Crisis mode

[southern.bellex3]

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? 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 :/

[southern.bellex3]

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!

Good luck and congrats on your new job! I'm not sure what advice to give you, since I am still learning myself, but I can tell you what my preceptors and fellow staff have reminded me of, and what I've just seen so far.

First of all, I can't remember the username, but as someone suggested, make you a checklist. I have started doing this, and it's helped me so much! You will find your own routine that works for you staying on top of things, but I've found that it's been working great for me. Each morning when I come in, I have columns of each thing that is expected for every shift. I make rows for the patients' room numbers. On that same sheet, I make a separate list of any special things I may have to do for other patients...like which have dressing changes, which are on tele so I can keep a good eye on their monitors, which got labs throughout my shift so I can remember to watch for results(or even those who will have them through the night/morning, so I can report that to the oncoming nurse).

Be prepared for everything. I have learned renal patients can change status QUICKLY. My 2-month "anniversary" is in 2 days, and even in my short time there, there has been a number of patients who've come back from dialysis and started seizing, or whose BP dropped suddenly, even if it was several hours post-dialysis, they had had stable vitals until then, multiple boluses/Trendelenburg, etc.

Most importantly..and I think this goes for a new grad in any unit, don't be afraid to ask questions!! You will realize who you feel comfortable approaching and whose advice you feel is safe, but if you have even the slightest feeling that something is wrong, or you're unsure, ask! It's better to ask a question you may think is silly than to make a mistake, or let go a subtle sign something bigger is wrong.

[laughing weasel]

Experience is something you get just after you need it. Ask questions and use the list. No one starts perfect at anything.

[holly123]

During my first weeks I got the best piece of advice from my preceptor that I still use everyday....During your shift, plan each moment as if your patient is going to code(which would take a goodhour of your time). So plan accordingly, have done what would need to be done and push back what can be pushed back. Then you can be on top of your game...it does get better after the first couple of weeks lol