Feeling incompetent

Nurses New Nurse

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So, I have been on the floor almost 6 months. I am finally starting to feel comfortable....getting into my own little routine. I know what is expected of me to get the "job" done (paperwork, meds, etc.) BUT....I am feeling like sometimes, I really dont UNDERSTAND what is going on with my patients physiologically. I feel like I am so busy that I dont even have a chance to think about whats going on. THAT SCARES ME!!!! Another thing is that the patients and family sometimes ask me questions regarding their illness and I dont know how to answer them. It makes me feel so incompetent :o

Is this one of the things that will come to me in time, with experience? Maybe I should go back to the books...its just that after working these 12's the LAST thing I want to do is open a book and read about nursing. Does anyone else feel this way?

You know....I have been sitting here thinking about how much time I DON'T have to break out books and review, but honestly there are times when I have 3, 4, even 5 days off between shifts. I am going to invest in a good patho book.....one that is maybe a bit more reader-friendly than my Med-Surg text...and really start applying some knowledge.

I became a nurse so that I could make a difference, and have a career that challenges me and pushed me the extra mile. Well it is definitely doing all of the above! This thread has inspired me to stop talking about how "lost" I am feeling and really go for it!

Remember...it's not all you. There IS a dr...and other nurses for the other shifts. If you don't feel comfortable about something...have another nurse look in on your pt.

That's a very good point, that the docs and nurses on the next shifts are all extra eyes on the patient and should be able to catch anything you miss, just as you'll sometimes find things that they've missed.

To me, this makes me question the wisdom, then, of having brand new nurses working 12 hours straight with a full load of patients. Yes, the new nurse will generally have at least 8-12 week with a preceptor working up to a full load, but as others note, it's not until a year that most new nurses feel like they're not just barely getting by by the grace of God. So during that year, for each shift, the new nurse ISN'T confident in their skills and abilities in that incredibly varied and hectic role as an acute care nurse. Add to that, it's a full 12 hours before the newbie is relieved and any inadvertent mistakes can be caught. Yes, the new nurse needs to ask for help and ask questions, but one usually doesn't know they missed something until someone else catches it.

Hmm... if new nurses only worked partial shifts at first, they might not feel as overwhelmed. They'd learn how to handle several patients at once, which they need to do, but if there'd be less time to get behind as their replacement would be there sooner and if the newbie were behind the next nurse wouldn't have as much catching up to do. And the newbie wouldn't be so wiped out from working a full shift that they'd be too tired to go look up and review what they need to.

I know, a scheduling nightmare! But I honestly don't think new nurses should be considered as equal to experienced staff when it comes to staffing numbers - after all, if the newbie is expected to rely on her/his colleagues for support, then they are yet another demand upon the experienced staff and that *should* be accounted for in staffing.

If it truly takes a year to feel competent, then that means working for a year feeling less than competant. And something seems wrong with that.

Specializes in RN- Med/surg.

jjjoy......I agree with parts...BUT>..if we could only work partial shifts.....I do believe the statistics of new nurses would drop considerably. I couldn't afford to pay my student loans if I worked partial shifts.

Where I work...they aren't considered equals. I love the facility I work at. They're fair and wise. The nurses that were oriented last summer are just now only taking 5 pts....rarely if EVER given the full work load of 6 pts. The charge nurses just know what they're capable of..and what's safe. THey seem to work well together. They'd rather give them a lighter load..that they can handle...than have them begging for help anyway because they can't get caught up.

I graduated in 2004 and worked home health for a while. Then I decided to try the hospital setting and It was pure **** at first. I dreaded coming to work, and even called in on occasion after a terrible experience the previous night. But I stuck with it and Just when I started kind of liking it and feeling a LITTLE bit comfortable, the hospital closed it's doors and we were all without a job. That was in May 2006. Since then I have not worked, but just stayed home with my new baby. I really want to go back to work now but am so scared of starting over. I'll have to get used to new co-workers, new doctors, and I am afraid I have forgotten alot too since it has been over a year since I worked. Does anyone have any advice or had a similar experience that might help encourage me to not be afraid of returning to work?

every nurses feels that way too. but nursing is a continous learning, so you should update your self every now and then...

Specializes in cardiac/education.
Hmm... if new nurses only worked partial shifts at first, they might not feel as overwhelmed. They'd learn how to handle several patients at once, which they need to do, but if there'd be less time to get behind as their replacement would be there sooner and if the newbie were behind the next nurse wouldn't have as much catching up to do. And the newbie wouldn't be so wiped out from working a full shift that they'd be too tired to go look up and review what they need to.

I know, a scheduling nightmare! But I honestly don't think new nurses should be considered as equal to experienced staff when it comes to staffing numbers - after all, if the newbie is expected to rely on her/his colleagues for support, then they are yet another demand upon the experienced staff and that *should* be accounted for in staffing.

