Am I a bad nurse???

[Newnurse65]

So I am a fairly new nurse. I graduated back in December, and started working as soon as I got my license in February. I was fortunate enough to not have trouble finding a job, but now I am starting to think I am not cut out for nursing. I quit my first job after a couple months because it was so stressful. I was working nights in correctional care, making a lot of mistakes,working much slower than others, and I wasn't really getting the hang of things. I honestly had no experience doing anything and the other nurses felt I was useless and holding them back when they were training me. I felt like I didn't learn anything in school, and I didn't understand most of their lingo. I went home crying most days, before I quit.

So after taking a much needed mini break, I got my ducks in a row and started applying to new nursing jobs. I ended up getting hired in a family practice clinic, which is something I was always interested in before I became a nurse. I thought it would be a piece of cake especially after my last job. Unfortunately I find myself making errors on things that shouldn't be very hard. For example writing the wrong patient's name on test tubes, getting nervous and not asking all the right assessment questions, forgetting to get specific things for exams, asking too many questions, inputting the wrong vitals, spelling incorrectly, not using the emr system correctly. It is only my first week, but everyone has been looking at me like I am a complete moron. Honestly, I'm starting to feel like I am a complete moron. It's also starting to annoy the girls I work with, I think they hate having to show me things twice. Maybe it's just me, but when you are training I need to see things done more than once before I can remember verbatim.

I often look back and think "damn why didn't I do this or that?" I think the owners that hired me expected much better, considering they through me on my own super quickly. Also the fact that I am a nurse, and most of the staff in my position are medical assistants and they are way more experience than me. They look at me and are like, aren't you a nurse? You should know more right? No. I'm just stupid I guess *sigh*. I'm afraid the office won't keep me if I don't get the hang of things. Then what? Two jobs in just a few months? I'm also starting to think if I can't even handle clinic work, I am a pretty useless nurse. Sometimes I think I should have gone into a different field, but I truly thought nursing was my calling. Did or does anybody else feel this way? Does it get easier? Or should I get into a different field, I don't even know what I would be good at. My work experience before nursing is limited to reception and clerical work,and it doesn't exactly pay the bills or interest me. If anyone has any advice, that would be greatly appreciated.

[gemmi999]

I have to constantly remind myself to "fake it until I make it" with regards to self confidence. If I go into work with a defeatist attitude, it's going to be a bad shift. Instead I'm upbeat, even if patient's a crazy and the off going nurse apologizes ahead of time for the situation they left me in.

Never forget that nursing and medicine is a team sport and that questions are one of the best ways to prevent errors. Not sure if you're labeling the blood with the right patient name? Ask the patient how to spell the name. Even if it's a common name like Mike. If the patient looks at me like I'm crazy I just say that there are a lot of unique spellings now-a-days. Unsure about vitals? You can always redo them and tell the patient "I think I inverted the numbers". Pick a day and bring in something nice (like coffee or donuts) for the MA's and tell them "thanks" for the help, even if they didn't help that much. Teamwork and medicine and questions. You can NEVER have too many questions.

[Maevish, ASN, RN]

You're a new nurse, even with 2 jobs under your belt. At my first job, it took me 6 months of working five 8-hour shifts a week on a tele/oncology floor (4:1 ratio) before I felt comfortable and not sick to my stomach before work. Good thing too because they decided to start making me a charge nurse without any training right after that:cautious:

You literally don't know if you're cut out for this or not because you've given yourself no time to adjust to any one job. If the orientation time/good preceptors aren't there for you it will make even a good job that much harder.

It takes awhile to not feel slow, but that's not the important thing because it's better to be on the slow side (which EVERYONE is when they're new, by-the-way) and not kill someone than be fast/sloppy and risk killing someone.

If you'd started out and stayed at a hospital for a year, you probably wouldn't have felt so much like a deer in the headlights at the clinic. Even if it's a job you don't like, you can always move (even though it's tough nowadays) or switch specialties.

When I started at the plastic surgery center, I felt like you did and I'm a seasoned ICU nurse. They do things differently, use different medications than I'm used to, chart differently, and I have more autonomy than I'm used to. It takes time and you can't say "Maybe I'm not cut out to be a nurse" when you've not given yourself a chance at all, really. Well, I guess you CAN say that, but you're doing yourself a disservice because you don't even know at this point.

Good luck and when you find another job, stick with it (especially if it's a hospital job) so you can make an informed decision.

xo

[NightNerd, MSN, RN]

Girl. If asking questions and taking it slow makes you a bad nurse, there are NO good nurses out there. None.

:) You are not a bad nurse. You are new. Please have patience with yourself and accept that you're going to take your time, ask questions, and be thorough, because that's what is safe for your patient! 100% of the mistakes I've made so far as a nurse are because I rushed and/or did not ask questions when I should have. You will be great! Just let yourself learn.

