg. Never really wanted to. However, the general concept of nursing when I was in nursing school was you "go get a year of med surg, and then figure out where you want to be in your career." Well just recently I was hired on the basis of my total experience in nursing on a med surg floor. It was hell. In NO WAY would ever go back to that! I will go work at Burger King before getting into that situation again! If you can stick with it and do it well, I have a profound and great admiration for you, but I couldn't do it at all.

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Hi:crying2:

I'm responding to your post cause I'm in a very similar situation...I'm a new grad who just started working on a telemetry unit.I had a 2 week classroom orientation and now I'm getting an 6-8 week (depends on how quick I will catch on) orientation on my unit...I'm orienting on days but will be working on evenings.Tommorow I'm starting my second week on the unit and I'm getting my first patients (last week I was following my preceptor for a whole 5 days) I'm intimidated by my preceptor who is an excellent,very well organized and extremely bright nurse...She has been a nurse for the whole six years,she doesnt write many things down,she is able to memorize almost everything...She usually has 4-5 patients since they are of a higher acuity (stepdown floor) but if she gets that 5th patient assigned to her she said she can get easily overwhelmed..I dont know how anybody can handle 6-7 patients by themselves,higher acuity or not...Days on my floor re so extremely busy that it is almost insane.I try to write down almost everything down but I still find myself forgetting to do many things or missing something.The worse part is putting the whole picture together,speaking with physicians as well as family members...I hate the fact that often I'm taking care of a patient that I almost dont know anything about.Then a family member or a doctor,social worker or nurse practioner ask me something about this patient and I stare at them and go blank...I cant focus on each patient indvidually cause there is just so many other things to do...I constantly feel overwhelmed,deafeated,low,stressed out,and doubt myself if this career is really for me.I'm thinking about coming to work an hour earlier and read up on my patients history so I can feel adequately prepared and purchase a book about improving memory...I also feel like crying a lot.:crying2:

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Specializes in med/surg/tele/neuro/rehab/corrections.

I felt pretty stressed out too my first 6 months but after that I calmed down. I still can't remember all kinds of things if they are not written down. That stressed out time ends sooner than you think. Just hang in there are realize that this is temporary.

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Specializes in Medical-Surgical/Oncology.

I think most new nurses find the little and big things scary because it is new. I am a new nurse myself and it has taken me some time just to relax and take a deep breath. We have a huge responsibility on our hands. When you done with your preceptorship you will find and develop a way of doing things that work for you. I make a square box and right the procedure that needs to be done. When I am finished or have completed it I will check the box. Now is the time to ask lots of questions and there is no such thing as a dumb question. Even if you have to ask it twice. Make the most of this time and try to find other new grads in your area that can relate to you. I think night shift is a great place to start. It is busy, but not as hectic as day shift, which I have done both. Understand you will make mistakes, you will question your desire to be a nurse and there will be days you will want to run home and cry. But soon, you will see that there is another day to do your best all over again. Nursing is 24 hour job. What one shift doesn't finish the next one can. I leave stuff and the other shift leaves things for me. As far as docs, I think being a new nurse we tend to get scared to talk to them on the phone and especially in person. Main thing, know your pts. and when you are talking to a doc you are advocating for your pts and expressing your concerns. Pretty soon you will know them all and be able to talk to them and acknowledge them by name and their specialty. Make the most of this time. Keep a journal. I wish I had done that from the beginning. Then you can look back and reflect on the things you have done, overcome, and mastered. Take it one day at a time! For now, that is all I can handle!

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I totally feel your pain. I have been a RN for just over a year now and also work med-surg. Let me just say that I med-surg is task oriented. I'm sorry to say that the more pts you have the less time you have to dig into their H&P, consult notes, do "housekeeping" on vague orders, put in nurse initiated orders, etc. I think this is really important, especially at teaching hospitals because Interns/Residents make mistakes too (not just the New Grad RN ;-) Don't be hard on yourself, you'll get it. Some people take longer than others, but when it clicks they are spot on!

