New nurse with job that is causing anxiety and depression - page 3

by nurseGi

HERE IS MY STORY: I graduated in May with my BSN from a university, i was a good student..graduated with honors. I took the NCLEX in the summer and got my first job in a large hospital in december. I am working on a geriatric... Read More


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    If you are exhibiting signs of depression, low self-esteem, and panic attacks within three months of employment. You will not get better "fighting back." without removing yourself from the hostile environment. Trust me. I know. This is unacceptable for a new graduate to go through. Their expectations should apply to a season nurse. It takes 4-6 months to precept a new grad. Do yourself a favor and go to HR for a transfer. They don't deserve you. Read your policy on workplace harrassment and present your proof. Those actions will make you a stronger nurse...that's fighting back.
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    Thank you all so much for your insight. They assigned me to a new preceptor, who is better then the other. I was put back on 12s (started yesterday), and the new preceptor taught me things the other preceptor never mentioned.. that I should have known by now. They tell me that I have a month left on orientation.. and this is gonna be like a crash course for me. Yesterday was hectic.. and I am never been so anxious in my life. This preceptor pulled me to the side after the day was over and told me what i needed to work on and told me she could tell something was wrong, she asked if i was happy here, and of course i started tearing up again and crying...cause i am NOT happy at all. Of course I didn't tell her that, i just said I am just overwhelmed and stressed. I also told her that i feel like i didn't get the proper education in the beginning of my orientation and now it is reflecting and I don't have much time left to prove myself. She told me its a normal thing to be going through and a lot of other nurses on the floor have been through the same. She told me she had been a nurse for 20 years in a nursing home and came to the unit and also felt overwhelmed and as a new grad it is going to be even tougher. She told me i could do this, i just have to come to work everyday and feel confident (so hard with all that has happened) and really try to know my patients in terms of there illness and history. I feel like an idoit crying infront of her, but I am a sensitive person and I have never been through something like this before. I come from a very supportive family, and its what I am used to. I have today and tomorrow off, and I have to come up with a list of my strengths and weaknesses to present to my manager and preceptor. I really need to take on a different attitude when I go there, i think I am living in fear and its reflecting on my performance, and also the comments I receive from my manager are a big let down.. but I just gonna try as hard as i can and what ever happens.... happens, atleast I can say I tried.
    NevadaFighter likes this.
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    Schools are doing a disservice to their graduates by emphasizing theory over the practical.
    The last two new grads we had, didn't know how to hang a piggyback.
    No exaggeration. They didn't know about fld compatability. They'd never placed an NG or a foley. Their IV insertion skills were limited.
    We want to blame 1) the preceptor or 2) the orientee, depending on what side of the spectrum we're on. Maybe we should be blaming the nursing programs that graduate nurses, who don't have the clinical skills to do the jobs for which they're hired.
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    I mostly agree with this post, but I'll add some qualifiers from my own experience. Sometimes, depending on region and availability of clinical sites/facilities, the education programs aren't always *able* to provide extensive clinical times. Particularly in rural areas, even the clinical time you do spend will mostly be dealing with 90 year olds with COPD exacerbations and pneumonia. Not that there's anything wrong with those patients, but they don't provide the most broad-based clinical experience. That said, students should come out of school knowing how to place a Foley, start an INT, and hang a piggyback. NG tubes ... That one I don't know. I don't think anyone in my nursing school class had that opportunity in 1.5 years of clinical.

    Quote from imintrouble
    Schools are doing a disservice to their graduates by emphasizing theory over the practical.
    The last two new grads we had, didn't know how to hang a piggyback.
    No exaggeration. They didn't know about fld compatability. They'd never placed an NG or a foley. Their IV insertion skills were limited.
    We want to blame 1) the preceptor or 2) the orientee, depending on what side of the spectrum we're on. Maybe we should be blaming the nursing programs that graduate nurses, who don't have the clinical skills to do the jobs for which they're hired.
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    I was a fill in preceptor on my old unit so I know a thing or two about how new grads get thrown to the wolves on many units. I have also seen unsafe new grads. If you were here telling us you had made serious patient care errors or that you knew more than or refuse to take advice from the other nurses etc. my advice to you would be very different. But the things you have stated regarding the feedback you have recieved from your preceptor and manager just sound like plain old new grad growing pains to me. It stinks having management that doesn't sound like they have realistic expectations of a new grads abilities.

