Feeling like I'm a lousy nurse (rant)

RNKITTY04 · Jul 4, 2005

Ha.. good one Nurse Mike. You sound like fun, to bad we don't work together.

Most (all) of the male nurses I have ever worked with were unbelivably cocky.

You seem like a refreshing breath of air :)

duwah · Jul 4, 2005

Seren, Tomorrow will be better. And the day after that better still. And if your charge laughs at you it even might be because you did something she found funny....even if it wasn't funny for you.

Like the time I walked down the hall trailing toilet paper...thank God it was just the housekeepers that early in the am.....

We persist because we make a difference. And you are making one just by caring and being there. Hang in there, it all comes.

CinLPN2RN · Jul 4, 2005

:lol_hitti

Too funny! Just classic. (and a good point)

Liddle Noodnik · Jul 4, 2005

Anyone feel this discouraged after their first week of nursing orientation?!

It is probably just Newbie-itis. If you are not anxious in general this will probably pass.

I have had a horrid performance anxiety for some time - it just makes the brain freeze up -

So work on the anxiety - some self talk such as "Of COURSE I am not supposed to know everything, that's why there is orientation!" And "what is the worst that could happen?" (well the worst is that they could throw you out on your ear - and you can always get back up again!)

Do some exercise to bleed off some of that anxiety energy - a 20 minute walk should do it - eating well, sleeping well, being as PHYSICALLY well as you can be.

Have you tried just saying how you feel out loud to your preceptor? she probably knows darn well anyway - but I find that trying to cover up the anxiety just makes it worse! tell on yourself and that's one less thing to worry about.

Hang in, yes it is normal, yes we all had that to some degree - you need a night out with some good girlfriends and realize that you are all in the same boat!

HappyNurse2005, RN · Jul 4, 2005

Hey I'm a stinky new nurse, too. LOL. I've been on the floor for four days. I suck. I have got the insulin syringe all ready to give, got the alcohol wipe out, and instead of wipingthe pt's arm to give the insulin, I wiped the IV port. LOL, i realized that mistake before I did it.

We also have IV trays, with assorted sized needles, connection tubing, op-sites, tape, saline, etc etc etc. Full. I knocked it off the bedside table and all over the floor.

I was trying to split a pill inhalf, using a trick my preceptor told me-chop it along the scored part with a scalpel. Yeah. Almost sliced my thumb off, but just barely missed a trip to employee health!

I feel like I know nothing. Nothing. SUre, i learned in school how to do trach care, even did it in clinicals before. But when a pt was right in front of me needing trach care, i'm like "uh, uh, uh....."

ZASHAGALKA, RN · Jul 4, 2005

Do you remember in nursing school when your instructors warned you about not correcting the nurses because they didn't always do things 'by the book?'

This is why.

As you get more experience, you will learn which shortcuts are 'safe'. You will remember drugs that you don't have to look up anymore. You will remember to bring that extra straw/towel, etc so you don't have to make extra trips.

I have often said that nursing school doesn't make you a nurse. It prepares you to become a nurse. ON THE JOB TRAINING is what makes you a nurse. I felt my first year of nursing was an extension of nursing school.

During my first year, I worked 4-12 and rarely started charting till report was over at 12:30 and rarely left before 2 am. My school didn't teach IV skills, so on top of MY 8 patients, I was required to start all the IVs on my unit during my shifts (so I could learn the skill).

On the plus side, my time management skills are sharp and I'm one of the best IV starters in my hospital - as a direct result of that grueling year.

With every shift, things get easier, you organize better, you 'get it' better. When I woke up one day about 7 months along and realized that, because of all those IVs I was starting, I could normally put an IV in first try, even on difficult patients, and in something like 5 minutes, DANG! What a revelation in how far I'd come!

Take a deep breath, you are doing fine. Your preceptor may make a snide remark or laugh, and that is rude, but you better believe, no matter how long ago it was, she was in your shoes. So don't sweat it.

They say nurse eat their young. Find a tough skin so you aren't a tasty morsel. It's also true that nurses are some of the most caring people out there. As you grow into it, you will see.

I will say this: the new nurses that annoy me aren't the ones that don't know everything; it's the ones that THINK they know everything - because they are dangerous to patients. You don't sound like that, so you have a huge headstart. I don't mind constant questions from new nurses seeking knowledge; I object to questions from new nurses trying to prove what they know. Keep asking questions that seek knowledge, even the stupid ones - you never know when some pearl of wisdom will land in your lap.

