Am I doing the right thing? New nurse getting butt kicked

Nurses New Nurse

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I am a new male RN, BSN. I graduated in August of '12 and started at my job on a neurology/med-surg unit. I never really wanted to do med-surg, but many nurses told me that it is a great place to start because you can hone your time management skills, prioritization, and whatnot. Where do I ultimately want to end up? I have no clue. I don't know what the end game is.

Anyway, as many new nurses have stated on this forum, I am truly miserable. I work nights because the pace is generally slower than days (our floor is extremely busy), and I care for between four to five patients (less than other med-surg floors in other hospitals in our city, but often higher acuity than what they see, I'm told).

I just feel constantly behind. It takes me forever to chart, to see all of my patients, and give a comprehensive report to day shift. I feel sick on the drive to work, and suffer 'GI distress' once there. At work I feel constantly on edge and snap at co-workers (definitely not a good thing). I just feel like I should be better at this job than I am. I feel like I should be more confident and comfortable. I know I should be grateful to even have this job, but I truly resent it. Am I expecting to much at this point? Is year one of nursing truly just this gauntlet of misery? (Sorry for getting emo there!)

I opted for med-surg post graduation. Was this a wise choice? Are there other areas in which a newer grad could also do well in? What are they? I have never left a job in less than one year of service, but this one has gotten me thinking that perhaps I should.

Ultimately, even if no one responds to this post, I'm happy that this forum exists so I can at least vent.

Thanks!

Specializes in Float Pool-Med-Surg, Telemetry, IMCU.

Hey there,

I am a relatively new med-surg nurse myself (1 1/2 years experience, counting my residency). My first year was HORRIBLE despite having had experience as a CNA in the hospital and as a home health aide in an AFH.

I used to throw up before work.

I used to cry after work.

I would get out late every single day.

I fantasized about leaving the field of nursing to become an apprentice chocolatier. :cat:

And then...I don't know what happened. Something clicked. I stopped stressing out and spinning my wheels. I realized that no one is going to die if I can't fulfill every single patient request immediately. I prioritize the important things (pain, nausea, bathroom) and everyone else can wait! I learned there are diplomatic ways to communicate with patients so that they understand that you are doing the best you can. Example: "Sure Mrs Jones, I will get you some ice just as soon as I finish a procedure in another room. Thanks for your patience." or "I will be happy to discharge you just as soon as I get my new patient settled, can you give me 15 minutes?". Most people are pretty reasonable and those that aren't, well...too bad. You just can't take it on when you know you are doing your best.

I still have awful days but it's a lot better now. I hope in time you will have a similar experience....the work may not get better but you will learn better ways to cope. Hang in there.

(And as for snapping at coworkers, it's become a running joke on my unit that I need to eat throughout the day or else I get super cranky. I have a hummingbird metabolism, I can't help it. Just laugh at yourself and your coworkers will forgive you your short temper.):roflmao:

Yep, I remember those nights. It does get better!

Once a more experienced nurse, sensing I was having a particular rough shift, told me that when those nights happen to always remember that by morning you will be a better nurse then you were when you started your shift. I found that to be true, and still have to tell myself that sometimes.

I am 1 1/2 years out of school. I worked my first year in a med-surg float pool, but as of July, have been in SICU. I can definitely identify with having been extremely nervous before work for the first few months, and even after that if I knew I'd be floating to certain floors where acuity tended to be higher. Then, when I moved to the ICU, I might as well have been a new grad all over again. I'm actually just beginning to feel confident enough going into SICU at night without the nervousness that the OP speaks of. And it still hits me when I know we have CABG's on the schedule that day.

Let me tell you though--it is like lifting weights. I use this example because it is a hobby of mine. You could say the same about running or anything else. Progressive overload. At first, benching 120 lbs was tough for me. But as more weight is added, the body adapts to lift more. I feel like the brain does the same thing. The more we learn and the more experiences we have, the more comfortable we feel. Sometimes, the worst experiences are the best because when you make it through a terrible shift, you realize... "Wow, I survived," and then the average nights suddenly seem a little bit easier.

In the SICU, we had a bad 3 or 4 weeks where it seemed like every night, the worst was happening. Deaths, codes, etc. As a med surg nurse, I had only dealt with a rapid response once the entire year. I definitely wasn't ready for this. I was getting terrified to go to work. I questioned whether I could truly cut it in the ICU. But finally, things slowed down and the average nights were no longer scary at all. And the average situation that I would have found stressful before now seemed manageable next to that horrible month.

