Any words of wisdom for a struggling almost-RN?

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HI all nurses,

I am finishing my final practicum of nursing school, I graduate at the end of May. The thought of graduating was really exciting a couple months ago, but now that I have only a couple shifts left and will be losing my student status I am honest to god terrified!

I am sorry this will be all over the place but I just need to get these thoughts out!

I just got off a night shift and I need to vent badly! I really try to approach my clinical days with a positive attitude but lately the days haven't been going well for me. My mentor emphasizes that I am at the point where I should be doing "everything" as the role of an RN. It boggles my mind how an RN can ever get to the point where she is organized and knows everything about all 8 patients and sound like a total pro when reporting off.

Last nights shift went not so great for me, I felt really behind in everything I was doing. I had planned on assessing 5 of the 9 patients we had but I ended up only assessing 3, while the LPN and other float nurse assessed the rest. I was really hesitant about asking for help b/c I know that I really need the practice to get the hang of assessing at least 4 but being aware of all 8+. There were so many moments during shift that I had to hold back tears and just remind myself that it wasn't a good time to breakdown (to save that for later at least!). One patient was a really agitated, jumpy neuro surg pt that took so much time and energy to get her to take her meds. I would spend at least 10 mins each time just trying to talk her into opening her mouth to take them. In the morning when she was being extra difficult about it, I was stressing about everything I still needed to do and it was all I could do to not burst into tears b/c of how frustrated I was, she was just pulling on my last straw. I felt horrible having those thoughts b/c I am supposed to be the caring nurse at all times but when the stress builds up I really struggle! I feel huge pressure to impress my preceptor b/c she is such a good nurse, every time I ask a stupid question or forget something I feel like I am sinking further and further down in her books. Did I mention I don't even really know how to probably transfer or safely ambulate a patient? (Nope didn't learn this in school, thanks university that was money well spent..) Or that I don't really ever know how to decipher what prn meds to give when I have multiple pain meds/anti-nauseants/sedatives to choose from and all sorts of routes...

To end the shift my report was less than stellar (I never really know what I am supposed to say), I never have time to read progress notes or even look through my patients' histories b/c I am so darn busy the entire shift, running running running I literally don't sit EVER! During report the nurse asked me well has this patient improved? What's the plan for her? ..my answer, "To be honest I'm not sure, I didn't get a chance to read through her chart". The nurse just shrugged and gave me the "thanks for nothing" look. I had a knot at the back of my throat for the entire last hour of shift and as soon as I was in the safety of my car the tears started flowing. I have been feeling so overwhelmed, unorganized, unknowledgable, incompetent, & STUPID for the last couple sets and tonight I reached my breaking point. During shift I kept thinking "I hate nursing..", I don't really believe I hate "nursing". I just hate knowing that I am struggling when I am used to being such an over-achiever is all other aspects of my life. In nursing school I have achieved top marks all 4 years, but it seems as though that doesn't help me in real-life nursing. Leaving shift feeling frustrated and torn apart inside every day is really taking a negative toll on my self-esteem. Graduation is supposed to be exciting. I feel like a total fraud saying I will be a registered nurse, because I don't feel that way at all!

It's just so frustrating that 4 years later I feel like I am barely prepared to begin caring for 8+ patients on a daily basis.

Thanks for taking the time to read my vent sesh. If you are a new graduate who at some point felt similar to how I am feeling please speak up and let me know if things "really do get better" like the nurses keep telling me (although there is no way I can imagine how things can improve right now). Even experienced nurses, you were students once too..do you remember ever feeling the way I do? What can I do to help myself feel more confident that things will get better?

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

the first year out of school stinks. you are overwhelmed but it does get better. i remember the sinking feeling when patient was in trouble with chest pain and i realized that i was the nurse. i remember vividly crying in my car on the way home never thinking i'd ever "get it". wanting to quit more times than i could count. :hug: it will get better. there is a forum first year after graduation. first year after nursing licensure for nurses | nursing students we're here for you to vent and blow off steam.

take a look at these brain sheets you may find one to help

doc.gif mtp med surg.doc doc.gif 1 patient float.doc‎

doc.gif 5 pt. shift.doc‎

doc.gif final graduate shift report.doc‎

doc.gif horshiftsheet.doc‎

doc.gif report sheet.doc‎

doc.gif day sheet 2 doc.doc

‎critical thinking flow sheet for nursing students

student clinical report sheet for one patient

i made some for nursing students and some other an members (daytonite)have made these for others.....adapt them way you want. i hope they help

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Specializes in Pedi.

I precepted a last semester nursing student last fall and, honestly, I think it's kind of unrealistic to expect a student to be able to handle a full assignment on their own by the end of the semester. My student had to complete 120 hrs... which is equivalent to 3 weeks of full-time work. No new grad is fully competent after 3 weeks on the floor.

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Specializes in Gerontological, cardiac, med-surg, peds.
I precepted a last semester nursing student last fall and, honestly, I think it's kind of unrealistic to expect a student to be able to handle a full assignment on their own by the end of the semester. My student had to complete 120 hrs... which is equivalent to 3 weeks of full-time work. No new grad is fully competent after 3 weeks on the floor.