Keep the faith - this is where you learn nursing.

~faith,

Timothy.

nursemike, ASN, RN · Jul 4, 2005

I am one of about 5 preceptees on my unit. A couple are total newbies, 1 did an externship there, and one did clinicals there. I've worked there several years as a UAP, but I'm a total novice as a nurse.

So, day three on the floor, one of the new girls with some experience on the unit (I think she had clinicals there) asks: "How many patients are you taking?" At this point, I'm still shadowing my third preceptor in three days, so I said, none, yet. She says: "None? I'm taking four!"

Now, they warned us in orientation classes not to do this, but still, a part of me is thinking I'm way behind. I mean, I'm nervous about taking one! But I had already decided I was going to lobby hard for at least one on day four, if no one offered, because if I wait until I'm truly comfortable, I'll be in orientation when I retire.

So, I got my patient on day 4 without having to lobby. Last night was my first night shift, with yet another preceptor, and I shadowed again. Thing is, each new preceptor is going to want to watch pretty closely, at first, and each has her way of doing things. My preceptor last night was surprised that I had already taken one, the previous day. Anyway, I'll get one of my own, tonight, unless they're all really bad, which is a possibility since we're in step-down.

This isn't meant to be a rant against my fellow preceptee, or my preceptors. My point is, we all have our own situations and have to work with whatever they are. It's a very good thing for me that I'm on my home unit, so I know a good deal about how these people work. The nurse I was with last night is a major role model for me--she's very good, and excruciatingly thorough. She does nothing half-baked, and it will be like that when I precept with her.

Others are more comfortable winging it, and things will be looser with them. It's all good--it's just a matter of knowing what to expect. Well, that and self-assessment. I have to have a pretty good idea in my own mind of what I'm ready for (even if I don't quite feel ready) and, more importantly, not ready for. I have to push myself a little to stay challenged, but not dive head first into something I can't handle. I have to know when to trust those with more experience, and when to speak up for what I know. I have to advocate to progress, but be willing to ask for help or clarification when I need it. It ain't easy, and I really feel for all of those who have to go through this in a totally new setting.

Thank God for all the many nurses out there who don't eat their young, and who enjoy the chance to pass along what they know. In clinicals and at work, I've met many who were as good at teaching as any of my teachers, and I'm grateful to all of them. I hope I can do the same for someone else, one of these days (many years from now!).

Good luck to us all, from a middle-aged newbie. My advice to us all is to push yourself--gently. Be humble, but not afraid. Be as confident as you can, but not foolhardy. DO NOT EVEN THINK ABOUT WHAT ANYONE ELSE IS DOING!

This is your time--worry about you. And be genuinely happy when an opportunity presents itself to make another's job a little easier, even if it's only gathering up the dirty linens.

Okay, team. Time to hit the showers, grab a bite to eat, and get out there and have some fun!

P.S. Oh, BTW: it's my hospital's goal to keep us with one preceptor as much as possible and as much as our respective schedules allow. Typically, you wind up with one main one and another now and then. In my case, part of the process is likely to be that EVERYBODY gets a chance. One of my four preceptors, so far, has been out of orientation for about a month. Oh, well...it's part of the price for staying on your home unit.

**RosesrReder, BSN, MSN, RN** · Jul 4, 2005

Maybe you are being over critical about yourself. Remember that no one is born knowing this stuff. I am sure that the more practice and time you put into your new career will help and make things better and easier.

Everyone has given you wonderful advice.

Good luck :)

BamaRN · Jul 5, 2005

The one thing I pride myself on is organization and time management. I have figured out a way to get my am assessment/med pass/nursing notes finished usually before the experienced nurses do. After report I gather all my piggybacks and narcotics that I will need for the morning pass and make sure my med cart is stocked with alcohol swabs, syringes etc. Then I take my cart down the hall. I go in the first patients room with all their morning meds. Before giving the meds I do my assessment. Then I give the meds and talk to the patients and/or pt families. When I walk out of the room I stand at the cart and do the nurses notes and opening statment. Then I go to the next pt and so on. This helps me alot. I have found that if you go do all your assessments then go back and do your meds and then go back and sit down to chart that you'll never get finished. Doing the assessment, meds and charting on one pt before I move on to the next also helps me to remember the patient - see if you go and do 7 assessments then go pass 7 pts meds then go sit down and chart you will have trouble remembering which pt is which and whose lungs sounded like what etc. This may not be possible where you work or you may think it sounds stupid but it really works well for me. The hardest thing Ive found so far is knowing when I need to call the doctor - i mean i know for life threatening things and such but you know - when labs are slightly off and things like that - I have to ask another nurse if they think I should call and knowing which dr to call for what problem too - like if the patient has 10 different MD's. Thats my weak spot.

