so i cried at work

Oh, I've bawled at work plenty of times. Never one of my prouder moments, but it always blew over. I don't know how old you are, but age does help. I also do my best to look really scary. No makeup, hair pulled back, perpetual Nurse Ratchett expression. People take one look at me and ask someone else for help.

My reports aren't very polished either, and I've been doing them for a loooonnggg time. I relay all the pertinent info (most of the time) but I say ummm every other second. I mean that literally. "Room 409 is um a 67 year um old with um COPD excer-um-bation." And yes, I sound like an idiot.

Try not to be so hard on yourself. I bet you're doing fine.

((hugs)). Everyone has a hard time at first. 8 patients? Hospital setting? Seems like a lot to me. Organization is key. You must learn to prioritize! You must learn to delegate to UAPs and politely tell family members that ask for juice "just a moment, I have an important issue to deal with". Especially if doing their non-essential task is going to put you behind on, lets say, meds or calling a doc, or cleaning a patient.

My advice is to get yourself a good report sheet to help organize yourself. Write down the name, dx, essential labs, IVFs, accucks, etc... in the same place on your sheet for every patient. On the flip side of the paper write down things you need to report or chart, ex: when you spoke w/ a doctor, when you medicated for pain. Once you get used to writing these things down in an organized manner it will help you to give report without feeling scatter-brained and chart necessary information. I do this because I can cram that sheet of paper back in my pocket and take off in a hurry after I scribble something down. It goes with me everywhere. :)

Is your charge nurse aware that you are a new nurse? Are there any seasoned nurses you can go to on your unit for advice or tips? We always try and give our new nurses less challenging assignments at first (sometimes this isn't possible) In that case, as charge nurse, I would make sure that I am following them throughout the day and asking if I can do anything to help keep them on task, etc.. Not hovering tho

If you feel so overwhelmed that you feel unsafe, is there anyway you can go back on orientation temporarily? Sorry, you cried. I cannot tell you the number of times I have cried in the bathroom or in the car. Hope everything works out. Keep us posted.

Being a male RN I've cried cuz someone unexpectedly died (one of my favorite residents) or having 50 people and being totally overwhelmed. It just goes to show that you care very much about what you do. Try having a little note book or a what I call a memory/brain sheet write down key words on each person when stuff happens. The more you do this job the better you'll get at it!!! If you need to get off the unit for a minute and breathe. And they wonder why nurses smoke!!

First of all, take a deep breath. You are going to do fine! In a few years, you'll be the one everyone comes to for advice and help. I have been a nurse for 22 years and when I look back at some of the crazy stuff I have done or said....I actually laugh now. Don't get me wrong, you will still have bad days and patients that drive you crazy and managers that drive u crazy, but you will be better prepared to handle it.

My only suggestion is for you to make yourself your OWN report sheet. Have a section with pt.s name, age, diagnosis, PMH, allergies, diet, IV's, wounds, weight, ect etc....any special porcedure. Then have a section for the report you recieved and then have YOUR section for the report you are going to give then next shift. Their updated diagnosis, what procedures, labs, tests they had and WHAT WERE THE RESULTS?? i WANT TO KNOW their vitals, assessment, issues, how do their wounds or incisions look, etc. Make it concise, to the point-and yet informative.

Second, make your report sheet almost like a plan of care. While you are getting report, figure out in your mind how you are going to plan your day, who ur sickest pts are and what needs to be done based on their dx.

Next, get a hobby....go out, have fun. Dont let nursing be the center of ur world. it will never work. Love ur life and u'll love ur job again.

A report sheet was invaluable to keeping me organized when I was on med-surg. I developed one over a couple years, slowly changing it as I got better ideas of how to organize. I've uploaded my report sheet to my Google Docs account and I'd like anyone who can benefit from it to feel free to use it as a template, but you need to customize to your practice and your facility.

http://docs.google.com/fileview?id=0B4GOm4zHWoKiYTE3NDg1MGUtYTFmMC00YjRkLTliYzEtOWQ4NTMxOTQxNDMx&hl=en&authkey=CJOntUU

I'd keep a stack of these in my clipboard and fill them out at the beginning of each shift. General info is at the top, information from the previous shift went on the left side, and I'd fill out new information as I obtained it during my shift on the right. Then when report time comes, it's just a matter of reading off report.

Good luck!

:hug::hug::hug: Follow the above advise...you will be fine..we have all had our days!!

A report sheet was invaluable to keeping me organized when I was on med-surg. I developed one over a couple years, slowly changing it as I got better ideas of how to organize. I've uploaded my report sheet to my Google Docs account and I'd like anyone who can benefit from it to feel free to use it as a template, but you need to customize to your practice and your facility.

http://docs.google.com/fileview?id=0B4GOm4zHWoKiYTE3NDg1MGUtYTFmMC00YjRkLTliYzEtOWQ4NTMxOTQxNDMx&hl=en&authkey=CJOntUU

I'd keep a stack of these in my clipboard and fill them out at the beginning of each shift. General info is at the top, information from the previous shift went on the left side, and I'd fill out new information as I obtained it during my shift on the right. Then when report time comes, it's just a matter of reading off report.