So when you have the bad nights, just realize they teach you, and while you can't help but be stressed,make sure you learn from them and let them be confidence builders. And go where you want to work. This "You must work med surg for a year or so before going anywhere else" is a load of crap. I did it and still felt I was no more experienced jumping to the SICU than a few of my colleagues who were new grads. Disclaimer: Just make sure whatever you do, you get a decent orientation and have a good support system among other nurses.

Specializes in Neuro, Med-surg..

JottRN, thanks for this post. It makes a lot of sense. I've noticed too that surviving crappy nights makes the more mundane nights easier to work through.

Specializes in ccu, med surg, ltc, home health.

I have been nursing 7 yrs. in med surg i have found that you take report, brush up on meds (which will tell you a lot about the pt's history), labs, then go see pt's. HaVING a good report sheet to right on is essential and sticky notes for reminders are good also. Just keep on hanging on

Specializes in Med/surg, ER/ED,rehab ,nursing home.

I was dropped into ER after I had oriented to med/surg in a small hospital. Our ER had a house RN, and two LPN's plus a doctor. Talk about GI issues....I truly did not know what the heck was going on. My coworker had been there two weeks. My first patient that night was a young man who had severed his brachial artery. I placed a blood pressure cuff on that arm, pumped it up till the bleeding stopped. Talk about a blood loss! The doctor came in to take a look, and said he wanted the blood pressure cuff deflated for so many minutes, etc. As he was walking out of the room I said if you want that done, do it yourself. This really shocked the other nurse. And me too, as I do not speak up much at all. The doctor deflated the cuff, blood resumed spurting, and he could not get it inflated again fast enough. Did I plan to do any of this, no. It just was instinct. This young man did make it to the big city hospital 2 hrs away, and had a vascular surgeon do the repair. He did not lose his arm. Even though I enjoyed mentally working the ER, Just thinking about working made me sick. Headache, stomach, bowels. I would not exchange that experience for anything. When I moved out of state, I applied for an ER job. First question asked of me was "where was my certification". It was on the job training for sure. No guidence by anyone. This small hospital had trained all of their OR staff and the like. Just nurses and doctors had licenses.

The last hospital I worked in had computers in every patient room, so you could chart the assessment while in there. Also meds were scanned and armbands scanned. I would say I got spoiled with all of the nice time savers we had. Some nurses still overcharted. We were to chart by exception. If what was covered in the nurse assessment form fit what you saw, you just clicked on it. Only abnormal stuff was charted extra. The electronic form gave guidence through all of this. I feel that you will do fine once you step back and chill a bit. It is all overwhelming. School does not give you the experience you need. I worked for agencys for a few years. That experience proved to me that I could be orginazed and get my job done. My reward for this was that the hospitals would ask for me to be put on assignment there. They knew my work. Good Luck

Specializes in Wilderness Medicine, ICU, Adult Ed..

After a year and a half on the floor I transferred to surgical ICU, which had been my goal. I thought that I knew nursing. Ha! I didn't know half of what I needed to. Some of the staff hated me, but there were always one or two colleagues who understood, and were willing to help. They got me through.

However, I still had a problem. I showed up every night scared. I would take report, go to my patients and assess them. And brother, were they in bad shape. Many where near death. I got more scared. I thought, "Good grief! This patient needs a GOOD nurse, not me!" I soldered on, but in a constant state of fear.

One night, something strange happened. My shift started as described above, with me scared, as always, when out of nowhere, this thought came into my head: "County, it is true that you are not the best nurse, you probably never will be, but you can be the best Nurse CountyRat in the world. Focus on doing that, and that will be enough."

I know it sounds crazy, but after that, I was calmer, and, I think, a much better nurse. I don't know why, I just was. I never felt casual or carefree at work (nor do I think that I should have), but I became a better nurse.

Do what you need to do to feel O.K. with your job, but please, don’t give up on nursing.

Translated to mean: "We had to start out in med/surg and be completely miserable and so should you!!!

.

Mission accomplished!!

I debated whether or not I should start out in med/surg because I felt that pressure from other nurses, but I decided to go to work where I wanted to work instead. I LOVE my job and I feel lucky every time I read a post like yours. When nursing students ask you if they should start out in med/surg....tell them NO! :)

"No" is not the right answer. You should never tell someone what they should do. Instead, provide guidance on how to make the correct decision for himself. Med/surg is not the wrong decision for everyone, just like LTC is not the wrong decision for everyone. As for the OP specifically, he stated that he didn't know where he wanted to work, so med/surg was as good a place for him to start as any.