You need your own time management system. I think being off orientation was the best for me because I was able to find my own groove. It is also good to precept with different RNs because you can pick up on different methods and mentalities.

Just stick with it and do fun things with friends and family on your days off. You will be a better at your job because of this. Take care of yourself first. Nursing is a noble career....but it doesn't define who you are as a person.

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Hello all,

I am a new grad almost getting off of precepting on a tele floor and will be on my own next week. Just curious to see how the other newbies are doing who started earlier this year....Since it would be about 6 mths, have you had a different outlook? Did you find your "routine"? Are you less stressed? I'm freaking out and totally related to how you felt then. Just wondering IF it really does get better.

Thanks shakedwnst924 for starting this thread and I hope it did get better. :nurse:

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[And if it doesn't go to night shift where its quiet.

Who says night shift is quiet? That is when fevers, hypertension, confusion, ER admissions, arrhythmias, etc. etc., happens...

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Specializes in Psych.

Hi,

This post was like, from a year ago, and I don't know if you will recieve it. I wanted to know how it worked out for you? Are you still on the same floor? Did you move on? I am in this exact position right now, and freaking out! It would be really nice to hear how it worked out for you!

-K

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Specializes in Psych.

Hey, how did it work out for you? I Know this thread is old, but I'm in this spot right now!

-K

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Wow 6-7 patients? I couldnt imagine that ratio, I am in a GN internship on a med-surg floor and our ratio is 1-4...very rarely is it 5 pts...this is my 3rd week on the floor on orientation and I am taking 3 out of the 4 of my preceptors patients. I very rarely have down-time but I get everything done including charting...I must admit I prefer for it to be busy, I like to stay active :) Hope everything worked out for you, I have found my internship very helpful so far (thank goodness for an AWESOME preceptor)...my internship is 3 months long and intern graduation is May 7! I feel ready already...it was also helpful that I did clinicals my last semester of nursing school this past fall before graduation so I was pretty familiar w/ the way things worked there. I find it helpful to get to work early and print out handoff reports and list all my pts meds by time 0900, 1100, 1300, etc and then as I pull them from the pixis i put a dot next to them and then when they are given to the pt I check them off and then I put a list of new orders at the end of each pts page and will mark those off as they are done. we also have computers at the bedside and so i chart right then and there as i am assessing the pt and chatting w/ them in the AM so that kind of helps.

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And if it doesn't go to night shift where its quiet.

:rotfl: That has to be the funniest thing I've read all day!!!

No matter what I did, it took me the better part of the first year to get mostly comfortable with the regular day to day things. Just in the last few months have the sudden out of the ordinary things not completely knocked me off my rocker. Keep plugging away and you'll get there!

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I think we all feel this way. I had 2 weeks of classroom orientation, and am in week 8 now. I've had 6 weeks on the floor, roughly, and am taking 5 to 6 pts with the supervision of my preceptor. It seems like I never get my charting done!!!! I focus on my patients because they are most important. I strive to get it all done, but charting comes last, period, unless it is absolutely necessary that it be done at that moment.

I'm on a surgical unit, we also take medical patients, and even the experienced RN's are having trouble getting it all done. That's the nature of the beast. So I say don't feel discouraged, just keep doing your best. We all suffer as newbies, you are not alone. You can do it!!

I find it super easy to get bogged down with patients going to surgery (i.e. paperwork, consents, calling family), pt's who pass away (more paperwork, family, calling everyone), and patients who are high acuity and end up in the unit. For me, the downfall of nursing is the paperwork!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! :barf01:

To make things worse, we are short staffed on RN' and aides. So I spend most of my day taking pts to the bathroom because no one is allowed to get up by themselves. I have patients who have been in the hospital for 3 or 4 days with no bath. You can smell them from the hall :scrying: I struggle with that because I want to help them clean up because I know they desperatley need to.

It's a sad state of affairs in most hospitals, and with the new reimbursement plans it seems it will only get worse before it gets better, but we are all in it together I suppose, and all we can do is try our best. You are definately not alone. :nurse:

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