Not many people that I can talk to about this...

Nurses General Nursing

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I'm a new nurse at my first RN job. I work in a large urban hospital in the Midwest. We are a level 1 trauma center so we can be quite busy. I work on a neurology floor that also acts like a med surg unit as well. I have been off orientation approximately 6 months. I love my coworkers (I work on the night shift) and I have had decent success there (my patients like me, or so my leads have said, and I was nominated for a Daisy award at the three month mark which was pretty cool).

Unfortunately, I'm miserable.

I specifically sought out a med surg floor because teachers and relatives who are nurses said that med surg is a great place for new grads to start in order to learn time management, assessment skills, etc. I had zero interest in med surg in school (it was my least favorite clinical rotation as a matter of fact). I was happier in ICU and oncology.

My biggest issues with my current gig are the nurse patient ratio and the pace. Also, many of our patients are very trying (since we're neuro we get a lot of dementia patients who can become violent, plus we get a decent amount of everybody's favorites: alcohol detoxers and narcotic seekers).

I had been having a really rocky start to my career: getting out of the door on time had been an impossibility for me until recently since I was always behind on charting. That has improved, but not by much.

In short, I feel like my job is too much, too fast. My coworkers are beyond awesome in how helpful and friendly they are, but I'm definitely the weakest link on that floor. I simply cannot get a grasp on the pacing, the multitasking and keeping track of everything that needs to be done with my patients. It's nerve-wracking to the point where I feel nauseous and feel my chest tightening on the drive in.

I'm sorry if this turned into a gripe session, I didn't mean for it too. I'm simply frustrated and feel trapped. What other options are there for me at this point? I'd love to have a lower nurse/patient ratio (wouldn't everyone?). I've considered OR, PACU, ICU, among other options. I just think it would be a red flag for hiring managers if they saw that I left my current job in under a year.

I feel like I can't 'hack it' here. I didn't want my job to feel like simply surviving for 12 hours, but that's where I'm at. I've had to stop myself from snapping at my more obnoxious patients as well (never looks good on a 'How did we do?' survey when the RN tears into the patient).

Advice welcome and appreciated. This is my second career and I don't want to back out now. I'm not a stranger to hard work, but this is beyond me.

Specializes in Neuro, Med-surg..
Can you try to focus on the things that you do love? Your awesome co-workers, the few patients you truly enjoy, the huge difference you make in some of their lives, your paycheck (hehe) etc..... I fee like if you could try to look at the good things and get excited about them maybe it would help.

I'm not a nurse so I have absolutely no idea what I'm talking about, but I thought I'd throw it out there. :-)

Best wishes to you. I really think you have come a long way and I think with a little time you will feel so much better about all of the craziness.

That's great advice. I have tried to focus on the positives of my job (and honestly, there are a lot): My coworkers are a ton of fun and very helpful/patient with me. I've gotten lots of positive letters and feedback from patients and their families, and I got nominated for that DAISY award at the three month mark (which surprised the hell out of me, frankly). And yes, I'm making more money than I ever did in the past so more doors are open to me in terms of where I can live, trips I can take, etc. The biggest for me is the simple fact that I am an RN at all. Before this, I kicked around at odd jobs. But now, since becoming a nurse, I've had friends and family tell me how proud they are of me. My friends seem to regard me with more respect than before.

I'd be lying if I said that my current position is lacking in intangible benefits.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Honey, it takes a year to stop shaking. Honest. Just hang in. It WILL come together.
THIS!!!!!!!!!!!!!!

It is a mininum of a year before you can think straight. Organization is key....you need a good brain sheet.......here are a few.

doc.gif mtpmedsurg.doc

doc.gif 1 patient float.doc‎

doc.gif 5 pt. shift.doc‎

doc.gif finalgraduateshiftreport.doc‎

doc.gif horshiftsheet.doc‎

doc.gif report sheet.doc‎

doc.gif day sheet 2 doc.doc

Specializes in Certified Med/Surg tele, and other stuff.
I do not think it is a bad thing to want to specialize. I would look at specifically where you would like to be. Make an appointment (on your off time) to speak with the manager of the floor. Discuss your interest in the specialty, and what steps the manager things you need to take to transfer to the floor. They may say a year of Med/Surg experience. They may have a different track in mind. Ask if there's any openings or potential openings on their unit. If there is not, or you find that they want more experience, bide your time and watch for internal job opportunities, and apply, heeding the managers advice.

