Crisis mode

Published

Specializes in Renal-Telemetry.

I am a new grad who has been working on the floor for about 6 weeks now. They told us about the 4 "Stages" we'd go through in orientation, and I think I have officially hit "crisis".

I'm working on a renal telemetry unit. I've been told by several of the nurses, including one I know who worked there 10 years and works at another hospital now, that this is a really hard floor to start out on as a new grad.

I don't want to toot my own horn, but I was always a really good student in both, class and clinical. I saw my references for the position from instructors and they were good, got really good end-of-semester reviews, was always told I had great time management and organization...I thought so too, until now!

I always feel like I'm forgetting something. I've even had this number of patients(I have been at 4 the past two shifts) as a nursing student, and didn't feel this overwhelmed, even though with my school we did all of the nurses' duties and wouldn't dare get the nurse/have the nurse to do something unless there was an emergency. We did it. I handled this. I've worked 28 hours in the past two days, have to get up in about 5 and 1/2 hours, and am still up bc I'm asking myself, "Did I do everything? Did I chart everything? Did I tell everyone who needed to be notified what it was?", even though I went over and over everything before I left.

I guess what I'm really asking is, is this a sign that nursing just isn't for me? Maybe just the floor not for me? Is this normal as a new grad? Most importantly...does it get better in time? :lol2: And if it is the floor not being for me, then where in the world will I fit in? I keep getting told by management and educators that if you can work on this floor, you can transfer anywhere and not have a problem. I am terrified of doing something wrong. I have always been that way, but it hasn't made me this nervous before. I know I have to get over that, but how?

Sorry for such a long post :/

Up Vote Up Vote ×
Specializes in TELEMETRY.

First of ALL..... slow down and take a deep breath. As a new grad you are always going to doubt yourself in the begining. So far you have been able to get this far so that in itself is an accomplishment. The other thing is NO NURSE is PERFECT! You will forget something, and you will make mistakes. The thing is not to make life threatening mistakes. Rememebr this is a 24 hour job so what is missed by you another nurse may or may not miss too. Just be oragnized, be anal, and try to relax, the more youy worry the worse things will get for you. I was like that in the beginning always thinking I missed something and usually I didin'y but a few times I did miss something small, it was called to my attention and then I never forgot to do it again. So take it day by day and one day you will be that cool calm and collected nurse. Be easy on yourself you are still learning. The first two years you are learning and eventually you will be a pro, just give it sometime.

Up Vote Up Vote ×
Specializes in PACU, CARDIAC ICU, TRAUMA, SICU, LTC.

I have been a nurse for 31 years, and still have those evenings when I get home from work and ask myself some of the same questions. I have developed a "system" for myself. I carry a breast cancer pink pen put out by Bic; it writes in pink ink. If there is something that I need to communicate to the next shift that is out of the ordinary, I write it in pink. Sometimes when I am driving home, I will think of something, so I just call the nurse who relieved me and let her know what I forgot.

As for charting, I am very diligent in that respect. However, if I did forget to document something, I use "late entry."

Be kind to yourself; you are new. It will come in time. We all second guess ourselves at some time or another.

Up Vote Up Vote ×
Specializes in Trauma/Tele/Surgery/SICU.

Not a really experienced RN here, just passed my 1st year anniversary, thought I would add my experiences..newbie to newbie.

Renal tele..absolutely a tough floor. Are your feelings normal? Absolutely. Does this mean nursing is not for you? Absolutely not!

When I was a brand new RN I was conviced I was the worst nurse there was. I would obsess about everything to the point that I ended up on antidepressants and benzos to deal with stress. I finally had to convince myself to just shut it off! Do I still question things? yes but not nearly as much as I used to. When I find myself obsessing on my way home from work I just tell myself it is what it is, I'm not there anymore...it's done shut it off and leave it at work. Trust me when I say if you are missing things....it WILL be pointed out to you.

Glow RN has it right...everyone makes mistakes the trick is not to kill anyone. As long as you are smart enough to know when your in over your head and to ask for help when you need it you will be ok. A new floor will just present a new set of challenges and you will probably feel exactly the same way you do now.

It is a huge adjustment from clinicals to real world and from newbie to experienced RN. I look back now and can't believe the progress I have made and you will too! One piece of advice I would recommend is find another new RN to talk to! I am lucky enough to work on the same floor with a school class mate who has become my best friend. She has kept me from curling up in the fetal position numerous times!

Hang in there....it does get better!

Up Vote Up Vote ×
Specializes in Trauma Surgical ICU.

