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Can I really handle this?!?

Hello!

I'm a brand new grad in a residency program and just started this week on the floor with my preceptor and I'm already wondering if I can really handle the work.

I'm an older nurse and this is a second career for me -- I'm not as fast as others on the floor (will I ever be?!?) and I find I'm overwhelmed with the tasks I haven't had much practice with, e.g., changing IV tubing, PCA pumps -- generally everything!

I'm so used to being in a working environment where I can master the skills within a short period of time, but this -- well -- it just seems like I can never get my ducks lined up in a row!!!

I had some good experiences during my nursing school preceptorship and one (thank goodness I have at least one advantage) thing I got a lot of practice with and learned how to do well was starting IVs....but that's just one skill!!!

I have been told I have a "wonderful manner" with patients, but when will I feel like I know what the heck I'm doing?????

Are there any older new nurses out there who feel the same way? Does it get easier? Do you get faster? Do you ever stop feeling overwhelmed? Do you ever stop feeling nervous (sometimes just plain scared!)? Do you ever wonder what the heck you're doing in the nursing field?

Any tips on organization? Any tips on getting down the IV lines (there are sometimes SO MANY on just one patient)? Any tips on PCA pumps?

OK -- enough rambling and venting -- thanks for listening. Any words of encouragement and tips on successfully learning the technical skills is greatly appreciated!

-Kari :smackingf

traumaRUs, MSN, APRN, CNS

Specializes in Nephrology, Cardiology, ER, ICU.

Hi and welcome. You WILL get used to the pace and you WILL become more organized. I just left bedside nursing (level one trauma center and I'm almost 48). My saving grace was my organizational skills. I took stock prior to going to the room to get supplies that I knew I would need - IV supplies, foley, meds, etc.. This way - I got my job done in one trip versus three to four. Depending on what kind of unit you are on - that will depend on what skills or tasks that you can group together.

Please hang in there. As to when it clicks in with you: again depends on the unit: for an ICU or ER - maybe up to one year, for a med-surg unit - six months to one year.

At any rate, ensure you get enough orientation - don't let them skimp. Also make sure you do your homework: know the important lab values, have an overall view of the standing orders, know where supplies are located.

Good luck.

NotReady4PrimeTime, RN

Specializes in NICU, PICU, PCVICU and peds oncology.

Just to add one thing to TraumaRUs's suggestions... Work on doing things right for now. You can get fast later. You'd be surprised how much time it will save you if you can just "get it right the first time". While you're on orientation you're not going to get the sickest, busiest patients on the floor a-a-a-a-and you have backup... extra hands, extra brain. Use them to good effect. You'll get it and one day you'll be looking back and wondering how you got there.

kellerpatty

Specializes in Burn ICU, Psych, PACU.

Hi: I, too, am a fairly new nurse. This is my second career and I'm what you would call "older". It's almost as if you were telling my story...I was successful at my previous position, organized and effective, but nursing is a whole different story! I remember my first week (I work in a burn ICU) and I thought I'd never make it. Luckily, I have had very good preceptors who time and time again tell me..."it will take you a year to start feeling comfortable." Well, I feel a little bit comfortable one day and then those old feelings come back...will I make it? But, I've chosen to believe them when they say "a year" and trust that they'll continue to help me a long when needed. You'll do well, everybody tells me us "older" nurses are an asset. I'm just learning to be patient with myself. Thanks for sharing your thoughts, they really helped me realize that I'm not alone!

P.S. I label all my IV lines first the line into the pump and then as close to the patient's IV site as possible. This has saved me many times! We have new-fangled PCAs and I just whip out my little instruction sheet and follow it exactly!

Just to add one thing to TraumaRUs's suggestions... Work on doing things right for now. You can get fast later. You'd be surprised how much time it will save you if you can just "get it right the first time".

Very valuable advice -- both TraumaRU's and yours regarding doing things right for now. I worry that I might pick up bad habits just because I'm trying to work faster. I've seen safety checks go by the wayside, e.g. med checks and that really scares me. Is that pretty common out there in the work place? It just seems that in order for all the work to get done within your shift you have to cut corners -- that just isn't right and seems like a huge patient safety issue not to mention that your license could be one day be on the line just because you're cutting corners to finish on time (overtime is frowned on).

Honestly -- I hope I'm never a patient in a hospital! Isn't that a sad statement?