[RescueNinjaKy]

I think the OP's situation shows up a major failure fairly due to

the academic take-over of registered nurse preparation.

I graduated from a 3 year hospital-based 'nurse training' program,

& years later did a 'modern' academic institution based

'nursing education' program.

As a hospital-based nurse trainee, a fundamental grasp of the

practical basics was required to progress,

& we had to pass 'Hospital Finals' exams which included

demonstrating such practice competencies to a real standard,

which were then certified.

This was a prerequisite step prior to even being

'put forward' - to sit the state final exams,

& a perquisite for being admitted to the register of nurses.

The academic program, by contrast, appeared to pay scant

attention to such actually meaningful matters, & I am certain

that many academic nursing graduates are in fact, as attested to

by the OP, not properly/practically prepared for the regular

daily functions inherent to real life nursing situations.

This is not only a professional-to-patient safety issue, but a

contributory reason for a ( certainly too high) ratio of nursing

graduates having the belated realization - that nursing work

as it is, really isn't for them, & promptly walking away from it.

A sad, expensive & wastefully needless outcome, IMO.

I appreciate the OP having the courage to be actively reflective,

& canvass the views of those experienced in the field here.

An 'Elephant in the Room' topic of nursing today though, huh?

I'm going to have to disagree with that statement because it is too general and broad. While I do feel that the hospital trained certificate nurses were quicker to hit the floor running than the "academic" trained nurses, I do not believe that all education is the same. Of course there are some programs that just plain suck but certainly it is one step too far to blatantly provide a blanket statement that today's nurses aren't prepared adequately. I certainly haven't felt that my school didn't prepare me. They trained me thru lectures and clinicals to be function as a new nurse would. The rest just naturally comes from the job and through experience.

Now OP, I'm gonna give you something to reflect upon. Don't berate yourself for not knowing how to do something or for not excelling. You are new, you are there to learn and build your skills. You will have questions and you will certainly be slower than the people who have been doing it longer than you have. That is all okay. Don't get too worked up about it. A side note, while they should be fostering a supportive and educational environment for all new people, some people are just lousy at teaching.

Now comes the critique. Some of the things you mentioned like mislabeling and inputting the wrong vitals. Those aren't due to a lack of knowledge. Those are careless mistakes and you need to be more mindful of them. Pay more attention to details. I can see where some people might get frustrated at your carelessness.

Personally, as someone who has precepted and have had nursing students, I don't mind when they don't know how to do something or have questions. What I do mind is when they're not attentive.

[gigi_rn]

Is there a reason you chose non-hospital jobs? Hospitals generally have much more structured orientation and more resources. Sounds like you've been really alone in both of these positions. Hang in there. You're not a bad nurse. A bad nurse would never ask themselves the question.

[James W.]

I'm going to have to disagree with that statement because it is too general and broad. While I do feel that the hospital trained certificate nurses were quicker to hit the floor running than the "academic" trained nurses, I do not believe that all education is the same. Of course there are some programs that just plain suck but certainly it is one step too far to blatantly provide a blanket statement that today's nurses aren't...

Now comes the critique. Some of the things you mentioned like mislabeling and inputting the wrong vitals. Those aren't due to a lack of knowledge. Those are careless mistakes and you need to be more mindful of them. Pay more attention to details. I can see where some people might get frustrated at your carelessness.

Personally, as someone who has precepted and have had nursing students, I don't mind when they don't know how to do something or have questions. What I do mind is when they're not attentive.

Disagree? Too general? Actually, I gave an overview of my particular experiences..

However, as an academic research paper subject, I reviewed the reasons put

forward for closing vocational nurse training programs in favour of academic

education programs.

One of the claims touted was the presumption of superior skills preparation

leading to higher levels of retention of nurses in career roles.

This has not been borne out in reality.

Certainly some new graduates are better supported to become proficient

in practice, in some settings, but this is not a certain given, esp' when a

'qualified RN' is expected to be 'productive'.

I do agree with your "attention to detail/mindfulness" advice for the OP,

- as a needful thing.

[lavenderskies, BSN]

It sounds like a lot of the signs are pointing to extreme performance anxiety. So embrace it.

Acknowledge it. Mindfully move forward. Slow down. Purposefully choose to not worry about your coworkers opinions. Yup, you know they think you're slow and you are. You won't always be slow. You will learn the groove and pick up speed. The more mindful you are about it the sooner you will be able to do it.

It sucks being awkward. Thinking you don't deserve to be awkward while learning sucks even more so don't think about that. Think about and visualize how you will be.

[TriciaJ, RN]

I think the OP's situation shows up a major failure fairly due to

the academic take-over of registered nurse preparation.

I graduated from a 3 year hospital-based 'nurse training' program,

& years later did a 'modern' academic institution based

'nursing education' program.

