Feeling incompetent

**SKM-NURSIEPOOH, BSN, RN** · Jun 5, 2002

...doing a rn-refresher course sound like a winner to me...if you have the time, energy, & money for it...of course. if you're still located in the same city or town where you graduated from, perhaps you could speak with the nursing department chair & see if you can't sit in on a few classes or clinical labs classes until you're more comfortable with your skills & critical thinking. good luck with whatever decision you :blushkiss decide to make.

starr234 · Jun 6, 2002

I am an LPN and I have been out of nursing for 5 yrs and I know how you feel. I work in a LTC, and to ask questions I have found gets you labeled as unknowledgeble at best in my facility. There are a few nurses that will help you, but for the most part there are those that will gossip about you being an incompetent nurse. I hear this being done almost daily where I work. New nurses have quit because of this problem. I have researched common geriatric diseases and brushed on meds. I ordered nursing books from amazon.com that were very reasonable. I have Clinical Skills and drug guides and Fundamental of nursing books. I decided to get my RN and my A/P class has helped me alot with critical thinking skills and nursing assessments. I am not at the level I want to be, but I am working on it. Good Luck

Kayzee · Jun 19, 2002

Another RN, The feelings you have described are something I feel everyone goes through. i have been in LTC for 6 years, and it is very difficult to maintain your sanity and at the same time be polite and wear a smiley face for families visiting. Nursing is a diff. job which requires alot of time mgt. skills. I think once you get comfortable with the residents and staff things will fall into place. The important thing is that you care about your residents, and show your caring through your work. At my facility I have gotten to the point that I just don't feel appreciated at all. Never have I heard a positive comment from mgt. I stayed because of the special relatioships you can form in LTC. I am now applying at Hospitals, and I know that I will miss many aspects of LTC. Allow yourself time and give yourself pats on the back, because in your heart you know you are doing the best you can.

km rn · Jun 20, 2002

Actually it sounds like you are doing well - we usually have 1 nurse for 24 residents and 3 aides. So you are carrying a heavier load then we are.

tigger2sassy · Jul 27, 2002

well said everyone!!!! please don't stop now-- we need you and your patients need you good luck

Love-A-Nurse · Jul 28, 2002

originally posted by anotherrn
i am very new to this forum. here is a little bit of background. i have been an r.n. for 11 years. most of this has been in ltc. i didn't work for 3.5 years to be with my young children. when i worked before it was because i "had to". i was very burnt out and frustrated. i'm not sure if it was because i was working when i didn't want to, or if i was burnt out by nursing. anyway, in the years i was off i didn't try to keep up with journals, or nursing in anyway. ceu's are not required in my state. i told my dh on a regular basis i never wanted to go back.

about a year ago i started missing ltc and went back to work on 3-11 weekends in march of '02. i absolutely love working with the elderly. i am enjoying the pt care like i never did before.

however i feel very incompetent. some of my skills are rusty. i have no confidence in my decision making/ critical thinking skills. i float to whichever unit they need me on. there are usually 25-30 residents. staffing is myself and 1.5-2 cnas. i usually pass all of my own meds and do all of my own treatments. i am having trouble getting everything done. also, i feel disorganized and harried. i also feel like i have forgotten basic knowledge and am rusty on crucial procedures. i'm not sure i could easily start an i.v. right now since it has been so long, and not something i routinely did in the past.

the nurses at this facility make a big deal about who is an r.n. and who isn't. also, i don't feel much comradarie among the nurses. i feel like my job performance isn't living up to my title.

if it wasn't for the residents i would hang up my stethescope now. should i keep studying the nursing journals and doing what i can to "brush up"? should i forget it and quit? are my fears legit, or am i just feeling insecure?

thanks for reading this long post. i haven't talked to anyone else about this for fear of being judged.

i just wanted to welcome you since you have already received great adivce.

night owl · Jul 28, 2002

(((((((((((AnotherRN)))))))))))) This hug goes to you from all of us and your residents. Hang in there kiddoe, things'll get better..."The sky's the limit if your heart is in it"...:kiss

Momto3RN, RN · Sep 7, 2002

I could have written your letter myself!! I, too, am new to this forum and I am so thankful to know that others are experiencing my situation. I started working a Medicare rehab floor in a LTC when I got my LPN and stayed on after obtaining my RN two years ago. Before nursing school, I knew absolutely NOTHING about health care though I've always wanted to be a nurse I LOVE the elderly and direct pt care but other aspects are driving my confidence into the ground. RNs and LPNs on my floor have the same job description with the exception of an occasional IV push med. My dilemma has been maintaining my credibility as a nurse. Since I never worked as a CNA, even the aides wouldn't take me seriously. Not to mention, mine was the Your-On-Your-Own floor after three days of orientation. So many of my skills have been acquired through trial and error which makes me wonder if I've been doing things right. I feel that my best solution would be to work with more acute care more often i.e. at a hospital but since I want to be home with my two small children, that option is not feasible right now.

