HELP! New Grad on Med-Surg / Telemetry Floor

[KayFuryPsychRN]

Hi,

I graduated in May 2011, and got a job at a community hospital in December 2011 on a med-surg/tele floor. I have had 12 weeks orientation, had 2 different preceptors, 10 weeks days 2 weeks nights, took an EKG class, and an ACLS class, and i STILL feel unprepared to be by myself. My unit is crazy, it's crazy busy all the time, they are trying to get it so we only have 4 primary patients with 2 LPN coverage, but we can have as many as 6 with an additional 2 LPN coverage.

I don't know how to prioritize, I'm not good with getting admissions, and I haven't had anyone die on me, so i don't know what to do for that. I've asked for 3-4 additional weeks, and my manager seems cool about it, but I truly am freaking out. I don't know how to deal with the difficult patients, you know, the ones that are half-crazy to begin with? Also I don't know how to deal with a confused patient, or the patient going through alcohol withdraw? I can deal just fine with the ones that are pretty much stable and that's it!

I come home crying almost every day. And before each shift I pace around my living room, nervous and anxious for what the next shift has in store. I suck at just about everything, and I am asking questions constantly, to the point where it's probably getting insane. I don't know what to do? And I'm worried their patience will wear thin soon. When something happens with one of my patients the whole day is thrown off schedule!

I am just freaking out and looking for advice. Other nurses seem to think that I'm just feeling this way because I am new at everything. But I'm not so sure. I don't even know what I need to call the doctor about all the time, or even which one of the 583926 doctors any one of the patients has on consult at the time. God help me!

Did I make the wrong choice in job? My good friend works in a nursing home, she says nights are a lot less hectic than that, and that hardly anyone gets IV meds or bedside procedures. People are generally stable there.

What should I do? I feel so overwhelmed I'm worried it's going to give me a stomach ulcer. I suck at prioritizing and I generally suck. I feel as though I love the medical field, but I'm not sure this is right for me! What do I tell them after 12-16 weeks of training if this isn't for me? They've been all so nice to me, but what if it's too overwhelming? What if I suck? I'm being serious here, I'm not looking for someone to hold my hand and tell me it's going to be ok if it's not! Help!

[nerdynurse00]

I too graduated in May of 2011 and I started on a Medical/Telemetry floor the first week of June. I had about 5 weeks of orientation then I was flying solo. I won't lie, it was absolutely, without a doubt, the hardest time of my life. I cried before and after every shift - and sometimes even on my breaks for about 2.5 months straight (and I still cry after some shifts!) On my days off, I was so depressed. All I did was cry, think about how much I hated my job and either looked for new ones or tried to think of other things I could do (I even considered going back to school to get a degree in Biology).

With my preceptor, shifts always seemed to go smoothly- nobody ever coded, nobody had MI's in bed, no respiratory distress, nobody died... but as soon as I was out on my own, I soon realized school had not prepared me nearly enough for what responsibilities I now had to carry.

On our unit, there is 1 RN, and 1 LPN for 12 or 13 patients. I oversee the care of all 13 of the patients, as well as take an assignment of the 3-4 sickest patients. The workload is extremely heavy and it is so overwhelming at times.

My best advice to you: 1) what you are feeling is very normal (I know, it's the last thing I wanted to hear at the time) and things WILL get better. Try to find the positive things that happened during the shift and focus on those when you feel youself getting down. Even if you know Med/Surg is not what you want to do (which I knew right from the get-go), we see so many different things in that field that we can kind of see things we may like and the things we know we hate

2) Find 1 or 2 good nurses that you can trust and have them mentor you. I actually befriended the nurse that most people were petrified of for her bluntness and "no BS" attitude- whenever I had a question, I tried to find her first. After I got to know her, I realized I was scared of her for no reason at all and I have learned a tremendous amount from her. So ask experienced co-workers out to breakfast after a crappy night shift to vent or meet up for coffee on days off- they are a wealth of information- and remember, they were once going through the EXACT same thing (whether they'll admit it or not.)

3) Find something you enjoy doing on your days off to take your mind off work. Exercise! Read! Go for adventures and travel! or watch insane amounts of mindless TV like Greys, Frasier or The OC like I do

4) Chalk everything up to experience- yes, your friend may have an easier job- but think of all that experience you have over her! Interpreting telemetry is a great asset to have, as well as all those things you mostly only encounter in acute care- such as IV meds, assisting physician with procedures, codes.. critical thinking! It's a great foundation to have and it'll pay off in the end.

5) Prioritizing and perfecting skills will come with time- don't sell yourself short! That you even care this much shows that you are a great nurse and your patients are lucky to have you! Believe me, you will be disorganized at first and things will not go smoothly (even the most seasoned nurses have those days!).. but after time, you will have fewer of those days.

I could blab on forever- I have learned so much in these past 8 months and I hope that after the misery I went through, I can use my experiences to help somebody else. I wish you all the luck in the world- whatever field of nursing you choose.

Laura

Shotguns and Syringes