I 100% agree. It takes most new grads ~ 1 year after graduation to competently be able to take care of 8 patients on a busy med-surg floor. A good percentage of these med-surg patients are so sick, that they would have been in an ICU or step-down unit just 5 or 10 years ago.

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wow Esme, thank you!!! Brilliant Stuff!!!!

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
wow Esme, thank you!!! Brilliant Stuff!!!!

You're welcome!

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Im not a grad but i am grad next month and I no exzactly what you mean!!! I just finished my last day of preceptorship Fri and I still was not comfortable. First off I want to say that it is not true that we should be assuming the role of the RN at this point. Yes we are seniors but we are not pros. Our preceptor should be teaching us and being with us not sending us off. Now my mentor did begin to let me do stuff alone but at anytime I felt uncomfortable i asked her questions. Secondly i recommend a report sheet. you can search them on google. I had them at report and still did less than stellar jobs at it! We are students and learning I dont care if we are seniors or not! this is the time to learn as much as possible not do the RNs job. I felt exactly the same way you did, but I began to pray each time before I entered my unit. That helped me. I also was very honest with my nurse and told her what I was very uncomfortable with. I hope it gets better:)

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Specializes in GYN/GON/Med-Surg/Oncology/Tele.

I too think it's ridiculous for a SN, let alone a new grad Nurse to have to take on 8+ patients! Our maximum at my hospital is 6 and the Nurses on my unit rarely ever have 5 patients! Heck one night there were 5 Nurses for 15 patients! Like others have said, the Preceptor should teach and guide you in the right direction, not expect you to know everything there is to know about Nursing and be competent enough to handle a full patient load by yourself! Even once you graduate from school and start working as a RN you're giving months of training under the supervision of a Preceptor! I'm sure you'll make a great Nurse...don't let a few bad experiences prevent you from being confident in your level of competence!

Good luck!!!

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Glovedgoddess...I too am in ur current situation so I totally understand where u are coming from ...I too graduate next month ...

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There were so many moments during shift that I had to hold back tears and just remind myself that it wasn't a good time to breakdown (to save that for later at least!)..... I felt horrible having those thoughts b/c I am supposed to be the caring nurse at all times but when the stress builds up I really struggle! I feel huge pressure to impress my preceptor b/c she is such a good nurse, every time I ask a stupid question or forget something I feel like I am sinking further and further down in her books....as I was in the safety of my car the tears started flowing. I have been feeling so overwhelmed, unorganized, unknowledgable, incompetent, & STUPID for the last couple sets and tonight I reached my breaking point...I just hate knowing that I am struggling when I am used to being such an over-achiever is all other aspects of my life. In nursing school I have achieved top marks all 4 years, but it seems as though that doesn't help me in real-life nursing......Leaving shift feeling frustrated and torn apart inside every day is really taking a negative toll on my self-esteem. Graduation is supposed to be exciting. I feel like a total fraud saying I will be a registered nurse, because I don't feel that way at all!....It's just so frustrating that 4 years later I feel like I am barely prepared to begin caring for 8+ patients on a daily basis.

Well, well well, glovegoddes, I hope you have had plenty of time to wallow in your self pity and self indulgence. It's obvious to me, not only from your current position; days away from graduation, but also the drive you have, that you are exactly where you are suppose to be. After the never ending tear drops from female nursing students, I can only hope you will be strong, confident and lay claim to your position. Honestly, I'm a patient who is not feeling well, and I don't give a crap about your "over achievement" in your nursing school. I am sick and I don't care to see your tears; I need you to be the well trained compassionate nurse I know you are, and help me! Carry yourself with appropriate, deserved confidence. Glovegoddes, the world is waiting on you, to get out there and join the nurse corp. they need us now. These LPN's or RN's who feed into your doubt and submissive posture, are playing silly games with you. Especially if you are young and pretty. Nature of the beast. Time to stop feeling sorry for yourself and get tough, no tears, just results, the world is waiting on you (us)....

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it's not about you, really. once you get that, the rest is easier. not being mean here, just the truth.

you'll get better at time management and report (and esme has given you some good resources) in time. but stop with the self-pity, really. as my grandmother would say, "it's so unbecoming."

another way to put it i've seen is, "put on your big girl panties and deal with it."

last, what worked for me, was that i looked around at all the other nurses doing it and i realized that i could, too, no real reason not to.

you've had your chance to vent, so now you can get on with it. in a year you'll look back and laugh. good luck to you! :hug:

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It's not about you, really. Once you get that, the rest is easier. Not being mean here, just the truth.

You'll get better at time management and report (and Esme has given you some good resources) in time. But stop with the self-pity, really. As my grandmother would say, "It's so unbecoming."

Another way to put it I've seen is, "Put on your big girl panties and deal with it."

Last, what worked for me, was that I looked around at all the other nurses doing it and I realized that I could, too, no real reason not to.

You've had your chance to vent, so now you can get on with it. In a year you'll look back and laugh. Good luck to you! :hug:

Bravo GMTEA!!! Great advise, obviously great nurse as well!! Thanks

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