Renal floor nurse here... new grad also. Yes, it is a hard floor. Our pts go south very quickly. I too have been told if I can make it on that floor I can make it anywhere..

Give yourself time. I felt the same as you. I also had nightmares about work. When I talked to my co-workers about it, they said I am now a renal nurse LOL... It has been 6 months for me and things are sooo much better than week 6. Things really got bad when I was off orientation but I asked lots of questions and clarification..

Your feelings do not reflect the nurse you will be or that you can't handle it, it only means you have now entered the "real world" of nursing. Man is it a shock.

Hang in there and keep going. You will feel better about your abilities etc as time goes on.

Up Vote Up Vote ×

Write notes to yourself. A dull pencil is better than a sharp memory any day.

Up Vote Up Vote ×
Specializes in Renal-Telemetry.

Thank you all so much for the advice and encouragement! I have been asking my preceptor questions...and I did tell her at one point I didn't feel ready for 4 patients, but she said that I was, that I'm already pretty much on my own. I don't feel like it though! lol. She is also orienting another new hire and most of our shifts, a lot of her time has been spent with her. She is a great preceptor and any time I've needed her help has given it, but I do think that her being "responsible" for both of us and our patients is probably a bit much for just one person.

You all made great points...once the shift is over, it's over. I'm going to just have to accept that it takes time to get in a practice, give 110% while I'm there, and let it go when I'm not.

Up Vote Up Vote ×
Specializes in Med/Surg, DSU, Ortho, Onc, Psych.

First of all learning time management TAKES TIME and experience. I've worked with RNs who have 20 years experience who still have bad days with their time management. I am still fairly new and am learning as well.

Use a little 'cheat sheet' or a small notepad you can carry in your pocket, and write down everything you have to do for those 4 patients, ie: meds, baths, dressings, observations, IVs, whatever. Take a little time at the beginning of your shift to quickly read through patient records and the last nursing entry after handover, and decide what is the longest procedure you need to complete, and try to allocate a little more time.

If you forget something, you will be told. If you remember something you should have did when you got home, just ring the hospital/facility and let them know. Better to do this than sit at home, or try to sleep and sweat about it.

You won't remember everything at first anyway. Give yourself a break. Also you will probably have to learn to manage more than 4 patients on a shift anyway, so if you can master 4 patients you will be on the road to good time management.

You will always have interruptions/emergencies - this goes with the territory of nursing, the trick is how to handle it and keep a cool head, and that is the hard part, but using a notepad etc is not shameful: then if you list things to do, you can tick it off as you go along. I know many RNs that do this even though they have worked as nurses for a long time.

Up Vote Up Vote ×
Specializes in Renal-Telemetry.

Thanks for the tips, I have been using a to do list when I work! It really does help. Today was a lot better. The patient-nurse ration on our floor is supposed to be 4:1 because of the telemetry, but due to staffing, it often ends up 5 or 6:1. I think after a couple weeks of 4, I will be able to handle it better. I just had a really bad weekend, and I think it made me snap lol. It's been building since orientation started with all the extra classes and stuff I have to take, but after these posts, I have promised myself that I can't go in there and expect to do "perfectly", and that I will do my best and that's that. It'll take time. I'm just gonna have to remind myself that more often!

Up Vote Up Vote ×
Specializes in Critical Care.

I'm starting on a similar floor this week. Do you have any advice? I can't find much of renal nursing on here that isn't dialysis. Thank you!

Up Vote Up Vote ×

Don't go into crisis mode... You are an individual who is right for a Nursing career. You have the right attitude. What I suggest is to get or make a "clinical flow sheet." You can use :yeah: one side of a piece of paper. Put down your patient's information, labs, any test results, any tests that are due, the hour meds are due. etc., etc. All you need is some organization, Volia.... a feeling of success!

Up Vote Up Vote ×
Specializes in Renal-Telemetry.
Don't go into crisis mode... You are an individual who is right for a Nursing career. You have the right attitude. What I suggest is to get or make a "clinical flow sheet." You can use :yeah: one side of a piece of paper. Put down your patient's information, labs, any test results, any tests that are due, the hour meds are due. etc., etc. All you need is some organization, Volia.... a feeling of success!

I've actually started doing this recently...I have always been a "to do list" type person, so IDK why I didn't do it before. It has helped me tremendously! I hope I'm not shooting myself in the foot saying this, but I feel like I have gotten a little better each day that I've worked.

Up Vote Up Vote ×
+ Join the Discussion