As a hospital-based nurse trainee, a fundamental grasp of the

practical basics was required to progress,

& we had to pass 'Hospital Finals' exams which included

demonstrating such practice competencies to a real standard,

which were then certified.

This was a prerequisite step prior to even being

'put forward' - to sit the state final exams,

& a perquisite for being admitted to the register of nurses.

The academic program, by contrast, appeared to pay scant

attention to such actually meaningful matters, & I am certain

that many academic nursing graduates are in fact, as attested to

by the OP, not properly/practically prepared for the regular

daily functions inherent to real life nursing situations.

This is not only a professional-to-patient safety issue, but a

contributory reason for a ( certainly too high) ratio of nursing

graduates having the belated realization - that nursing work

as it is, really isn't for them, & promptly walking away from it.

A sad, expensive & wastefully needless outcome, IMO.

I appreciate the OP having the courage to be actively reflective,

& canvass the views of those experienced in the field here.

An 'Elephant in the Room' topic of nursing today though, huh?

I'm with you. There seem to be a lot of touchy-feely diploma mills out there these days and they are not preparing their graduates for the realities of nursing. Nursing itself seems to have become more brutal with nurses being expected to do more with less and in half the time.

This translates to a huge disconnect between school and the real world. Students who would have been gone by the first Christmas are now graduating and either not passing the boards or not succeeding at their jobs. Even the ones who are actually suited for nursing are at a huge disadvantage from being inadequately prepared.

Schools are ruthless and employers are ruthless and young nurses are being thrown to the wolves. The advice I'd have for anyone contemplating nursing school is to research the school thoroughly before enrolling. For the new grads who are struggling (like the OP): hang in there. Remind your coworkers that you're new and really want to do a good job and ask for help. Most work places have at least one kind soul who will take you under her/his wing.

If the place is so bad that not one person will help you: move on. Be up front with your next employer that you will need a proper orientation to learn the ropes. Good luck!

[TriciaJ, RN]

I have to constantly remind myself to "fake it until I make it" with regards to self confidence. If I go into work with a defeatist attitude, it's going to be a bad shift. Instead I'm upbeat, even if patient's a crazy and the off going nurse apologizes ahead of time for the situation they left me in.

Never forget that nursing and medicine is a team sport and that questions are one of the best ways to prevent errors. Not sure if you're labeling the blood with the right patient name? Ask the patient how to spell the name. Even if it's a common name like Mike. If the patient looks at me like I'm crazy I just say that there are a lot of unique spellings now-a-days. Unsure about vitals? You can always redo them and tell the patient "I think I inverted the numbers". Pick a day and bring in something nice (like coffee or donuts) for the MA's and tell them "thanks" for the help, even if they didn't help that much. Teamwork and medicine and questions. You can NEVER have too many questions.

Great advice!

[BumbleBuddy]

You are not a bad nurse, you're just nervous and new to the job. Everyone makes simple mistakes when they are new and will still make simple mistakes when they've been working for 30 years. Just try to stay calm and slow your brain down a little so your body can catch up! You'll do great once you've settled in to this new position and some of that new job jitters goes away! :)

[srercg]

new nurses really need to get on with a hospital and work some med-surg before they go anywhere else. LTC and doctors offices do not provide much training. The only place you will get really good training as a new nurse is with a teaching hospital. They expect this, they are set up with UP FRONT class room training and a good 6-12 weeks of preceptor training before you are "thrown" into it on your own.

Anywhere else just is not set up for training a new nurse.

Too many places like that expect that you learned all that in school. You learned nursing in school. You learn HOW to be a nurse on the floor.

You have to get "training" - you can't just step into your dream job right out of school. You're going to have to learn the ropes.

[jdub6]

You are a new nurse, but some of these mistakes could be bad for your career and cause bad outcomes.

You are in a workplace with little or no formal education program, no nurse preceptor and experienced nurses to learn from and no other new nurses to learn with. The MAs may be very competant but their role is slightly different. It sounds like you maybe need a structured orientation of at least 6 weeks, in an environment with other nurses with a range if experience and with nurse managers involved and ideally nurse educators.

While i know hospital jobs (which would likely give the best orientation esp if you can get a new grad program) are very difficult to get that would be ideal. Otherwise though any environment that's larger with more structure, more people to learn from and more experience teaching. Dialysis companies have excellent orientations usually since it is such a unique specialty. LTC in general don't though some people can learn there if they have a couple good supervisors willing to help.

Personally i recommend looking for a job with a better orientation. Apply for all hospital jobs and hope something sticks and start looking into things like dialysis. Even if that's not where you want to end up you are looking for an environment where you can safely transition to a professional nurse- you don't have to stay forever just a couple years to get a good foundation. Leaving 2 jobs quickly isn't ideal but you can simply say you are looking for a place to learn from other nurses and need a more skills intensive environment with more available preceptors at this point in your career.