[lilbug]

I am a new NICU nurse. I just finished my 2nd week out of orientation (which was 12 weeks) and I am feeling like I can't do this job. In simplest terms, I feel like a retard at work, honestly. I feel like I had a good orientation but I feel like I don't know what I'm doing now that I'm on my own. I guess you can say i'm a bit overwhelmed! Day 2 out of orientation, I got an admit at the beginning of my shift...a 25-week twin. I had only had 1 real admit in orientation so I felt completely lost during this 25 week admit. I had some help in the beginning but was pretty much left on my own. I was so slow on getting everything done that night. The next night I came in, they gave me that kid again. Apparently he had been pretty stable during the day but during my first assessment, he was really bad. By midnight he crashed. His twin had started pulm hemorrhaging a little before midnight and when I suctioned my kiddo a little after that, he was pulm hemorrhaging too! My kid was too sick and couldnt live on the vent or oscillator so we pretty much bagged him until parents came to hold him while he passed. Of course, luck had it and his brother passed as well within the next hour. It was awful! I was so stressed I didnt think I could go back to work. I had never been a part of a code so i had no idea what to do. I didnt know exactly what to write down during the code. I had to give him blood, plasma, and epi (never done any of that before) and felt like I didn't get as much help as I needed. I had no idea how to document anything after he passed and had to ask a couple people in order to finally document what I nedded...and it was like pulling teeth to get the help. How was I supposed to know what to do?!?! Usually, most people in my unit are very helpfully but it was a crazy night considering both twins were coding at the same time. I was not prepared to handle this situation at all.

This past week, they gave me an easier assignment one day and then this weekend, they gave me a double vent assgn both days. Again, never got a double vent assignment when I was in orientation so I was overwhelmed with time managment. I made a stupid med error..gave a med late, but that was the worse thing that happened sat night. The next night I had that same assgn again and one of my baby's was pretty bad. He had such a bad episode that I had to give compressions which again, never did that before! I felt like an absolute moron and didnt know exactly what to do...its definetly different doing it on a real baby versus a plastic doll! I know I did everything I was supposed to do that night (and on time) and felt better about handling all of the baby's episodes. I was getting more comfortable bagging and stimulating him during his episodes but it still scares me! Is it normal for me to feel like an idiot??? I feel incompetent at times and that maybe Im not ready to be doing this. I love the NICU, I wouldnt want to work anywhere else. I know I need these hard assignments so I can keep learning and building up my confidence but I am so nervous going into work every day.

Help!!!

[NICUandLearning]

Originally Posted by lilbug

I am a new NICU nurse. I just finished my 2nd week out of orientation (which was 12 weeks) and I am feeling like I can't do this job. In simplest terms, I feel like a retard at work, honestly. I feel like I had a good orientation but I feel like I don't know what I'm doing now that I'm on my own. I guess you can say i'm a bit overwhelmed! Day 2 out of orientation, I got an admit at the beginning of my shift...a 25-week twin. I had only had 1 real admit in orientation so I felt completely lost during this 25 week admit. I had some help in the beginning but was pretty much left on my own. I was so slow on getting everything done that night. The next night I came in, they gave me that kid again. Apparently he had been pretty stable during the day but during my first assessment, he was really bad. By midnight he crashed. His twin had started pulm hemorrhaging a little before midnight and when I suctioned my kiddo a little after that, he was pulm hemorrhaging too! My kid was too sick and couldnt live on the vent or oscillator so we pretty much bagged him until parents came to hold him while he passed. Of course, luck had it and his brother passed as well within the next hour. It was awful! I was so stressed I didnt think I could go back to work. I had never been a part of a code so i had no idea what to do. I didnt know exactly what to write down during the code. I had to give him blood, plasma, and epi (never done any of that before) and felt like I didn't get as much help as I needed. I had no idea how to document anything after he passed and had to ask a couple people in order to finally document what I nedded...and it was like pulling teeth to get the help. How was I supposed to know what to do?!?! Usually, most people in my unit are very helpfully but it was a crazy night considering both twins were coding at the same time. I was not prepared to handle this situation at all.

This past week, they gave me an easier assignment one day and then this weekend, they gave me a double vent assgn both days. Again, never got a double vent assignment when I was in orientation so I was overwhelmed with time managment. I made a stupid med error..gave a med late, but that was the worse thing that happened sat night. The next night I had that same assgn again and one of my baby's was pretty bad. He had such a bad episode that I had to give compressions which again, never did that before! I felt like an absolute moron and didnt know exactly what to do...its definetly different doing it on a real baby versus a plastic doll! I know I did everything I was supposed to do that night (and on time) and felt better about handling all of the baby's episodes. I was getting more comfortable bagging and stimulating him during his episodes but it still scares me! Is it normal for me to feel like an idiot??? I feel incompetent at times and that maybe Im not ready to be doing this. I love the NICU, I wouldnt want to work anywhere else. I know I need these hard assignments so I can keep learning and building up my confidence but I am so nervous going into work every day.