underwatergirl · Jul 5, 2005

The one thing I pride myself on is organization and time management. I have figured out a way to get my am assessment/med pass/nursing notes finished usually before the experienced nurses do. After report I gather all my piggybacks and narcotics that I will need for the morning pass and make sure my med cart is stocked with alcohol swabs, syringes etc. Then I take my cart down the hall. I go in the first patients room with all their morning meds. Before giving the meds I do my assessment. Then I give the meds and talk to the patients and/or pt families. When I walk out of the room I stand at the cart and do the nurses notes and opening statment. Then I go to the next pt and so on. This helps me alot. I have found that if you go do all your assessments then go back and do your meds and then go back and sit down to chart that you'll never get finished. Doing the assessment, meds and charting on one pt before I move on to the next also helps me to remember the patient - see if you go and do 7 assessments then go pass 7 pts meds then go sit down and chart you will have trouble remembering which pt is which and whose lungs sounded like what etc. This may not be possible where you work or you may think it sounds stupid but it really works well for me. The hardest thing Ive found so far is knowing when I need to call the doctor - i mean i know for life threatening things and such but you know - when labs are slightly off and things like that - I have to ask another nurse if they think I should call and knowing which dr to call for what problem too - like if the patient has 10 different MD's. Thats my weak spot.

I think the most competent and good nurses are the ones who learn to organize themselves, time managment and priotize. You got babe...you are way ahead of the ball game.

I believe in calling the doctor whenever in doubt...if the doctor complains or is a jerk then tell him you are still learning and you want the best for the patient. Think if you were the patient, you want the doctor called when??? Also it CYA (cover your ass)...if you report something off to an MD you cover yourself...you are giving the patient the best care you can...

Hope that helps

grinnurse, RN · Jul 5, 2005

The one thing I pride myself on is organization and time management. I have figured out a way to get my am assessment/med pass/nursing notes finished usually before the experienced nurses do. After report I gather all my piggybacks and narcotics that I will need for the morning pass and make sure my med cart is stocked with alcohol swabs, syringes etc. Then I take my cart down the hall. I go in the first patients room with all their morning meds. Before giving the meds I do my assessment. Then I give the meds and talk to the patients and/or pt families. When I walk out of the room I stand at the cart and do the nurses notes and opening statment. Then I go to the next pt and so on. This helps me alot. I have found that if you go do all your assessments then go back and do your meds and then go back and sit down to chart that you'll never get finished. Doing the assessment, meds and charting on one pt before I move on to the next also helps me to remember the patient - see if you go and do 7 assessments then go pass 7 pts meds then go sit down and chart you will have trouble remembering which pt is which and whose lungs sounded like what etc. This may not be possible where you work or you may think it sounds stupid but it really works well for me. The hardest thing Ive found so far is knowing when I need to call the doctor - i mean i know for life threatening things and such but you know - when labs are slightly off and things like that - I have to ask another nurse if they think I should call and knowing which dr to call for what problem too - like if the patient has 10 different MD's. Thats my weak spot.

This sounds like a great idea. I am going to try it when I go back to work on Wednesday. We have puters in the hall where we can chart. Will let you know how it goes for me. I think this is great can't wait to try it out thanks.

Luv2BAnurse · Jul 5, 2005

What you described is pretty much how any new job is until you get a routine down. As for your preceptor snickering, she may not have been snickering at you. Perhaps you did something that reminded her of herself, or even someone else. That does happen. Where I work, when certain nurses say something totally wrong we laugh, even if it's oh so silly. Demermol, Phenermin, Glucoma, these are all examples, and I'll not say which I said :) What I am getting at is, you ARE new, and you will do fine, it takes time. We were all there at one time.