First day as an RN tomorrow...sick to my stomach

poopprincess · Sep 21, 2011

Hi Peerless! I'm a fairly new nurse (2 1/2 mo.; 1 on my own). I know how you feel, as I felt it too. As a matter of fact I threw up prior to my first shift because my anxiety goes straight to my stomach. So here is my advice. Things in the real world are drastically different from nursing school. The first few weeks will be focused on learning your facility and it is very task oriented. You will have to get your time management down before things ease up. I am not a fast learner. It took me a few weeks to really get the hang of things. We hired another student from my program who came out of orientation in 3 wks. (took me 6, I had requested 2 more). Just stay true to yourself. Don't guess at things because your patients safety is always a priority. Ask questions. Ask questions. Ask questions. haha Seriously, my place really liked the fact that if I needed help, I asked. I didn't care how small it was, if it was a 'stupid' question or not, I would double check until I felt better. They don't expect you to know it all and it's OK. Besides, they have their own way of doing stuff and they are going to teach you their way. Just focus on getting a routine that works for you down. Do things in the same order so you get used to it. Once you start, you'll see what I mean. Focus on assessing, med passes and documentation. The critical thinking part will come later. You know more than you think you do, but anxiety prevents us from thinking critically. Once you get your rountine down, your anxiety will get better. I have found that staff is split. Some nurses love to teach and are great resources. Just lean on your preceptor and those nurses for help. There are a few at my place that are only there for the money and I just ignore them. I was the only new grad in training there when I went through. I found most people were more than willing to help me and I still need assistance frequently even though I am on my own. Good luck with everything. Your first will probably be breezy, as I mainly shadowed (as did friends at different facilities). The more good shifts you have, the more confidence you build. Congrats on your new position! Look at it as an adventure-I love PEDS but didn't get hired there.

Are you working days/nights?

1JerseyCCRN · Sep 21, 2011

Realize that you will Never be alone, you will hopefully be with a preceptor for a while. Speak up and let them know if you are unfamiliar with a procedure or medication. Remember you are only ONE person, you can only do what you can do. Its very scary to start out, I remember being scared for at least a year. When you hear of something new going on in the unit, ask to watch or participate. Be honest when you dont know how to do something, we old nurses tend to forget how much you dont get to experience in nursing school. I remember I would make brain sheet, I would fold a piece of paper in half, write "report" on one sheet with all the systems (I do Neuro, Cardiac, Resp, GI/GU, Skin, Lines and Meds) the on the back of that sheet I would write tasks for every two hours (like turn, meds, residuals, neruo check ect....it will be different in your unit) then on the back of the folded sheet I would write out my assessment so I could add to it if needed through the day. Also I put K___, Mg___, ect so I dont forget to check my labs first thing in the morning. This way I have all my info I need for the day on one sheet of paper. Good luck! You will do great:)

Medic/Nurse, BSN, RN · Sep 21, 2011

so - how do you eat an elephant???

one bite at a time!

really - it will be okay. everyone has been there and, if honest, were terrified too. i'd be more worried, if you were not a bit worried. but - no need to make yourself sick (though i threw up the night before too and i'd been a medic for years and worked at the same hospital for a few years before in a support role - so, i understand and it was not necessary in hindsight.)

folks want you to do well and most all will help you do just that!

breathe.

listen more than you talk.

take notes.

ask questions.

breathe.

it will be fine (well, as long as you breathe normally in and out your nose and do not lock your knees ).

you will do fine - everyone started somewhere and "they" must be super impressed with you as it is a tough market. i'm betting that you will rock it. let us know how it goes! even after 20 years i learn something with every patient - you are starting a magnificent journey. good luck!

:anpom:

Isabelle49 · Sep 21, 2011

Hope you let us know how your day went.

imintrouble, BSN, RN · Sep 21, 2011

After 17 years I still remember the terror of my first job. Fondly.

It will be ok. They can't eat you.:)

carolmaccas66, BSN, RN · Sep 21, 2011

My advice: Go to bed early, and then the next day, get to your shift a little earlier, have a bit of a look around, get orientated to where things are, etc. Find out who ur preceptor is.

Ask questions all the time. Don't guess anything. If unsure re medications (meds), use a MIMS to look them up or ask a senior RN. Don't EVER give meds if unsure, even if ur behind & pressed for time (I've seen 2 many people make med errors cos they 'got behind' & thought speeding up would save them time, more fool them). Be interested and act like you want to learn. Learn good time management, get ur procedures such as wound dressings etc done early and do your notes/computer charting AS EARLY AS POSSIBLE, as time will fly away from you on wings. If anything else happens to a patient/s after you've done ur notes, just add it into the record. If u don't know something a patient asks you, say 'I don't know cos I'm new, but I'll get such & such for you' - being honest goes a long way.

