[NurseBunky]

So I do remember learning about reality shock in school but I never thought it would happen to me. This past week has really been something. I work at a pediatric hospital and have been moved up to 4 patients...4!!! I know it doesnt sound like much but holy cow. I'm having issues with time management, and stress. My preceptor keeps telling me I'm doing great but I just don't feel like I am, and the fact that she doesnt notice the beads of sweat dripping down my face every 10min is quite alarming. Her assessment skills suck!! LOL!! I figure I'm probably in the Shock and Rejection stage of reality shock because I have excessive fear and mistrust, have decreased energy and feel fatigued, and I feel like I'm doing a horrible job and kick myself for every mistake I've made even thought they were minor. My boyfriend thinks that I'm becoming too much of a perfectionist. I'm even having trouble sleeping at night the night before I go to work. I'm trying out ways to come down from the day and detach myself but nothing has worked so far!!

Please help!! Has anyone else gone through this? If so how did you get through it?

[willdgate]

Just believe that you don't have anything to prove to anyone anymore, like when you were in nursing school, try not to make life-critical mistakes, but you will make mistakes understand that and move on

[llg]

1. Schedule regular "de-briefing" sessions with someone at work you can trust -- a preceptor, mentor, friend, etc. that review your progress in learning. You might do it in a formal process with your preceptor -- or through casual conversation on breaks with your friends, whatever works best for you. Such sessions can help you decrease the stress a bit.

2. Celebrate each milestone as another step in your progress. (e.g. performing a new skill, helping a patient, becoming more independent, etc.) Marking your progress should help you see that "yes, you are making progress." In time, you will make more progress.

3. Force yourself to regulary make a list of both the positive and negative aspects of your job. Maintaining a balanced viewpoint about your job and your performance is key to your success. That's why I said to force yourself if necessary

4. It's good to see you maintain a sense of humor about your situation (i.e. about your preceptor's assessment skills). Maintaining a sense of humor is another key to success at surviving reality shock.

5. Maintain a life outside of work. It will help you relieve stress and help put your job into perspective.

Good luck ... and Welcome to Reality!

I just realized -- your name -- bunky. Bunky F. was my mentor back when I first became a nurse in 1977. We used to go to breakfast together after working night shift. You need to find yourself "another Bunky" like I had!

llg

[lannisz]

I still use the advice my senior year preceptor gave me....she said "when you start feeling rushed and overwhelmed, that is NOT the time to speed up, it is the time you SLOW DOWN." When you start to feel panicked (and believe me, I still have plenty of those moments!) consciously make yourself stop, take a few deep breaths and think about what you are doing. What needs to be done right now? What can wait? Are you drawing up meds? Check and double check. Breathe. Slow down. It's not a waste of time and will save you time and trouble in the long run.

[MIA-RN1]

how are you organizing your assigment sheet? That is a key to good time management.
I have mine w. the patients names and room numbers across the top and then columns down in hourly increments. At the beginning of shift, I fill in all the routine things I need to do (vs at 1600, etc) as well as anything else that can be scheduled (when next med doses due, etc) then I just fill in the rest as I go and things come up.
name/room name/room name/room name/room
1500


1600

1700

etc etc. (You have to imagine the lines.) I don't have the template here--my nurse educator made it for me at my request at work. But try something like that. THen you can just cross out what you did, and you always have a working sheet of what needs to be done and when.

[youngatheart]

I feel the same way as you do. I am still on 3 patients, on a med surg/telemetry floor. They wanted to give me 4 this week but these have been heavy patients. Some days i feel really organized then all of a sudden whoosh things happen at once, and i have to take a breath and reorganize and prioritize. One morning my phone didn't stop rining for an hour and a half. My whole day seemed to go down hill from there. My preceptors have not been very good and I don't seem to get the help when needed. Just remember do your best prioritize. I have yet to have a 8 hour shift. I always seem to be the last one done. They want to give me 4 patients by next week. Oh boy! eventually we will have a maximum of five patients. Yikes
t

[NurseBunky]

Thank you all for the advice. Today was a bit better. My regular preceptor had to go to several meeting today so they put me with another nurse. She was excellent. She was waaayyy more laid back and I felt comfortable. I only had 3 patients but I felt like I knew what I was doing and was able to organize my time much better. She told me if I could handle my previous preceptor and her energy then I could handle working on the floor I'm on. I like my regular preceptor b/c she's detail oriented, knowledgable, and she challenges me mentally. I think it was just too much too fast. I'll definetly try all of your techniques!! Thanks again.

Feel free to keep the stories and advice coming!!

[nursingisworkRN]

Well, I believe we both ended up on the same boat. I am somewhere in between loving my job and not knowing which way is up. This is my reality SHOCK of a lifetime. I have been on my own for 6 shifts now and have been terrified. Anything can happen at anytime and somethings I just don't know how to handle yet. Foresight seems to be the key to being a good nurse....I think the quote is something like "hope for the best, prepare for the worst." If you are still hanging in there, then you are doing a great job. I too am somewhere in between perfection and reality. But the reality is that mistakes will be made and if you are careful and smart about it, nobody will get hurt. Try to shift the focus from self blame to solution. What can be done about it now? Much easier to work on the future than it is to change the past.

The reality (and maybe I do believe the best in all people) is that as new nurses we are doing our best. Really. Everyday on the job we give 100%. It is not realistic to compare yourself with the nurses who have been around for awhile. Use them as your role models, but not the competition. We all start at the same place, just not at the same time. Be gentle with yourself. Find ways to reward yourself (massages, bubble baths, girls night out, maybe a new _________?) for all of the hard work you are doing.

As far as not sleeping, I have been experiencing that as well. Lately, as I drive home after my shift, I think about the day. If I felt I did horribly, I think of what I could do differently in the future. If it wasn't related to me but rather the situation, then I focus on 1 thing I did that made a difference. This helps me focus and stay positive. Sometimes it is the little things. I am perfectly capable of ordering ice cream, getting extra blankets, providing pts with ice chips, giving a back rub, etc. I imagine you are too. We are our own worst critics. Try to drown out the negative and find comfort in knowing that many have gone before you and many more will follow in your footsteps. Keep your chin up! Robyn