Any new nurses out there that feel NERVOUS?

Daytonite, BSN, RN · Aug 20, 2005

Hi, Nicole Congratulations on getting over your first big hurdle--nursing school! :chuckle Welcome to Phase 2, on the job experience. The truth is that getting through nursing school was only the beginning of your education. All new grads have the same concerns and fears as you.

I was a nurse manager in a large city hospital that had a wonderful orientation program for new grad RNs. Believe me, the nurse educators know that you haven't had all the experiences you've mentioned. This is not an unusual thing, and you are in the same boat as every other new grad around the country. I wouldn't be concerned about your age and any stereotyping. Most people are going to judge you on your attitude, willingness to learn, and how you are dealing with your situation.

You are now an employee. As a paid employee you are going to be expected to perform your job. What you are obligated to do for the hospital and the patients is to review a procedure (if you're not sure of all the steps) before you perform it. Observing was something you did in school. You won't always have the luxury of observing as an employee. I am sure the educators have been showing you excerpts from the nursing procedure and policy book. They review those kinds of things in orientation because they come up a lot on the nursing units and they want you to know that there is a specific policy and procedure the hospital wants you to follow with regard to them. Often, you can't take the time to pull open the P&P manual and consult it during a busy shift. (However, you can always do it on your own time if you are so inclined.) Review a specific procedure with your preceptor or another nurse, and then do it. It will serve you absolutely no benefit at all to put things off. You will never learn that way. Think of yourself as being thrown into the water. It's sink or swim time. Our nurse recruiter specifically asked the nursing instructors of the new grads she hired what a student's attitude was toward performing procedures for the first time. :chair: She also asked if the student put off performing procedures or waited to be the last one in the group to demonstrate a procedure back to the instructor. After you've finished a procedure review your performance and decide if there is another way to do it that would be better. You are going to find that a difference in the way you hold an IV catheter before you stick the patient may make all the difference in the world to you personally. It takes many, many times of performing procedures before you feel confident in doing them. Some procedures will take longer to master than others. (It took me 6 months before I finally starting feeling like I knew what I was doing with IV insertions.

It's OK to tell your preceptor that you feel nervous because you've never done a certain procedure before, but don't repeat it ad nauseum). Tell her that you went over the procedure and are ready to give it a go. Another thing you can do is just tell your preceptor, "OK. Let me go through the steps of changing this colostomy bag with you before I go in the room to do it." Positive attitude, face your fears. These are two good attributes for any new RN.

An oncology floor will have patients with a lot of medical problems going on, so you are going to see a lot. There will probably be a lot of IVs and chemotherapy. Make sure you know where a nursing drug reference is on the unit. Don't give any medication you don't know until you have looked it up to get the basic run down on it. If you don't understand why a particular medication was ordered for a patient, question it. If you decide to take your own drug book with you make sure it is clearly marked with your name and keep an eye on it anyway so it doesn't "walk away". Just like the nursing drug reference, there is also an IV drug reference for nurses that will give you information on IV pushes, how fast, and what solutions they are not compatible with. I would assume that if you stay on this oncology unit any length of time that the hospital will put you into a special class for oncology nursing and administration of chemotherapy. Ask about this because the chemo drugs are very specific to cancer patients. By being cautious and double-checking your meds, your preceptor and co-workers will see another good attribute--caution.

Insofar as nurses eating their young. . .I hope you find that the other RNs are helpful. If you notice one being particularly nasty, just stay away from her if you can. If you find one who is willing to help you out, hang onto her and remember to thank her and tell her how grateful you are for all her help. The eaters of the young have their own little problems and agendas going and they really have nothing to do with you. Nurses who have tantrums while failing to see someone who is struggling with learning and getting acclimated to being an RN should be ashamed of themselves because they were in your position once themselves. And, if you have enough chutzpah (guts) you should tell them that to their face after they've had their little hissy fit. Practice it when you're alone a couple of times so you'll be ready to blurt it out if it ever happens. Better yet, just say "sorry I asked" and walk away in the middle of their outburst--it will tick them off immensely. These people thrive on having an audience to perform to. Don't give them one.

I would also like to advise you to keep all your textbooks and notes from school handy. You are going to find it very helpful to read through some of that material again and again when you get home from work to help you get a better understanding of the disease process going on in your oncology patients. You will have actual, live patients to use as examples to compare with what your textbooks say about very specific diseases. The more you understand, the more confident you will be.

The time it takes for you to feel like you know what you're doing on the job varies. As an experienced nurse (30 years) it takes me about 3+ months to get acclimated to a new job on a nursing unit. As a new grad I would expect you to take longer. I am sorry to say that you may have some days when you will be glad to be getting into your car and going home so you can have a good cry. :cry: These days come with less frequency as time goes on. You will also have days when you feel like you've just jumped over the moon and won the grand prize. Just remember to do your self-analysis and you will always improving.

Good luck to you. Dazzle them with your intelligence and common sense.

christvs, DNP, RN, NP · Aug 21, 2005

Nicole-yep I was nervous when I started as a new RN one month ago at my med/surg/tele job. I still get nervous now but feel much better about things since I've had some practice. We have a drug reference & a separate IV drug reference guide in our med room at work-so whenever I'm about to give a med or IV push med that I'm not familiar with, I make sure I look it up to see what it's for & how slowly I should push it, etc. It makes life much easier for me! :) As for doing new procedures, on my unit-the nurses are really great cuz they let me observe something once & then the second time I do it but they walk me through the steps-like this happened with a bladder challenge the other day-I watched one time, & the next patient who needed one-I got to do it-with my preceptor walking me though it. Hopefully you'll get the same support with things you've never done before. :)

-Christine

NurseNicoleRN · Aug 22, 2005

Nicole-yep I was nervous when I started as a new RN one month ago at my med/surg/tele job. I still get nervous now but feel much better about things since I've had some practice. We have a drug reference & a separate IV drug reference guide in our med room at work-so whenever I'm about to give a med or IV push med that I'm not familiar with, I make sure I look it up to see what it's for & how slowly I should push it, etc. It makes life much easier for me! :) As for doing new procedures, on my unit-the nurses are really great cuz they let me observe something once & then the second time I do it but they walk me through the steps-like this happened with a bladder challenge the other day-I watched one time, & the next patient who needed one-I got to do it-with my preceptor walking me though it. Hopefully you'll get the same support with things you've never done before. :)
-Christine

The nurses were great! i started on the floor today and my preceptor was awesome. she let me do everything but helped me too. i drew blood, pushed iv meds, changed a port dressing and accessed it worked with the new pumps and omnicells, charted, i did everything and i feel great about it i learned alot!!!!! im not nervouse anymore everyone is sooo nice and willing to help it was great. if you have any experiences with orienting feel free to post