So, I am a new nurse and I just started working as a RN in May. I am working on a orthopedic/neurology unit that is VERY busy. Sometimes, it is almost unmanageable. I go into work feeling as though I have to vomit! I used to accept challenges with open arms and want to learn about everything, but now I feel dumb and defeated.

I go to work and most of the time with a negative attitude. I am in constant worry that my patient is going to crash and I won't know what to do. I feel that I know nothing and I am doing nothing for my patients. For instance, the other night I had a CRAZY patient load and most of the time on this unit I have to do my own orders for most people because there is only one unit cooridnator for 38 bed unit! I was running around like a crazy person trying to car for a patient in a lot of pain who was DTV and another with Pulmonary emolisms who was confused because her sodium was 125. I don't even have time to talk to my patients When I gave report to the next nurse she just gave me a lecture on all the stuff that I didn't do. Like bladder scan my PE lady because she was voiding frequent small amounts of 200, which I didn't have time to address because my other patients had more important issues.

I feel so dumb and useless. For a while I thought I was really getting the hang of things, but then I would do something stupid like miss a coumadin order or go home and realize I forgot to flush an IV. I feel like a failure and I don't know what to do. I just want to be a confident, good nurse and know how to handle stressful situations. I feel as if I want to avoid them at all costs because I don't think I can handle it. I am trying so hard and I try to get help and advice on situations and I get negative feedback from other nurses like "I should have known that." What do I do to handle situations better and not get so afraid? I just don't want to make mistakes. I just want to take care of my patients and go home at the end of the night feeling like I've done a good job. I feel like a horrible nurse.

advice would be greatly appretiated

The first year is horrible, and it sounds like you have a very high patient load. What shift and how many?

evening (3-11) I have up to five patients, but sometimes 2 admissions in a shift. It gets very crazy.

I'm a new grad too, and I think it sounds like you work with a terrible group of people. I can't even imagine getting lectured like that. I guess I still don't realize how lucky I am to be in an environment where the nurses really support each other, and especially nurture their new grads- you sound like you need some of that.

The other more experienced nurses should be there to support you, and if you need help with a serious situation that you don't know how to handle, they ought to be more than willing to guide you.

Sounds like a tough situation. Just try to realize you are still learning. Don't beat yourself up for the small stuff- just realize it happens when you are new, and learn from it so it doesn't happen again. I'm hesitant to say this because I don't want to come across like I don't take things seriously, because I do but in my world (and unit) if you miss an order, you missed it, just fix it the best you can and move on. If you forgot to flush an IV, well, you forgot. It happens. It happens to EVERYONE, and don't let anyone tell you differently. Beating yourself up about it and feeling like a fool isn't going to change the fact that it happened. The key is to take a mental note, learn from it, and take steps to ensure that you don't continue to make the same mistakes. In my case, of course, I've missed an order, but to alleviate the problem, I thought about how I could make sure I was not forgetting things like that, went home, and made up a new sheet that I carry with me for each pt that I take report on and record the shift's info to give report off of. I added reminders to check for new orders.

Unfortunately it sounds like you are in a situation where instead of helping you figure out how to not make the same mistakes again the nurses around you are too busy putting you down. I have no advice about that, and my heart goes out to you there. The only thing I can think of is to try to find a couple of nurses whom you feel comfortable with and can ask for advice. Geesh, you are a new grad, you aren't supposed to know it all yet. We all came out of school knowing the very basics. Now is the time that we are learning not only more knowledge, but are trying to figure out time management and all the rest of the job. Everyone makes mistakes. EVERYONE. Don't waste energy on feeling bad about it. Use the energy to look and see where you can improve. Pick a goal for improvement for each shift, and think of ways to facilitate that improvement. You can do it, and making mistakes in the beginning doesn't make you a bad nurse. It makes you a new nurse!!:redpinkhe

I'm a new grad too, and I think it sounds like you work with a terrible group of people. I can't even imagine getting lectured like that. I guess I still don't realize how lucky I am to be in an environment where the nurses really support each other, and especially nurture their new grads- you sound like you need some of that.

