New graduate nurse in med-surg

Editorial Team / Admin · Dec 5, 2014

I've never worked as a med/surg nurse, but I knew that I would never have been able to handle it (where I had my clinical rotations, nurses were responsible for 10 patents on the med/surg floors!). However, I did find my niche in the OR.

However, you said you just graduated in September, but how long have you been working? Real world nursing is quite different from the textbook nursing taught in school, there's a big culture shock when moving from the protected school environment to the "oh boy, it's all on me now" work environment, and whatever other differences there are between school and real world. It's normal to feel overwhelmed; in fact, the consensus is that it takes a year for a new OR nurse to feel comfortable- I'm sure there's a similar saying for every specialty.

It could be that you just need to relax, accept that you will make mistakes, push yourself but not too hard (there is a fine line between pushing yourself and expecting far too much of yourself as a brand new nurse), and work through the various stages of nursing competency (Google Patricia Benner if you aren't aware of her novice to expert theory). It could also be that med/surg isn't your niche, but give it some time and try to get some experience under your belt before moving on.

tokmom, BSN, RN · Dec 6, 2014

There is no way you will have complete footing anywhere in a hospital setting, IMO in eight weeks. It takes roughly a year to feel like you have the policies down, flow, M.D. quirks, etc..

I have worked M/S most of my nursing career. It can still be a balancing act on those busy days. But I'm lucky to work in a facility that adequately staffs the floor.

Continue to ask questions and don't feel guilty. You will NEVER know ALL the answers. Focus on your organization. Create a brain sheet and most of all try to relax. You can do this, just give yourself some time.

Nola009 · Dec 8, 2014

What's your patient to nurse ratio? Is your charting software user-friendly? What's the culture of your unit? I think that unacceptable conditions in any of the aforementioned categories could pose a problem for any nurse, let alone a newbie. To answer your question, yes, I know of a new grad not making it on M/S. Our nsg supervisor gave her 3 6-8 week orientations and it just wasn't working out, so she resigned.

1Jessie86 · Dec 8, 2014

What's your patient to nurse ratio? Is your charting software user-friendly? What's the culture of your unit? I think that unacceptable conditions in any of the aforementioned categories could pose a problem for any nurse, let alone a newbie. To answer your question, yes, I know of a new grad not making it on M/S. Our nsg supervisor gave her 3 6-8 week orientations and it just wasn't working out, so she resigned.

Thanks for your reply. I'm still training. I'm about 6 weeks into a 16 week orientation. The nurse-patient ratio is 4:1. I'm working my way up and am at 3 patients right now. There's no specific culture on the unit.

withorwithoutyou · Dec 10, 2014

I am in the same boat. I definitely know how you feel. I have been in orientation for about 5 weeks. The charting and the policy is what is keeping me back. There is so much to learn about charting.

cynmrn · Dec 12, 2014

While I don't think that med/surg nursing is for everyone and there will always be people who just don't fit in that unit, I think you just need to give yourself more time. I still feel like a newbie sometimes, and I'm over a year in. But, that drowning feeling has diminished. It's hard to move away from nursing school/clinicals and into the "real world," because it's so much different. There is so much to do and so little time. Be patient with yourself and on't be afraid to ask a lot of questions. Think about why you became a nurse in the first place when the times get tough. For me, it was taking a step back and having a conversation and connection with a patient (even though much of my panic was because I would get behind). I became a nurse because I love that relationship/rapport, and when I got that, it would help me through.

If you continue to feel like a fish out of water after your orientation, see if you can request a longer orientation. If you continue to go to work disliking it all the time, reevaluate whether that unit/acute care setting is where you want to be. I am currently a school nurse and working PRN at the hospital because while the hospital has many merits, I just didn't want to do it full time.

Lev, MSN, RN, NP · Dec 16, 2014

It does get better, but even when you're out of the woods there will still be days when you feel like you're drowning. The charting takes up a huge amount of time. I'm happy to be out of med-surg and headed for ED, which I know will still be super busy, but hey, less charting. It takes 6-8 months to start feeling comfortable in med-surg. You are so so new. The fact that they're letting you advance with taking on more patients means that you are doing fine. Believe me, they wouldn't let you move on if you couldn't keep up. It's normal to have tons of questions and to feel dumb sometimes.

sunshyne17 · Dec 16, 2014

Speaking from the somewhat newbie at Nursing - I have been working Med Surg almost a year and still there are times I forget things.

I second/third/fourth (not sure how many ppl recommended) some type of sheet to keep track of things to do, things done.I like to chart as I go at least as much as I can. If I don't finish before I get pulled into something else, it's ok. I jotted down on my sheet and at least I started. I am not a fan of charting after my shift is over - I want to go home!

Hang in there, it is overwhelming at first. You are learning how to be a nurse and look up orders, and make sure your aides are providing care as ordered. It takes some getting used to. You will definitely need more time than a month!