Burned out after only 3 weeks.

[pullingallnighter]

I'm feeling very depressed. I was able to get a job on a general medicine floor at a large teaching hospital and I was very grateful to have a job since I've heard it can be tough for new grads right now.

But it's been very rough. My new grad orientation consisted of two days of hospital orientation followed by five shifts of unit orientation. After that, I was on my own. I was juggling 4-5 patients with only 5 orientation shifts under my belt. I was titrating heparin drips, ordering PTT labs, passing meds, taking admissions, doing wound dressings, and a whole slew of tasks that I feel woefully unprepared for. Most days I don't eat lunch. There are no secretaries on my unit and call lights are hooked up directly to the nurse's phone so I'm constantly getting calls as I running around like a mad woman.

The end result is that I already feel burned out and it's only been my second week alone. I worked as a nurse's aid for two years at a different hospital and thought nursing was my calling, but now that I'm at this new hospital, I just hate it so much. I spend my off days depressed and anxious about the next shift. It's frustrating because I received a longer orientation as a nurse's aid than as a nurse.

I don't know what I got myself into. I keep fantasizing about leaving nursing all together and doing something else with my life that's less stressful, gives me the ability to sit down for 30 minutes to eat, and let's me have enough time to drink and go to the bathroom. Thanks for reading my vent.

Depressed New Grad

[Mommy&RN, BSN, RN]

5 shifts of preceptorship is outrageous! Even an experienced RN that comes to the hospital get loner orientation.

[Sun0408, ASN, RN]

The orientation you received is your downfall or shall I say their downfall.. That is outrageous to think you can take a new grad, give 5 shifts and expect them to perform, be happy, stay and another other word you want to add..I rarely say start looking for a new job but if the hospital thinks this little of you, your pts etc.. It is what I would do.

New grads often feel very overwhelmed, stressed, cry, feel less than just because they are new and learning the ropes but those new grads also received 4-8 weeks orientation.. So some of what you are feeling is "normal". Your lack of orientation is the main issue. After 5 shifts, you hardly know where the supply room is. If you decide to look elsewhere, ask what the standard orientation time is.. If its less than 4-6 weeks, keep moving on if possible.. 6 weeks is a good start for new grads.

Of course no amount of orientation will get you feeling like you did everything right, you didn't miss something, or mess up but it does give you more time to develop as a nurse. I wish you the best and keep us posted.

[julz68]

Wow! I agree with the PPs...you surely didn't get nearly enough orientation. That's just ridiculous IMO. I had 6 weeks and still feel overwhelmed at times. Only been on my own for one week now. My advice is to not give it all up tho...you worked too hard to get your license to throw it all away. I would, however, start looking for a new position elsewhere in the meantime. Perhaps you could get on at your previous hospital? I can't even begin to imagine how stressed you must be...and here I thought I was stressed out after only 6 weeks! I've read on here that some new grads get 8-12 weeks orientation so I was kind of jealous of that. I am doing OK with just 6 weeks but I still feel overwhelmed at times...like last night when I had a confused/ combative pt setting their bed alarm off every 2 minutes while trying to take care of 4 others.

I really feel for you. Hope you can find something better that offers more support for new grads. Good luck!

[NRS86]

I feel the same way! and I've had a longer orientation too, so I can't imagine being thrown out on my own like that. I'm also depressed and anxious and question whether or not to quit. I'm not sure if its the floor I'm on or if it is nursing in general. Is this normal!!?? I can't live like this for too much longer

[HouTx, BSN, MSN, EdD]

PPs all make very solid points - good advice.

The no-unit-secretary thing is just awful; what a mess! I can see how doing the 'call bell boogie' would consume a lot of your energy. The "hourly rounding" technique has been shown to actually reduce frequency of call lights. Optimize your time in each room by anticipating any 'hotel' or comfort services. For example when you are giving a prn med- if the patient is a coffee drinker, swing by the pot and bring a fresh cup with you when you go to his room. Look around the room and take care of anything that is out of synch - TV control, call bell, table, trash can, adjust blinds, etc. Before you leave, ask the patient if there is anything else they need. Make sure you tell each of your patients that you will be coming back in an hour. I know that it sounds like a lot of hype, but it actually does work.

I hope it gets better soon.

[Umbrellacorpnurse]

PPs all make very solid points - good advice.

The no-unit-secretary thing is just awful; what a mess! I can see how doing the 'call bell boogie' would consume a lot of your energy. The "hourly rounding" technique has been shown to actually reduce frequency of call lights. Optimize your time in each room by anticipating any 'hotel' or comfort services. For example when you are giving a prn med- if the patient is a coffee drinker, swing by the pot and bring a fresh cup with you when you go to his room. Look around the room and take care of anything that is out of synch - TV control, call bell, table, trash can, adjust blinds, etc. Before you leave, ask the patient if there is anything else they need. Make sure you tell each of your patients that you will be coming back in an hour. I know that it sounds like a lot of hype, but it actually does work.

