New nurse with job that is causing anxiety and depression

Nurses New Nurse

Published

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 med-surg floor. When I found out I got the job i was so excited and happy, just where I wanted to start out to gain good experience. The first month (december) was fine, I had 3 weeks of in classroom learning and started on the floor with a preceptor the 4th week. I started with 1 patient and moved up from there (im now up to 5), Nurses on my floor can get up to 8 patients. I noticed my preceptor was very care-free and usually busy with her patients to even teach me things.

When january rolled around I had a meeting with my preceptor, manager, and my educator. My preceptor told them that I wasnt progressing as well as I should and also told them (infront of me) that she had high expectations from me cause i graduated from a good school and didnt think she would have to teach me even simple things. I went on to say that nursing school now is more on book theory, going to clinical once a week is not going to give us the experience we need to start on a busy med-surg floor and know what we are doing and feel comfortable. I also told them that i felt that i wasnt being taught well cause of how busy my preceptor was. My manager moved me to 8 hour shifts from 12hrs so i would be there 5 days a week instead of only 3 and experience more. I was devestated after this meeting, i felt incompetent and that I wasnt doing well. The 8 hour shifts were HELL..1) because they dont pay for our lunch so really we have to stay 8 1/2 hours and 2) by the time im done with all my documentation on my patients it is 10 hours a day 5 days a week. My manager told me to show motivation so she could see if there was "hope" or not. Can anyone agree with me that this would me emotionally and confidence draining on a NEW GRAD? I feel like my preceptor was watching every move i was making now. I would have her write down my progress after each shift, I would read it and it would be all negative things. Not one time have i been told good job or that I have improved on something, when I knew truly that I have been learning a lot and progressing. I've been depressed for weeks (i never suffered from depression before).

I had a meeting with my manager yesterday and she said I will be starting 12 hours shifts this week and that she is going to extend my orientation by 2 weeks (now i have a month longer) cause I am still not ready to be on my own. My manager told me that I interviewed unbelievably well and she knew it was going to be difficult to train a new grad but basically not this hard. She also proceeded to tell me that she was going to get rid of me a week or 2 ago but decided that there "might" be hope. I then broke down in her office and cried. She told me crying was normal and that other new comers have cried before cause it is a stressful place to work. They had new grads struggle in the beginning and end up OK. She told me she needs more motivation from me (10 hours/per day not enough)? I also stayed after clocking out one time to work on my IV skills, she mentioned that they cant keep giving to me and that it is a 2 way street. I don't know how much i've got left to give, I cry every day on the way home and everyday before going in. I love nursing, my patients love me..I truly think nursing is for me, maybe I am just in the wrong place? I feel like the pressure is on and that they are watching me closely, Im scared that I am going to get fired soon. Getting fired within 3 months of getting hired would probably make getting hired anywhere else 100x more difficult. I dont wanna sit home for a year and look for another job (i have student loans to pay!!) and also go through telling my friends and family that I have failed at my first job. I want to share with everyone what my experience has been like so far and I want to hear if some of you feel the same way or have gone through the same situation, i hope none of you are cause this really sucks.

Specializes in Trauma/Tele/Surgery/SICU.

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!

0 Votes
Specializes in Med/Surg, Acute Rehab.
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:)

0 Votes

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!

0 Votes

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.

0 Votes
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.

0 Votes

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!

0 Votes
Specializes in LTC,Hospice/palliative care,acute care.

I'm so NOT a new nurse but I still have times in which my job causes me anxiety and depression...Actually,I'm in the middle of one of those times right now- trapped between unrealistic families who will twist your words and lie to admin about you,admin who will let the crap slide downhill so the frontline takes the blame,being blamed for things that just can not be prevented in elderly end stage demented residents.My co-workers and I have joined forces and travel in pairs for protection now.We won't talk to family members or visitors without another staff member as a witness,we do skin checks together,double and triple and quadruple check ourselves. It's defensive nursing.

That "o,please no" feeling in the morning when the alarm rings,wondering what fresh hell awaits.Fearing making one wrong move,fearing loosing your job at any time.It's not fun,we all feel your pain.

0 Votes
Specializes in Pediatric.

I'm so sorry that you're going through this... My only advice would be to document the things (be specific) that you feel are making it difficult for you to succeed at this job (NM attitude, absent preceptor etc) That way if you do unfortunately get terminated, you can file unemployment and have specific examples on why you shouldn't have been let go.

And I've been where you are right now, it sucks. I got fired from my first nursing job within the three months, I was absolutely heartbroken.

0 Votes
Specializes in Med/Surg, Acute Rehab.
I'm so NOT a new nurse but I still have times in which my job causes me anxiety and depression...Actually,I'm in the middle of one of those times right now- trapped between unrealistic families who will twist your words and lie to admin about you,admin who will let the crap slide downhill so the frontline takes the blame,being blamed for things that just can not be prevented in elderly end stage demented residents.My co-workers and I have joined forces and travel in pairs for protection now.We won't talk to family members or visitors without another staff member as a witness,we do skin checks together,double and triple and quadruple check ourselves. It's defensive nursing.

That "o,please no" feeling in the morning when the alarm rings,wondering what fresh hell awaits.Fearing making one wrong move,fearing loosing your job at any time.It's not fun,we all feel your pain.

Just lovely.....this is what we went into nursing for! :banghead: I love that phrase.."defensive nursing". Might have to borrow it for our next staff meeting!

0 Votes
+ Add a Comment