new grad problems adjusting to big hospital- help!

tokmom, BSN, RN · Jul 24, 2011

How long have you been in your current position?

You are certainly not alone in all of this. Read the new grad posts on AN. How many posts do you see that proclaim that the first day, week, month, year has been a breeze?

Being on a new floor is difficult as it is, even for an experienced nurse, but we fall back on our previous experience and we do ok.

You, on the other hand, don't have that and probably are feeling completely bombarded with all this information on top of learning a new routine!

What is it about the telemetry that makes you stare at it blankly? If you are having problems, bone up on it. Try skillstat.com, take a tele course, ask questions!

Use your preceptors for help. Identify your weak spots and have them give you some ideas how to get things to run a bit more smooth.

Bottom line, don't give up. One day (and soon) it will click.

GM2RN · Jul 24, 2011

How long have you been in your current position?
You are certainly not alone in all of this. Read the new grad posts on AN. How many posts do you see that proclaim that the first day, week, month, year has been a breeze?
Being on a new floor is difficult as it is, even for an experienced nurse, but we fall back on our previous experience and we do ok.
You, on the other hand, don't have that and probably are feeling completely bombarded with all this information on top of learning a new routine!
What is it about the telemetry that makes you stare at it blankly? If you are having problems, bone up on it. Try skillstat.com, take a tele course, ask questions!
Use your preceptors for help. Identify your weak spots and have them give you some ideas how to get things to run a bit more smooth.
Bottom line, don't give up. One day (and soon) it will click.

I agree with all of this, and in particular the part in bold. When you identify your weak areas, formulate a plan to work on them and put in ON PAPER. Writing it down is important. Don't try to tackle everything at once, but take it one step at a time.

Above all, work on organization, even if you don't feel that this is a particularly weak area for you; there is always something that you can tweak. Getting and staying organized can really help you move forward.

Also pay attention to other nurses and watch for tips that you can learn from the way that they do things.

Finally, ask your preceptors how they think you are doing. You might just be too hard on yourself right now and are doing better than you think, which is common for new nurses.

APatriganiRN · Jul 24, 2011

Thank you both for the advice and encouragement! It's only been 2 weeks...so I know it probably sounds like I'm not giing it a chance.but I really am trying. I went against my gut, and I usually pick things up very quickly, so I'm not used to struggling. I will get speciali2d training in telemetry as part of my orientation, but I will be sure to take it upon myself to review it on my own time asap. Also, the writing things down is a great idea too; I try to do this anyway, but I will be sure to really try to do more ofthis. The only thing that worries me, like I said, is that I went against my gut, and since I'm struggling right now I'm really kicking myself.

GM2RN · Jul 24, 2011

I get what you mean about struggling. I was used to excelling at pretty much everything I tried in life, but I struggled some when I first graduated from NS. What you need to do now is stop worrying that you made the wrong decision and tell yourself that you can do this!

You also need to give yourself some time. It will take you at least a year to start to feel comfortable with nursing, and maybe more.

And when I said to write it down, I didn't mean just "things," I meant to actually write down your plan for working on those things that you have identified as weak areas. Go over it every day, at least in the beginning. It will remind you of how you need to go about improving, and you can tweak it along the way.

You WILL get it.

nohika · Jul 24, 2011

It's only been 2 weeks

:) Don't kick yourself - it takes most new RNs about a year to even feel comfortable in their job. You can do it!

Yiggs · Jul 24, 2011

I'm a new grad RN who had multiple job offers, and picking one was really tough. The two that I narrowed it down to were a part time medsurg position in a smaller community hospital where I'd done a lot of clinical time, and a full time position in a bigger hospital on a busier floor with sicker patients. Since I want to go to grad school to pursue a career as an APRN, I of course picked the latter. Now I feel totally lost! I struggle through the computer system, I stare blankly at the cardiac monitors, and I just don't feel "right". My coworkers are really nice and my manager is awesome, and my preceptor is a great teacher. I just don't understand why I'm having so much trouble adjusting, and I can't help but think maybe a more "basic" unit (if there is such a thing) at a smaller hospital would have been better for me? It's frustrating to try so hard and still not cover everything! What can I do to make this a smoother transition??? Please help! :-(

Congrats on your new position. While you might feel inadequete now, give yourself 'props' for the things you do know, and the proceedures that you are skilled at. Many times when we have difficulty adjusting to something new, like reading telemetry strips, we tend to think that we might be inadequete in everything else. I would suggest you make short term and long term goals. One of your short term goal could be to recognize normal sinus rhythm, sinus bradycardia and sinus tachycardia (without prompting) by the end of your first month of training. If you already feel comfortable reading these, set new goals - definitely you should know very soon afiib and v-tach. As far as the equipment on your unit is concerned, set goals and practice until you achieve them, and check off as you celebrate each success! Do the best you can, and as another peer said, do courses that will help you develop certain skills; also hook up with nurses who are skilled and who you would like to emulate, and learn from them. All the best! Keep us posted.

xtxrn, ASN, RN · Jul 24, 2011

All of this means is that you're NORMAL!!! :yeah:

If you didn't feel overwhelmed as a new grad, you'd be a scary, scary nurse ! :eek:

You'll get the hang of all of this- it just takes time :)

:banghead:

stoberto · Jul 25, 2011

Just wanted to add, if you like your co-workers and management you should definitely stick it out...it will take a while but eventually you'll be an expert working on a floor with people you like, and you'll be happy you did.

xtxrn, ASN, RN · Jul 25, 2011

Just wanted to add, if you like your co-workers and management you should definitely stick it out...it will take a while but eventually you'll be an expert working on a floor with people you like, and you'll be happy you did.

TOTALLY agree- it's really hard to find a group of co-workers and management that are good to work with...the rest will come in time :)

GM2RN · Jul 25, 2011

TOTALLY agree- it's really hard to find a group of co-workers and management that are good to work with...the rest will come in time :)

I gave kudos to this but felt it important enough to warrant it's own post. Finding a good/supportive work environment is worth its weight in gold.

carolmaccas66, BSN, RN · Jul 27, 2011

Go in on a day off, and get someone from computing to teach you the computer system, then you're not under pressure.

Next, ask someone to explain the monitors. Get a book, most wards have reference books re cardiac monitors and how to interpret them.

Ensure you have a plan BEFORE you walk on to the ward. To do this, go in a bit earlier and find out what patients you will have. Use a cheat sheet - names down one side and bed number - and times up the top. Then you just grab their charts b4 starting ur shift & write down what you need to do for that shift.

Going in on my days off was a pain, but it really helped me cos I wasn't under pressure at the time and I learned more.

ALWAYS have a plan for caring for ur patients. If ur blindly running backwards and forwards, you just waste time and don't get anything done. Planning and time management is the key to good patient care.