Good luck!

Thanks so much for that report sheet!

I've seen a lot people cry at work. They just get so frustrated and lose it for a minuite. These are experienced nurses too, it happens to everyone. You can't know everything about each patient and you have to get over the "super nurse" mentality drilled into you in school. It's not possible to do everything (although I know that is not how we are trained). Know the basics about your patient. Prioritize what "absolutely needs to be done" from what "would be nice to get done" and for gawd sakes GO TO THE BATHROOM !! Realize that there is no such thing as a perfect shift. Personally I'm happy if I got the important things done, my patients got some rest, their pain and nausea was fairly well controlled, they're still alive (maybe even slightly better) and I havn't screwed anything up. Anything more is gravy.

Hmm, I don't have any advice really since I won't graduate til next month so I don't know what it's really like to work the floor alone. But you have only been a nurse for a month? Where is your preceptor? I thought you were suppose to have one for a few months first.

I feel for you, I'm new myself and also have an 8 pt load. I haven't cried at work as a nurse yet, but I'm sure it's just a matter of time.

The "brain" sheet mentioned above is a great idea and one a lot of nurses use. Personally, I don't use one because we print out the kardex and a flow sheet for every pt. Our flow sheet has the name, diagnosis, dr, diet order, last set of vitals, etc and lots of items with blank space to fill stuff in. On the flow sheet I fill in all the appropriate stuff as I get report (IV location, fluids, specimens, telemetry, etc) and then in the upper right corner I write all the "extra" stuff I get (history, labs, procedures, etc) from report. When I assess my pt, I put that info in the bottom left corner. Anything that develops during my shift I want to pass on (labs, new orders received or needed, pain, etc) goes in the bottom right corner of my sheet. Then we I go to give report, I can rattle off the standard stuff I filled out in the middle of the page, add in anything still pertinent from the report I got (upper right corner) and follow up with the bottom right corner that contains anything that happened on my shift they need to know. If something is really abnormal in the assessment I mention it, otherwise they have to assess the pt and it's in the computer if they really wanna know what I thought. By having a good flow on paper, I do a relatively good job keeping a flow during report.

With pt/family requests, I think it's tougher. I don't want to be the nurse who hides from (or worse ignores) patients and families but taking the time to get a blanket/ice/tissues/whatever for every patient can really add up. This is especially true as a new grad when everything takes twice as long anyway. If there's something quick I can do while I'm there (covering them up for example) I do it. If it requires me to leave the room and return and I honestly don't have time, I show them how to push the light or let them know 1) I will do it when I get a chance or 2) I will let their aide know so they can do it (if they aren't busy). I don't make someone wait for the bathroom or to get off the bedpan but it's not the end of the world if they don't get another pillow in the next fifteen minutes. You have to prioritize your time and that means prioritizing the needs of your patients too--the fresh water can wait when the guy next door needs his pain meds.

I actually think it's tougher to make these adjustments when you did well in school/clinicals/previous job. I'm not used to being ignorant and my coping skills with regards to fear, failure and inadequacy are seriously rusty! I'm not good at being bad so I just keep reminding myself it won't be like this forever! I started a journal when I began my new position and it has helped me keep my progress in check and I do think that helps with the confidence. I'm still scared, I still feel stupid and I still can't keep pace with my co-workers but I can see where I've made progress and that let's me know everything else is going to improve too.

A report sheet was invaluable to keeping me organized when I was on med-surg. I developed one over a couple years, slowly changing it as I got better ideas of how to organize. I've uploaded my report sheet to my Google Docs account and I'd like anyone who can benefit from it to feel free to use it as a template, but you need to customize to your practice and your facility.

http://docs.google.com/fileview?id=0B4GOm4zHWoKiYTE3NDg1MGUtYTFmMC00YjRkLTliYzEtOWQ4NTMxOTQxNDMx&hl=en&authkey=CJOntUU

I'd keep a stack of these in my clipboard and fill them out at the beginning of each shift. General info is at the top, information from the previous shift went on the left side, and I'd fill out new information as I obtained it during my shift on the right. Then when report time comes, it's just a matter of reading off report.

Good luck!

CROCUTA: Great report sheet!! Thank you!

Original Poster: I am sorry! I cry sometimes, too. This is a stressful field... and it seems that it is not what we were taught it would be, sometimes.... so many adjustments.. professionally and personally. I wish you luck, and know you will make it... :redbeathe

DX: Risk of RN Related Stress due to rigors of the job

Select the best nursing intervention to achieve the outcome: Stress reduced.

A: Empty the nearest bedpan on patient's head

B: Scream like a howler monkey until patient hides under blankets

C: Leave work, Find the person who first inspired you to be become a nurse and smack the %$X#*! out of them.

D: Cry

Correct answer: Cry

Rationale: Crying allows for a temporary reduction of stress, may release endorphins, and allows the nurse to vent negative thoughts which may impede critical thinking.