Does anyone else feel as if they are barely treading water?

MIA-RN1, RN · Aug 22, 2006

Whew, graduated in May...started on a busy med-surg floor end of June. I knew the first 6 months to a year would be hard...but I feel like I am about to go under at any moment. I run around like a chicken with their head cut off trying to keep up with orders, med administration, trying to reach docs, learning procedures, etc. I usually sit down to chart after I give report to the next shift. I dread going to work....I'll have 3-4 days off and all I have on my mind is going back. I never sit down, I inhale lunch, I usually stay an hour to an hour and a half late. I only have one more week on days, then I go nights. I hope this will help as I am at a teaching hospital and there won't be 30 residents/ med students hovering about hogging all of my charts. But then, I am worried about my cicadian rhytm being all screwed up! What the heck was I thinking going to nursing school? I hate this. I plan on getting my floor experience and moving on, if I can make it that long! Thanks for letting me vent!

it sounds like you would benefit from an organized assignment sheet. I break mine down by the hour and write in the hourly tasks, including when med doses are due, for each patient. Then I cross them off when I do them. I also take a minute to chart as soon as possible and I never save it for the end unless its been a particularly hairy day.

I was feeling overwhelmed at first until I developed the assignment sheet. I can't send you a copy, as its on the computer at work and I just make copies. But its got pt's names/room numbers at the top, divided into colums, and then horizontally its divided by hours. Maybe something like that will help you.

Good luck.

youngatheart · Aug 22, 2006

Txnurse, I feel the same way you do. I graduated in May and took nclex in june, started July 10th on a telemetry/med surg/pulm/renal floor. (lots of different things must be the overflow floor. At times I feel like i am holding it together then all of a sudden something small will put the whole day in a tail spin. They just assigned me 4 patients (aren't they all heavy?) in two weeks they want me to take on 5 (total). I have had 4-5 preceptors, 2 of which have been very good the other ones never check on me see if i need help. I have tried several different forms to get organized but nothing has really helped. The hourly form from coopergirl sounds ok but it takes alot of time to get that organized on 4-5 patients, but I appreciate the advice, I am orientating on Days but in Oct will go to nights 7pm-7am. I am such a day person that I feel my circadian rhythm will also be screwed up. But i have to think positive, less doctors, less orders at night, patients not going off the floor for some test! Maybe after a few months I can get my nursing legs and feel comfortable. The only real bright spot is I have a friend that I graduated with also working nights on a different floor and can eat a snack with her and vent a little bit. Keep your head up hopefully things for us will get better as time goes on.

BrandNewNurse · Aug 22, 2006

Treading water?? Barely.

I graduated May 12, 2006 and started working on May 30 in a busy pediatric emergency room. It's a teaching hospital, the only children's hospital in our state. I work 7p-7a, work 7 nights in a row, then off 7 nights. And I do not recommend it! LOL! My butt is dragging most of the time. And I feel so lost! I don't know what the heck I am doing. My days/nights are always screwed up, and I'm a huge grouch. I'm also 4 months pregnant, so that adds to the stress and fatigue. I keep waiting on the light at the end of the tunnel.

TXNurse,I think things will definitely slow down for you once you go to nights. I worked on a peds/med-surg floor during school, and things were so much calmer at night. True, it will mess your rhythm up. What will you be working? 3/2 split? Good luck! We're all here with you, just trying to make it!!!!! :bugeyes:

Dempather, RN · Aug 23, 2006

"I graduated May 12, 2006 and started working on May 30 in a busy pediatric emergency room. It's a teaching hospital, the only children's hospital in our state. I work 7p-7a, work 7 nights in a row, then off 7 nights. And I do not recommend it! LOL! My butt is dragging most of the time. And I feel so lost! I don't know what the heck I am doing. My days/nights are always screwed up, and I'm a huge grouch. I'm also 4 months pregnant, so that adds to the stress and fatigue. I keep waiting on the light at the end of the tunnel."

You work seven nights in a row, 12 hour shifts in a pedi ER? AND your pregnant? Did I miss something? You're like... super woman. I will never again cry about my 1 1/2 hour commute.

I'm still on orientation.. second week at work. I feel like it's the calm before the storm. All the instructors keep stressing organization and support systems. Do you guys have good people to talk to on the floor when you feel like things are getting a little out of hand? Are you still working with preceptors?