The worst thing you could do it to change your nursing persona or practice due to over stressing it. You have spent a great deal of time and energy to create a practice that your co-workers admire. Don't throw all that work away. We all have "things" that gets to us--I happen to enjoy addiction nursing, but ICU would not be my thing in the least. So think about the things you like, and keep your eye on openings. Keep on refining your practice. It will come together, even though now it doesn't seem so. Once you find your niche in multi-tasking, it will take you far. And that takes at least a year. Talk to your nurse educator--get your ACLS, PALS, NALS whatever it is that you can to make yourself marketable to your choices in specialization. Research what you can about getting certified in your chosen specialty. And let the manager of the unit know that you are interested in pursuing that option as well.

Another thought is if you are a union facility, look at your contract. There is sometimes language about "shadowing" in a potential job. Your seniority would give you a slight edge on someone who would be an outside hire. Or anyone who was hired after you.

There is no harm in asking for guidance to get where you would like to be. That your plans are in place going forward may make it a great deal easier to do what you are now.

Good luck in your endevours!!

Neuro AND med/surg ARE specialties. They do have certs of their own. People seem to forget that. ;)

OP, what is your ratio?

I agree with many posters here.

1) It takes time to learn any floor, no matter where you go. You can bet your bottom dollar that transferring to ICU, PCU, PACU, OR, etc.. is going to come to have it's own time management and the typical over-your-head feelings.

2) Speaking of specializing, you typically have to have hours and years of working on a floor, and IMO, don't worry about that just yet. It's too early anyway, and save it for a specialty you enjoy.

3) Congrats on getting nominated on the Daisy. That is a coveted award at my facility and to be up for nomination says a lot about you as a nurse.

I'm not going to tell you where to go, because every place has it's challenges and its pain in the butt things. The beauty of nursing is one is able to go to different areas and do many things so they can find their fit. However, make sure you give it enough time before you do so, or you are shorting yourself thinking you can't do it, when you really could, but just aren't giving yourself time.

Specializes in Neuro, Med-surg..

Neuro AND med/surg ARE specialties. They do have certs of their own. People seem to forget that. ;)

OP, what is your ratio?

I agree with many posters here.

1) It takes time to learn any floor, no matter where you go. You can bet your bottom dollar that transferring to ICU, PCU, PACU, OR, etc.. is going to come to have it's own time management and the typical over-your-head feelings.

2) Speaking of specializing, you typically have to have hours and years of working on a floor, and IMO, don't worry about that just yet. It's too early anyway, and save it for a specialty you enjoy.

3) Congrats on getting nominated on the Daisy. That is a coveted award at my facility and to be up for nomination says a lot about you as a nurse.

I'm not going to tell you where to go, because every place has it's challenges and its pain in the butt things. The beauty of nursing is one is able to go to different areas and do many things so they can find their fit. However, make sure you give it enough time before you do so, or you are shorting yourself thinking you can't do it, when you really could, but just aren't giving yourself time.

I'm a bit embarrassed when it comes to posting my ratio since, compared to many other hospitals, it's quite low. On nights, I can take a max of five patients. There's talk of us getting a sixth, but nothing concrete has come of it. Personally, a sixth patient would have me reeling but that seems to be where things are headed.

I should add that another thing I dig about my floor is the sheer variety of medical issues and situations I see. Every day I work I literally learn something or see something new. I can't even count the number of times I've seen something my patients presented with that I didn't even think was possible. My floor IS a tremendous learning experience.

Honey, it takes a year to stop shaking. Honest. Just hang in. It WILL come together.