Help!!!

Yeah I felt like that when I came off orientation. It does it better, but going to orientee to registered nurse takes longer than the walk into work. You will feel more confident and comfortable. But you should not feel uncomfortable asking for help or saying that you are not sure if you are doing it right, or saying you dont know what to do. I have found that I just need to have people there that I really know what to do but the fear clouds my brain. My favorite saying was when I came off orientation what is scary is that people think I know what I am doing and that I can do this.

[mianders]

I do not know of any nurses, in any specialty, that did not feel overwhelmed in the beginning. Nursing school does not prepare you enough for the realities of nursing. They just teach you the basics. You chose a high stress area of nursing to go into, so it will take time before you feel completely comfortable in it. Hang in there. It will get better.

[littlepeach]

Sounds like any new nurse! Sweetie you will be fine!. Although it does concern me that you have never assisted with a code before. Sounds like you managed. May be need to talk with charge nurse or manager and get someone you can turn to as a mentor while you are at work. Experience is a priceless commodity. Use and embrace any colleagues that are willing to help. Good luck and don't let it get you down. Even when you finally do feel comfortable with your work environment, something is gonna come around again and pull the rug right out from under your feet. That is the fantastic thing about our profession and specialty. We never stop Learning. Hang in there!

[WeeBabyRN]

You are at a difficult time in your career. There were many shifts where I felt incompetent when I got off orientation. I think the first couple of months off orientation I wanted to quit my job about 29 times a day. I was barely hanging onto a thread, surviving a shift at a time. Now, I can't imagine working anywhere else. You can do it, muddle through this time, because it will pass.

[littleneoRN]

We all felt overwhelmed when we started, and sometimes still. I'm surprised that they would have you be admitting a new baby on your second day out of orientation. We do patient care on our own several months out of orientation before starting to take stable admits, which 25 weekers don't qualify as. I'm sorry that you had your first death so soon into your time on your own. It sounds like you are doing very well despite a busy plunge into being on your own. Just keep asking for help, and don't beat yourself up when things don't go perfectly. Just keep coming back, but take time to take care of yourself too.

[sharrie]

Honey after reading what you have dealt with in such a early part of you career I am not surprised you are feeling overwhelmed. It is only natural and it will get better.

Use the experience and support of the other staff on the unit and don't be afraid to say when you are feeling out of your depth.

[deeDawntee]

OK, I think you are a true hero! Oh my God, talk about shifts from Hell. I think you are truly amazing. You need to give yourself a huge amount of credit. You can be the nurse for the children in my life anytime. Hang in there. You have what it takes, no doubt about it.

[lilbug]

Originally Posted by littleneoRN

We all felt overwhelmed when we started, and sometimes still. I'm surprised that they would have you be admitting a new baby on your second day out of orientation. We do patient care on our own several months out of orientation before starting to take stable admits, which 25 weekers don't qualify as. I'm sorry that you had your first death so soon into your time on your own. It sounds like you are doing very well despite a busy plunge into being on your own. Just keep asking for help, and don't beat yourself up when things don't go perfectly. Just keep coming back, but take time to take care of yourself too.

Thanks for all of your kind words. I guess in my unit they like to push us in the beginning and make us be admit numbers and take ventilators for a few months. Apparently this will give us experience and help us with skills and help build up confidence after awhile. I see their point, especially because in the beginning, us new nurses get a lot of help from the older ones. But I have heard criticism from some other nurses saying that is a little rough for us newbies. Nothing like teaching us how to swim by throwing us in the deep end!!! All i can say (especially coming from a former swim instructor, lol) is that's not how you give someone confidence. Sink or swim?!?! I'm definetly sinking to the bottom here. Ive just learned that I have to take it one day at a time and focus on what I did well and go from there. It's the only way I am going to survive!

...welcome to the world of NICU nursing...

[Sweeper933]

Where I work, we always try to give newer nurses the harder assignments (admits, HFOV...) that way they can build their skill level and their confidence as well. However - we would never let somebody admit a 25 weeker unless they had done so during orientation. And if they hadn't, then the charge nurse / manager for the night would be right by their side the entire shift - helping them out, making sure that everything gets done correctly. Same thing with giving blood products... if a new nurse has never done those things before, somebody is always available to help them out.

On my unit, we tend to wait until a few months out of orientation to have new nurses take NRP. That way they can concentrate a little more on patient care. If a baby that they're taking care of codes, then the charge nurse and other nurses run the code. Although you "have to learn sometime", codes often times need to be ran fast, without time for explanation. When possible, we try to have the non NRP nurse record the code, this helps them learn what all goes on...

Hang in there - it does get better!