End of shift frustration

[Cabbagehead]

I'm a new grad still working with a preceptor. The end of orientation is rapidly approaching (2 wks).

As expected, increasing my patient load has stressed me a great deal. I focus on my mistakes and may or may not realize my victories on any given shift. There is not too much positive reinforcement on the unit, and I wish there was, especially when it comes to putting patients before paperwork. I found myself grabbing meds for two patients at once.. carrying the one set in my hand and putting the aspirin for another patient in my pocket. I found myself charting an assessment... not remembering the date and/or gauge of their IV site, so defaulting to the previous shift's assessment. (lesson learned: they can be wrong).. anyway, I spent the last 10 minutes of a busy shift trying to contact radiology to confirm they were sending the oral contrast for a patient's CXR. it was the weekend and i could NOT get thru to anyone. i tried 5 different numbers, let some ring forever, got a hold of a couple people who just redirected me.. called the operator...

the night nurse was aware of what was going on, but it was my responsibility to get everything settled. I thought otherwise- wouldnt she take care of it? I just wanted to go home and couldnt take any more. my preceptor intervened and got on the phone, trying another number; finally getting through. i was embarrassed and worried as she pointed out that you cant just leave like that. i'd simply given up!

i'm worried because now is the time i should have tons of energy and willing to stay late, etc. But i wanted to leave. I had my jacket and bag with me-- literally walking out the door-- when i spotted my preceptor on the phone; finishing the job that was mine.

how could i do this? frustrated with my attitude...

[AirforceRN, RN]

Nursing isn't a profession that doles out the hero cookies...sure you get some thanks and once in a while there is a pat on the back, but for the most part, you have to realize that you have done the best you can and take comfort in that.

Taking on a full assignment is a daunting task for all new nurses. Even experienced ones forget things sometimes and end up frustrated with themselves. It took me almost two years just to figure out a cheat sheet that worked to help organize my time. You see the older nurses that can handle 5 heavy patients just as easily as baking cookies and you wonder "Will I ever get to that point?"

The answer is yes. It takes time...you learn the tricks of the trade (NOT to be confused with shortcuts), you learn who to call and when, you learn to organize and prioritize and you learn that it is easier to ask then to call radiology fruitlessly for 45 minutes.

Finally you learn to pat yourself on the back after a tough day's work because nobody died and Mrs Smith had a really nice bed bath and feels better.

You realize you are having difficulty and that is SO much more then many nurses (even seasoned ones) ever do (remember that "critical thinking" thing in school? They weren't just whistling dixie you know).

Good luck in the future. Give it time.

[RedhairedNurse, BSN, RN]

Orientation is very stressful. You will feel relieved when you get off orientation. You will also know that there will be no one to do you job for you and that makes a huge difference. Autonomy is a good thing. You'll be fine. Don't be so hard on yourself.

It gets so much better when your on your own, believe me, it was such a relief for me for orientation to be over. You will still have plenty of people around you to ask if you're ever unsure of anything. And be sure to ask, don't ever do anything if you are not 100% sure.

[TX_TeleRN]

Frankly, you are doing alright! MY ! Some nights will be good ... Some nights will be long ... And some nights will be very daunting... Just hang in there! The only thing that I would recommend is: talk to your preceptor to review what you could have done differently to make matters better and learn from this experience. And... Don't leave before your preceptor, as your preceptor cannot leave before you either.

You are almost cut loose to be on your own. When you start solo, you'll feel even more overwhelmed and "forgetful." But that's OK! Stay calm as best as you can so that you don't make any big mistakes. It is better to go slow, and do things right to prevent hurting anyone. Speed will come as you gain your skills. Work on figuring out a system that will suit you best in managing your time. You will get the hang of remembering details with your assessments to chart later.

For example, every RN-to-RN report is given differently so I found that by making my own report sheet (as many other RNs do), it helped me find info more quickly. And when I assess a pt, I quickly scan my sheet to verify what was given to me was correct, and I make corrections so that I could chart later. It's more pages to carry, but I dedicate 1 page per patient so that I can reuse these sheets until the pt discharges or transfers off my unit. I recommend that you also check out blogs on time management and/or report sheets.

I think it took me a good 2-3 months on my own before I was able to leave before 8pm! I solicited other seasoned RNs to learn of their routines and see what components I could use for myself. Now?? I think there has only been a handful of times when I left on time (i.e., just 12 hrs to my shift), but for the most part now, I am content if I only run 15 min. late.

Hang in there!