New Grad, 8 patients. HELP!

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  1. This is a discussion on New Grad, 8 patients. HELP! in Medical-Surgical Nursing, part of Nursing Specialties ... I feel terrible posting this because I realize how lucky I am to have a med-surg job as a new...

    by Aug 17, '12
    I feel terrible posting this because I realize how lucky I am to have a med-surg job as a new nurse...but I'm just looking for coping advice...

    I am one week away from being off orientation (orientation is 6 weeks) and I am already freaking out! I knew Med-Surg would be terribly challenging, but I never knew it would be like this. It is standard to get 8 patients on my floor (I work days). 8 patients to me feels terribly unsafe. When you factor things like critical labs, hanging blood, starting new IV's, patients crashing, rude doctors, demanding families, etc.....8 patients is just too much! I am terrified I am going to miss something important and risk losing my license because I am just so overwhelmed with everything that's going on.

    Maybe it was naive of me, but I thought I'd be able to have more interaction with the patients. The whole reason I decided to become a nurse (once again, maybe this was naive) was because I thrive off of patient interaction. I like feeling like I make a difference and in med-surg I barely have time to spend 10 seconds with one patient before running into the next room. I am feeling so discouraged and am questioning if med-surg or even hospital nursing is for me.

    Becoming a nurse has been a huge dream of mine for YEARS and I feel lousy for questioning myself already. I am just wondering how people do this. Is 8 patients on a super busy unit do-able?
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    by circularstaircase Aug 17, '12 8:23 pm
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  3. 6 Comments so far...

  4. Aug 17, '12 by
    It is do-able..yes. It is right, no but you will get better, faster and more efficient. You will get better at time management, delegation and dealing with families more effective. The first 6 months will be the worst time, it will be a huge learning curve for you. You will make mistakes, you will miss things BUT every mistake is a lesson learned and next time, you won't forget When in trouble, ask for help, not sure what to do, ask. I promise, you will get better and if after a few months, you feel this is not safe; find a new job with a lesser ratio.

    My first 3 months were hell, by 6 months I was getting pretty good at keeping it together and by a year I had a real understanding of what I was doing and how to manage it all. This takes time, don't be too hard on yourself.

    Also nothing wrong with asking for more orientation time if you feel you are not ready to deal on your own, but just keep in mind, your NM may not feel the same way.
  5. Aug 17, '12 by
    IMO, nights is better for new nurses. I find nights to be more manageable usually. It gets busy but there seems to be more support. 8 patients is too many and sounds overwhelming. See about nights maybe? Good luck! Sounds like at the least you'll learn a lot.
  6. Aug 18, '12 by
    A lot depends on the acuity of your patients and if you are doing primary care or if you have techs and how many techs you have. I've been a nurse for two years. I started nights on med surg. I've only had a max of 7 patients at one time and that is a lot. I agree with eatmysoxRN, see about transferring to nights and ask for some additional orientation time. I was on my own for a while and was feeling so stressed and overwhelmed that I hated my job. I asked my NM for additional orientation time with a specific nurse whom I felt provide good care and seemed to have good time management skills. After 3 additional days with this nurse I felt more settled and less stressed. If you don't take some type of action now, you will end up hating your job and having to take blood pressure medication!
    Susie2310 likes this.
  7. Aug 18, '12 by
    Ok, I posted this once and it disappeared. Weird..

    Anyway, 8 pts is a lot...period! That's even a tough load for an established RN!

    I echo the others. Ask for more time or move to nights. If you can't do either, then cut yourself some slack on how much you can accomplish during a shift. You will pick up speed, but 8 pt's is still a lot.

    I worked for a facility that would give us 6 minimum and it burned me out. Now I work for a facility that is max 5, and it's so much more doable.
    Susie2310 likes this.
  8. Aug 19, '12 by
    Thank you so much for the replies everyone!

    I actually asked my nurse manager if I could switch to nights but unfortunately there currently aren't any night positions available. She did say she would let me know if something opens up, so fingers crossed something opens soon. I am afraid I am going to burn out real fast on days, which is unfortunate because I have wanted to be a nurse for sooo long.

    Sometimes I regret accepting this position knowing the patient staff ratio was so high, but I was so desperate for a job as a new grad. Ehh, I'm just going to try and stay positive and hope something on nights opens up soon!
  9. Aug 21, '12 by
    8 on days is a lot, but like others have said you will start to be faster and more efficient, hang in there you will get the hang of it, I felt the same way, got sick every day before work, but you will get through it!