Advice please: New grad very scred

Geeg · Jul 13, 2003

Is the problem that the orientation is too short or indadequate? If it is, complain to your supervisor right away. The expression "The squeaky wheel gets the grease" applies ten fold in the hospital setting.

kimmicoobug · Jul 13, 2003

I have heard from more experienced nurses that it takes a full year (more or less) until you feel comfortable on the floor. I think it may also depend on the orientation and what their expectations are of you. I am also a new RN and feel that my orientation has gone very smoothly. First, I shadowed, then I took a patient and did everything (taking off orders, meds, etc.)for that one patient. Then it increased to two, then three. The highest number of patients I have taken so far is four, since at my hospital that is considered a full load (4-6). Anyways, sorry to hear about your predicament. I really hope it gets better for you...

InfoNurse1595 · Jul 13, 2003

No, the orientation is great. My basic problem is I'm so scared! I'm scared of codes, I'm scared of making a med error, i'm scared of carrying so much responsibility, I'm not very assertive, I don't think I'd make a good nurse....I cannot even begin to see myself as a charge nurse! ugh, the concept alone scares me! i'm also scared of hating my job so much that it affects my attitude, my personality, and my life. I sound like a major baby, I know....but is this a normal feeling? Will it go away? Or should I start looking for a different type of nursing job?

gwenith, BSN, RN · Jul 13, 2003

Okay it sound like you need a major injection of self confidence and starting nursing does affect some people that way. First - keep up a running comment in your head congratulating yourself when you did something right. - Gave out teh meds - no one dead? - good ! Got that one right!!!!

Don't get caught up in the irrelevant (oh! dear ! have i put teh tape on the dressing the right way??? Instead consider - dressing fallen off - no patient comfortable - yes - good job!

Take the precuations you feel you need to stay safe. Get drugs checked with someone else take the drug sheet with you and check again when you get to the patient when giving an injection check before during and after - yes! after :) I caught someone else doing that the other day - checking the ampoule before they discarded it. It is not a safety check it is a reassurance check and if you need it then it is not wasted time.

You will start to feel more confident.

ERNurse752, RN · Jul 14, 2003

How did you feel about nursing while you were still in school?

Do you hate it b/c of what the job consists of, or do you hate the feeling of fear?

It's a good thing to be scared...when you're new and you don't know anything, you should be scared. That means you care, and that you're smart enough to know what you don't know.

What kind of RN position are you starting in? How long will your orientation be?

Have you been told that you will be in charge soon, or are you looking farther ahead into the future?

I think it is too soon to be able to judge whether or not you're cut out for this. Give it some time...ask for feedback from your preceptors on how you're doing. Hopefully you are in a supportive environment.

I've been there and done that...I've been a nurse for 2 years now, and just now am getting to the point where a lot of things that used to scare me don't anymore. And some things still do...

You will become more assertive in time. It's something you have to work at. The more times you find yourself in a situation where you need to be, the better you will get. Eventually it won't be a big deal anymore.

Med errors: go through the 5-6 rights (whichever way you learned it) every time. Probably anyone can tell you that at one time or another, we've all made a med error, or come very close.

Codes: Learn your CPR and your ACLS...that will go a long way.

Good luck with your orientation. Congratulations on becoming an RN. Hang in there...

:cool:

glow_worm · Jul 14, 2003

I understand what you are saying. I am a new grad -- though I haven't started working as an RN yet, I mostly dread the thought of beginning this career. Often during clinicals I would question my reasons for entering this field, and wonder how I ended up choosing such a physically and emotionally demanding job in search of my "life's fulfillment". How do wiping butts and cleaning pools of bodily fluids, doing endless paperwork and documentation, taking an endless barrage of verbal beatings from dissatisfied MDs or patients or family members, working with gossipy and cut-throat "eat-their-young-type" co-workers, risking endless possible side-effects or complications from your own nursing interventions (catching them in time, being responsible for them), missing breaks and feeling ever-present fatigue (never having enough time to eat lunch), and constant feelings of inadequacy create "fulfilling" work?? And all of this for crappy pay and no respect? Was I CRAZY to go into nursing? Why not engineering, medicine, or veterinary science?

I have a friend who graduated last year. She was one of those people who always wanted to be an OB nurse -- she idolized the nursing profession, and wanted to "make a difference" in women's healthcare. Well, reality struck in her first job -- she would hide in the unit's bathroom several days a week during orientation and cry! She loathed her preceptor, and found the unit to have an impersonal, fast-paced, cynical culture -- it was in stark contrast to her ideals: compassionate/sensitive care, where nurses had time to nurture the mother-infant bond by providing lots of teaching and emotional support. There was never enough time to do nursing the right way, and documentation was especially stressful b/c of the constant threat of lawsuits in OB. Anyway, it was a major crisis for her -- she hated nursing and regretted her decision to enter the field.

Another classmate was also disillusioned with her first job -- she told me that she discovered that nursing theory is pure b---sh--, for in reality a nurse is "nothing more than a slightly better paid waitress". It's just blue-collar grunt work, nothing more.

So I haven't heard a lot of positive things from my classmates.

*****

My mother, on the other hand, is a very experienced nurse. She remembers how difficult the first year was, and told me to just try to stick with it no matter what. Her advice is to at least put in that first year. The reason it feels so difficult is because IT IS! New nurses have all the responsibility of more experienced RNs, yet sometimes we lack the knowledge and experience needed to solve basic problems. We have poor time-management skills, don't know how to prioritize, have only clinical experiences to draw upon, and an overwhelming & constant number of problems that need to be solved quickly... the first year is a huge challenge. It is REALITY SHOCK.

