[RNcDreams]

how much I don't know.

I'm 8 months in at a community ED (my first RN position) and it's beginning to click. I'm getting better at predicting what needs to be done, working on my focused assessments, and have gotten pretty darn good at starting IV's.


However....

I stress a LOT over information that I don't know...... I stress about:

a.) choosing the ER instead of the floor (even though I know this is the specialty that I like, I freak out that I might not be measuring my PR intervals perfectly and that I only do Cardizem & Heparin drips every now and then.....what if I've set myself up to be a horrible nurse who can't take care of "routine" patients??)

b.) All of the PO/IV meds I don't give on a regular basis... I know I can always look them up if/when I have to give them, but it makes me sick to think about how little I know in terms of drugs

c.) I worry about giving IVPB's correctly.... I will fixate on whether or not I need to get those last few cc's into the person....

d.) I worry when I have a "hold" for a long time in the ED because I've never worked on a floor for a prolonged period of time, and it makes me feel sick because I want to take care of the person in the best way that I can and yet I don't know everything I need to know because I'm accustomed to the "putting out fires" pace in the ED....have I ruined my potential??

e.) I worry that I have started on a small scale at this community ED and that I'll never be good enough to work somewhere bigger. Will I be able to get into an ICU? What do I do next?


I suppose I need some wise words from the seasoned nurses.....

Is everything dependent on that first job, or does it matter more if you are willing to learn and open to direction?

[CPNEgrad07]

Sounds like you have valid concerns, and i'll bet you are addressing them as best you can. Do you look up stuff on your off days? Like homework when you were in school? Do you ask questions at work as you go along?
Relax--you are only 8 months into a BIG field (and you are only 22 years old; i've got clothes older than that). Learn every shift, add to your base, keep building, and sooner than your think, people will be coming to you with THEIR questions.

[yellow finch]

Heh. You sound like a lot of nurses I know, including myself. If you didn't worry about such things then nursing may not be for you. However, you appear to be concerned with valid issues and giving the best possible care.

As a new nurse, you were hired into the ER because the manager saw something in you that said you were ER material. Know that and live that. You are capable of this job!

I've only been a nurse for 3 years and am finishing up my graduate program... but I still look up meds daily! The routine ones are, well, routine. You get used to them. But there are lots of drugs with new information, interactions, contraindications, etc. that have been around a long time. You still need to know every single med you're giving and what to look out for after administration. Yes, you should be looking up drugs. You are not a walking drug book.

IVPBs... you do what you can and you run as much in as possible. A couple of cc's difference isn't going to make a difference in the person's infection. As long as you give as much in the bag as possible they will survive.

What the heck is a "hold"? You're learning far more than others. A floor nurse won't know how to put out a fire. Enjoy your experience! Don't worry about what others are doing.

Is the ICU your goal? I think ER experience is very welcomed in the ICU. Heck, we're orienting a nurse right now who was the ER supervisor for 6 years. She hasn't been at the bedside for that long. Anybody is teachable as long as their willing to learn.

Basically... be gentle with yourself. You have that first year to learn and ask a bunch of stupid questions. Don't hold yourself back by worrying about these little things. You're perfectly normal and have the same learning curve we all had at first. Some people just hide it better than others.

Take this time to educate yourself, offer your assistance to other nurses if you have the time, and don't put yourself down for any of these things. We all have quirks. Make them work for you!