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lisaannjamRN, RN 4,769 Views

Joined Sep 8, '09 - from 'Pennsylvania'. lisaannjamRN is a RN. Posts: 62 (40% Liked) Likes: 49

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  • Apr 14

    You are not alone and I applaud you for hanging in there... I could not. I landed my dream job 3 months after NCLEX, but hated it from day 2 (I knew day 1 would be rough so no surprise there). The hospital offered 6 weeks orientation (which is ridiculous) - management had no problem letting me do 9 though. The floor was crazy - short-staffed, the aides took offense at being expected to do their jobs, 5-6 patients, high acuity (we got everything except vent patients), nonstop admissions and discharges... the other nurses were mostly VERY kind and willing to help, except that when you were running around like crazy so was everyone else, so no one had the time. I spoke to my manager multiple times about how I felt, nothing ever changed. My anxiety spiraled out of control... losing sleep, dreading work multiple days in advance of the shift. I'm left feeling like an epic failure, quitting 6 months in as a new grad -- i have NO idea what I'm going to do now -- but as others have said on other threads - no one will take care of you but you. Don't kill yourself over it. If you can hang in there - excellent!! People told me "it gets better" a million times (but that's hard to believe when some of the most experienced nurses also leave 1-2 hours late from a 12 hour shift). However, my health is more important to me than trying to keep dealing with the insanity until maybe one day I wouldn't feel like dying before, during, and after every shift. I am convinced there is an area of nursing out there that is right for me, I just hope I can find it...

  • Apr 14

    You are not a lone Coolbeanz! I am a fellow new grad as well working on a telemetry unit and I've been on my own for about 4 months now. I know exactly how you feel and still feel some of it to this very day. I had tons and tons of anxiety before work, during work, and after work for every shift, but that's part of being a new grad. It's natural to feel this way because we are all new to this field or at least this particular job.

    BUT, let me tell you this, it gets easier as the shifts pass by! I speak from first recent first hand experience. After a month of being alone, I'm pretty sure you'll start to have less anxiety and more confidence. Me now, when I look back, I am feeling a lot better than when I first started. Things happen on shift, good or bad, but your coworkers and team is there to help you. I made a topic here back in January regarding some very bad anxiety I was having. Before every shift, I would TRY to take a nap, but would wake up with severe anxiety, tachycardic, sweaty, and my mind racing and thinking about "what if's" for work. I would also leave work and sit in my car for 15 minutes figuring out if I forgot anything. But yes, anxiety, overwhelmingness, fear, worriedness, etc does start to pass as the shifts go by. To this day, I sleep pretty comfortably before work. I still get a little anxious here and there but nowhere near as bad when I first started. I'm definitely more confident at work and when you need help, always ask!

    Make sure you have things to help you cope with the stress and anxiety. Things to mention that really helped me get through was praying/reading my bible. It really helped me calm down before work and was my form of "meditation" if you wish to call it that. Working out 3-4 times a week helped me burn my stress related to work and not only that, I eat pretty crappy at work so working out helps me build up energy, de-stress, and stay healthier. I have awesome coworkers and amazing charge nurses and they are always there willing to help out and answer any question, no matter how dumb it may have been. I think the BEST coping strategy that helped me get through the past months was venting to fellow new grad coworkers. We would talk outside after work or grab some dinner together and just vent. We all knew what we were/are going through and are able to comfort each other because we all have been there and done that. You will also find comfort on these forums too

  • Aug 20 '14

    Being a new nurse is freaking scary. All the time you spent binge drinking coffee, cramming for tests, memorizing lab values and texting under the desk seem so heavenly and pleasant in retrospect, for once you pass your state board exams and set off into reality, thats the actual tough part.

    After 2pm tomorrow, I have officially 3 more shifts at my job before I hang up my stethoscope, and try some new adventures for a bit. This doesn't end my nursing career by any means, I am just taking a small hiatus to travel, and enjoy being young - for if this job taught me one thing, it taught me to enjoy life while you can, because getting old and sick is super lame. This also means that my last day will mark one year of employment with one of the more challenging nursing facilities in my neck of the woods.. One year may not sound like much, but to me it is a major accomplishment, as I had found days where I wanted nothing less than to crawl into a soft cozy blanket cave, and stay there for days, eating ice cream and crying in the dark.

    In this year I have learned SO Much. Things that school was completely wrong about, and things that were spot on.

    Here is what I can tell you:

    Doctors aren't all total A-Holes! In fact, as long as your efficient and nice, they're usually okay, Its the mean tired nurses you gotta worry about, they do eat their young, but not before stalking the hunt for weeks behind the victim's backs, then shredding them into pieces out in a desert safari.

