New grad nurse in hospital and feel like I won't make it through orientation.

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So I'm a second career nurse (never worked in health care before - in school I was working in former my career through school). I graduated in December, passed the boards in February and applied to every job possible. I was lucky enough to be accepted into a new grad residency program at a well known hospital out of state (and moved by myself over 600 miles from home). I was told the program would be a 12 week orientation with a preceptor, as part of the two year residency committment. Well I've worked about 4 weeks on busy med/sug floor with the same preceptor (so far I've worked 15 - 12 hour shifts), and I'm due to change preceptors soon). The problem is I feel like I'm drowning already. My clinical skills are week, and I'm pretty sure my preceptor thinks I'm stupid (as well as the other younger nurses on the floor). I'm full of anxiety all day long, and feelings of shame, and doubt. I cry almost daily, and feel like I will never get the hang of everything. I'm supposed to be taking care of 4 patients on my own now, but I'm still at 2, and still being told I'm too slow and my time management is not where it should be. Again, everything is completely new to me, and I thought the program would be more of a transitional period from school to RN (with more one-on-one assistance.) But I'm finding the expectations to be much greater and faster than I anticipated. Not to mention the fact that I'm really supposed to be on my own at 8 weeks, not at 12 weeks which is what I expected (and really feel I need more like 6 months). My NM said she wants me to be at the expected 4-5 patient level in about 2 weeks. All of this is completely overwhelming me and I feel like I won't be able to make it.I know people say the first year is the hardest and just push on through, but I feel sick to my stomach that I'm going to have a major screw up, due to rushing around or forget something pertinent. I'm wondering if it's worth it for me to continue in the program -considering the amount of stress and anxiety I'm experiencing (it just feels so wrong to me). And I don't want to work in an environment like this. I feel like I made a huge mistake in going into nursing. I don't like the responsibility of caring for people so sick when I feel so incompetent. And I know my preceptor and other younger nurses on the floor think I'm stupid. (I wish I could do PT - but the schooling takes so much longer and at my age I can't do that). With no acute care experience, where can I go to work as a nurse? I just don't want the pressure that I'm feeling..Any thoughts/advice to a struggling, extremely stressed and anxious second career nurse?

Have you talked with your preceptor at all about this? If you have the opportunity, it could be good to talk with him or her. I was a staff trainer for new educators for a long time before becoming a nurse, so I've been on both ends of this! If you can come up with two or three specific things that your preceptor could do that would help you succeed, that might be helpful. Also, try approaching the conversations from a solution oriented perspective, rather than one of problems.

Also, though I'm new too, I hear that what you are feeling is normal. Talk to your manager about getting your orientation extended and about how you are feeling. I know it is hard to have these conversations, but they are crucial. You can also ask for feedback from the nurses who you feel think you are stupid--"What is one thing you see me doing that you would do differently?" "I notice that you are really good at _____. Can you teach me how to do that?" "I feel like I am still slow at ______. Do you have any tips for how to do _____ more efficiently?"

I hope that is helpful. Remember the quote, no one can make you feel inferior without your consent. Stick with it; you can do it.

Talk with your precptor asap like above poster stated. It will be even harder to find ANY job if you give up now. The market is so tough right now, if you can get help, get it now from the job you have and make it work :). You can do this! Fake it until you make it.

I wish somebody told me these words when I started. It really sucks that this seems to be normal in nursing :(. Hang in there and be safe

krissyr....I feel the same way as you do. I just finished my third week (out of 12 orientation weeks) at my new job on an LTAC Respiratory unit, and I feel so uncomfortable, out of place, in the way and just deer in the headlights. I actually thought one of my four patients was coding today - turns out the patient was just heavily medicated the night before and the side effects carried over. Scared me to death though.

I cried on the way home tonight...mainly thinking about how I want to be a great nurse and I just feel like I have no idea what I'm doing. CNAs and RTs have come to me with questions this week that I just don't know how to answer, and it's frustrating. I know I'll probably be bumped to 6 patients next week and it scares me. I had a couple good days this week where I was able to complete AM med pass and treatments no problem, and then a couple of days (like today) where I ended up with Calcium Carbonate all over the front of my scrubs because meds through a J tube are a pain! hahaha. The thought of adding two more patients to the mix gives me some anxiety, and the thought that I'm supposed to manage 9 patients by the end of my orientation freaks me out. BUT. I'm trying to take it one day at a time, learn from my experiences so far, help the aides when I can (because I'm huge believer in "teamwork"), and just do what I can during the shift. And like Cicadarn said, I'll talk to my preceptor and manager. I don't quite feel like I'm totally underwater, but if I have 6 patients assigned to me next week, I just might.

