Can I really handle this?!?

Trauma Columnist · Aug 29, 2006

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.

Pediatric Critical Care Columnist · Aug 30, 2006

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 · Aug 30, 2006

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!

blaaveispiken · Aug 30, 2006

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?

blaaveispiken · Aug 30, 2006

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 · Aug 31, 2006

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.....

youngatheart · Aug 31, 2006

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!

blaaveispiken · Aug 31, 2006

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:

leigh.anne · Nov 15, 2006

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, MSN, RN, APRN, NP · Nov 15, 2006

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!

chiapet · Nov 20, 2006

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!!"