Raw: Two Months After Graduation. One Month After Employment.

During orientation, we were shown this video. It showed a new nurse happy to begin her career, but then she crashed. She became depressed, and frustrated. She came to quickly hate her job, in spite of being enthusiastic and excited when she started. She felt like a failure and isolated. She was miserable. Nurses Announcements Archive Article

Raw: Two Months After Graduation. One Month After Employment.

I watched that video in orientation thinking, "these people are crazy. I'm a ray of sunshine and hope! I am a positive person! I believe in myself and I am ready to learn and BE AWESOME!!!! I LOVE THIS PLACE!!!!!!"

But here I am. Three days shy of a month in on my first job. And there is a bit of dread in my heart. I'm not sure how it got there. It snuck up on me rather insidiously. A couple of weeks ago, I was walking toward my car and I passed some respiratory students. I beamed at them happily and said, "Hello!" As I walked away, I heard one of them say, "Wow that was a happy person!" She was right. There was joy in knowing I could wake up to the hospital, my new home.

What happened? Is it that the high of graduation has settled, and the reality of going back to grown-up world has come back? Is it that I feel so completely incompetent?

I know what you students are thinking while you read this. "I'm going to be on top of the world! I'll never feel that way!" But mark my words - there is this strange feeling that sinks in where you realize that school didn't prepare you for this, and that you really aren't good at it no matter how hard you tried to be, and you have so, so much to learn.

I read that so many times here, and I believed it. I think I held that giant beaming smile on my face because honest to god, I went in prepared for how hard it was supposed to be. Even then, it overwhelms me knowing how much I need to know, but just don't yet. I wish I could take home the charting system to practice. I wish I could take home the omnicell to practice. I wish I could take home the policies and procedures link on the intranet to memorize. But then again..... surrounding myself by the ongoings of my children on days off has kept me sane.

Four days off.

Four.

Why do I feel like I'm always at the hospital? I'm home more days than I am there.

You know what is a little bit more frustrating? I'm a bit of a junkie for the critical care unit I am on. I absolutely love it. And yet.... I have buyer's remorse. I think to myself, "there is no way I'll get good enough for this... Maybe if I chose (med/surg/OB/peds/ortho) instead it would be easier......" Realistically, I know that's not true. I mean, probably not true. I usually STRIVE for a challenge and feel let down when I miss opportunities. I know I'd be frustrated if I were anywhere but where I am. But I'm frustrated, too, because I am where I am.

Being on orientation, I am frequently pulled for other experiences. In 4 weeks, I've had two days with my own patients. I've loved my experiences, of course, but I'm feeling the weight of, "I should be making progress by now, but I'm not getting the opportunities to." I'm not meeting goals. I've gained a lot of experiences, but I haven't met goals. Is trading one for the other good? How does that work exactly?

I have the blues. I'm very much a fighter. I'll keep moving and striving to be awesome. I know it's a long haul before I will feel like I'm awesome. I've waited through nursing school, I can wait longer.

But.... man.

You graduate nursing school, and you think to yourself, "I reached the goal! I'm there!!!!"

And then you pass the NCLEX, and you think, "No more studying these giant ugly books!!!"

And after that, at work you get your first name badge with the words "registered nurse" on it.

And you think, "I made it. I am here. I have arrived."

You save your energy up for that finish line. And then you reach it. And you feel you're on top of the world. No one thinks about what happens next, emotionally speaking. You walk into your first job, and find out that because you were so high on that mountain on top of the world that it is that much further to fall down when you have really hard days.

And you look up to where you were, up there on that mountain, and you remember...

"I wasn't supposed to fall."

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ixchel

About ixchel

Critical care BSN, RN

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Specializes in NICU, PICU, PCVICU and peds oncology.

I was just like you when I started my first hospital job 19 years ago. I was so excited and thrilled to finally be able to say, "I'm a registered nurse and I work at the biggest hospital in the city! Go me!!" As reality set in and I started to feel less special and more not-even-average, I wondered if I was on the right path after all. But I kept showing up. I changed jobs a couple of times. Eventually I started to feel more capable, more confident and more like I really had made a good choice. The smile came back. Patients' family members commented on it. "You've always got a smile for everybody. You cheer us up when we see you." Now I'm one of the old souls on my unit, the ones others come to with questions and for feedback. And I know this is what I was meant to do.

Give it time. It's still very early days for you. The victory laps ARE over and there's always a feeling of let-down when that arrives. But there are other mountains to scale and lots more victory laps in your future. Some will seem like small potatoes but hey, nursing evolves and changes all the time and so will you. You haven't fallen, you're still on your way to the summit.

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Specializes in critical care.
I was just like you when I started my first hospital job 19 years ago. I was so excited and thrilled to finally be able to say, "I'm a registered nurse and I work at the biggest hospital in the city! Go me!!" As reality set in and I started to feel less special and more not-even-average, I wondered if I was on the right path after all. But I kept showing up. I changed jobs a couple of times. Eventually I started to feel more capable, more confident and more like I really had made a good choice. The smile came back. Patients' family members commented on it. "You've always got a smile for everybody. You cheer us up when we see you." Now I'm one of the old souls on my unit, the ones others come to with questions and for feedback. And I know this is what I was meant to do.

Give it time. It's still very early days for you. The victory laps ARE over and there's always a feeling of let-down when that arrives. But there are other mountains to scale and lots more victory laps in your future. Some will seem like small potatoes but hey, nursing evolves and changes all the time and so will you. You haven't fallen, you're still on your way to the summit.