    Your reactions are normal. You have been placed under a microscope and basically threatened with do better or else. Most people make more mistakes under these conditions due to stress and anxiety. It is a vicious cycle. No one likes to be told they are not making the cut. It impacts our self esteem, makes us feel less than or incapable. You have to find a way to mitigate your anxiety or it will defeat you.

    Lets face it NurseGi, what is the worst thing that can happen. Lets say you are let go from this job in a month. Lets say they march you down the hallway booing you as you go. Lets say your manager clucks her tongue at you while saying....ah ha! I knew YOU would never make it. In the grand scheme of your life what does that mean? Do you really think the people who love you will not understand? Heck you don't even have to tell them the specifics, you can always say you were down-sized or let go due to budget constraints. You will never have to return to that unit or see those people again. Sure it may mean starting over, but there are worse things in life. If you confront the fear of not making it on this unit it will lose its power over you and you may be able to get your anxiety in check.

    My advice to you:

    Your new preceptor sounds like a better fit than the old one but I will warn you that no matter how nice she seems DO NOT say anything negative against your manager or old preceptor. Instead of saying you don't feel like you got the proper education say things like: I didn't realize how hard this transition would be, I don't feel like nursing school prepared me, I feel like an idiot most of the time, I am overwhelmed etc. Do not speak to the specifics of your situation with anyone at work!!!!!!!!

    When you write your list of strengths and weaknesses use specific things they have told you as weaknesses. Do NOT write what you perceive as weaknesses, they do not need any more ammunition against you. Match your weaknesses with a strength if at all possible. You say your preceptor said you need to know your patients illnesses and histories better? Weakness = lack of knowledge of the pathophysiologies common in patient population. Strength= Actively seeking to improve knowledge deficity by studying patho phys of DM, CAD, or whatever conditions you see frequently, using the following resources: Your nursing texts, medscape, etc. etc. You say you are only up to 5 patients at this time and you haven't made any mistakes? Weakness=time management. Strength=Demonstrated ability to safely care for 5 patients on unit. You let them change your schedule, came in for unpaid I.V. training? Strength=Demonstrated flexibility in scheduling. Weakness=Not proficient in IV starts, Strength=Completed facility approved IV training.

    Approach this next month as an extension of nursing school. Jump through their hoops so you can gain some valuable patient care experience. Even if you are let go and you never put this on your resume it will still benefit you.

    It is a crummy thing that you have not found the support you need on this unit so you need to be supportive of yourself.
    The first year is rough! In your first year as a nurse you will encounter something new every single shift. It will take you a good 6 months just to master the basics. You will need to run things by your coworkers and need their assistance. This is not a sign of failure or weakness. It simply makes you what you are...a new nurse. Go to them and ask, even if they are rude, roll their eyes at you, yell, or make snide comments. Keep your patient's safe always and get help when you need it! You are not there to make friends, or make your coworkers or managers lives easier. NEVER let anyone make you feel bad about needing support. If your manager doesn't understand and counts this against you...she scares me!

    Remind yourself before and after every single shift that it is ok to be new. It is ok to not know how to do something, who to call, where this is located etc. It does not make you a bad person or a crappy nurse. Those other nurses you see, the ones who seem so smart, so proficient, so incredibly better than you are right now? They were once clueless newbies too!

    Your experiences thus far are not a reflection of you, your worth as a person, your intelligence, and has absolutely no predictive value of what type of nurse you will become with more experience. Remember that, repeat that, over and over again.

    Finally, network with other new grads for support. Spend some of your time off doing non-nursing related things with your friends and family!
    Esme12, roughmatch, netglow, and 1 other like this.
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    Quote from imintrouble
    Schools are doing a disservice to their graduates by emphasizing theory over the practical.
    The last two new grads we had, didn't know how to hang a piggyback.
    No exaggeration. They didn't know about fld compatability. They'd never placed an NG or a foley. Their IV insertion skills were limited.
    We want to blame 1) the preceptor or 2) the orientee, depending on what side of the spectrum we're on. Maybe we should be blaming the nursing programs that graduate nurses, who don't have the clinical skills to do the jobs for which they're hired.