Hi: I, too, am a fairly new nurse. This is my second career and I'm what you would call "older". It's almost as if you were telling my story...I was successful at my previous position, organized and effective, but nursing is a whole different story! I remember my first week (I work in a burn ICU) and I thought I'd never make it. Luckily, I have had very good preceptors who time and time again tell me..."it will take you a year to start feeling comfortable." Well, I feel a little bit comfortable one day and then those old feelings come back...will I make it? But, I've chosen to believe them when they say "a year" and trust that they'll continue to help me a long when needed. You'll do well, everybody tells me us "older" nurses are an asset. I'm just learning to be patient with myself. Thanks for sharing your thoughts, they really helped me realize that I'm not alone!

kellerpatty -- thank you -- your post made me feel so much better! Please tell me you have more days now that you DO feel comfortable than days you don't. How long have you been working on the floor? Are you still in orientation? I'm working in the oncology unit, but we are a med/surg overflow floor AND we take tele patients. Lots to learn...

mom2michael, MSN, RN, NP

Specializes in Rural Health.

A CCU nurse that I precepted with one day taught me this neat trick with all the IV lines - she took the colored tape we use to label the charts (each color represents a doc) and she color coded her IV lines - one near the bag and another piece of the same color at the site. She's been a nurse for 20 years and still does this when her patients have multiple IV's in case she has to pull and replace one quickly - she said it's saved her numerous IV headaches over the years.....

I am in my second at hopefully last career, I am 46 years old have always prided myself on my orgainzation skills but in nursing I have no organization skills, Just when you think you are going ok some little problem occurs and blows your day away. Having a really difficult time. Am on my 6t week of orientation and feel like i am drowning. Hate this feeling. Can't wait for a year to zoom by hopefully in six months things will eventually get easier. I work on a busy floor most nurses get a total of 5 patients each. I have my hands full with 3 and now they give me four and next week 5. UGH. STRESSED OUT!

A CCU nurse that I precepted with one day taught me this neat trick with all the IV lines - she took the colored tape we use to label the charts (each color represents a doc) and she color coded her IV lines - one near the bag and another piece of the same color at the site. She's been a nurse for 20 years and still does this when her patients have multiple IV's in case she has to pull and replace one quickly - she said it's saved her numerous IV headaches over the years.....

What a great idea! I copied and pasted that tip into a list of tips I've been copying from this forum.

Thanks a bunch! :wink2:

I am 44 and on my second career since 8/06. I also work on an oncology/medical floor. I too am overwhelmed and scared. I ask for divine help each day I work and thank the nursing gods when I go home each night.

I'm trying to learn priorities. I simply cannot do everything that is expected in a day. To me, important tasks are assessments & documentation, meds, orders, checking labs/tele strips, and admissions/discharges. If that was all there was to do, I think I'd be okay. Add things like I&O's, calorie counts, daily weights, pain assessments/interventions/outcomes, nurse report sheets, specimens, fresh water, toileting, finding help, repositioning, answering calls, talking to family members (do they really think I know anything?!?), etc... I don't feel good about my patient care and I don't feel safe. I feel like I'm too busy to practice any critical thinking...I'm just doing the tasks. :bluecry1:

I realize the PCT's are responsible for many of these tasks, but quite frankly, they are also spread thin. Sometimes they just don't care. Last week, I recieved report about an elderly alzheimer's patient who wasn't eating. I fed her that day and she ate quite well. I think she wasn't eating because nobody was taking the time to feed her!

I feel like I'm on a treadmill balancing plates on a stick. As the day wears on I'm trying to balance more and more plates. The cheering section is great. They smile and say, "you can do it" as they toss me another plate. I really don't like my job and I don't even like to talk about it. It's depressing.

DolphinRN84, BSN, MSN, APRN, NP

Specializes in Med Surg Cardiology.

I'm not a second career person, but I just wanted to comment because I feel the same way as you guys. I cry everyday now because I'm overwhelmed and anxious, and I just started orientation last week. This is my second week. Things are going ok, but sometimes I feel that I don't know what the heck I'm doing. I'm trying to learn to take one day at a time. I don't know why I have this sudden feeling to rush all the time. The nurses also told me that it can take at least 6 months to a year to feel comfortable. I hope that's the case. I really want to be a good nurse, and I want to do the best that I can. We all want to!

I too am a new grad in my first nursing job. This is a second career for me -- I worked in sales/acct. management/service for 15 years. I was successful and made good money. I was tired of the corporate gig though. I was then a stay at home mom for 7 years, the latter part of which I was in nursing school. I did very well in school. I precepted at the same hospital/unit as I am now working. It went well enough so that they hired me!

Long story short -- I am absolutely overwhelmed anyway! Tonight I start my fourth week of orientation. Last week was awful -- in fact, at one point I was walking down the hall saying to myself "I'm done". I found myself wondering if I could get hired back at my old company. Never in my life have I felt as disorganized and inept as I feel as a new nurse.

My preceptor is a very good, and a somewhat new nurse (3 years). She is very young and knows her stuff and works very fast. However, she lacks patience with me. The other night I had a very difficult patient (I work L&D) and she had me do the admission assessment etc. However, the pt. was very needy and so I had to change her underpads several times and do several other things for her (pt. care before paperwork, right?!) during the period of time my preceptor had allotted for me to do the assessment. She was clearly irritated and although I told her that I had been attending to pt. needs/requests, I nonetheless felt that she thought I was an idiot or something. That is hard to deal with for us adult learners!