The other more experienced nurses should be there to support you, and if you need help with a serious situation that you don't know how to handle, they ought to be more than willing to guide you.

Sounds like a tough situation. Just try to realize you are still learning. Don't beat yourself up for the small stuff- just realize it happens when you are new, and learn from it so it doesn't happen again. I'm hesitant to say this because I don't want to come across like I don't take things seriously, because I do but in my world (and unit) if you miss an order, you missed it, just fix it the best you can and move on. If you forgot to flush an IV, well, you forgot. It happens. It happens to EVERYONE, and don't let anyone tell you differently. Beating yourself up about it and feeling like a fool isn't going to change the fact that it happened. The key is to take a mental note, learn from it, and take steps to ensure that you don't continue to make the same mistakes. In my case, of course, I've missed an order, but to alleviate the problem, I thought about how I could make sure I was not forgetting things like that, went home, and made up a new sheet that I carry with me for each pt that I take report on and record the shift's info to give report off of. I added reminders to check for new orders.

Unfortunately it sounds like you are in a situation where instead of helping you figure out how to not make the same mistakes again the nurses around you are too busy putting you down. I have no advice about that, and my heart goes out to you there. The only thing I can think of is to try to find a couple of nurses whom you feel comfortable with and can ask for advice. Geesh, you are a new grad, you aren't supposed to know it all yet. We all came out of school knowing the very basics. Now is the time that we are learning not only more knowledge, but are trying to figure out time management and all the rest of the job. Everyone makes mistakes. EVERYONE. Don't waste energy on feeling bad about it. Use the energy to look and see where you can improve. Pick a goal for improvement for each shift, and think of ways to facilitate that improvement. You can do it, and making mistakes in the beginning doesn't make you a bad nurse. It makes you a new nurse!!:redpinkhe

Thanks so much! You made me feel a lot better! I am actually going to start looking for a new job. This unit is VERY poorly managed. There are only 3 nursing assistants to 38 patients! AND one unit coordinator! I have to assume all rolls to get anything done. Ugh...but thanks again!

I think I would too. (Look for a new job) I think the only time I would really get down on myself for making a mistake is if there was a poor outcome for the patient directly related to my missing an order or whatever. Otherwise, I tend to just move on and try to make sure I don't do it again. I could totally imagine the faces of some of the nurses on my units if I was all upset over forgetting to flush an IV.. they would totally roll their eyes and laugh and tell me to forget about it. Now if I did it over and over and over again, there'd probably be a different reaction, but even then, it would be supportive and in a "how can we make sure you are remembering these things? Lets work on this, this and this" way or whatever.

So, I can tell you from my experience, not all places are like the one you are working. I hope you can find a more supportive environment.

Cut yourself some slack, and remember, these are all just growing pains! (I tell myself this often!)

Alana, that's actually a reasonable load for evenings.

It seems, to me, that you are too hard on yourself. Everyone has forgotten to flush a line, everyone had missed an order in the ever-changing world of slips of paper being taped to the wall. Kaka pasa. It also sounds as if you can't depend on support from your team.

I don't know that leaving is the best thing to do. They say that "nurses eat their young" for a reason, and I am not convinced that another situation would be much better.

My biggest suggestion is that you work on your paper brain - your daily worksheet grid. Some people can use a scrap of paper stuck in their pocket, others need basically their own Kardex per patient on a clipboard - work out a written tracking system that will work for you. I'm a big believer in writing it all down. And I can't use a one-page brain for my whole patient load. They each need their own sheet. Work out a spreadsheet with times and a couple of columns for each time and at the start of your shift WRITE DOWN what needs to be done when. And short of a code, check that stupid order change wall every time you pass through the nurses' station.

You can do this. You're a samrt, caring, competent nurse. Don't let

dragon lady witches convince you otherwise.

From what you've said you have done nothing major.

Hang in there and work out a system for tracking the myriad of tasks expected of the superwoman we call nurse.

