Got through my first day.... but I'm scared to DEATH

  1. My first day of orientation on a PCU/tele floor was Tuesday. I'm a new grad, just passed boards 2 weeks ago. I finished my Practicum in February, so I have not done any patient care for the last three months and I just felt sooooo overwhelmed... Is it normal to have the "I dont know if I can do this" feeling when you are first starting out? Started out with five patients, got one admission, 3 discharges, so many meds, meds not getting sent by pharmacy, doctors not coming in to see their patients, new equipment that I have never seen/used before, all documentation is "old school" paper charting (everything was computer in all the facilities I went to in nursing school)... I feel like I know NOTHING!!!! I'm on day orientation and the norm patient load is 5-7 on days. I will be working nights and could get up to 9-10 patients!!!! My hospital/nursing orientation isn't scheduled until the end of the month, so I know NOTHING about policy/procedure. Not really asking for advice, I guess I'm just venting....

    I guess all I can do is pray that I will start to "get it" soon. I've worked too hard for this to give up...
  2. Visit PatricksRNMommy profile page

    About PatricksRNMommy

    Joined: Feb '05; Posts: 93; Likes: 114
    Registered Nurse; from US
    Specialty: PCU/Telemetry

    11 Comments

  3. by   tmdidio27
    Hang in there.... I started on a cardiac stepdown floor fresh out of nursing school. Although the pt ratio was 1:6 days but we had computer charting.. It is very overwhelming at first. The one thing I must say that really helped me and I do it to this day is prioritizing!!!!!! Don't be afraid to ask for help and ask questions. I have been nursing for 5 years now and I love it. I am now in the cath holding area. It takes a good year to feel confident and comfortable trust me. So take your time and hang in there...
  4. by   All_Smiles_RN
    the ratio sounds a bit high for pcu/tele...

    everyone has that flustered feeling at first. it goes away in time. :-)
  5. by   PatricksRNMommy
    Thanks for your comments... I have been taking three on my own the past few shifts and I'm overwhelmed, but hoping it will get easier... And I'll be on nights, so MAYBE it will be a bit calmer (crossing my fingers).
  6. by   MrChicagoRN
    It takes time to learn a bunch of new stuff.

    Just make sure your manager knows what it is you still need to know.

    Be sure you are ready before going to nights, and be sure you are properly oriented to nights before being let loose on your own.

    But things should go well. The institution wants you to succeed. They didn't hire you fail!
  7. by   PatricksRNMommy
    Whew.... got through my days orientation and am now orienting on nights. I don't feel like I'm going to pull my hair out anymore ... I think I am more suited for the night shift. I have more time with my patients, more time to look up things that I'm not sure of, I took 6 patients on my own without feeling overwhelmed!!! Things are definitely looking up Thanks for all your kind comments.
  8. by   mrod
    Wow, that is awesome, good for you. I can see myself relating to you soon. I just graduated and I will be taking my boards in 2 weeks and I am starting on a tele floor as well. I will also be moving to cardiac step down unit 3 to 6 months after I start on tele and I will be working nights as well.
    I was just telling my family that I feel that I am not sure if I can do this. I really think that all I know is how to pass the boards and nothing about a nurse. It is scary!
    But in time that feeling goes away and you become more confident just like anything else. Do you remember how you felt after your first exam in nursing school? I thought I could never do nursing school and I graduated with honors!
    Good luck and congratulations on your RN!! :roll
  9. by   lubdubRN
    Hi there,

    I am also a new grad. I take my boards Thursday! I will be starting orientation in 2 weeks in Cardiac Surgery ICU. I worked there as a Care Partner (CNA on steroids role) for two years and am familiar with the unit, but not from the RN side. I am nervous and excited and nervous! Did I mention I was nervous!? It is a new intern program

    About the boards...I have been studying and I feel like I'm ready, but when I keep looking at the darn Kaplan question bank its something else I never
    heard of ...and I'm like OH my God! I guess you can't know everything. I would like to know how someone else's studying for the boards is going.
  10. by   JOEYZ
    When in doubt just pick someone in your unit or call someone up on the phone and yell at them lound enough that the entire unit can hear you..........thats what seems to be the favored method of the cardiovascular surgeons that I work with, LOL. OK, all kidding aside........this is a normal thing to feel for anyone. The first month or so that I was in CVICU I felt like I was going to have a heart attack every day, and I was use to working in this environment with these people already as a respiratory therapist. The bottom line is was a change in responsibility for me and here you are in a position where YOU are having to answer question and are responsible for the care of the patient when the doctor doesnt want to come in or doesnt feel like making rounds. One of the best passages in the bible........"and it came to pass". This will pass and you will look back on how stressed out you got and find humor in it. Good luck.
  11. by   agent66
    Hi,

    Sounds like your're feeling a little better already. If you can sleep nights are great. They are challenging but in a different way. You do have more patients but less procedures, phone calls, doctors etc. You also have to be independent because you don't generally have all the resource people you have on days. It is a great time to actually read through charts and do "detective work" as well. Best of luck, keep your chin up, it can only get better.

    P.s. If you are already a mom, being a nurse should be a piece of cake, the skills are quite similar.
  12. by   loriann
    Your patient load does seem high. I work on a tele-step down unit and we have 4-5 patients max. Are you doing your own tele monitoring or do you have a tech?

    As for getting through, I asked loads of questions and still do. I've only worked on my tele unit for 9 months, but it does get easier and you'll find you will start retaining all sorts of information and just do things second nature after a few months.

    Hang in there and take care!
  13. by   PatricksRNMommy
    Thanks for all your replies... I have been on my own now since the first week of June and I'm feeling alot better (most days LOL)... I haven't yet had 8 patients at once.... although I have had 6 and 7 some nights. The nurses on my unit are very quick to help out and the charge nurse and CNAs are great too. We have a great monitor tech who gives us a "heads-up" if our patients rhythm starts looking not-so-good. Don't get me wrong, I still have those mornings where I can barely hold back the tears until I get to my car, but most days I leave feeling proud of myself, and feeling like I'm really starting to "get" this whole nursing thing.... Now if only I could stop having nightmares about my patients coding....

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