I hope it gets better soon.

This only works with the not needy or entitled patients. With that crowd it just encourages them to act like they're at the Ritz. This is a hospital not a 5 star resort. I'm here to save your ass not kiss it. Here are your meds and fresh ice water and a fresh blanket. No I'm not doing foot rubs, back rubs or ick...happy endings so don't ask. No I will not give your walkie walkie behind a sponge bath. No...there is not going to be a mint or you pillow but if you behave there might be a mint mouthwash with your 9am meds.

Too much pampering is what turned our current generation into whiny little kittens who can't function without constant stimulation (and before you flame me I am in that generation so I see the idiocy first hand)

[julz68]

This only works with the not needy or entitled patients. With that crowd it just encourages them to act like they're at the Ritz. This is a hospital not a 5 star resort. I'm here to save your ass not kiss it. Here are your meds and fresh ice water and a fresh blanket. No I'm not doing foot rubs, back rubs or ick...happy endings so don't ask. No I will not give your walkie walkie behind a sponge bath. No...there is not going to be a mint or you pillow but if you behave there might be a mint mouthwash with your 9am meds.

Too much pampering is what turned our current generation into whiny little kittens who can't function without constant stimulation (and before you flame me I am in that generation so I see the idiocy first hand)

I tend to agree with this to a certain degree. I try to do everything to make the patient comfortable, but sometimes they will take advantage and run you ragged! I do give back rubs if time allows if a patient can't relax and is in pain. But when a patient is on their call light every few minutes for things that are not necessary it gets rather annoying. For example, I had one that wanted fresh water...which is fine, but when I brought the pitcher back, it had too much ice. I dumped some out and filled it with more water. Then it had too little ice. Really? That can get very irritating.

[Inori, BSN, RN]

aw... do your best and remember it gets better each day. Soon you will realize that you are no longer afraid and are already strong. one day I came into work and forgot to be scared I was too busy. Then when they assigned me a newbie nurse to watch over I realized that I had matured as a nurse such that I am trusted to guard, teach and guide the newest member of the family. So yes it gets better.

Tips to help: type up a list of things you need to do each day in the order you do it so you can check off and follow your "procedure" each day so that you build it into a habit, things to do at start of shift, and end. medication 3 checks, pt 2 identifiers, 5 rights, and if you need cheat sheets do that too. I walked around for 3 months with davis notes nurse's notes in my pocket not that i ever had time to consult it but it made me feel better. AND when you feel you're shakey, completely overwhelmed, go close the door, bathroom drink some cold water, open window get some air clear the head. Then go ok how was that? patient alive, no injuries, no one got hurt, license intact, still have job and no one died. OK we good. Talk to your friends and if possible find a work mentor. Journaling (offline) do not use web journal there is risk that it gets read, ms. word on home computer or paper diary also helps lol i decompress by talking to mom and friends family.

Remember you are the nurse so you set the boundries and pace and not your patients. I do not allow patients/families to rush me because its my license at risk and I will take as long as I need to do the job right ok not too long you get the gist of it. You cannot be fired for being slow but can if you make a mistake.

[sugarwahine10]

You definitely needed a longer orientation & it's your right so you aren't risking your license. Unfortunately, the norm on type of patients anymore are bariatric, hoyer lifts, tons of wound care, 2 hr turns that take two people, if going to a test then need 4 people to transfer, etc., and I could go on and on. Few pts make the job satisfying. If I had known what nursing was really like in a hospital I NEVER would have became a nurse. Very stressful and I rarely get a lunch, breaks, or go to the bathroom on a 12 hr shift! I have looked into other avenues for nursing, but the paycut is so drastic...

[Blue Roses]

Out of nursing school I had three months of orientation on the unit before I was on my own!!! And I STILL burned out at that place after a year!! I was more prepared with the orientation I got, but the environment there was ALOT like what you discribed. I ended up with severe anxiety and panic disorder, and moderate depression. I left that place and now I'm VERY happy in my new job at a completely different hospital.

I would say tread carefully in this job you have now, get a support group behind you and get some really good stress releif ideas. Take your tasks one or two at a time and don't be ashamed if you NEED to step into the bathroom for a moment to calm down. I really really really hope your situation gets better and doesn't end up the way mine did. I know its hard but really you can't be the best RN you can be until you first take care of yourself. If all else fails. talk to someone at work that you have come to trust, away in the break room, or somewhere else private. They might be able to hook you up with resources within the hospital to help with the situation. Also, if your employeer has an Employee Assistance Program, I'd take advantage of that too. I did and talking to the counselors there kind of helped me sort out my thoughts and priorities.

[lmccrn62, MSN, RN]

Have you tried talking to your manager? Your orientation is pathetic. I am not sure how to help you. You have barriers there and they don't seem as though they will get better. You may need to look at a place that will train you better and have a assigned mentor to help you become the nurse you want to become. Some facilities unfortunately do things this way. My guess is retention is probably not good. Good luck!