Thanks all for your input. I did speak with my NM and she's changing my preceptor, so I'm hoping that I have a different experience (one where I'm not looked down upon for not knowing a certain skill). I know my lack of confidence is a huge factor, but I'm wondering how one has confidence in doing things they've never done before? And I see other new grad nurses (the younger one's) all seemingly able to handle the 4 patients they are taking on, while I struggle with two patients. I was told by my NM they would evaluate my performance over the next 2 weeks and see how it goes (she did say it's in their best interest to help me succeed). I just find it so overwhelming, and wonder if the extreme stress is worth it and at what point does one decide - maybe this type of nursing is not for me? Thanks and good luck to you all.

Specializes in public health.

Remember, all nurses feel stupid and inadequate when they first start. Just think about what if someone takes your job and you are now unemployed. Trust me, it's much better to have a job than not. Calm yourself and pull yourself together. Think about the kind of mistakes or areas of weakness. Then when you are not working, brush up on those knowledge. When I was a CNA I found the nurse educator was really helpful. You can talk to her/him about your concerns. Just don't say you can't do it anymore. Ask the nurse educator what can you do to improve fast. Also, we are all human, if we keep doing the same we will get it at the end. Good luck!

Thanks sourapril..I'm trying..Just need to get my anxiety under control and take it one day at a time. Thanks for your input..

Specializes in Cardiac.

I just want you to know that those of us up to 4 patients at this time don't feel like we can handle it all. We are just as flustered as you are. I got put on 5 a few days ago for the first time and I was completely overwhelmed. It is NOT just you. My preceptor claims I am doing well and is very encouraging despite how flustered I feel, just remember it may be the way you are perceiving the situation moreso than you actually performing poorly.

Or... that's what gets me through waking up and getting ready for another shift...

Specializes in Critical Care.

Here's the thing about being on your own after residency: you WILL make mistakes. You will have to force yourself to take every mistake you make and reframe it as something you either A) learned to do the right way for next time, or B) need to work on in order to improve. It sucks...you feel alone and incompetent...other nurses talk smack about you, CNA's talk smack about you. ESPECIALLY if you don't have prior healthcare experience. You have to put on your big person britches every day and suck it up. Go slow, and be safe. Let them talk. You'll get faster and you'll still be safe.

Every morning after my shift as I fall asleep, I try to think back on the night and reflect on what I need to do better. Not obsess/second guess, just acknowledge my shortcomings and move on. Some days are harder than others. Like someone else mentioned, as a noob, there will be a few days where everything flows, but most of them you end up covered in meds. Persevere, and keep your eyes and ears peeled for tidbits of info from those who offer it, even if they are gruff.

Specializes in Critical Care.

Oh...and don't expect to be besties with your preceptor. You'll see some that are, and it'll bum you out, but after you're on your own you'll be able to identify those who will support and mentor your learning the most. Some unexpected people may surprise you!

Try to remember what it was like when you learned to drive. The year before getting your learner's permit was the loooonnnnngggggessstttt year of your LIFE. Then you sat in the classes and couldn't wait to get behind the wheel.

And it was harder than it looked when you were watching your mom drive you around. All those things to remember! All those things to observe! You couldn't have the radio on because it decreased your concentration just enough to make you even more nervous. You ground the gears, and the tires squealed when you jammed on the brakes parking in the lot. When your mom, riding shotgun, yelled, "Stop!" when you didn't see the guy in front of you didn't have functioning brake lights, she scared the bejaysus out of you and made you mad at the same time.

When the big State Police guy took you out for your driver's test, you were shaking in your boots. But you know what? You passed. You couldn't believe it, couldn't believe you had that thing in your wallet, because still when your mom handed you the keys it was scary. The first time -- and the second, and the fifth-- you drove the interstate into the city by yourself you thought you were gonna die. But you didn't. It got better.

And now.... flash forward mumblemumble years. You buckle up and back down the driveway, drive with three kids yakking in the back seat, listening to Terri Gross on NPR, aware of every damn fool on the road, and you haven't had a problem with parallel parking since the Reagan administration. While drinking your morning iced coffee. And planning your grocery list. And you remember to get gas.

See?

You can do this. You're just ... new.

Specializes in Critical Care, Education.

As an educator who has worked with new grads for plenty-five years, the OP's situation is very familiar.

In my experience, the primary stumbling block to managing a 'full load' assignment is the inability to prioritize. New nurses tend to apply the same level of urgency to each and every task that in on the 'to do' list because they do not yet have a frame of reference that helps them quickly categorize everything into "must do" high priority, "should do" medium priority or "nice to do" low priority. Preceptors must help them learn to do this.

Just think about a normal work day - a never-ending barrage of new events & demands on your time. If you perceive everything as a high priority, it will be impossible to accomplish it all. The problem is not that a new grad is working too slow.... they are usually working at a frantic pace, not even stopping for meals or breaks. But that work is like an inchworm bobbing up and down at a manic pace, but never getting anywhere. Preceptors need to coach our newbies and help them develop a better sense of the big picture; help them focus on identifying and acting on high priorities - then tackling lower priorities as time allows.

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