Any advice for anxious and socially awkward new nurses?

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Any advice for anxious and socially awkward new nurses?

I'm a brand new nurse. I'm on week 6 of my 8 week orientation on a cardiac tele floor. I admit, I am a slow and visual learner. It might take more than 5 times for me to understand it about the same things. My preceptor gives me 4-5 patients to take care of on my own. Of course, she's there when I have questions. But otherwise, she lets me do most things like giving meds and calling doctors. I have high anxiety, am shy, and get nervous. 

Morning rounds stress me out because I hate public speaking. These rounds are so formal because we go into an empty room. I've seen rounds during clinicals where nurses just stand and round, quick 1 minute. My preceptor is with me and she chimes in when I'm missing something but to do it every single time stresses me out. I feel like I am too slow at learning, some days I get it and some days I don't. I'm not even using critical thinking skills. At this point, I'm only task- oriented, trying to complete giving meds and orders or finishing assessments.

I can tell my preceptor is annoyed with me. She says I'm doing great. But she also asks me if this is my last week with her and if I am going to nights to orient on nights. Like she's trying to get rid of me. I will have a different preceptor because my preceptor is going away on vacation and learning with a new preceptor stresses me out too. Any words of advice.

18 Answers

Specializes in psych.

Being new to anything can be tough, nursing is no different. You will hopefully be able to calm yourself easily as time passes.

You probably feel so alone right now but the sentiments you are sharing felt true for probably 95% of us as new RNs (minus being shy/quiet, but most of us are intimidating speaking to the docs as new grads).  

Being task oriented in the beginning is completely normal; critical thinking will become easier over time especially when the tasks start to become second nature and your experience with different clinical scenarios grows.

Your preceptor might not be coming from bad intentions when she asks if it's your last week with her. What proof do you have of that when you admit she tells you you're doing great? Even if she is annoyed, which very well may not be, it's not your fault that it takes a lot of time and effort to train a new grad. It's expected that training a brand new nurse is a lot of work and it's completely expected. 

I was a brand new RN just less 2 years ago and felt like a massive burden to my preceptor, and now I am actually precepting and while it's hard work, I don't think negatively of my new grad preceptees. Can it realistically be frustrating at times? Yes, yes it can. But new grads deserve so much grace because we were all one at some point!

Give yourself some grace. You will amaze yourself how far you'll have come in 6-months, 1-year, and 2-years. I am finding myself less stressed out than ever before just because stuff is finally starting to fully click and I give myself a chance to notice my progress. 

If you have graduated from nursing school and passed NCLEX, you are not slow at learning. You are only six weeks in on a complicated unit.  I had a six week course, in order to START interpreting telemetry.  Most people are afraid of public speaking. Hopefully you will not have those rounds at night

Don't be so hard on yourself and give it some time.

Specializes in OB.

I agree with BTDT, everything you're describing is super normal for a new nurse, particularly on a unit as complex as cardiac/tele.  I doubt your preceptor is trying to get rid of you!  Don't be so hard on yourself.  It takes a good year or two to feel competent.

Specializes in Oncology, ID, Hepatology, Occy Health.

Another in agreement here with Been There Done That. You will gain confidence as time goes on. 

Use the round to ask about things you don't know. They are supposed to be an EXCHANGE of information, and you will appear motivated and interested for asking. 

I was very shy when I started out. These days I can't keep it shut.

Good luck.

Specializes in Tele, ICU, Staff Development.

When learning, it's completely natural to be task-oriented. Like a child learning to tie their shoelaces for the first time, you must be focused and deliberate to be a safe practitioner.

Review everything you've learned in the last six weeks to see how far you've come. Starting an IV, passing meds on five patients, entering orders, and more.

A student nurse watching you would probably be in awe. It's all relative. Be kinder to yourself. Lots of love ?