    There is never enough time in your day. Ever. and you will never finish all your work. so quit trying. You will probably forget to drink water, eat, use the bathroom, or stop running for like the first 9 hours of your shift, and whatever you're scheduled to work, expect to stay about 1-2 hours past that, and you still wont finish. Oh and your scheduled "Days off" will be filled with calls from work, trying to take away your day off.

    You should probably get a sleeping pill prescription. Ambien is a beautiful thing, but the $2 "Sleep Aid" works just fine.

    Poo Happens. A lot. And Puke and Pee and Bedsores and Skin Tears and G-Tube intestinal fluid explosions.

    Many-a- Laughs will be laughed, so lighten up and retain your humor with every day. It will get you very far.

    Many a tears will be shed, so don't wear mascara, and dont think it's a bad thing to breakdown into a waterfall of sobs to your boyfriend at 12AM, hopefully he's nice like mine

    They can try and try, but Nursing Home food will never taste good. Especially Puree Ham Sandwiches.

    Sometime's your patience will wear so thin, that you need to step outside and breath, or shout into a pillow, or smoke a cigarette once in a blue moon, even if you don't smoke. Call me crazy but sometimes all you need is Three Words: After Work Cocktail.

    Death isn't as scary and sad as you'd think it to be, in fact, at times, it really is a beautiful release and a happy thing for many. I have experienced so many eerie, magical events happen before/during/immediately after a patient's death that it's made me reconsider alot about our existence on earth. and when people say "I just dont wanna die alone" Trust me, chances are you probably will, I think some people end up choosing it that way, and its not necessarily a bad thing.

    Buy good shoes. The uglier the better!!! Just do it. Those ugly shiny clogs are just perfect. Pink Snakeskin, Breast Cancer Ribbons, Whatevs! Your knees, back and feet are about to be sore and ruined for the rest of your life, so try to slow the process a little bit.

    Just Listen. Over and Over again on NCLEX questions, class exams, lectures, They told us, when a patient is talking, the best thing you can do is just listen. It sounds easy enough. Just do it! Even if your rushed, which you will be, don't scramble for quick answers to problems, or ways to solve their emotional hardships, just sit down and don't say a word. They will do all the talking for you. They might cry, or yell, or whatever, but sometimes all they need is for one single person to just give them time to sort things out.

    And lastly:

    TRUST NO ONE. Seriously. Friendships in the workplace can ease the pain, but when there is a bunch of high stress women in a big room together, it is a big recipe for drama. Dont trust anyone else with your keys, dont tell anyone anything personal, dont add any coworkers on Facebook, just do your work thing, and keep the rest of your life separate. It has been the best decision I have made this whole year. I have seen employees get girls "they dont like" fired, Narcotic Diversions, Marriages have split up, Cat fights have happened in the middle of the hall. All things I have had the pleasure of staying way out of. As if your job isnt hard enough, you dont need that extra Bologna. Just do your job, and leave.

  • Jul 30 '14

    The first year of nursing is miserable. Everyone is miserable during the first year of nursing. You go from being a college student to being responsible for a full load of patients, and you aren't sure you're up to it and you're worried about what would happen if you made a mistake. Not IF you made a mistake, but when you make one because you just know that you can't do this and you're going to kill someone. You go home worried about whether you did enough, noticed any potential harbingers of a decline in your patient status or passed on everything you needed to pass on to the next shift. Sometimes you stay awake all night worrying about it. Or you fall asleep only to wake in a panic, sure you've forgotten the one crucial detail that could have prevented someone's demise.

    The first year of nursing is miserable. I'll say it again. The first year of nursing is miserable. Even after 38 years, I remember vividly just how miserable the first year of nursing can be. I worried that I had missed an order or an important lab value. I worried that I had signed off an order but had forgotten to actually DO what was ordered. On one occasion, I actually got up in the middle of the night and drove to the hospital, sneaked up the back stairway to my floor and ducked into the end room to make sure I really HAD decreased the Heparin drip as I was supposed to have. (Someone had -- I'm still hoping it was me and not the night nurse who found the order when she went through doing 24 hour chart checks.) I was so afraid I'd do an IM injection wrong and injure someone's sciatic nerve, dooming them to a lifetime of pain and suffering that I'd have to go into the bathroom and vomit before giving an injection.

    The first year of nursing was miserable. I felt as though I was overworked, that no one appreciated me and that I was an inch away from making a potentially fatal mistake at any moment. I worked as hard as I could, but my time management skills weren't fully developed and I didn't have the experience to detect trouble on the way as the more experienced nurses could. Instead, I detected trouble right about the time the feces hit the fan . . . far too late to head it off at the pass and just in time for one of my more experienced co-workers to save my (my patient's) bacon.

    Truly, I WAS unappreciated -- which had a lot more to do with my own attitude and my inability to get along with my co-workers than it had to do with my co-workers, who probably would have liked and appreciated me had I been a bit more likable. But I was too stressed, too convinced of my own incompetence to be able to spend the energy on the social niceties that would have helped me to fit in to the team.