    I couldn't agree more with this observation. I truly believe that the OP and other new grads, including myself, when I graduated 4 years ago, were totally unprepared for bedside nursing when we graduated. Unfortunately, I didn't know that I was so unprepared. Like the OP, I did very well in school, but believe me, that meant nothing when I got to the floor. Our clinicals during school, were, for the most part, a waste of time. Instructors were more concerned with the required care plans we turned in, rather than finding opportunities for us to provide patient care. I never had more than one patient during any of my clinicals, so you can imagine how horrible my time management skills were.

    nurseGi, you've gotten some great advice from the PPs and I hope that this new preceptor makes a difference for you. I went through 3 preceptors at my first job because I felt that they did not have great teaching skills. That is usually the problem. You can be a fantastic nurse, but not necessarily a great teacher. You first preceptor, and management too, seem to be out of touch with what nursing programs focus on these days, otherwise your preceptor would not have said what she did about you going to a good school and why don't you know such and such. I believe they had unrealistic expectations from you because of this.

    It seems to me that they see real potential in you, and that's why they're extending your orientation. But I'd still be wary, and aggressively look for another job during this time.

    If it doesn't work out, I'll paraphrase what a pp said "they didn't deserve you!!"

    Good luck
    netglow likes this.
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    Sugarcoma,

    You ARE so cool. Your advice applies to everybody! I have printed out your post, it can be something to go back and read for just about any bad job situation!
    Sugarcoma likes this.
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    Hospitals in some areas will not allow students to do certain things. Some schools will tell students what skills they are allowed to do in clinical, and they are also told that if they do certain other skills - no matter if a facility RN shows them how and supervises, they will be tossed out of the program, end of story. Sometimes this is an individual problem of the instructor who should not be an instructor. In school, usually it's too late when you find you have a chicken as an instructor. Very few skills will be practiced in clinical with that instructor.

    What is a student to do? Well, here is what most students try to do: inform the kind facility RN who wants to teach, of the predicament. Usually the kind facility RN will just love to foil your instructors and instantly turn into a secret agent and make sure you not only get to do that one forbidden skill, but be sure you get to participate in many other skills as well! It's a gamble you take. Just hope your instructor never finds out.
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    Quote from netglow
    Hospitals in some areas will not allow students to do certain things. Some schools will tell students what skills they are allowed to do in clinical, and they are also told that if they do certain other skills - no matter if a facility RN shows them how and supervises, they will be tossed out of the program, end of story. Sometimes this is an individual problem of the instructor who should not be an instructor. In school, usually it's too late when you find you have a chicken as an instructor. Very few skills will be practiced in clinical with that instructor.

    What is a student to do? Well, here is what most students try to do: inform the kind facility RN who wants to teach, of the predicament. Usually the kind facility RN will just love to foil your instructors and instantly turn into a secret agent and make sure you not only get to do that one forbidden skill, but be sure you get to participate in many other skills as well! It's a gamble you take. Just hope your instructor never finds out.
    I am a new nurse and I can tell you for certain that most of my clinical sites were restrictive and limiting. We weren't allowed to pass meds at one hospital, couldn't do anything with IV's at another, no insulin at another, we were treated as free CNA help basically. It was mostly because of mistakes other nurses or nursing students had made in the past. I also had lazy instructors who were inconvenienced by us asking To be shown things and were more interested having us do concept maps then out on the floor getting our hands dirty. So needless to say, I did not get the clinical experience that is crucial but I can make a concept map that made my fellow student weep from shame and inferiority and write a paper in perfect APA format! If I were to get a job in a hospital I would need a lot of support from a preceptor. I am a little traumatized after reading all the pp.
    roughmatch likes this.
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    Quote from chrysdamian

    I am a new nurse and I can tell you for certain that most of my clinical sites were restrictive and limiting. We weren't allowed to pass meds at one hospital, couldn't do anything with IV's at another, no insulin at another, we were treated as free CNA help basically. It was mostly because of mistakes other nurses or nursing students had made in the past. I also had lazy instructors who were inconvenienced by us asking To be shown things and were more interested having us do concept maps then out on the floor getting our hands dirty. So needless to say, I did not get the clinical experience that is crucial but I can make a concept map that made my fellow student weep from shame and inferiority and write a paper in perfect APA format! If I were to get a job in a hospital I would need a lot of support from a preceptor. I am a little traumatized after reading all the pp.
    I agree with you about clinical experience. We spent more time on paperwork than actual skills. My concept maps and papers were awesome too, but I just wish we were allowed to do more hands on stuff. I can put an IV in a dummy, no problem, but that is way different than an actual human!! I start my first job next week and I'm nervous as all get out!


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