 

Starting off, you're going to be task oriented as you begin to integrate everything you've learned into practice. It's like driving: after you've been doing it for a while, everything becomes second nature - buckling up, signaling, maintaining speed, anticipating other drivers' moves...you'll get it if you stay the course. I know it's hard to fathom now but you have to believe in yourself and you'll get there. Consider making a custom brain sheet in your spare time that you can bring to work so you can note all of the important things to report during hand-off. Lastly, I just finished up orientation in the OR; I've been coming into work about 15 minutes early just so I can get my tasks started ahead of schedule since I'm taking so long. I'm not allowed to clock in early, so I'm doing this using my own time, which I don't mind because I'm so determined to succeed in this new role.

Specializes in NICU.
Sweetme2 said:

I can tell my preceptor is annoyed with me. She says I'm doing great. But she also asks me if this is my last week with her and if I am going to nights to orient on nights. Like she's trying to get rid of me.

Precepting takes us out of our normal groove. When we are precepting, we need to take time to teach you, allow you to slowly take on more and more responsibilities, check your charting, and constantly gauge your progress. We are responsible for your progress. When you are on night shift, your preceptor can resume their assignment at their pace instead of yours. It doesn't matter if you are the fastest learner or slowest learner, it is more work to be a preceptor.

Specializes in Justice ⚖️ Nursing.

I'm pretty sure preceptor sign up for that, so you'd think they would have the patience. My preceptor was a jerk, and many share that sentiment so I wouldn't worry about that too much. All that anxiety and shyness will melt away before you know it. Don't worry! 

Rocketskates said:

. I know it's hard to fathom now but you have to believe in yourself and you'll get there. Consider making a custom brain sheet in your spare time that you can bring to work so you can note all of the important things to report during hand-off. Lastly, I just finished up orientation in the OR; I've been coming into work about 15 minutes early just so I can get my tasks started ahead of schedule since I'm taking so long. I'm not allowed to clock in early, so I'm doing this using my own time, which I don't mind because I'm so determined to succeed in this new role.

Love this advice. I also made my own custom brain and it helps me a LOT! Especially so when I was brand new. I also arrive a minimum of 15 mins early, normally closer to 25, to prepare. My shifts go way smoother when I do. I have time to read orders, labs, and H&Ps so I'm not relying on the nurse "telephone" game in report, which often misses or innocently misrepresents things.  

NICU Guy said:

Precepting takes us out of our normal groove. When we are precepting, we need to take time to teach you, allow you to slowly take on more and more responsibilities, check your charting, and constantly gauge your progress. We are responsible for your progress. When you are on night shift, your preceptor can resume their assignment at their pace instead of yours. It doesn't matter if you are the fastest learner or slowest learner, it is more work to be a preceptor.

Agree with this.  It also takes time away from patient care to some degree, since every task takes longer and delays moving on to the next.  Never mind the additional time spent at the nurses station explaining things.  This makes time management while precepting very challenging, even for a nurse who loves to teach.  And sadly, many preceptors don't.  They are often assigned an orientee whether they want one or not.  So don't take it personally if your preceptor seems agitated.   
 

Talking with patients gets better over time.   Until it does I'd work on some go-to conversation starters (hint: sports for men, children for women).  Also try to chat while you work (except when doing thinks like med admin that require full concentration).  This makes you seem approachable and they will be more comfortable.   If you aren't talking to them much it may you seem unapproachable, which leads to awkward silence.  
 

As to talking in front of groups like in your rounds, try to reframe how you think of it.  Instead of thinking of it like a performance you might mess up, think of it like an opportunity to prove you know your stuff!  Sounds silly but worked for me and when I struggled with this.  
 

Good luck starting your career.  This is all normal for a new grad and does improve over time.  Hang in there, it will get better!  

Specializes in Psych/Ortho-neuro rehab.

What do you do well? Shine at that.  Is there another nurse that you could help with what you are good at? Set up a buddy system to help each other out. Reach out, give, receive. 

 

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