I work on a busy neurosurgical unit in the southeast where we have 5-6 patients per nurse. I've been there since the beginning of the year. When I first started, everything was confusing, and everything felt foreign. After 7 months, I feel that I am getting the hang of things. Don't get me wrong- I feel like I learn something new every day, but compared to where I was when I started, the difference is night and day. It will take you a while to get into your own habits, and to understand what to expect with each type of patient you care for. Eventually, you will learn that all surgical patients need to be weaned off of their IV meds, they need to poop, they need to walk. You will learn how to recognize complications like hematomas, CSF leaks, and what warrants calling the doctor for. No one expects you to know everything right away, and on my unit, I have never gotten in trouble for asking. I feel like I may have gotten on a few nerves for the multitude of questions I've had throughout these past few months, but at least I know I tried my best to give safe patient care.
My biggest piece of advice is: stay organized. Make your schedule at the beginning of the day, and stay on top of it. Check charts often. Write everything down. Never be afraid to call the doctor for concerns you have, because you've got to start to trust your nursing intuition. The majority of the time, things are fine, but trust your gut. The worst feeling is going home after a shift, and feeling like you didn't do enough for a patient. Eventually, your brain will adapt. It just takes time. You will do great!