Struggling new grad. Tips on critical thinking

[leilo0, BSN, RN]

Hello everyone

I'm a new grad 2 months into my orientation in a busy medicine floor and just like most new grads, I am struggling with my transition in to the nursing role. I don't know how I 'm going to do this once I'm on my own.

I am very task oriented and everyone says critical thinking comes with experience and in time i'll be able to put the puzzle together. I just don't know when I have to page the MD or deal with the situation first and am also clueless/uncomfortable about making suggestions to doctors about what to do with patients or just talking to them in general and unable to answer questions right off the bat.

I am worried that because I can't critically think, I'm going to miss something important or follow a doctor's order that can potentially damage a pt.

How can I enhance my ability to critically think and to practice safely?

I know sometimes it's important to ask questions but sometimes, I can't even catch red flags or think something doesn't seem right. For example, one pt was complaining of epigastric pain after having a scope the day before. I did not think much of it until my preceptor told me that in females, MI is not your classic chest pain radiating down to your left arm but can be something innocent like heartburn pain. See I know that but I didnt put two and two together.

I feel clueless and hopeless and am thinking of quitting because the stress of this responsibility is too much too bear :( please help

[classicdame, MSN, EdD]

Given this information, how will you change your plan?

How will you prioritize your work today?

What other alternative measures would work?

What else could be causing this problem?

How will you determine the effectiveness of your interventions?

[Esme12, ASN, BSN, RN]

Hello everyone

I'm a new grad 2 months into my orientation in a busy medicine floor and just like most new grads, I am struggling with my transition in to the nursing role. I don't know how I 'm going to do this once I'm on my own.

I am very task oriented and everyone says critical thinking comes with experience and in time i'll be able to put the puzzle together. I just don't know when I have to page the MD or deal with the situation first and am also clueless/uncomfortable about making suggestions to doctors about what to do with patients or just talking to them in general and unable to answer questions right off the bat.

I am worried that because I can't critically think, I'm going to miss something important or follow a doctor's order that can potentially damage a pt.

How can I enhance my ability to critically think and to practice safely?

I know sometimes it's important to ask questions but sometimes, I can't even catch red flags or think something doesn't seem right. For example, one pt was complaining of epigastric pain after having a scope the day before. I did not think much of it until my preceptor told me that in females, MI is not your classic chest pain radiating down to your left arm but can be something innocent like heartburn pain. See I know that but I didnt put two and two together.

I feel clueless and hopeless and am thinking of quitting because the stress of this responsibility is too much too bear :( please help

Time, time, and more time. A few calls to the MD when they treat you like an idiot (whatever). Question, question, question. Allow yourself to be human. Take you own pulse first. Know how to ask/call for help and know when someone is not breathing and know how to call a code.

You will make mistakes. Listen to you inner voice. Find a mentor you can trust. Forgive yourself...you are only human.:hug:

[Bringonthenight]

It WILL get better. It really will get easier with time. Critical thinking doesn't just happen overnight, your asking too much of yourself. Relax. Breathe. Ask questions. Watch the experienced nurses. Learn.

[NurseB_, BSN, RN]

I'm about to graduate nursing school in week and I'm going to be starting my job soon after. During my practicum experience I would felt the same way that you are now. I would understand the rationale AFTER my preceptor would explain it, but I wasn't able to put two and two together on my own. I understand that it will take time and I will allow myself that time, but it's frustrating sometimes when you have to say DUH I KNEW THAT!

[nrsyann]

I swear you took a peek inside my brain and wrote this post. I have 3 shifts left before I'm on my own. Hold me. I'm on a busy floor, too and our acuity is fairly high. I struggle with many things right now, but one of the biggest ones is when to call the doc. Which doc do I call/page? I've done this, that, and the other, but have I really done any critical thinking about what my patient is experiencing? Time management. Prioritization. Etc, etc, etc. Everyone keeps telling me I'm doing fine. Everyone keeps saying that it takes time and I'll be just fine. Everyone is very, very helpful and nice. Thank God. But I hate feeling stupid pretty much every single day.

One bright spot is that when I look back over the last 8 weeks I can't believe how much I've learned!

Hang in there...we can only do our best.

[juana15]

Hi! Just following up to check how's it going? I'm a new grad & feel exactly as you described & I'm hoping i get better soon! I don't react quickly enough when situations arise & I always seem to think in hind site.

[SierraBravo]

When you experience something new, write it down and then when you have free time (or at home) do some research on it. That way the next time it pops up in your practice you will have that knowledge. The problem as a new grad is you don't know what you don't know. And like others said, with time this will get better.

[BlueDawnRN, BSN]

I felt this way 2 months into orientation. I had no idea how I was going to be able to work on my own either. I'm now 6 months in and working on my own and I'm doing fine. Things are really starting to come together for me, as it will for you. Just keep learning and keep asking questions. It will get easier every day.