Anyway, I appreciate this opportunity to express my sympathy with those in this situation and being allowed to vent my own frustrations. I love nursing and the best nurses I've known may not all have had terrific technical skills, but their caring attitude and selflessness have put them on my "top nurses" list!!

Nursenan0 · Sep 26, 2002

I also am new to this forum and can relate to your experience. In a facility I recently worked in, I was actually called to the office to be told..."You have an RN behind your name" It was then more or less explained to me that I was suppose to be "above" the other help. I was told NOT to "socialize" with my STNA's on duty. Unfortunately I was also feeling very inadequate after being out of nursing for 4 years. After making friends with the lpns I worked with ( as I was the only not administrative RN) I soon found that our DON expected RNs to conform to her standards. I recently (7 months ago) relocated to a different state and found a skilled facility that appreciated my thinking and opinions....my confidence came back, and I asked to be trained on all procedures I was uncomfortable with. My peers were eager to comply and very understanding. I moved to charge nurse of a 150 bed facility, with 5 lpns and 11 STNAs who back me , as much as I do them. I've now moved on to MDS-RN for more experience and education with the option of working to keep my skills intact on the floor. I'm the fish out of water again as I havent a clue whats going on, but I figure its all an ever changing learning process...and yes yes I'm rambling but the point is... Keep pushing forward, if you enjoy it, you need it and the field definitely needs you!!!!! I choose to believe that some people are just miserable and want everyone else to be also...I refuse!!!!!I love being a nurse and I'm happy!

Keep looking forward......and smile

Good Luck

Nursenan

caliotter3 · Sep 26, 2002

There are a lot of good ideas in this thread. I remember my first problems but it was b/c I was new, not out of the field for awhile. One of the things I did to help myself (b/c I was never getting it done) was to sit down and actually try to map out my 8 hrs according to what needed to be done and when, you know, prioritize. I did this one time when I was away and relaxed. The list is an excellent tool. You can make blank copies to fill in. Give yourself from such and such time to work on txs and try not to be distracted by anything else. Another biggie--changes in condition. You get your residents w/probs during rpt. When your CNA's (in our fac, CNA's did VS) do VS at the beginning of the shift, emphasize to them that they are to report to you any time they have abnormal results or they see a prob brewing, as soon as they notice it. Sometimes it is hard to impress on some CNA's that they are the eyes and ears of the nurse. This way you are not hit w/a big problem at a bad time or the resident goes too long with out you taking approp action. Another idea, to try to give yourself a feeling like you are taking control of your destiny, why not enroll yourself in your own school of nrsg review? Pick the procedures you want to review, even the easy ones, and schedule study and practice time. If you don't already own one, buy one of the picture procedure manuals (Swearingen, Smith&Duell, or Springhouse's Illus Man of Nrsg Prac) and just go over these procedures. If you can enlist the aid of a colleague, fine. Otherwise, if the work atmosphere is really negative, it is best to keep your misgivings to yourself. Other nurses, after awhile, won't be looking around to bother you unless they are a troublemaker to begin with. Well, anyway, there are lots of ways to organize yourself and you will probably think of some yourself. Meanwhile, remember that each day you go through the drill from start to finish is another chance to get it down so that it will start to get easier in spite of how you now feel. Well, real long, but this is the place to get ideas! Good luck. Hey, noticed you started this thread a long time ago. Why not check back with us and let us know how it's going? Bet you already feel like an old pro! Cali

renerian, BSN, RN · Sep 26, 2002

I am looking at going back to acute care. I took a job at a facility but they kinda did not tell me the ratio of care was 1 to 50 patients................GEEZE LOUISE .........I felt like asking them if they saw the W for wonder nurse on my shirt!!!!!!!!!

Anyways I am interviewing for a peds burn unit position tomarrow as I enjoyed burn unit.......sick I know. I have not practiced acute care since 92. I worked in home health 11 years and LTC/'SNF 3 years in that time. Don't give up.......I am very nervous................

Do you find people here are supportive? I do.

renerian

Kateann · Sep 27, 2002

Hello to all,

I also am new to this form and am experiencing the same feelings of frustration and feeling overwhelmed in my new job. I recently was hired in a LTC facility. I had a very good orientation but it still didn't prepare me for the real thing. I I love the elderly but am so overwhelmed with all the responsibilities that I also feel that I can't get all my work done. I had such a bad evening last week that I went into the supply room and cried. My supervisor came up on the floor to bring me some supplies and found me in there crying. This particular evening was awful. It was my second evening off orientation. Had to call the supervisor because I had a CNA who refused to do a assignment. Had 3 new admissions had to send a patient to the hospital and had a resident who fell.

I had meds to do TX's that needed to be done and paperwork piled high. I never left work till 12:30. I cried all the way home. I was going to hand in my resignation tomorrow, but after reading all your posts I have decided to hang in there. It is comforting to know that I am not alone.......

Thanks to all