Drowning New Grad RN Resident

[RNCaliNurse]

I just started a 3 month new grad program on a cardiac tele floor and I feel like I'm never going to make it. My Preceptor is WONDERFUL but I just can't seem to get the hang of things and cannot manage my time well. She is constantly stepping in and if it wasn't for her nothing would get done. I don't even have time to look at most diagnostics or dr notes. And charting on one pt takes me about 30-40 min. I feel so defeated. On top of that I can't ever seem to remember which patient is in which room and their names. I remember everything the moment I see them (diagnosis labs meds etc) but not off the top of my head if we're talking about room numbers. I'm afraid I'll mix them up. Yesterday I went until 4pm without a single drink of water, food, or bathroom break because I was so behind. I thought nursing was my calling but school did not prepare me for this

[Rose_Queen, BSN, MSN, RN]

Take a deep breath. What you are going through is perfectly normal. Nursing school is totally different from real world nursing, so you are experiencing a bit of reality shock, and most (if not all) new grads are going to experience it. The common consensus is that it's going to take about a year for you to feel competent in your role as a nurse. You just started, so of course you're going to need help, guidance, and take longer than the experienced nurses to do things, including charting. Also, I would advise against relying on memory when it comes to patients- it's not a test, and the chart is your resource to help keep things straight- I'd be more afraid of mixing things up if relying on memory.

[Ms Petite 93]

Hi! I am literally in the same boat as you. It takes me literally an hour to finish at least 3 of my 5 patients charting. On a good day, I'm on time which is few and far in between. Just today it took me an hour to fully chart on everyone. I felt bad being the only night shift left behind charting--except for the night shift charge.Hey it can happen when you get an admission, transfer, all in one shift.

I know that there is a light at the end of the tunnel. We are new and this is definitely normal. I have had immense support from the staff and charge nurses which I'm grateful for. My charge nurses have relayed to me that if I was "great" they would be concerned..as that is not the normal for a new resident. Just the fact that you are safe right now is priority. Everything else will fall into place. All I can do is do my best and make sure my patients are still alive. Yes, I will miss some stuff that the day shift nurses may be annoyed about....but at the end of the day I'm still learning and my patient did not start going down or die on my shift. That's what's most important to me is my patient's safety. No matter how slow I may be with my med pass.

I feel defeated as well and can't wait to be that nurse with 6 months under her belt and look back at this like wow I made it. I don't feel at all confident but I've received great feedback from my charge nurses. We are still learning..it takes a year to even feel remotely comfortable according to Pat Brenner.

There will be tears shed and frustrations felt. But we will get through this sister. In no matter what way, shape, or form we will get through this. Treat yourself, go out in the fresh air, enjoy life when you're off. Then get right back in it ready to conquer our weaknesses one by one every shift. Think positive-I am-thats the only way I'm keeping sane :)

Honestly I pride myself in thinking no matter what..I did my best.

[SedatedRN]

When you have 4-7 patients on a medical unit it's almost impossible to remember every little tid bit. I print off thier "summary" or "story", write out thier actual name vs initials, code status, and highlight thier room number so I can whip my papers out if I need to write down somthing or report somthing on them. Make checks on your paper to keep your charting on tract (assessment, care plan, I&Os, meds). I remember when I used to think I can't wait to tell patients/family I have more then 3,6,12 months of experience:) when I was a new grad. Things should level out, remember you do what you can on your shift and the next shift can help out too.

[pmabraham, BSN, RN]

Good day:

I'm a recent new grad working on a cardiac telemetry floor. It reads like you are not using brain sheets regarding keeping track of your patients (aka labs, assessment, treatments, meds, etc.). May I suggest starting to use a system to keep track of such information?

The Ultimate Nursing Brain Sheet Database (33 nurse report sheet templates) has many brain sheets from which to pick. I would also recommend asking your coworkers if they could share a clean version of what they use. I ended up making my own in Microsoft Word; that way I can update it as new ideas come into play or if I see a section that isn't working as intended. Attached is a picture of my brain sheet; it's two sided. I use it on a folding clipboard in landscape mode.

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Is your charting computer-based or paper-based? Have you asked any of your coworkers to review what you are charting, as well as make recommendations as to what to do differently?

May I suggest that you make it a point to take your meal break even if it puts you further behind. We need that break, as well as a bathroom, breaks even if it is to go into the bathroom to remind ourselves to breathe, and we will get through the day.

Thank you.

[amzyRN]

Time management sheets are good for floor nursing. I would definitely use one to organize your activities. If it's taking you 30-40 minutes to chart on 1 patient you might be doing something wrong. It really shouldn't take you that long even as a new grad. Ask your preceptor for pointers on that. A full head to toe can be done in 3-5 minutes and should not take longer than 5 minutes. Clustering care and prioritizing are helpful for time management. Try to push yourself to speed it up without sacrificing safety.