I have wanted to be an L&D nurse for a long time but I am wondering if I am in over my head. I posted a thread in the OB/GYN forum and received some very good advice/support which I am going to try out.

At the very least, I am going to complete my orientation and see how I feel at that point. One thing I know I am guilty of is being VERY hard on myself and imagining that everyone is talking about what an idiot the new nurse is. Not very good use of my energy.

Good luck to all of you. In the spirit of the season: "God bless us, every one!!"

Dont let your age make you think you are "slower to learn" than younger nurses. I am also an "Older" new graduate nurse and my advice is to take it easy and just focus on the important things. I have posted before that I worry first and foremost about patient safety a close second is going to court and jepardizing my license. Dont let these patients who are on the light every 4 minutes get to you, as far as the technical, as the other posts have quoted "You always have help" and has many have told me "No question is stupid" I was hanging blood the other day, everything was going great!!!!!!!! WELL I had a question about some wording on the bag, so my charge nurse (who is great) comes in and answers my question as I am hanging the bag of blood back up on the hook the tubing becomes dislodged and yes you guessed it BLOOD EVERYWHERE!!!!!!!!!!:bluecry1: My point is that you are not expected to be perfect, I can laugh at it now but at the time (as I am covered in blood) I was mortified!!!!!!!!!! :scrying: Take nursing day by day. I have been nursing for a whole 9 months :bowingpur but I am now just starting to have less palpitations driving to work. Remember my motto: Day by day. Good luck:yeah: :yeahthat:

JoAnna McNurse

Specializes in Med-Surg, Oncology.

Another "old dog" reporting in.....

But I've got you ALL beat. I am 57 y.o. and retired from an onc pharma career that inspired me to want to be a nurse instead of a drug pusher.

I finished school/NCLEX in Aug. Was hired in the Onc department of the Hospital I did my preceptorship in. The first 2-3 weeks I thought I was doing pretty good. BUT..... as each day passes, I swear, I am getting worse. Now this may be because they have pushed me to do 4 patients and the patients are getting more acute every assignment.

The other day, my nurseing internship instructor was up and delighted to hear I had taken 4 patients the last 2 weeks and wanted to know when I would start with 5!! I set the record straight on that RIGHT THEN and told her I had no intension of doing 5 patients for a good long time or ever !!!

I refuse to be pushed. It is not in the best interest of the patients, other Unit staff nurses or ME to try and count on me to do that many patients on our oncology unit. I end up doing a half-assed job and others have to pick up the pieces I "drop."

I honestly don't know if this hospital business is for me or not. I reall want to get to an infusion center and give chemo but I'm trying to learn some of these basic nursing skills. But.....like many of you, my confidence is so shaken on a regular basis that I just don't know if I'll make it or not.

I have a new theory on "THE NURSING SHORTAGE." I'm not really sure there is one. I think that hospital nurses are run so ragged with heavy loads, acute patients and often, like us new nurses, lack of time to really get competant with our skills - that many leave the hospital area and take office jobs or ANYTHING other than hospitals !! Ha Ha

I'm praying all your saying about getting better over the course of the year is true. Right now, I get giant butterfly's everyday as I drive to work.

mom and nurse

Specializes in Acute rehab/geriatrics/cardiac rehab.

Hi - Just wanted to say that I started on the floor as a new nurse at the age of 46 a couple of years ago. At the beginning I had anywhere from 7 - 10 patients at a time (rehab). Things have become better at the hospital I work at and now we may have only 6 or 7 patients. Though the other night I spent 8 and 1/2 hours going room to room, etc and didn't have time to sit and eat....this (not eating) has recently been a rare occasion.

I spent much of my first year in tears.....and I still have tearful days.....but they are few and far between. I stuck it out and things are better now two years later. I was recently asked to help precept a new nurse half my age. As is usual, she started off with only 3 stable patients and was quite an expert on nursing care (we're all experts with 3 stable patients)...and now she is up to 7 patients and informed me that she now realizes she'll never be able to practice nursing care like she'd learned in school....it was sad to hear her say that and yet I knew that for the most part that is reality....

I've learned it is not age that determines how hard nursing is for us. Nursing is hard no matter what age you are. And I know for sure I would have left by now had I still had 8 - 10 patients a shift....it helps if you have a listening ear with management and they are working on the situation. We have that at our hospital.... management listens and that's why I stay....

But I have to admit...I'm back in school again trying to earn a Masters so when I'm half dead and can hardly run anymore perhaps someone will notice my degree and hire me. And.... If I ever do leave and work at a job outside of hospital nursing (for example community health nursing which only requires a BSN in our area..).....I will never return to hospital nursing

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