    I didn't have the option of quitting my job and moving on. I was supporting a husband who was going to school full time, and health insurance at that time was not portable. I had to make my job work. And as time went on, I had a few scattered moments when I felt as though I could handle it. And then a few more moments. And then most of a day went by, and I handled what came my way, noticed signs and symptoms ahead of time and was able to head off potential badness before it became a full-fledged code. There were times when I was able to lift my nose from the grindstone long enough to notice that a co-worker was in trouble and needed help.

    As I developed time management skills, assessment skills and interpersonal skills, my job got easier. I was able to interact more positively with my colleagues. I got to know the people on my shift, and we went out together. Some of them became friends. As I became more competent, my co-workers became nicer. (I know it was ME, not them. I became more likable and they responded positively.) Somewhere around the two year mark, I realized that I liked my job, my colleagues and myself. I had become competent.

    Had I changed jobs, it wouldn't have happened, or it wouldn't have happened as soon. I was lucky, in a way, that I was forced to stay at my first job.

    The first year of nursing sucks, but it does get easier, trust me. And one day you'll look back over the years and remember how lost and scared and incompetent you felt . . . and know that it was all worth it.

  • Jul 16 '14

    Not every long-term care nurse chooses LTC as a profession. Sometimes, it chooses us.

    But no matter how you've arrived at your first job in a nursing facility, there are challenges awaiting you that you didn't anticipate, especially if you're coming from acute care or another environment where even chaotic conditions have some form of logic to them. Here are a few things you should expect as a new long-term care nurse:

    Expect to chase after supplies.

    I have never worked in a nursing home where they kept everything in one place. You'd think they would put all the catheter supplies together, but no---whenever I had to change a catheter, I had to go to three different storage areas to obtain the necessary items. Even house stock meds were kept in different cabinets: vitamins and supplements at the nurse's station, OTC pain relievers and bowel care meds in the medical records office. I never did understand the reasoning behind this, so I lobbied administration to change the layout of the supply closets so we didn't have to waste time running all over the facility. Of course, they never did.

    Expect to become the nursing version of McGyver.

    LTC nurses need to be creative in order to solve the problems that frequently arise in a facility which always seems to be short of supplies and slow to make necessary repairs. You'll use washcloths or foam pipe insulation to wrap around the arms of wheelchairs when the vinyl gets torn up and causes skin tears. You'll utilize foam tape to "Nerf" splintered doorframes and the sharp corners of nightstands to prevent injury. Sometimes you may even have to use a Foley catheters as a G-tube because nobody ever remembers to order the insertion kits.

    Expect to be challenged by a wide variety of situations.

    Contrary to popular opinion, LTC is NOT boring. Yes, you will have routine tasks such as med passes and fingersticks on your 17 diabetics, but no two days are the same, especially if you work on a skilled unit, which is like a hospital only without the staffing and the equipment. Unfortunately, SNF patients are sometimes transported from the hospital in unstable condition---in fact, I've sent patients right back to the hospital without allowing them to be transferred from the stretcher. But even on the custodial care unit, you'll deal with a host of problems: falls, dementia, hovercraft families, scabies outbreaks, diabetic crises, psychiatric issues, and fights between residents.....to name a few.

    Expect to become a diplomat.

    It is difficult to hold your tongue when a resident's family member chews you out for the umpteenth time today because "Mom" isn't drinking enough fluids or eating enough or getting out of bed every day or having her 20-minute dental routine followed to the letter. It is beyond tempting to tell them to take her home with them if they feel they can take better care of her. But as you become more experienced, you learn how to let their constant complaints and demands roll off your back, and how to de-escalate a crisis situation by "killing them with kindness".

    Expect to be looked down upon by other healthcare professionals; but remember, you are the expert on your residents.

    Regrettably, long-term care is still regarded as the bottom of the barrel by many nurses in other specialties, as well as administrators, doctors, therapists, and even EMTs. I can't count the number of times I called the ER to give report on a resident I was sending out and was asked if I'd taken vitals! It's as if they think LTC nurses don't have the sense to do the basics before calling in the cavalry. And if I had a dollar for every time I tangled with EMTs over their reluctance to transport a resident because of insurance issues or "she looks OK to me", I'd be a rich woman today. But there is no need to let the idiots get you down.....when it comes to your people, YOU know best.

    Expect to be chronically understaffed.

    This is an issue everywhere, even in the best facilities. Granted, you can have days when there could be 15 staff on the floor for 30 residents and it still wouldn't be enough, but even on a good 3-11 shift, 3 CNAs and one nurse for those same 30 residents is pathetic. And when you complain, the general response will more than likely be "Suck it up, Buttercup" and that you should be grateful because XYZ Nursing Home's staffing is better than what the state requires.