It comes together but I still can't say I love it or don't want to tell the obnoxious patients off. I go to work with the idea that it is a JOB. the primary thing is I get paid. I suck up how I really feel for 12.5 hrs. That approach has actually made the whole thing a lot more tolerable!

It comes together but I still can't say I love it or don't want to tell the obnoxious patients off

What, yu mean you haven't become a saint? ;)

Specializes in ER.

Ok, I'm gonna be the voice of the crusty old bat-meanie nurse. ;) I do believe that most nurses do NEED to learn on a med-surg floor. If you can't handle where you are now, because you are still trying to learn your time management skills, you should NOT look to go somewhere where you need more skills (ICU/CCU/OR). New nurses look at the amount of patients they have, on a particular floor, not the acuity. It's not fun, but you just did something HUGE- You got through nursing school, passed your boards, landed a job- That is an accomplishment to be proud of. This is part of the learning process. I agree with those who are telling you to hang in there and give it some time- It does get better with more experience. I'd suggest talking to your fellow nurses, and explain that you feel like the weakest link. Ask for suggestions on your time management. Make sure you are trying to get as much experience with different things as you can. New experiences and situations are very stressful as a new nurse. Good luck, and I hope it all works out for you.

Specializes in Clinical Research, Outpt Women's Health.

Just view it as a temporary position and an opportunity to learn as many skills as you can and that you will move on some time in the near future. When you are ready and feel you really have the skills to offer. Any hiring manager will understand that neuro is really tough.

Specializes in Public Health, L&D, NICU.
I'm a new nurse at my first RN job. I work in a large urban hospital in the Midwest. We are a level 1 trauma center so we can be quite busy. I work on a neurology floor that also acts like a med surg unit as well. I have been off orientation approximately 6 months. I love my coworkers (I work on the night shift) and I have had decent success there (my patients like me, or so my leads have said, and I was nominated for a Daisy award at the three month mark which was pretty cool). Unfortunately, I'm miserable. I specifically sought out a med surg floor because teachers and relatives who are nurses said that med surg is a great place for new grads to start in order to learn time management, assessment skills, etc. I had zero interest in med surg in school (it was my least favorite clinical rotation as a matter of fact). I was happier in ICU and oncology. My biggest issues with my current gig are the nurse patient ratio and the pace. Also, many of our patients are very trying (since we're neuro we get a lot of dementia patients who can become violent, plus we get a decent amount of everybody's favorites: alcohol detoxers and narcotic seekers). I had been having a really rocky start to my career: getting out of the door on time had been an impossibility for me until recently since I was always behind on charting. That has improved, but not by much.In short, I feel like my job is too much, too fast. My coworkers are beyond awesome in how helpful and friendly they are, but I'm definitely the weakest link on that floor. I simply cannot get a grasp on the pacing, the multitasking and keeping track of everything that needs to be done with my patients. It's nerve-wracking to the point where I feel nauseous and feel my chest tightening on the drive in. I'm sorry if this turned into a gripe session, I didn't mean for it too. I'm simply frustrated and feel trapped. What other options are there for me at this point? I'd love to have a lower nurse/patient ratio (wouldn't everyone?). I've considered OR, PACU, ICU, among other options. I just think it would be a red flag for hiring managers if they saw that I left my current job in under a year. I feel like I can't 'hack it' here. I didn't want my job to feel like simply surviving for 12 hours, but that's where I'm at. I've had to stop myself from snapping at my more obnoxious patients as well (never looks good on a 'How did we do?' survey when the RN tears into the patient). Advice welcome and appreciated. This is my second career and I don't want to back out now. I'm not a stranger to hard work, but this is beyond me.
I get so frustrated with nursing faculty. I don't think med/surg experience is necessary for being a good nurse.I had a very successful career in the hospital. Doctors loved me, and loved for me to have their patients. I was a good bedside nurse, and I never did a single day on a med/surg unit! Some of us just aren't cut out of med/surg. I don't think it will shock managers of other units that you are looking for a change. They chose their units for similar reasons, possibly. Other units are busy, too, but it's a different kind of busy. If you're unhappy, go somewhere else!
Specializes in Peds Medical Floor.