Lisky90 · Aug 23, 2006

MEEEEE!!! Chicken with my head cut off is the perfect description. I spend the day trying to remember sooooooo much...that half the time I don't even hear people talking to me...or that if what they are saying is not more important than what is already up in my brain, it just doesn't register. I am up to 4 pts...all on vents...one with funky cardiac rhythms, one with no urine output, a BS of 49, whose tubefeed I held due to 110cc of residual and no BMX2 days, the third had a fever and was pulling on his trach...and the fourth with neuro issues and is unresponsive. My preceptor has taught me a ton...but as I run around like a lunatic...she runs around behind me saying "did you do this???" "did you do that???" and telling me that I really can't get behind...and that once I'm on my own that I'll have 5 or 6 pts...and that I really need to chart as I go. While I completely agree with her on the charting, and I really appreciate her keeping such close tabs on me, I also feel like this assignment is unrealistic. I have been an RN for 5 weeks!!! There are experienced nurses that float to this unit and sink...swearing for 12 hours straight about how ridiculous a 4pt assignment is with pts at these acuity levels. I feel like it is crazy to have assignments such as this...but that is the norm in this unit. Just when I think "Wow...I can't believe I'm handling this" for the maybe 5 seconds that that occurs throughout the day...my preceptor is telling me what I forgot. And then after working for 12, 13, 14 hours a day...I spend my days off obsessing over what I should've/could've done different. I CAN'T WAIT to have my nursing legs under me!!!

MIA-RN1, RN · Aug 23, 2006

Oh gosh I am so glad I am in maternity nursing! I get four couplets most of the time, sometimes five. Sometimes they are only moms if the babies are in the special care nursery because the scn nurse's then assume care for the baby. We definitely have a surgical component d/t C-sects but mostly its routine postpartum care. Well sort of lol. There is usually one patient that is weird. So I have about 8 patients if you count them individually, which I think I should. After all, I'm responsible for both of them. Calling them couplets makes it look nice, is all.

Anyway, I started on June 5, had about 2 weeks of 'classroom orientation' and then on the floor. I came off of orientation last week and I felt ready.

Everyone I work with is really supportive (well mostly, there is a tech that I think might be a problem but not sure yet) and I feel that I can go to anyone with questions. Even the residents are willing to give me a mini-lecture if I need info on something.

cardiacRN2006, ADN, RN · Aug 23, 2006

I am up to 4 pts...all on vents...one with funky cardiac rhythms, one with no urine output, a BS of 49, whose tubefeed I held due to 110cc of residual and no BMX2 days, the third had a fever and was pulling on his trach...and the fourth with neuro issues and is unresponsive.
I also feel like this assignment is unrealistic. I have been an RN for 5 weeks!!! There are experienced nurses that float to this unit and sink...swearing for 12 hours straight about how ridiculous a 4pt assignment is with pts at these acuity levels. I feel like it is crazy to have assignments such as this...but that is the norm in this unit.

Uhhh....., yeah this assignment sucks! I'd say you're doing the work of 2 ICU nurses with that assignment! All on vents?! Girl, you should be toasting yourself with a fine glass of wine for surviving that day with only 5 weeks of nursing experience! You rock!

Pediatric Critical Care Columnist · Aug 23, 2006

Uhhh....., yeah this assignment sucks! I'd say you're doing the work of 2 ICU nurses with that assignment! All on vents?! Girl, you should be toasting yourself with a fine glass of wine for surviving that day with only 5 weeks of nursing experience! You rock!

No kidding this is a ridiculous assignment just as it is, never mind with two more patients tacked on. It has the potential to be disastrous. I don't think I'd stay in that job long. I have looked after four trached and vented variously-impaired kids at a time and it was hell. AND I wasn't a new grad, I was an ICU nurse. You have my utmost repect for not running from there screaming after every shift.

slu_rn · Aug 23, 2006

I feel the same way. I'm in a Level III NICU with 2-3 pts. Our acuity these past weeks have been insane. A PPHN kid with blood frothing from the ET tube, a belly that is swollen and blue from a perfed bowel, etc. I spent my last day off looking at all the colleges around here for a 2nd bachelors. I just don't know that I can handle this. I cry at the thought of going back to work. I don't know what it is that I don't like... I really regret graduating..

Lisky90 · Aug 23, 2006

OH...you have no idea how encouraging your words are to me right now. A. to know that I'm not alone and B. to know that I'm not crazy!!! I try to tell my friends and family how crazy this job is...and they just can't fully understand like all of you can. A toast to those of us who feel like we're on the sinking ship...a fine glass of wine would be perfect right now...as would a pizza...as I'm sooooooo hungry after this shift as the Doritos and the ice cream just haven't done the trick

steelydanfan · Aug 23, 2006

All I saw in June-July were the energetic posts of new grads who had passed thier NCLEX exams. It is now August, and already posts are surfacing from tired, beaten down new grads who feel threatened, incompetent, and unsupported.

Is this any way to run a profession?

You bet it ain't!