New Nurse Jitters

  1. I don't know why I'm posting this as I'm sure everyone goes through what I'm feeling. I guess I just need to hear from others about their experience and maybe get a little advice. I graduated a month ago and have yet to sit for my boards. After some much needed rest I wish to start working but am unsure what is in store for me. Lots of jobs for new grad's here, that's not the problem. I wanted to go into a specialty area but was told, during my last semester, that I should go to med surg as I really don't have the clinical skills I need. I'm ok with that as I want the best experience and am willing to wait a year before going to the ER. It's just that the med surg units in my area seem to be staffing at a ratio of 8 to 10 patients, days, and 12 nights. New grads get nights! My sister inlaw is a DON in another state and says that sounds horrendous and no wonder there is such a shortage. I know you guys are going to tell me "Join the real world, this is what it's all about!" but, I want to know how you get through this in your first year. I'm a little angry at my college as they only gave us one day a week clinicals (we were LPN's....but I was the one who had never worked, just went from school to school) and I don't feel prepared.

    Ok, long post I know, but, I just needed to vent my fears and frustration. Can anyone relate? Also, if given the choice, as I am, would you do 12 hour shifts or 8 considering your first year?
    Thanks!
    •  
  2. 20 Comments

  3. by   smithsd
    Dear Doug, I will not be any help to you because I graduate in December, but I feel the exact same way!! I was told I needed to be on the medsurg floor to gain more clinical experience, and I am terrified (they call the floor "the trenches!")
  4. by   Harleyhead
    As the old saying goes poop or get off the pot. I have always opted for 8 hour shifts. I have worked 12 hour shifts and prefer 8s.I have worked med/surg and I am still there. It does give you a wide range of skills. I have floated to tele and once to ICU. My med/surg skills always pulled me thru. Speak to some nurses you know get a feel for work in your area and go sit for the boards.
    before you know you will be on this side of thisBB doing what I am doing. Good luck
  5. by   dstout-rn
    I have been a nurse for just over a year and had the opportunity to go to work in the ER that I had worked in for two years during nursing school. I changed my mind at the last minute and I am soooo glad. I went to the ICU and strengthened my assessment and clinical skills and plan to go back to the ER in a few months. I don't recommed the ER for anyone who is new grad because you have to have such strong assessment skills and there is no way to learn that in nursing school there just isn't enough time devoted to clinicals . I didn't want to go to med--surg either don't let people tell you that that is the only way, most med-surg floors are too busy too teach you and you will find yourself on your own much sooner from what I've heard from fellow nurses.
  6. by   suzannasue
    Doug and all other new nurses,
    I am an old "battle axe"...have been in nursing probably longer than any of you have been alive !!!!!!!!!! I,too, started out on med/surg and had all the fears you have expressed. I wanted to be in critical care SSSSSSSOOOOOOOOO BAAAAAAAAADDDDD!!!
    Back in those days,a new nurse had to be on med/surg a year on the 3-11 0r 11-7 shift before consideration was even mildy entertained by administration for transfer to a specialty area !!!!!!
    We worked all of the holidays and were basically the underside of the nursing totem pole!!!!!! However,I can assure you that you will gain skills you will use when you specialize. As a new grad,I couldn't start an IV to save my life...my hands would shake and I would break out in a sweat!!!!!!! After the umpteenth time of calling upon a more seasoned nurse for help and getting lectured about my lack of skill in that area,I became more determined than ever to finely tune my skill of peripheral cannulation. Med/surg IS
    "the trenches" of nursing...it gets all of the conditions from which night mares are made!!!!!! And here is the BIG BUT!!!! BUT you will learn to prioritize and delegate during your tour there!!!! I eventually worked all sorts of units...ortho/neuro,peds,post partum,and my skills learned on med/surg were a life saver.
    As I moved on to critical care,I continued to use those "basic skills" from med/surg in conjunction with the new skills necessary to work those high acuity areas. My confidence in myself grew and I can assure you...time is a great thing. Remember to be patient with yourself. Hopefully you will have a preceptor (like me!!!) who vividly remembers the first days of being on the front lines of nursing. None of us were born with the knowledge and skill it takes to be a nurse. You will see eyes roll and hear things said to you that should be kept behind lips,but never lose faith in yourself. I have wiped tears from the face of many a new nurse who has proclaimed that as their last day as a nurse. I have listened to their concerns and fears and have assured them that all of this anxiety will be replaced one day with confidence. It takes time. So often we expect perfection from ourselves and,yes we work in a field that demands perfection...we hold the lives of human beings in our hands:yet we forget we are humans,imperfect and flawed yet full of possibilities and capabilities. I wish you all the best that life has to offer!!!!!!!
    Keep me posted on your progress...I will always be around for
    encouragement!!!!!!!!!

    Good luck Yall!!!!!!
    Will keep you in my prayers and in my heart!!!!!!