Ok I'm gonna say it....5 patients. You are lucky. I had 8 the last couple of nights. :/ Granted I don't work a neuro floor, but the rest of the stuff I deal with on a regular basis. Hang in there OP!! The first year is the hardest!!!

Specializes in Neuro, Med-surg..
Ok I'm gonna be the voice of the crusty old bat-meanie nurse. ;) I do believe that most nurses do NEED to learn on a med-surg floor. If you can't handle where you are now, because you are still trying to learn your time management skills, you should NOT look to go somewhere where you need more skills (ICU/CCU/OR). New nurses look at the amount of patients they have, on a particular floor, not the acuity. It's not fun, but you just did something HUGE- You got through nursing school, passed your boards, landed a job- That is an accomplishment to be proud of. This is part of the learning process. I agree with those who are telling you to hang in there and give it some time- It does get better with more experience. I'd suggest talking to your fellow nurses, and explain that you feel like the weakest link. Ask for suggestions on your time management. Make sure you are trying to get as much experience with different things as you can. New experiences and situations are very stressful as a new nurse. Good luck, and I hope it all works out for you.[/quote']

After I started this thread, read the great responses and also vented a bit to my coworkers about my frustrations, I really agree with much of what you wrote here. I feel like if I left now, I might really be setting myself back. I'd need to learn a new floor as well continue to grapple with current struggles. I also feel like I would be giving up too easily if I left now. I don't want this to beat me. Thanks!

I'm a new nurse at my first RN job. I work in a large urban hospital in the Midwest. We are a level 1 trauma center so we can be quite busy. I work on a neurology floor that also acts like a med surg unit as well. I have been off orientation approximately 6 months. I love my coworkers (I work on the night shift) and I have had decent success there (my patients like me, or so my leads have said, and I was nominated for a Daisy award at the three month mark which was pretty cool).

>

I had been having a really rocky start to my career: getting out of the door on time had been an impossibility for me until recently since I was always behind on charting. That has improved, but not by much.

In short, I feel like my job is too much, too fast. My coworkers are beyond awesome in how helpful and friendly they are, but I'm definitely the weakest link on that floor. I simply cannot get a grasp on the pacing, the multitasking and keeping track of everything that needs to be done with my patients. It's nerve-wracking to the point where I feel nauseous and feel my chest tightening on the drive in.

>

I should add that another thing I dig about my floor is the sheer variety of medical issues and situations I see. Every day I work I literally learn something or see something new. I can't even count the number of times I've seen something my patients presented with that I didn't even think was possible. My floor IS a tremendous learning experience.

You know what? You are describing a pretty normal first year. And, to coin a phrase, it gets better.

You are, in fact, getting better-- you said so yourself, your charting is getting more efficient. I'll bet dollars to doughnuts that if you look at it dispassionately you're better at a lot of those things new grads always tell us they are "terrified" about doing or not having experience doing; you're getting better. You are learning a "tremendous" amount and you really like that; words I wish we heard from new grads more often!

So you think you're the weakest link on the floor-- so what? Who else would you expect to be in that spot if not the new grad with the least experience? But you say your patients and coworkers love you, which tells me you're not a total screw-up, they see themselves at your stage in you, and they are nominating you for an award as a recognition and encouragement to help you get through this challenging period in your very early career. And soon... they'll be hiring another new grad, and you can compare yourself to that, if you feel the need to do so. :)

This isn't beyond you. If it were, you'd be getting counseled to think about something else and nobody would want to have lunch with you. :)

So. Tell me again what your expectations were? Or do you just feel a teeny bit better now you've gotten it off your chest and heard from some of us who have been there, done that, and feel you can get past this hump?

:flwrhrts: :flwrhrts: :flwrhrts: :flwrhrts: :flwrhrts:

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