OMG...Off orientation and freaking out

rn/writer, RN · Sep 12, 2006

It's time for you to take a couple of steps back and breathe for a few moments.

If you don't relax a little, you stand a good chance of either making yourself sick with stress or making mistakes that are a result of being wound too tight.

Get yourself a small notebook and start writing in it daily. Write questions that occur to you that you don't have time to research on the spot. Write little tips and tricks that you learn from your coworkers. Write near misses that you don't want to trip you up in the future. Most important, write things you did well, problems you solved, complements you received, and and all successes that come your way.

When you are feeling overwhelmed and depressed, pull out that little book and look at the progress you've made.

What you're suffering now is two things--a serious, though understandable, lack of perspective and a self-centered outlook borne of fear.

Your perspective is too limited right now. You are so focused on the two inches in front of you that you can't see the big picture that will help you let some of the tension go. That's normal, but it's also painful. Keep telling yourself that you have made it this far, you want to do a good job, and you will keep learning. Follow the policies and procedures to the best of your ability--they're designed to help you avoid mistakes--but understand that no one is perfect. You will make errors now and then or forget something or misinterpret something. But if you develop good habits, hopefully, your mistakes will be small ones or you'll catch them before anything serious happens.

The self-centered outlook is also normal. Anxiety tends to narrow your focus. But it also increases the chances that you'll miss things. Again, step back and try to look at the big picture.

In the not too distant future, you will find yourself feeling better and actually enjoying coming to work. Don't be afraid to ask questions. "Off orientation" doesn't mean "knows everything now," and no one expects that of you.

Take good care of yourself physically and shift your attention to something completely different during your off hours. Ride a bike, watch a mindless movie, bake bread, get or give a massage. Let your poor ol' brain unclench and everyone will benefit.

I hope this helps.

RNSuzq1, RN · Sep 13, 2006

Hi NurseBunky,

I think we're all in the same boat (off orientation or about to be) - and slightly terrorfied... I have a week left with my Preceptor - even though I've been doing the bulk of the work on my own for weeks, it's still nice knowing you have a back-up. The other day I told a Nurse Ed. on my floor that I'm worried about being totally alone and don't know as much as the other Nurses on the floor. She reminded me that I'm New - most of them have been Nurses for years and like any job, if you're at it for years, you get good at it. She said she's been a Nurse for 15 years and still asks questions - and everyone on the floor supports each other, so I feel a lot better about it.

You mentioned being scared that a patient will ask a question that you can't answer off the top of your head. I think that's something we all worry about - we dont want to look stupid in front of the patient. This happened to me last week - some questions about a surgical procedure I wasn't familiar with. I told the patient that I was new to the floor and would come back with an answer in a few minutes. Everyone was busy, so I looked it up on the computer - even printed up some info. for the patient to read. Instead of them thinking I was a ding-dong not knowing the answer right off, they were thrilled that I went to the trouble to look it up and give them reading material. I guess the best thing we can do is take it one day at a time and eventually we'll be as comfortable in the job as the rest of our co-workers...

**canoehead, BSN, RN** · Sep 13, 2006

I used to say that I was new to the floor and didn't know the answer in as much detail as I liked, and I would get another nurse who had been there longer, when a parent asked a lot of questions. I would even say "do you mind if I listen in?" to the parents, and no one seemed offended or upset when I was honest about not knowing. They DID get upset when I only was able to answer halfway or tried to bluff. You can tell if someone is bluffing.

SillyLilly · Sep 14, 2006

I should *hopefully* be hired soon. I know my self, and I will probably have anxiety attacks before every shift. I dont want to give myself negative thoughts. But I know how I am. I am going for 12hr shifts so i dont have to deal with my stress evvverry day, although i am aware of the possibilty of orienting 5days a week.

I plan to do alot of what RN writer has. I recently made a new friend who is a newer nurse. And I think coming to this site is and has been extremely helpful for me.

crb613, BSN, RN · Sep 19, 2006

I am just off orientation too. You cannot know everything...no one does! Try to relax. Most hospital have resources (books, computer, charge nurse) for you to look up/get info....use these. If I don't know how to do something or am uncomfortable w/my skill or knowledge....I ask for help. There is nothing wrong with simply saying I don't know how to do this, nor is there anything wrong w/asking questions. If something really trips me up, I may not have time to fully research it at work, but when I get home I dig a little deeper. This helps me a lot. I have questions now & 5 years down the road I still will!

I also get asked a lot of questions...some I don't know the answer to. I just tell the pt I am not sure, but I can & will look it up. I know if I were the pt I would much rather someone just be honest w/me & get the correct info...instead just giving me any answer to avoid admitting they don't know!

I am sorry you are feeling so stressed.....If I felt like I could not provide safe care, I would ask for more training.....nothing wrong with that either! Good luck to you!

NurseBunky · Sep 23, 2006

Thank you all for your advice. I'm on week three on my own and doing fine. I still get butterflies on my way in to work but once I start working and helping out my patients I start feeling better and more confident. All of the night nurses I work with are awesome. I couldnt have wished for a better team. Everyone is so helpful and available to me to ask questions and they certainly dont mind showing me things. Congradulations to everyone off orientation or coming off orientation. Thank you all senior nurses that don't eat their young!!

kit3375 · Sep 27, 2006

Thanks so much rm/writer. I needed to read that message! I am a new grad myself and have the very same feelings. I feel like I'm a bundle of nerves and anxiety. Getting adjusted to the night shift life is only adding to the list! Thanks for the encouragement and the ideas.

rnsrgr8t · Sep 27, 2006

Just a quick comment to all of you new grads out there (congrats!). I have been a pediatric nurse for 8 years. I have never had a parent be upset because I did not know an answer to a question (still happens to me all the time). I am just honest, tell them I don't know, promise to find the correct information for them and ALWAYS come back and give it to them. If you do that every time, you should not have a problem. Noone expects you to have all of the answers and you never will. Good Luck!

kit3375 · Sep 29, 2006

Thanks so much rnsrgr8t. It feels so good to hear someone with experience admit they don't always have all of the answers. I know that experience is the best way to learn answers, and I am having faith that with time I'll get more confident in my career I worked so hard for....

rnsrgr8t · Sep 29, 2006

Thanks so much rnsrgr8t. It feels so good to hear someone with experience admit they don't always have all of the answers. I know that experience is the best way to learn answers, and I am having faith that with time I'll get more confident in my career I worked so hard for....

You are quite welcome! I am sure you will do well! Good Luck!

Ruby Vee, BSN · Sep 30, 2006

so i'm off orientation and am soooo unsure if i'm ready. granted i've had about 2 months of orientation and working with a preceptor. the last 3 weeks i was pretty much on my own but still had questions. i think i'm always gonna have questions. i feel like i don't know everything but how does one know everything. i'm scared a parent is gonna ask me a question and when i tell them i'll find out they'll think i'm incompetent in taking care of their child. there are also a great bunch of nurses on night shift that i can use as a resource but i'm still scared. i always felt anxious the night before and the day of work when i was on orientation and it's even worse now. i worry about the type of patients i'm gonna have, types of medications i'll have to give, labs i'll have to draw, care i'll have to do, questions i'll have to ask, and oh no what if i forget something...the list goes on and on.
does this madness ever stop?!!!

relax, take a deep breath, and tell yourself that you're competent or they wouldn't let you take patients by yourself, and you're learning. anxiety is normal, and no one knows everything. the longer you work there, the more you'll know. you've gotten some good advice from others in the thread -- the advice about a notebook is great! good luck! i'd worry about you if you weren't anxious!