    Expect to fall in love.

    LTC nurses don't do what we do for the money (it's also one of the most poorly paid specialties). We do it because we find so much to love in the wizened faces of our elderly, the funny things they say, the way they hold our hands in a tender moment. No matter how demented or ill, they will provide you with wisdom gleaned from their eight or nine decades of life, as well as a million and one laughs! I'll never forget the resident who once asked me, when I knocked over a couple of Jevity cans in the next cubicle, if I was the cat. Knowing that despite her dementia she had a wicked sense of humor, I said, "Yes, Elaine. MEOW!" To which she replied, "Oh, OK, thanks for letting me know," and promptly went back to sleep.

    The hardest part of these special relationships is that sooner or later, your residents will break your heart by leaving you.....and every loss will change you. Some deaths will hit you harder than others, but eventually you'll learn that good-byes are not always the worst thing that can happen.

  • Sep 4 '12

    I spent the first 9yrs of my nursing career in LTC/skilled... I cant speak for all LTC facilities obviously but I can tell you that I used my critical thinking skills everyday. I imagine it is up to the individual nurse how they practice. I learned more about prioritizing care and time management than I ever could of in a hospital setting.
    My props to you for actually trying out LTC to see how hard it actually is. Every time I sent one of my patients to acute I was talked to as if I was incompetent. I dont think acute care nurses actually know what goes on in LTC.
    I now work in dialysis, having left LTC because I was growing tired of the "do more with less" attitude . I wish more acute care nurses would come work in LTC, and see exactly what we do.

  • Sep 4 '12

    I love when patient's family members in the ED stand in the doorway and stare at you. Yea, that's going to hurry things along and get your family member out of here faster!

  • Sep 4 '12

    Currently one behavior comes to mind, and it's from a doctor: Asking me a question that requires I look at the paper chart to answer it, when he/she is holding the chart, and then acting like he/she doesn't have either the chart or the ability to read.

  • Sep 4 '12

    I'll start with people who say "I went to nursing school" Okay, but are you a nurse?

    I need my meds today. Also I can't pay for them.

    Moms who let their kids run wild and scream. I get that stuff hurts, go ahead and cry. No need to run like a wile monkey or screech like you're dying, I assure you that if you were dying you'd have no time to yell like that.

    And let's not get started on the drug-seekers!

  • Aug 25 '12

    Quote from sistasoul
    We are told it is our time management skills that are lacking and not the workload. Also, you will be written up for overtime and then you can be written up for working off the clock. Catch 22. Managent doesn't want to hear how it was the shift from hell- that is why they are in management- too get away from the crazy bedside.
    Have you ever noticed that Nursing is full of no-win situations for nurses?

  • Aug 25 '12

    A few months ago one of my coworkers casually said, "I'm going to punch out and finish up my charting. I don't want management to get mad at me."

    I responded, "The company made tens of millions of dollars in profits last year. This company is making lots of money and I want to be paid for every minute that I work." Another coworker overheard my statement and agreed with me.

    I have never been reprimanded for staying clocked in while finishing up undone work. If every nurse remained on the clock while completing their work, this would make corporations deal with high nurse/patient ratios, unbearable workloads, and so forth. It is easy to target one nurse who stays on the clock, but it is way too hard for administration to fire every single nurse in the facility who remains clocked in while finishing up. This would amount to masses of nurses who would need to be replaced and properly trained.

    Power comes in numbers. All nurses must stop giving away their free labor by working off the clock. They are making themselves poorer while making healthcare facilities wealthier.

  • Aug 25 '12

    We are told it is our time management skills that are lacking and not the workload. Also, you will be written up for overtime and then you can be written up for working off the clock. Catch 22. Managent doesn't want to hear how it was the shift from hell- that is why they are in management- too get away from the crazy bedside.

  • Aug 25 '12
  • Aug 25 '12

    In some facilities, if you raise a fuss about it, you will be fired. It's a sad situation. That is one area where a union contract might be of help.

  • Aug 23 '12

    Perhaps this is just the 'guy' in me; but you are allowed to stick up for yourself in ANY situation/job.

    If you can gather the courage in a situation like that, you can always call your nursing manager "unprofessional" after they call you "ignorant", especially with another nurse in the room. If the NM reacts (people who heavily criticize are historically bad at receiving criticism), you have basically manipulated them into doing or saying something even more dramatic than "ignorant". Then you remember everything you can, write a letter about exactly what was said, and it becomes an HR mess in which you did nothing wrong but call out your nursing manager for being unprofessional which he/she was in the first place.

    (BS in psychology here)

    This may not be 'good' advice. However, your NM clearly doesn't need to be in a position like that, belittling nurses. Save the manipulation for next time. The bigger your back bone, the more power you have in the work place


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