New Grad needs help

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    I Recently passed my boards and got my BSN in July. It was hard for me to find a job so I took whatever I could land first. I got hired in September at a LTC facility, but this is where I need help. I constantly come home worried thinking I did something wrong or just feeling guilty for no reason. There's nights where I question myself if I'm meant to be a nurse bc I'm also having some lateral violence at work ontop of the constant worrying. I'm scared I'll miss some paper work or document wrong or just anything lol the supervisor isnt really helpful bc I hear it from the other nurses that she hates it when I'm asking questions. I want to tell her it's better to measure twice and cut once. I'm so scared to encounter a situation where I don't know what to do. I worked so hard for my license and would never ever want to lose it or most importantly harm anyone.. There's days when I work with a good nurse and days where I work with a nurse who expects me to know everything. Please what's some good advise for a new grad nurse?
  2. 15 Comments so far...

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    Oh and one more thing, I work 3-11 and finding that I really miss spending time with my family especially my daughter. This is what bothers me the most
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    LTCs are a tough environment. In my experience, the other nurses took a lot of shortcuts - it took me a while to catch on to them. That could be why the other nurses don't want to help you. And the 3 facilities I have worked in, the horizontal violence was rampant.

    Working 3-11 was good for me when I had small kids but then when my daughter went to school I was very greatful go find another job.

    I guess just do the best you can and keep trying to find another job.

    What state are you in that you have a BSN and can't get a hospital job?
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    Every new grad goes through this. It took me 6 months to finally not be nervous about coming to work, and a year before I felt confident. It's very scary when you're new! You don't know what you don't know.. My advice is to get a routine down and always have a consistent way of doing things. You will be less likely to forget anything that way. But....don't be so fixated on your routine that you can't be flexible when needed because things can sometimes things change very quickly! It sounds like to me you are mostly scared of making a serious error. That is normal. And I will tell you right now you will make an error. You w ill make many errors in your career. But you won't make the same error twice.

    When I orient new grads, I always tell them to make assessing their patients a priority. I mean really assess them, not just half-way do it like you see many nurses do. Make sure you are paying attention to your vital signs. Make sure you know what drugs you are giving are for....ideally you should look at labs before giving meds, and NEVER give meds before you know the patients vitals. Always call the doctor if you suspect something is wrong or see any worrisome changes in a patient, even I you think it's not that big of a deal. Particularly changes in LOC. Make sure bowel/bladder function is adequate. I've gotten report from nurses before and saw in the chart that there was no urine output, low blood pressures, etc, and they didn't know.

    Basically what I am trying to get across is that as long as you are paying attention to those key things on your patients you will be fine. I think the biggest part of our job is just paying attention and taking action when needed. Keep asking questions. If there is something you feel you aren't qualified to handle alone and no one will help, then refuse to do it. The last thing you want to do is guess and mess up. Admit when you are out of your skill set and knowledge base and, at that point, it's on the charge nurse to provide the necessary education or change the assignment.

    I would also continue to look for a different job, sounds like this place is not a good environment for someone who is learning. Hope that helps!
    Last edit by HeartRN_09 on Nov 11, '13
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    Thank you so much for your help, I live in Pa and there aren't many jobs out there. The meds and treatments isn't the problem it's just the environment, getting pulled, and like I said before just feeling scared. I ask questions bc I don't know and I want to learn. If you miss something on a nurses note like forget to document something, could you lose your license? The nurse that I work with has 20+ years experience and I have maybe 1 month now lol I asked her for help before bc I discovered a wound on a resident and I didn't know what was the best way to treat it and she goes "c'mon didn't they teach you that in nursing school, your school should be ashamed." It's not like I asked her to do my work, I just wanted reassurance. Either way thank you again everyone for your help.
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    Charting scared the crap out of me in the beginning. They don't teach you how to chart in nursing school. My experience has been that there's a fine balance between charting too much or not enough. If you chart too much you can get into some gray areas that leave you more open for questioning. If you don't chart enough, it makes you look negligent. When you are charting about an incident that happens, just stick with hard facts...vital signs, assessment findings, etc and then make sure to include what you did about the situation, ie, calling the physician, rat team, increased oxygen, applied pressure to stop bleeding, etc. Never chart about a bunch of abnormal findings without Also charting your interventions, physician call and orders rec'd, etc. Your charting should paint a clear picture of what is going on with the patient and what interventions were done about it. Avoid long time gaps in charting....then it looks like you neglected the patient. So you won't necessarily lose your license over forgetting to chart minute things, but if something were to happen to a patient...they are already assuming the nurse was negligent....your charting should show that you weren't. Hope that makes sense.

    Sorry you are having to deal with old nurses who eat their young. What they don't realize is making sure you are well trained not only helps you but them as well because you will be more independent and eventually able to help them with their load on occasion! Imagine that! So remind them of that! And when she wants to drop the line about "shouldn't you have learned that in nursing school?" Just respond with "maybe, maybe not but it doesn't change the fact that I still need to know what to do!" And here's a little factoid about most nursing schools....they teach you how to pass a test not how to be a nurse. You learn how to be a real nurse on the job.
    Last edit by HeartRN_09 on Nov 11, '13
    ceebeejay likes this.
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    Your day-to-day practice should be guided by the policies & procedures of your employer. This would include the approved methodologies for wound care as well as the 'how when and where' of charting. FWIW, I agree with the problems of working 3-11 when you have young children.... it's very difficult.
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    Quote from philliesfinest
    Thank you so much for your help, I live in Pa and there aren't many jobs out there. The meds and treatments isn't the problem it's just the environment, getting pulled, and like I said before just feeling scared. I ask questions bc I don't know and I want to learn. If you miss something on a nurses note like forget to document something, could you lose your license? The nurse that I work with has 20+ years experience and I have maybe 1 month now lol I asked her for help before bc I discovered a wound on a resident and I didn't know what was the best way to treat it and she goes "c'mon didn't they teach you that in nursing school, your school should be ashamed." It's not like I asked her to do my work, I just wanted reassurance. Either way thank you again everyone for your help.
    That sounds completely out of line. No they don't teach a lot of wound care in Nursing school. That is why there are continuing education classes/ certifications for such. And it is a big deal in LTC. They do have to be documented and treated appropriately or they can become huge liability issues. Keep your chin up and ignore that nasty nurse.
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    Again thank you for all the support and help, there's days I come home thinking I'm not good enough to be a nurse and there's days where I'm positive and everyone here is making me feel better just by letting me vent lol thank you
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    Hey philliesfinest - I am in PA too! I just started at a LTC facility and there are so many patients and so little time! I am hoping to catch on in the next 3 months.


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