If it truly takes a year to feel competent, then that means working for a year feeling less than competant. And something seems wrong with that.

Once again, JJJJJJOOOYYY, we are in agreement!

I know partial shifts would be GREAT for me! I think I'd rather work less hours and work everyday at first than work those huge 12's that turn into 14's. I am so dog tired by the end of the shift...not only from the physical labor but from the THINKING that all I want to do is go home, put my feet up, and forget that I chose this profession, lol. Forget about researching diseases! I want to, but then.....you know.

And yeah that with the newbies not being counted in the staffing ratios. That would be so much better in a perfect world, lol

And yeah, a year to feel competent????? That SUCKS. Something IS wrong with that, I am right there with ya! No wonder so many new grads end up with anxiety and depression! Who wouldn't????:o

I have only been doing this for 2 months and I feel the same way at times. My big thing is documentation. I need to find a book that will show me what a good note is supposed to look like when a patient has an issue. I have Smart Chart but that's too high level. I'm in a Nursing home and need something for LTC. I get frustrated when I have 21 patients on 3-11 and you have families asking you what's going on when you have finger sticks and blood sugars that read "HI" on the glucometer which forces you to call the Dr get new orders right them up chart them blah blah blah. It's frustrating cause I feel like a walking pharmacy. What happened to ASSESSING each patient and talking with them to find out what's going on? Who has time for that? Anyway, if you know of such a book that will help me with LTC documentation please let me know. Thanks.

I haven't read this book myself but I'm passing on a link to it here: https://allnurses.com/forums/f224/

Specializes in Jack of all trades, and still learning.

It seems in the US you guys stay in one area for your first year?

We have to do rotations here - we can put in preferences as to where we want to go, but often you don't get what you want.

I find it really hard, because by the end of the third month, you feel you are just starting to get on your feet, when you have to move on to a totally different field.

I am only just starting to build up confidence, because I have had the best support someone could possibly ask for, from my clinical nurse educator, as well as the different clinical nurse managers on each ward.

What I am finally starting to learn is:

1. you don't have to do everything; ask for help.

2. you don't have to know everything; ask - and say to your patient, that you are going to refer their question to a senior, or that you will look up their notes to give them more feedback. I believe that shows you respect their concerns, and they can see you are genuinely trying to help.

Specializes in med/surg, telemetry, IV therapy, mgmt.
i have only been doing this for 2 months and i feel the same way at times. my big thing is documentation. i need to find a book that will show me what a good note is supposed to look like when a patient has an issue. i have smart chart but that's too high level. i'm in a nursing home and need something for ltc. i get frustrated when i have 21 patients on 3-11 and you have families asking you what's going on when you have finger sticks and blood sugars that read "hi" on the glucometer which forces you to call the dr get new orders right them up chart them blah blah blah. it's frustrating cause i feel like a walking pharmacy. what happened to assessing each patient and talking with them to find out what's going on? who has time for that? anyway, if you know of such a book that will help me with ltc documentation please let me know. thanks.

allnurses student forums has wonderful resources to help everyone out. please make use of them:

what a great group of nurses...takes time and patience !!!!! each one of you... (BE PROUD OF BEING A RN) and what you have done will create golden opportunities !!! you will find a comfortable area of comfort to use those great learned skills !!!! have a great week and laugh a little !!!

I have been an LPN for two years and will be graduating in December as an RN, so I am in the books everyday and still find myself unable to answer patient's and family's questions about their disease processes as well as forming my own questions about them. I do, however, have some tips for you that work really well to prevent me from feeling incompetent!!

And just so you know, I work Med/Surg as well as Orthopedic and get to deal with a variety of disease processes instead of just one body system.

Develop a good rapport with your doctors (hopefully you're not working nights and can actually do this). There are few doctors that, if given respect and courtesy, will be too busy to educate you on your patient. I don't ever hesitate to ask what something means, what s/s may develop, what the lab values may indicate, etc.

If a patient has a question you don't have an answer to, find it right then. Most facilities have some education tool on the computer for lay information for patients. I honestly have to do this often, especially for discharge care or prevention care. It only takes me a second to type in the topic and hit print and not only are you learning, but youre teaching your patient more effectively by giving them material that they can reference later if they forget. Most of the time, the patient's feel you are going the extra mile by getting them 'extra' information. What's sad is that they consider it extra-its a shame we cant dedicate more of our time to patient education instead of paperwork. Seriously, taking a minute to look it up while you're at work is quick and you'll better relate it to whats going on with your patient and it saves you from doing homework at home :)

And most importantly-stay confident. You know more than you realize, nursing is just chaotic and its hard to connect all the dots sometimes. And yes, experience helps-I know so much more than I did two years ago, but every patient and their case is different, so you can't rely on that. You have to rely on your knowledge and knowing where to get it;)

Good luck

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