However, it is necessary to stick with it! The reason that I dread beginning, I realize now after reading your post & responding to it, is because I'M SCARED OF FAILURE. However, that's not a good reason to avoid this challenge, or quit before it has even really begun. You know this is true: that even if you feel incompetent and clumsy while learning through trial and error, you will eventually build your skills and knowledge base. It is a huge challenge for you, but it's important to give it all you've got and go through the motions. Nothing good or of value comes easily. In the end, you can take your year of experience and try something else -- become a research nurse (coordinating study trials, for example --the only patient contact involved are interviews/histories), work in a small clinic, or be one of those nurses who does triage by phone.

After a year of floor experience, you can go anywhere. For personal and professional reasons you should stick with it. Who knows -- after a year, like my mother, you may begin to get into the flow, increase your competence, and grow to love it! She has been a floor nurse in a hospital for over 33 years -- she didn't love it at first, but grew into the role. She strongly feels that nursing becomes more meaningful as a profession as time goes on -- as you get older, as you develop excellent bedside skills and realize that you know how to do your job well. As you realize that you really are making a tremendous difference in other people's lives -- then it becomes deeply fulfilling.

:)

ERNurse752, RN · Jul 14, 2003

Oh, and a few good books on the subject:

Your First Year as a Nurse: Making the Transition from Total Novice to Successful Professional by Donna Cardillo

My First Year as a Nurse: Real-World Stories From America's Nurses (1st Year Career) by Barbara Finkelstein

From Novice to Expert: Excellence and Power in Clinical Nursing Practice by Patricia Benner

renerian, BSN, RN · Jul 14, 2003

I think it does take a year to feel comfortable on your floor. The first six months are like a whirlwind. There is so much to learn after you graduate.

renerian

jjjoy, LPN · Jul 14, 2003

I don't have any answers, but I can relate to your feelings. There's a difference between not wanting to go to work and DREADING it. Some folks get a rush from the acute care environment and demands. Some don't love it, but it's tolerable. Some would find sitting in an office something that drives them crazy and would rather do just about anything else. We've all got our own quirks.

We each have to find what works best for ourselves. It's especially difficult when it seems like no one else understands how you feel. So let me tell you my experience. The floor is just too hectic and distracting for me. A nice, quiet office sounds really nice after experiencing the true nature of floor nursing. I'm looking at alternatives myself.

My advice is not to give up yet. It's been just two weeks so far. Try not to look too far ahead. Don't worry about how you need to be to be a "real nurse." Just look at what YOU can accomplish each day. It's a real lesson in discovering your limits and acknowledging them. If your preceptor is pushing you to do something and you don't feel comfortable with it, practice standing your ground with dignity and tact. "I'm not comfortable with that" repeated a few times may not get you praise, but should ensure that you aren't too overwhelmed. And don't be afraid of overusing those important words "I need your help."

You're going to feel a lot of pressure to be able to handle a lot of things, and you just need to focus on YOU and what you CAN handle. Not what you or anyone else thinks a new grad "should" be able to handle. If your progression ends up being too slow and cautious and you are threatened with dismissal, that's better than being let go because you made too many mistakes by taking on more than you could handle.

I do recommend scheduling an appointment with your manager and preceptor and see if they have any advice for you. It's scary, but again, if it's already that terrible, might as well find out as much as you can about your performance. You might also want to inquire about changing preceptors. Sometimes that can make a big difference - not that the first one is bad, just perhaps not a good fit in terms of your learning style and personality. Finally, ask about coming in a few hours on an off day (no pay) in order to observe with no distractions of your own responsibilities.

Give it another a week or two and see how you feel. You may feel more confident that floor nursing isn't for you. Or you may feel like you're getting it and it's not so bad after all. Just be sure to do more than gripe about it! Good luck!

InfoNurse1595 · Jul 14, 2003

ERNurse - My first position is on a neurology/neurosurgery floor at a very large university hospital. My preceptor is great...I couldn't ask for anyone better. She is very understanding and gives me great feedback, and I feel comfortable asking for feedback too. My orientation is 3 months long, with a 1 year (reality training) program that is also just as rewarding. Thank you very much for the book info...I will definitely have to check them out. You have been very helpful!!!

gloworm - You have put into words exactly what I am feeling. I often question why I decided to do nursing....with all the challenges that the job involves, minus the praise, it seems that the only perk is the high-paying entry level salaries that nursing provides...sorry to admit that. The paycheck is the only thing I'm looking forward to at this point. Ugh, if only I could fast-forward to a year from now. The thought of enduring this challenging year ahead of me puts me in a panic attack. But you are right, I really do need to just stick this out for a year at least. And if by the end of this year I feel the same, then I know its time for a change. Thank you so much for your advice, its nice to know there is someone out there who feels the same.

jjjoy - thank you as well for the advice! I am definitely going to consider it, and it has helped me cope with this frightning feelings I've had ever since I've started working at this hospital. I just hope it gets better, and from your advice, it looks like there is a good chance it will. Thank you so much!

jacolaur · Jul 14, 2003

You worked so hard and came so far....don't give up. The hospital setting is one the best training in the world of nursing...maybe try changing the hospital your at. I started my career in a wonderful teaching hospital...they were so good at letting me grow into my job...there were nsg students, med students, residents....we all were newbies and I didn't feel so alone...please give yourself the gift of knowledge from working in the hospital setting...it will be with you forever and give you the confidence you will need for your future in any career in nsg.