I am a newer graduate nurse (graduated may 2014). I have been working for about 3 months as an RN in a skilled nursing facility. I have always been envious of my peers in school who just seemed to exude confidence. I have always had a problem with second guessing every decision that I have ever made. My question is are there any new graduates who feel the same way? I have had my colleagues tell me that I'm a great nurse but I need to be more confident. I feel overwhelmed most days. It's hard because where I work I typically have anywhere from 12-16 patients at a time and I feel that majority of my overwhelming feelings are due to the patient load. Is there anyone out there that feels the same as I do? Or maybe, am I alone in my search for an elusive confidence that I personally cannot achieve? lol

You may not be confident as part of your personality. This doesn't mean you can not be confident in your practice. LTC is tough. I would use as many resources as you can, stay as organized as you can, and develop your own routine to stay on top of things. It will happen, it just takes a tad more time.

Best Wishes!

I remember having similar feelings when I graduated from nursing school many years ago, and started on a busy surgical floor. I had 10 patients, with the help of a CNA who had a habit of disappearing into the lounge and knitting. She was a lot older than I was, and had a chip on her shoulder, so I had a hard time getting her to cooperate. Meanwhile, I was overwhelmed by the IVs, the endless medications, the bed changes, the family members with a million and one questions, etc., etc., etc. The unit manager told me my time management skills left something to be desired, and I always felt as if I were just putting out fires, rather than managing the situation.

(I found out later that I'd been stuck with that particular CNA because no one else wanted to work with her, and they figured I was too shy to make waves about it.)

The confidence will come. When you first get out of school, it's been drilled into you that every single detail is important. They don't really teach you to prioritize very well, probably because they don't want to give you the idea that any nursing task is unimportant or dispensible. As a result, you're running around trying to do everything perfectly, and that's almost impossible, especially with a big load of patients!

With experience, you learn which tasks you must not ever skip or abbreviate, and which can be safely put off. You get used to doing two or three things at once without even thinking about it, and sifting through 100 observations to focus on the ones that really matter. And you get quicker at procedures, just from repetition and developing "muscle memory."

Don't worry about those other nurses seeming more confident than you. That doesn't necessarily make them better nurses. Confidence will come, as you get more comfortable in your position. In the meantime, you can always fake it.

Someone once told me that school provides only about 30% of the knowledge and skills you need to function in a profession. It gives you what you need to enter the field, and then your real education begins. I believe it. I'm still learning every single work day, and I graduated in 1980.

Do the very best you can and get out of LTC as soon as possible.