OP...I've been an RN for almost 6 years; the last 3.5 spent in the ED. Even though I'd been a nurse for a couple of years already, it took me a full year in the ED to start to feel like I knew what I was doing and to feel comfortable with my time management.

In July of last year, I transferred to a different hospital, still in the ED. I expected to need some time to get used to a different system, but I didn't expect it to be so hard or take so long. It's been 6 months now and I'm starting to feel like I have things under control...most of the time anyway. :)

All that is to say that you need to give yourself at least a year to feel like things are really falling into place. Maybe it will happen sooner, but don't feel like it should.

Since you don't really know what your "end game" is right now, give yourself that year to decide if you want to try some other area of nursing. Right now you can't know if med/surg is for you or not because you don't have enough experience. If you let your frustration cause you to give up on it now, you will just end up job-hopping because you will experience some of that same frustration initially in any unit you go to until you realize that it is normal and part of the process you must go through.

Specializes in Neuro, Med-surg..
After a year and a half on the floor I transferred to surgical ICU, which had been my goal. I thought that I knew nursing. Ha! I didn't know half of what I needed to. Some of the staff hated me, but there were always one or two colleagues who understood, and were willing to help. They got me through.

However, I still had a problem. I showed up every night scared. I would take report, go to my patients and assess them. And brother, were they in bad shape. Many where near death. I got more scared. I thought, "Good grief! This patient needs a GOOD nurse, not me!" I soldered on, but in a constant state of fear.

One night, something strange happened. My shift started as described above, with me scared, as always, when out of nowhere, this thought came into my head: "County, it is true that you are not the best nurse, you probably never will be, but you can be the best Nurse CountyRat in the world. Focus on doing that, and that will be enough."

I know it sounds crazy, but after that, I was calmer, and, I think, a much better nurse. I don't know why, I just was. I never felt casual or carefree at work (nor do I think that I should have), but I became a better nurse.

Do what you need to do to feel O.K. with your job, but please, don’t give up on nursing.

I really appreciate you sharing this. Sometimes, I think I'm setting unrealistic standards on myself that sort of set me up to fail (or at least make my life more difficult on the floor than need be). I want to know everything RIGHT NOW do that I no longer am the rookie, but logically I know I nor anybody else will likely know everything there is to know in this field. And I should likely work on not comparing myself to others do much and focus on my own personal development.

Thanks, County!

Specializes in Neuro, Med-surg..

GM2RN:

Thanks for this. I had wondered if a profound learning curve would apply to each area of nursing like it has to my initial job. I agree that telling a person they should not start in a particular area is counterproductive. That may be the field they would have excelled in!

Specializes in Wilderness Medicine, ICU, Adult Ed..
GM2RN:

I had wondered if a profound learning curve would apply to each area of nursing like it has to my initial job.

Starting out as a practicing nurse involves a HUGE learning curve, and, while 1 year seems like a long time, it is often barely enough time to get off the runway. And, while the learning curve does get flatter with experience, it will challenge you throughout your career.

But that is true of any work that is important. Becoming a nurse is very hard, but that is the price that we decided to pay because we wanted to do work that mattered, work that gave us a chance to do more, and be more, than we had been before. The same is true for any profession that is important to others. If nursing was only a skilled trade, it would be easier, but that is not the path that we chose. It is hard to be a nurse, harder to be a good one. The day that you think that you have mastered nursing is the day you need to start thinking about a career change.

Specializes in Public Health Nurse.
You stated you took a job in a unit you had little or no interest in. For me personally that would be a major stressor on the job. I have no interest in L&D and a great interest in ICU or ED. I feel I would be much more successful in a unit I desire to work in rather than one I know from the start I have little interest in.

While I agree with HM on this, the reality is that as new graduates we can no longer be picky where we want to work as is is challenging to get that first job. I personally do not want to work Med-Surge, but I have yet to find a job since passing my board in August, and at this point after submitting so many applications I will consider any unit to get my foot in the door.

I found the brainsheets after reading another post, and I have since saved them to see which one will work best for me.

I too worry about time management, I always had an issue with that, and of being too hard on myself when making mistakes.

To the OP, hang in there, the consensus is that it gets better after a year.

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