  7. by   suzannasue
    Me again....
    Hope no one thought I was inferring that med/surg is the only place to hone one's skills !!!!!! It isn't...lots of other places are just as good if not better...and yes,I agree...I have seen many a newbie get out of the profession because they were thrown to the wolves on the floor. At our institution we have stopped the "early exposure" to full pt load as a method of retention. I,as a preceptor have had difficulty with co-workers who fail to understand that when my newbie has 2 of my 6 patients,I still have a full patient load and am not the one to get the "next 2 admissions". Med/sug is a very difficult place to work and the pace is very quick. In order to orient any new grad to "the real world", it takes time...time that some nurses refuse to give no matter what area you choose as your first place to practice nursing.
    Hope you all find your niche!!!!!!!!


  8. by   dstout-rn
    Yes years ago med-surg was the only way into the hospital. But having 8-10 patients was not the norm on night shift either. Students graduated from nursing school having spent more time with patients than books (a BSN grad who had clinicals two days a week for a total of 4-5 hours each, "yeah a true experience of nursing care!") I worked in a level one trauma ER during nursing school to gain more knowledge than school ever wanted me to get from them. More than once I asked my instructor a question too get the answer of I don't know I never worked in this area? Anyway, I think with the nursing shortage a new nurse may get better mentoring and preceptor teaching in an area with less patient to nurse ratio. As for priortizing you can learn that in area of the hospital in any role including the nursing assistant who works the floor! I currently work in a neonatal ICU and i was terrified my first day of work but now I after a year am starting to be able to anticipate my patients needs and organize myself well. I LOVE IT!!
  9. by   mustangsheba
    Your nurse to patient ratio is way out of line. Is there any way you can move to another area? I have never had more than eight patients for a shift on med/surg, and that was before we had all this paper work. I started nursing in the trenches, working nights and I have never been sorry. I have worked in many areas since then. I am an agency nurse, so I occasionally end up in an area where I lack some of the skills that would make me a top performer. For instance, I was assigned to a renal unit last night. I ask a lot of questions. I'm old enough and confident enough in my basic skills that looking stupid doesn't bother me any more. I have those skills because I started on med/surg. I didn't want to start there, but I believed then, and still do, that my basic knowledge needed to be broad. I was lucky in that while working at that small hospital, I often floated to PP, nursery, PCU, and mental health, so my experience was varied. Ask for a long orientation. Your nursing school was remiss in providing only one clinical day a week. You seem to have a good handle on what you don't know. That's probably the most important knowledge to have right now. Good luck! I know you will do well.
  10. by   dstout-rn
    In my area NICU we have a ratio of 1:3 typically. My friends who have gone to many med-surg areas have 7-10 pts on 11-7 shifts.
  11. by   burger914
    I have new nurse jitters also! I graduated last month took the boards and passed! Thank heaven! Now, the real scary stuff begins. I have applied for a job at a state hospital on a med-surg unit, but the patients are all psych patients as well, which is where my real interest lie. I took everyones advice on this board and decided to at least get some med-surg experience. The pay and benefits are excellant, but the orientation seems a little short. Only four weeks, but more if needed. I am definately scared out of my mind!!! I will find out this week if they are going to hire me. I wish you alot of luck with your career.
  12. by   RNinMay
    Burger, ask for longer if you get the job!!!!!!!
    These short orientations for new nurses is why I chose to go to the ICU. I am a new grad and my orientation is 6 months long. I feel that in the unit I wll learn more because I won't be running around like a chicken with my head cut off trying to take care of 10 pts!
    I have already worked there 3 shifts, and my preceptor has time to answer my questions and teach me the details. It's like being in clinicals in nursing school with your own private instructior. I love it!
    I would have gladly (well okay maybe not gladly, but been more willing ) gone to med surg if the orientation period were longer, but I don't think it is safe to be thrown to the wolves. I don't want to become discouraged and quit nursing before I even start!!
    Now, if that letter saying I passed the NCLEX would just come......................
  13. by   burger914
    Rachel,
    6 Months of orientation? Wow! Thats fantastic! I think you are right, I really can't see how I will be ready after only 4 weeks. I think maybe I shouldn't worry about the money so much, and worry more about becoming a good nurse. These past months have been more stressful than most of nursing school. Trying to study and pass the boards and trying to decide what to do career- wise. There is no shortage of nursing jobs in my area. I can pick and choose really. Well I am going to speak with the head nurse and tell her I feel really uncomfortable with 4 weeks. Thanks for the advice and good luck on the boards....there is nothing as great as opening that letter and seeing the word "PASSED"!
  14. by   RNinMay
    This hospital I am working for does pay a little less than some of the other ones, but like you I am choosing which environment will make me a better nurse--I can always ask for more money later---once I feel I deserve it, you know??
    I wish you all the best in your job hunting! I will let you know when I find out about boards..........

close
New Nurse Jitters