Worried about my future as a nurse, and afraid I'll be fired - page 3

I am currently working my first job as an RN on a med-surg/neurology floor. I graduated August 2012 with a BSN. I've been off orientation for under 3 months. This morning after completing my... Read More

  1. Visit  j_tay1981 profile page
    0
    Mlb,
    Thanks so much, that's something I really needed to hear!
  2. Visit  RN_BSN09 profile page
    1
    Quote from j_tay1981
    Do you all prefer to chart as you go, or leave the charting for large chunks after seeing people? I started off doing the larger chunks, but I got really behind and would forget aspects of my assessments. I've recently tried to implement on the fly charting. I think I need to be more diligent with that since 'Chunk Charting' hasn't been my friend.
    I have found that I chart as I go for pretty much everything, except for my assessments. The start of the shift is always so busy... so I can pretty much remember most of the assessment in my head, and I'll write down certain things on my brain to remember for later... such as which side of the body something was on, etc. When I have seen everyone and taken care of the initial stuff, I'll chart the assessments when I have more time to pay attention to detail.

    For everything else, like going into and out of the rooms... pt teaching... lab results... dr. calls... new orders... etc, I will chart as I go, because if I don't, I may forget.
    j_tay1981 likes this.
  3. Visit  Phlavyah profile page
    1
    I could have written your post myself. I have been out of orientation for almost 2 months now, and I'm constantly late charting. I make mistakes and spend the nights beating myself up. Charge nurses are nice to me, but I walk around waiting for the day the hospital will hand me a pink slip... And I would not blame'm at all. I feel so stupid, I compare myself to the ppl who graduated w me and feel they have already gotten it, and I haven't. I was one of the top students in RN school. The only one chosen to go to critical care and I can't seem to organize my thoughts and feel as if everything I learned in school has slipped my mind... Whats wrong w me?!
    Walking back to my car after my shift is a true "walk of shame". I wonder if I'll survive as an RN...
    mitral likes this.
  4. Visit  RN_BSN09 profile page
    2
    Quote from Phlavyah
    I can't seem to organize my thoughts and feel as if everything I learned in school has slipped my mind... Whats wrong w me?!
    Walking back to my car after my shift is a true "walk of shame". I wonder if I'll survive as an RN...
    I think every new grad has these exact thoughts and feelings! We all want to have it figured out after a few months... but it honestly takes 6 months or more to really have a routine, and things start to sort of "click". Every now and then you will have to stay late charting for those crazy shifts that happen, but give yourself some more time... you will get there!
    mitral and j_tay1981 like this.
  5. Visit  cateisgreat profile page
    1
    I think it is great that you recognize your weaknesses and have the support you need to work on them! I am on my 4th shift as an RN and the drive home from the hospital is always fraught with concerns about things I did/didn't do or should/should not have done. "They" say that it takes at least a year to graduate from Novice to Beginner RN, and for areas with higher acuity it could take longer than that. Nursing school teaches what you need to know for minimum competency, that is all. Keep your chin up and keep investing in yourself.
    j_tay1981 likes this.
  6. Visit  j_tay1981 profile page
    1
    Phlayvah,
    It sounds weird because what you wrote and what I wrote are so similar, I know how you feel. Despite this, reading your post makes me not only want to tell you to keep your chin up and hope alive but also turn around and say that to myself (and I'm the guy who started this thread!)

    Neither of us would have gotten to this point if we didn't have SOMETHING that could make us successful as RN's. No matter what that thought has helped me through some tough shifts. That there is some spark somewhere inside me that could someday ignite into a more confident RN.

    I hope you have that sense too about yourself.

    Good luck to us both!
    mitral likes this.
  7. Visit  PA_RN87 profile page
    0
    Quote from Phlavyah
    I feel so stupid, I compare myself to the ppl who graduated w me and feel they have already gotten it, and I haven't. I was one of the top students in RN school. The only one chosen to go to critical care and I can't seem to organize my thoughts and feel as if everything I learned in school has slipped my mind... Whats wrong w me?!
    I could have written this myself. I'll be starting orientation next week, and I start on the floor April 1. I'm so scared, and I always compare myself to others, which only brings me down (you'd think I'd have learned by now to NOT do this...). I'm just hoping that my preceptor works with me, and that I don't do something that gets me fired. I always ask questions if I'm not sure, but I'm afraid I'll seem incompetent. At least I'm not alone in my worries!!!
  8. Visit  kChoRN profile page
    1
    I have a friend I work with that has the EXACT same story as you. Her first name also starts w/ a J and literally had the exact same response from our educator recently. It was eerie, I thought you were her for a second.

    Best advice I can give you as a fellow new RN is that it gets better. We are not all cruising and you're not alone in your stress. I have 5-8 patients as well on a Med-Surg-Neuro floor and it gets busy. What I have found helps me is that instead of writing everything by pencil, I type my notes in a brain sheet. I also screen capture the medications to be admin from the eMAK and print them out. I literally write nothing down except what I get in report. Everything else, I type and keep with me. The next day I come in, it is all still there under my log in and I add stuff to it or change it as appropriate.

    I have also found I save hours of time charting by doing only the essentials and trusting the "Within Normal Limits" button. By using a lot of free text entry and doing comprehensive, but simple charting, I save time. It used to take me 6-hours to do all my charting, checking orders, and chart checks, but I can do it all in less than an hour. I'll post a picture of my "brain sheet" below.

    It has the physical assessment I did on the Left and all the Chief Complaint, Hx, Resulting Labs or imaging etc, active orders, and plan on the right. I print out a med list separately. Once I notice the SCDs, or something else, is inthe room or the IV fluids are right, I use a red pen and just check it off -- Then I'm confident I didn't miss something.

    I work nights, however, so I'm unsure if you're days or nights. Days might not work with my system as things change FAR to quickly, but if you're nights, it may help.

    Best of luck to you! You're doing great, keep on trucking! I had a little breakdown on AllNurses.com a few days ago, so I certainly feel what you're feeling too.

    Here's a pic of my brainsheet: https://www.dropbox.com/s/x9qg9d22ao...2001.54.57.jpg
    j_tay1981 likes this.
  9. Visit  j_tay1981 profile page
    0
    kCho:

    Wow! Thanks for the advice and screen cap! They were helpful to me. Since starting this thread, I had a few days where I just hated life, but have since seen a huge improvement in my efficiency. Oddly, although I've gotten a ton of great advice on this forum and from others, there isn't one single thing I can point to and say "Changing this made all the difference". I just came to work one day and the improvements just manifested. Knock on wood, but things have been going well for me. I was actually nominated for a Daisy Award last week, so I must be doing something right, you know?

    It's always good to know you're not alone in something like this; it helps me fight off self-pity and focus on what needs to change.

    BTW: I do indeed work nights. Right now the pace of days would be way to intense for me.

    Thanks!


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