Jan, there is a reason why you are one of my very favorite AN'ers, and this right here is such a huge reason why. Thank you for this. I am holding back tears right this second just thinking about it. ❤️

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Specializes in CICU.

There is a reason why new RNs in critical care get months and months of orientation. And, after orientation, if your employer is smart and kind, your staffing will reflect an appropriate experience mix so that several new people aren't alone together.

There is still a TON to learn, but you can get there. So many of us have before you.

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I hear you! I am four shifts into my position on an acute medical unit and I know this will be me. This is what is currently keeping me sane:

1) walking home from work. I'm lucky to live pretty close. This is my time to reflect on the day and to breathe.

2) remembering that, in orientation and in school, they told us that there is research to support that the first three months are usually the most, well, insane (they use a different word!), a descent into the underworld so to speak, for almost all new grads. Then research shows that things pick up.

3) improvement is incremental: I can see the difference between grads from my class who were hired a month before me and me, even if they can't!

4) my dad's words (doc): when I started out, I was humbled to realise that I knew about 10% of the stuff I encountered in a day. 90% was "oh man, I've never seen this before". Then it moved to 20/80...and, about two years later, I realised it was 80/20 or more. But I still find stuff I don't know. So I admit it, and look it up and ask about it.

5) I am not expected to know everything but am expected to remain calm enough to ask for help instead of barrelling along going "I'll figure it out, I'll figure it out." If the IV pump is recalcitrant, then sure, I probably will figure it out eventually. If the problem is a mysterious onset of wheezes and SOB, maybe not....

6) Every single practicing nurse went through the same thing. Every one. They survived. Those who truly found it wasn't worth it, did leave...but I have flashes/moments when I love my job, so I think it IS ultimately something I will do.

7) when all else fails, I pretend to be a hobbit on a long journey where they only way forward is through the swamp of bodily fluids or over the mountain of lab values. So to speak.

Good luck!

OH and finally, something that I realised during my preceptorship. When I find myself thinking, I'll never make it through XYZ time period (the day, month, set of shifts, hour), I break the time down into something smaller. I have the energy for one shift: I KNOW I can handle 12 hours. Or, I KNOW I can make it to next break (or to the time I next get to sit down) if I just go pee now...stuff like that. I try to only handle the shift I've got and not freak out about the next one.

I do have new-onset GERD though....sigh.

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Right around passing NCLEX and getting a job offer, but before beginning work, I already got really depressed for a couple days. I just felt like I already accomplished everything I wanted... now what? The "victory laps are over" comment from above basically hits the nail on the head! Everyone in my life was so proud of me and thought I was so amazing, but I just felt kind of... blah. When I finally realized why I felt that way, I just had to start to remind myself of how lucky I am to be in my position, how much I wanted this, and how many more amazing things are ahead for me in my career. I am about to start on that job finally and I am feeling much more optimistic. I am expecting to get that wave of depression again as I get overwhelmed with my new job but I know how to handle that and I know to be grateful for every moment. Thanks for posting this. It really helped me reflect.

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OH and finally, something that I realised during my preceptorship. When I find myself thinking, I'll never make it through XYZ time period (the day, month, set of shifts, hour), I break the time down into something smaller. I have the energy for one shift: I KNOW I can handle 12 hours. Or, I KNOW I can make it to next break (or to the time I next get to sit down) if I just go pee now...stuff like that. I try to only handle the shift I've got and not freak out about the next one.

I do have new-onset GERD though....sigh.

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I am so happy to hear/read someone else verbalize what I have been feeling since I started my job back in March! Such a huge learning curve and there have been so many things that nursing school could have never prepared me for. I cry more days than not, and working nights has been a big adjustment especially with being a newlywed I miss my husband like crazy but I know that everyone has to start somewhere! I just didn't think that I would feel so utterly incompetent most of the time. I seriously question my reasoning for becoming a nurse at times - especially after the nights from hell. And working in a hospital in a urban setting where you see a lot of the same underserved type of population over and over and over those nights come all too often. Good luck!

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Specializes in Critical Care, Postpartum.

I am always brutally honest when I share my woes of being a new grad. I too started in critical care and definitely had "buyer's remorse." The people I worked with were great, but realized this area of nursing was not for me. I wanted to quit within one month but knew I would be hurting myself if I didn't stick it out for at least a year and I did just that and moved on to a specialty I'm much more happier in.

Going from new grad to primary nurse is tough. My nursing program was rough (ABSN) but it was child's play in comparison to your first nursing job. Give yourself time to hone your skills, build confidence, and build rapport between yourself and doctors. I luckily started at a hospital were there were no residence so your opinions about the patients' care was valued.

The tears and the knots in the stomach will be there, but throughout time the tears dry up and the knots disappear. And then you come back and give advice to other new grads experiencing the same things you once felt. Full circle moment.

Good luck new grads! You'll make it.

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This sums up my personality 100%. The fact that you realize how strong and confident you are will allow you to keep better and better learning how to deal with all the new stress until one day, the stress will be minimal. The optmistic me hopes anyway. Great article.

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Specializes in Emergency.

Well written, read this quote today and thought of this article...

"It isn't the mountains ahead to climb that wear you out; it's the pebble in your shoe." - Muhammad Ali

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This was a good article for me to read. I have some friends in nursing and they told me the exact thing you did. I am just getting started on my path (associates at Community college then bachelors), but this is a good point to keep in mind. It will be a job that will need constant education. Always have to be learning.

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