:)

"unfortunately it sounds like you are in a situation where instead of helping you figure out how to not make the same mistakes again the nurses around you are too busy putting you down. i have no advice about that, and my heart goes out to you there. the only thing i can think of is to try to find a couple of nurses whom you feel comfortable with and can ask for advice. geesh, you are a new grad, you aren't supposed to know it all yet. we all came out of school knowing the very basics. now is the time that we are learning not only more knowledge, but are trying to figure out time management and all the rest of the job. everyone makes mistakes. everyone. don't waste energy on feeling bad about it. use the energy to look and see where you can improve. pick a goal for improvement for each shift, and think of ways to facilitate that improvement. you can do it, and making mistakes in the beginning doesn't make you a bad nurse. it makes you a new nurse!!"

thank you for the words of support! i could not have said better. i think that sharing our mistakes would be helpful so you could know that everyone makes mistakes. everyone, even the best of the best. i wish i could share my mistakes with all of you but i am still a new grad looking for a placement and so there is not much to share. however, there is something i can say. i would like to tell that during my second semester i started to eat myself for every small thing i did not know. it was not helpful at all; moreover, it was very devastating, increasing the level of my stress and crushing my confidence. the more i was eating myself the less i was able to cope with new situations. what did help? i began to say to myself that i do not have to be perfect and i have to take small steps instead of trying to become a great nurse in one shift. and sorry for saying this but noticing that experienced nurses make mistakes too was very helpful.

you are a good nurse because you do care! do not eat yourself, especially when there are "others" who like to bite.

you will grow into a great nurse--- just give yourself time. no child could learn running in one day or even month.

Unfortunately, the people around you make a big difference in how you feel. I was new over 17 years ago and got put down by the anal nurses...sigh. and now I'm new every few years since I like to change jobs and get new ways of doing old things. Workplace violence is a new buzzword in nursing, it can be even a clique of nurses who decide not to talk to you. Yesterday morning I gave report to a new hire in our busy telemetry unit...I simply asked where she was from and took an interest in her background. She was so encouraged and exclaimed how I made her feel welcomed. I was surprised by her reaction, she must have been feeling put off by some of the nurses. Find the encouragers on your unit, if they aren't there, don't mess around, find another unit. Some units have to learn the hard way....lose all their new nurses before management gets the hint.

I too am a new nurse, its so hard to put the learning in your head into action. I think the advice about writing things down and using a system to remember things is good advice. As for your "teammates" shame on them. Every nurse should mentor newbies. It makes for an easier workplace and better patient outcomes. The work load is lighter on everyone if competent care is given and they can help you with that. Every experienced nurse has tricks that help them keep up with the work. Try to find a mentor to give you some tips.

i remmember when i was a new nurse feeling just like you and everything i had to ask how to do and get screamed out for asking the best thing you could do is get in a more supportive enviorment someone you coud ask when help is needed instead of biting you head off

Take a deep breath. Exhale. Now do it again.

We are brand new nurses! Our floors are so busy. Take the good stuff home with you-- the things that made you want to be a nurse and reflect on those little things.

We made mistakes. Shoot, I've made a few myself. I think our first year is definitely the hardest (I hope anyway!) Find a mentor-- perhaps the person who precepted you. My mentor/preceptor is a fine lady who is almost 70 years old. I adore her and she gives such great advice even for being rough around the edges.

When someone is barking at you-- thank them for their observations and learn from them. Sometimes I really have to bite my tongue-- but it has made me more friends than enemies, and I learn about things in the process, too.

Hang in there!

I'm a new RN too and understand how you feel, Nursealanarae.

I work days on a medsurg floor, taking up to 7 patients and usually doing several discharges and admits in a shift. Fortunately, I'm working with a very supportive group of people, but still feel overwhelmed and manage to look like an moron at least once a day.

I know where everything is on the floor and how we do things, but when something out of the ordinary happens, I feel panicked and can't seem to remember anything I learned in school until after the fact, which does me no good during the critical moments.

I turn into a mumbling fool when talking to doctors, especially when I have to call them on the phone. When I don't know they answers to their questions, I feel like even more of an idiot.

I even had to write myself up for a med error this past week. The pt was fine, thank God.

Every day, I go in to work hoping that I will have all my stuff together when I talk to the docs, I won't make an error, and most importantly, that my patients will remain stable. I've never had a day yet where all 3 of these things happened, but I can still hope, eh?