New nurse feeling overwhelmed and miserable! - page 3
First off, I would like to state that I know I am extremely blessed to have landed a job in an acute care hospital very close to graduation. I know there are many new grads that look for jobs for... Read More
0Jan 22, '13 by HyperSaurus, RNI am a night shifter with team (Rn and LPN) nursing on a medical with tele unit with 8-12 patients, 7 months off of orientation. It does get better!
Here's my routine:
2330--LPN looks up med times for the night, I look at charts, check any new labs, orders, read tele stripts, and occasionally call for any impending disasters
0001--LPN starts on vitals, midnight meds, I go with her and do my assessments. I try to start charting my assessments between every pt (I have 8-12 pts, so I chart on relevant details first, then go back and finish everything else later)
0200--Hopefully we've seen everyone, now put out fires, give any prn meds, chart, read H&Ps/progress notes
0400--Draw any labs from central lines, still chart, prn meds
0500--Continue charting, check labs, call for any weird labs, prn meds
0600--Last minute issues, read charts, prepare for report, prn meds
0700--Report! and Freedom!
This is all assuming, of course, that everything goes smoothly, there aren't any admits, rapid responses, or armageddon (you never know, it could happen)
If I'm on our oncology unit, we do primary nursing with no aides, so it's different there. I will admit, we're spoiled. On nights, we do not primary more than 5 on either medical or oncology.
I'm a relative new grad (7 months off of orientation). It definitely took some time to get into the flow of things and I'm still adjusting my routine (I've only recently started charting in between pts). I still have a lot of questions (thankfully my manager is very helpful, as are the more experienced RNs). I admit though, that I am generally not an anxious person, and while I've had days where I've called my dad (also an RN) in a panic because I think I've missed something, I never seemed to have the absolutely gut wrenching nausea, panic attacks, or inability to sleep. It is frustrating at times, that there doesn't feel like there is enough time to really get a good perspective of my patients, that I feel some nights like I am just putting out fires, or that my patients are just in a holding pattern until the day starts,
1Mar 5, '13 by Larry3373Quote from nsgstuHi! Thanks for posting. I posted on this thread a few months ago. Going toward my eighth month now. It's getting much better. Starting to consistently leave work on time. I still haven't lost any patients, dnr or otherwise. Confidence level has gone way up. I still don't desire to charge. All I can say is hang in there and when you are not sure of something, ask! Get a few second opinions. I recently had a 93 year old pt go into respiratory distress, applied 3 l o2 nc and afterwards she was ok. Had another more experienced nurse assess her only to conclude with me that I just needed to keep a close eye on her. The point is, my clinical judgement has increased and I know that I'm not alone in my decision making. Learn who you can call for questions that you can't handle. Obviously this will usually be the doctor, but at my facility there is a house sup, director of nursing, and a clinical nurse data specialist. If the charge nurse can't help, you should know where to turn for help. Anyway, good luck and the best of wishes to you!Thanks for sharing Hypersaurus, RN. I am going on my own tomorrow and sick to stomach right now. I so want this feeling to end ASAP.
South MS RN
0Aug 9, '13 by amzyRNI've got almost about 1 year under my belt and I still feel unprepared sometimes, but I'm now more about to prioritize without thinking about it. Always ask if you don't know the answer. If you feel like your patients are too unstable talk to your charge nurse. Always assess your sickest patient first and remember your ABCs. Look for "skin signs" and restlessness, they are usually the first signs of distress. Always look at labs and know about meds you're giving. Trust your gut and don't feel afraid to call docs and have assessment data ready to tell them, a full set of VS, relevant assessment data, lab values, etc. Practice makes perfect. You can do it.
1May 20, '14 by chanteurdelamourJust curious. Is it normal to feel like you're finding your groove after about three months and then getting hit with worse stress and anxiety soon after that? I ended up quitting my job at a LTC facility after 4 months because every shift I had a panic attack or felt nauseated and had to run to the bathroom 3-4 times which seemed impossible. Staffing had gotten worse and there was more anxiety about being forced to work longer hours to make up for the lack of nurses. I couldn't sleep, I would hear call bells and phones, I'd have nightmares about things going wrong at work. I'd be terrified at the possibility of my phone going off, with work wanting me to come in or being talked to by the DON about flaky CNAs. I was sleep deprived, living off of water and saltines, and just completely overwhelmed. I just wonder if I didn't stick it out long enough, or if the job really was a bad one. I think my new job as a camp nurse will be much better. Even if I do have 530+ kids in my care at a time.
0May 20, '14 by krisiepooI'm a new nurse, going into my 3rd month of nursing
I have realized that there are going to be good days and bad days. I hold onto those good days and don't take them for granted. On those bad days I realize that I am only one person and I can only do so much. I've had a couple days that within the first 20 mins I wanted to crawl into a corner, suck my thumb and rock like a baby, LOL. However, on my very worst day I just kept chugging along and while I'm sure some things didn't get done, the most important things did (blood, meds, dressing changes, etc).
I also ask questions ALL THE TIME. I apologize (sometimes) and I nearly 99% of the time get "I've been nursing for "#" years and I still ask questions, never apologize". or something similar. I will thank patients for their patience with me and helping me learn and nearly all of them have been very accommodating and enjoy "helping" me learn. It gives them some power when they're in a powerless position.
as far as my routines... I come in and get my assignment and look at my assignment sheet but I don't generally have time to look them up before report because we're not allowed to clock in early and I'm not willing to spend more than 12 hours at the hospital if I'm not getting paid for it. So I come in and get report from the previous nurse. We do bedside reporting so I have the patients tell me about what's going on as well and if there's anything we missed that I need to know. I get their meds for the shift together (we have mobile work stations). I look up their most recent notes, I look up the surgical reports, I check orders, I check what assessments need to be done at what time, most recent vitals and labs. Then I start with my assessments and med passes. I generally start with the walkie/talkies who won't need a lot of attention and will be "easy" assessments/med passes. then I usually start with dressing changes, get people turned/cleaned up, etc. That's usually the first 4-5 hours of my shift. But I am someone who generally goes with the flow and this works well for me in nursing. I can't get caught up in "everything that has to be done" because then it's overwhelming to me but if I look at one step at a time, it's more manageable.
We have some amazing charge nurses, though. They are just really helpful, they make us feel comfortable and they're hands on. they have been doing as many discharges as they can for us, they do chart checks when they're able, they've helped me start IV's, they've gotten blood for me, they've sat with confused/aggressive people who we were waiting for the drugs to take affect. So really, our whole group is supportive of each other (lets be honest, it's not all unicorns and rainbows, but the overall atmosphere is pretty great). I got lucky in my first assignment