Published Jan 9, 2008
luv2shopp85
609 Posts
What do you guys do when you have bad days?/? I graduated in June 2007, passed NCLEX in aug 2007, started working sept 07. I am currently working on a neurosurgical floor. And I just feel CLUELESS.. I dont know why i graduated from nursing school!!!!
I worked night shift last night and I am working on a neurosurgical floor and its just so hard !!! I feel like I don't know anything at all. I had 2 patients code last night. And I did not know what to do. I had a 90 year old patient with no heart or BP problems, only in w/ alzehimers and possible bowerl obstruction. His heart rate was in the 40's bp was 100 over something. The one nurse told me to check the blood sugar - I wasn't smart enough to think of that on my own. He then became unresponsive and we called a code. I don't really know what exactly caused all this.
I just don't have a good ability to think critically. It seems like since I'm out of school I'm forgetting everything!
I will have a patient going bad and then call the doctor, but I will forget to check the bp, heart rate, pulse ox, etc before calling. I just feel so dumb sometimes. It makes me wonder if I Picked the wrong profession or if I'm in the wrong specialty.
I'm sooo confused!!
surfer betty crocker
41 Posts
are a bad case of the nerves gettin in your way? you said that you call the doc when a pt is going bad and you forget to take vs and 02 sats--but you just put it out there--so now, next time you know what to do when you have a pt going bad. it was unclear if you graduated from nursing school in 2000? you typed 200--are you a newbie? or nursing for 7 years since you type you have been working since 2007. if you are a newbie-congratulations im a newbie too. and although im going on a limb here, i think you have it in you to 'critically' think, but the kind of critical thinking that makes you take a blood sugar first thing is the kind of thing that comes with experience i think. now, next time you will do that. the learning curve is unbelievably steep, heck its a 90 degree angle! the floor i work on, they are all 'ticking time bombs' and the nurses keep telling me sometimes they just 'go' w/o warning. i can say don't be too hard on yourself but that's easier said than done. and in my exp. so far, its hard to focus intently on learning psychomotor skills and think 3 steps ahead simultaneously. the only thing i can say is ask questions, research stuff you don't know and give yourself a break. if you can stick it out for year do that then decide if nursing isn't for you. if you can stick it out then try other areas of nursing, even better. i think your feeling is quite common among new nurses. i can sympathize.
Oh sorry... I did type the year wrong.
I graduated in June 2007, passed nclex aug 2007, and started working Sept 2007
I just feel like there is so much going on and I can't keep track of everything or keep up.
I never get time to chart my Intakes. The nurse's aides charts the Outputs of foleys, just regular urine output, and drains.
I'm still having trouble with prioritizing but I am getting better I think. It just sucks becaues I am working night shift and day shift-rotating. And Night Shift is a lot more slow paced, then when I'm back on Day shift its a lot of stuff at once which makes it hard to keep up.
Do you think it would be a good thing, that when you have to call the doctor about a patient that you just automatically get the vitals, listen to heart sounds, listen to lung sounds-just to be prepared?
Also, I work on a neurosurgical floor so I get confused at times as to which patient requires a full neuro assessment -such as upper extremity strength, eoms, face symmetry, tongue deviation, finger to nose. I know that we do with stroke patients, or patients who have some kind of brain tumor. I'm not sure about seizure patients?
Then I know that I do a modified neuro assessment -just check the lower extremity strenghts on patients who are having back problems and get back surgery.
But then a confused patient - i dont know which to do.
care4u2010
55 Posts
You graduated so I know that you have the knowledge to make it through the tough times. The fear of the unknown just gets the best of us sometimes. Neuro is a very complicated subject and a very hard area to work in. You are new to this so give yourself some time to adjust and learn. No one knows it all. Keep reading and researching in that area and you will do just fine. Soon other nurses will be asking you questions.
Mississippi girl
07rn2b
10 Posts
luv2shopp, I think we are in the same boat. I'm on a cardiac floor, and most days I feel like I'm sinking. I walk out of work wondering why I went into nursing and how they could even license me. I struggle with catching the "little things" and the ability to put 2 and 2 together to come up with what's going on with my patient. People tell me that it gets better, but after 6+ months, I'm beginning to wonder, and to doubt myself.
Neuro is a really challenging field to be in, and I give you a big :w00t:just for having the courage to start there right out of school. It can't help any that you are rotating from days to nights either. That's a drain in and of itself.
Good luck to you!
Virgo_RN, BSN, RN
3,543 Posts
Your unit should have standard protocols that you can look up. That might help with knowing what kinds of assessments to do with which patients.
As far as knowing what to do when a patient starts to go downhill, right now, what you do is you get help. Do not go it alone, thinking you "should be able to handle it". As you gain experience, you will be able to handle more, you'll be able to recognize signs that things aren't looking good and act more quickly. But even the very experienced nurses on my unit ask for help when a patient's not looking good. It's called teamwork!
RiverNurse
170 Posts
I am SO glad for these forums! I can certainly relate to your experience. I graduated in August, 2007, NCLEX in Oct, 2007 - began working on Tele/Med-Surg right after.
Last week I was going to do a neuro chk on a pt. We were having a brief conversation when she coughed then couldn't breathe - gasping for air. She became cyanotic. I absolutely freaked (NOT a good thing) - but I was able to at least call the charge nurse for help. As it turned out the patient was having a panic attack.
Color me embarrassed - and now - a little more skilled and ready for next time. Sometimes I think I should have "clueless" pasted on my forehead...
Hang in there - please PM me if you like.
shellsgogreen
328 Posts
I graduated in May also, and I feel fear every time I step onto my unit - I know that it's all a learning process, and many around me tell me they would be concerned if there wasn't an element of fear in the beginning.
Right now, I would just like to get through one day feeling as though I am somewhat on top of everything, and to feel as though I really am doing enough to help my patients -
So Luv2shopp, Slangdell and 07rn2b, you are definitely not alone!
Hugs to all :icon_hug: