First day on my own- now scared to go back

[kayleen4246]

I had 12 shifts of orientation to the postpartum unit, which I thought was sufficient until I just worked my first day on my own. I was told I would receive easy patients initially, until I got used to the flow of things. I feel like I was hit with a ton of bricks. They gave me three couplets, but we typically have 4. I had a post-tubal with a possible infection, another patient with DM who questionably spoke English, and another brand new tubal. We do couplet care unless the babies are in the nursery and since it was during the day, the babies were in the rooms. I eventually ended up discharging two of the patients (infection ruled out after straight cath UA) and then immediately received two more patients from two other nurses who were leaving early. One of the two I received was a c-section with PIH, gestational DM and an infection requiring IV antibiotics (I never hung a piggy back in my orientation at all). Her IV infiltrated and we couldn't get another one in (ended up having to call in anesthesia) and then when I took her to the bathroom she passed a clot the size of an orange (not even kidding, it was measured at approximately 200 mL conservatively). She was not hemorrhaging but that clot was scary.

I know that this is probably just my inexperience and that maybe these situations are "easy" patients but I felt like a complete failure. I know my coordinator was annoyed with me. I was way behind in charting and I forgot really important things like rechecking a temp on a baby (It was 99.4 and we are to recheck in an hour and I didn't get it done- when I did recheck it was fine but I still failed to do it when I was supposed to) and I also was an hour late giving oral Cytotec to the mom with the clot. I know mistakes like that can't happen and I'm beating myself up over it. I was honestly so upside down I didn't even know what to ask for help with. I cried when I left work- I've never cried leaving a job before. I go back tomorrow and I'm scared, I can feel my anxiety building the closer the shift gets. I'm scared that maybe I can't get it together enough to do this job. I'm sorry this is so long- I guess I just want to know if this is normal to feel this way and if it is, does it get better? How do I get better at this? Thank you for reading this. I don't know any nurse who aren't brand new like myself and I feel like people that aren't nurses don't necessarily understand the pressure/stress of it.

[Serendipity_74]

Welcome to the PP unit! Your first day on your own was definitely filled with a LOT. Just rest in the fact that eventually you will gain a sense of control. It takes time to develop a good work flow and even when you do there are times when an emergency mucks it all up. Work on getting a brain sheet to keep you organized, take a DEEEEEP breath and get back in there! It will all come together and you will look back on this day and wonder WHY you were ever so stressed. :)

[iPink, BSN, RN]

Take a deep breath...I'm assuming you're a GN because you stated you never hung IV antibiotics. When I started out as a GN in critical care, I had my fair share of patients who were postop with jpeg draining to suction, on an insulin drip, on four point restraints, peg tube and that was my entire team. However, I made sure my first couple of shifts on my own were scheduled the same days as my preceptor so I could go to her or she would check in on me. Most of the time, my facial expressions gave me away if I was feeling overwhelmed.

You said you're not sure what to ask for help with. Well, did you ask another nurse or charge to help place the IV? Why Anesthesia? What is your hospital policy with passing meds? At mine, we can pass meds an hour before or an hour later. You have to learn to use your Charge Nurse as your resource and ask for help. Besides not asking for help, the biggest thing new grads have trouble with is time management. You have to make check boxes on your brain-sheet so you don't forget what is next on your "to do" list. After taking the vitals of the newborn, you should have placed a checkbox and highlighted it if you had to and put the time it needed to be done. Even the most experienced nurses make checkboxes!

You will get better, just learn from your mistakes and give yourself the necessary time to grow as a PP nurse.

[kejRN88]

Wow! Sounds like a rough first day. First of all, take a BIG, DEEP breath. Not every day will be like this. I do agree with having a check list of what needs to be done. When I worked on the Ortho unit, I wrote things in different colors and used a highlighter to remind myself of what I had done and what needed to be done. It really did make a big difference. And, please do use your charge nurse as a resource! Usually the have been where you are and they can be a big help. Best of luck to you!