Almost a Year In -- Desperately need advice/encouragement (LONG)

JSFCC · Jul 17, 2008

What's worse, first semester nursing school or first year as a nurse? I start nursing school in a month....

lucky1RN · Jul 17, 2008

I don't think anything you're feeling is abnormal. That first year is SOOO hard. I don't think "you care too much" was a helpful comment from your co-worker. I believe you should be empathetic toward your patients while maintaining professional boundaries. You have a huge responsibility and are still learning to deal with that along with all the intricacies of the job. If you have a history of depression...combined with some sleep deprivation, I would guess that you're having more trouble than your co-workers in dealing with your first year in nursing. Can you see a counselor about the depression? Can you do anything to improve your sleep while you work nights? Can you eat better? Exercise more? Meditate? Just anything to help you deal with stress? Is there a more senior nurse/mentor who you trust at work that you can talk to? A faculty member from your school who might offer insight?

Take care of yourself. Good luck!

Smokey9283 · Jul 17, 2008

It truly takes at a minimum 6 months before a nurse will begin to feel comfortable in a new position. The best advice that I can offer is to utilize your resources. Ask questions when they arise and don't worry about what the other nurse will think. In my experience there is probably someone else there that has the exact same question. Also it is better to ask the question and get it right, then to not and miss something important. CC nursing is very indepth and the amount of charting and assessment needed in critical care patients is approximately the same amount that would be needed on a med/surg floor. (of course on the med/surg floor would not be as in depth, but the work load is about the same.) In the end, if it is causing you this much stress, then maybe as a new nurse you need to explore the med/surg aspect first. Hope everything works out for you.

Smokey9283 · Jul 17, 2008

Can you do anything to improve your sleep while you work nights? Can you eat better? Exercise more? Meditate?

I worked night shift at a NH for approximately 2 years. What I had to do when working those shifts was as follows.

1. I always had to have my room pitch black when I came home to sleep, this created the illusion of night.

2. I always had to give myself at least 8 hours to sleep.

3. I shut all of the phones in the house off while I was trying to sleep.

4. I always tried to stay up extra late on the night before my 1st scheduled shift, so that I could sleep in late on the following day

5. I tried to take a nap before a first night shift too (at least 2 hours)

Hope some of this gives you some insight

Texas Tornado · Jul 17, 2008

What's worse, first semester nursing school or first year as a nurse? I start nursing school in a month....

Whichever you are doing at the time

Seriously I think it depends on what you are most challenged by. Both are hard, but some people have an easier time with one over the other. For me the first year of nursing was harder.

Good luck in nursing school!

pagandeva2000, LPN · Jul 17, 2008

When you calm down a bit, think about writing what is important to do, such as a check sheet of some sorts. Do you use SBAR at your facility? I see many RNs writing notes on their SBAR during the course of the day, and use that as a guide for their documentation. This way,you are writing things on each patient as they occur, such as the symptoms, who you contacted, what their response was, the ultimate decision made, and such.

I am an LPN, so, we function a bit differently, but I know that the first year can be very overwhelming. I had my license since 2006 and there are still millions of things that I still don't know even within my function. But, I carry a 'log' of what I think needs to be documented on each patient, especially if I didn't get a chance to do it immediately. Also, I try to generalize certain statements that may need to be charted, but not in such detail, such as: reviewed s/s of impending stroke with patient, reviewed disease appropriate self management; to cut down on writing too much (unless an incident occurs).

I wish you the best, hugs and kisses to you! And, yes, the suggestions on winding down when you get home are so important. I make sure that my bedroom is clean, bed is made, have relaxing music, take a shower, read a book that relaxes me, watch my favorite programs and also call friends who I know can understand if I really need to talk.

locolorenzo22, BSN, RN · Jul 17, 2008

I'm currently in orientation, and while I'm not in Critical care....I feel for you. The hospital just hired a new critical care director, and she has been a RN for 18 years....she mentioned that to ALL new grads...orientation really lasts a YEAR...or longer. You just have to take it day by day....care about your patients, but just deescalate the nerves as best as possible. Talk to your doc about maybe needing a different dose or med?

What do you do for interest/fun outside of work? What do YOU feel is the SINGLE most important thing you want to work on?

Riseupandnurse · Jul 18, 2008

I feel for you!! I didn;t even START to come out of those feelings a little until I had two years of experience, and I'm not in critical care. And after 18 years I'm not at all over them by any means. Therefore I don't think I will ever not worry about my nursing. I envy so much those who don't seem to worry as much. The truth is, nursing is not controllable by any of us. Patients go bad or write letters of complaint when you least expect it. And we ALL make mistakes and have situations we could have handled better. Is it wrong that often it helps a lot when I see or hear about some of the things that happen to or are caused by my fellow nurses?

GadgetRN71, ASN, RN · Jul 18, 2008

I'm in my second year as an RN, and it's better but I still have my moments. For me, the leadership aspect has been the most challenging-all the politics and nonsense of the charge position really gets to me sometimes.

You may not be doing as badly as you think...you have to take what your coworker said with a grain of salt. Sometimes, your bosses think you're doing just fine-anyone with a brain in their head and a shred of compassion will remember that you are still a new grad for all intents and purposes.

Is there anyone at work that you admire and that would be willing to mentor you? Doesn't have to be a formal thing..just someone you can go to with questions, concerns or a sympathetic ear.

FNimuaeMae · Jul 18, 2008

Hey, give yourself a break, I give you huge kudos for going into critical care fresh out of nursing school. I myself did 5 years of med surg before I made that transition, and believe me, I was TERRIFIED to go to work every day for a good 6+ months after getting off orientation in the ICU.

But eventually, you might get to a point where you feel up to doing a little extra time, and the emotional stress isn't quite as bad. One thing that helped me was I was orienting on day shift after being a night shift RN for years. I hated the whole day shift thing! I've always found the night shift RN's in general to be a bit more easygoing.

My advice- get enough sleep, enjoy your days off, try to de-stress about work as much as possible. I always had a good 40 minute ride home from my old job, and would talk to my mom (also an RN) about what went on during the shift... it was like therapy!

You will make mistakes, we ALL do, but what distinguishes you is how you own up to them and handle them. I've made mistakes at work and had to go bawl in the bathroom afterwards, but you learn from them and it makes you a better nurse.

If you feel you're feeling too anxious, perhaps your meds need an adjustment. Sometimes that happens, and you need to take care of yourself.

I say just keep plugging away... its a long painful journey but it will eventually get better. Just be good to yourself. And if eventually your inner voice says critical care just isn't your thing, you won't be the first to decide that. There are tons of other things you can try!

Good Luck!

Missy

WWRN · Jul 20, 2008

Thank you all for your words of encouragement and advice it's greatly appreciated.

I am in counseling, but not as regularly as I probably should because of my schedule. I recently had an adjustment made to my meds and it is helping somewhat. I'm getting ready to head back to work after a week off and am anxious to see if I feel better at work too.

I think a large part of my problem is not feeling like I have a life outside of work because with working 12hr nights and trying to maintain the same sleep schedule on my days off it's very isolating. Therefore, I'm considering a full time 3p-11p shift in the same unit. Yes, I'd have to go to work 5 days a week which scares me. I'd have to deal with families more which is also scary. The leadership on that shift is less consistent and there are other negatives, but I feel like the only way to fairly gauge if CC nursing is for me is to do it with adequate sleep... What do you guys think??

Thanks again for all the replies!:redpinkhe