Smile, smile and make a few (appropriate) jokes around staff & patients. Breathe deeply and try to relax a bit. Do something relaxing and write a journal of ur experience when u get home - it's a great tool for refelection.

Best of luck!! Come back on here and please let us know how you get on.

ADD: 4got 2 say, write everything down on a cheat sheet, then u never forget stuff! Cheers.

Peerless · Sep 23, 2011

THANK YOU so much for the replies of advice and tips; I really appreciate that.

I work day shift, 7a-7p; and my first day was very exciting, but terrifying.

I didn't screw up majorly or anything like that, but I felt like such a newbie that I thought at times to myself privately, "did I even GO to nursing school?"

What happened in this one day of RN work seemed so different that what clinicals and school was all about.

I felt shell shocked to be honest with you. It seemed like a million things were going through my head at once, and I was only picking out little things here and there. I keep repeating it, but I felt like I didn't know anything; and I just felt like I was a witness to take your child to work day.

I did have an awesome preceptor who was super nice and informative. We had five patients together, and I pretty much got to do 'everything' with two of them. Practicing my assessments, passing some meds, and doing a few nursing skills was what we started with.

But I think the thing that makes me nervous and crazy is the communication aspect of nursing. I feel like there are words and phrases/codes that I don't even know, that these nurses and MD use with each other on a very consistent basis. How do you know who to call to answer this question, how do you know this patient needed this and that.

I just felt so lost at times, and I really asked myself in my head "wow, do you know what you got yourself into? Can you handle it?"

I say yes I can handle it... but I tremble thinking about if I really CAN handle it.

Will I be able to answer this patients question?

Can I answer this MD's order or request?

Will I know the answer to this family members question?

Will I know how to document this, chart that.

Can I perform this nursing skill?

Will I choke?

I'm excited, but still very afraid.

xtxrn, ASN, RN · Sep 23, 2011

Like others have said- you're never truly alone :)

Nobody expects you to have it all together when you're a new grad- and if you DO, people run like crazy because that is THE most frightening thing a new grad can do is come off like they know everything. :up:

The fact that you are looking at your strengths and weaknesses tells me you're someone I would have liked to work with :)

It gets smoother, easier, and less scary with time.

carolmaccas66, BSN, RN · Sep 23, 2011

You won't know everything at first, don't set yourself up for failure.

If u don't know something, say: "I don't know I'm new here, but I will get the other RN" or find out or something.

Nurses and doctors have their own code when talking. When I coordinated a plastics & burns unit, the surgeons had their own code & at first, I was clueless re opearating list changes, etc. You will get the hang of it. Well done! You will be OK I reckon.

~Mi Vida Loca~RN, ASN, RN · Sep 23, 2011

It can be scary at first. Have confidence in yourself and be open to learning and things will come back to you. It's so much different then school. It's exciting and scary. ENJOY IT! Remember why you got into this and HAVE FUN! Congratulations on your new job!!!

turnforthenurse, MSN, NP · Sep 23, 2011

About 3 months ago I was in your same position. I just moved from Ohio to Texas with just my husband (we're military) and away from all of our friends and family. I knew NO ONE. I knew nothing of the hospitals (except for what I researched on their websites, and some fellow users on Allnurses were able to fill me in on some information) and I also knew no one. I was afraid of my coworkers and what they would be like. I was wondering if they would be accepting of me because I am a new grad or just leave me to fend for myself (sadly, that has happened before, but not to me). In my new hire group, there were only 2 new grads in the bunch - myself included.

I feel like I couldn't be more blessed with such a fabulous group of nurses. Everyone is so nice, receptive to any questions I might have (and they say there is no such thing as a "stupid question" but I feel like some of the questions I have asked have been pretty stupid!) and the teamwork aspect is fantastic. And even though I'm still so new (still haven't hit that 6 month mark yet) it feels great when you have more seasoned nurses asking YOU questions :) (not the kind of "knowledge" questions, but asking for your input on how to go about something!)

But anyway, just give it time! You can't be expected to know everything right off the bat. In fact, nurses who have 20+ years of experience under their belt still don't know everything. It's an forever on-going learning process.

ASK QUESTIONS, ASK QUESTIONS, ASK QUESTIONS! If you're ever in doubt, ASK QUESTIONS! Or get a second opinion. Try to round with the docs if you can. Ask them questions. Most of the time they are happy to to teach or explain things to you that you don't understand. And don't be scared about calling them...they're just another person on the end of the line.

Always look up your medications...I find myself looking up medications A LOT. It helps you learn! Oh, and pharmacy is a WONDERFUL source, so if you're ever unsure about something regarding medications, they are your best asset.

It takes time to feel comfortable, sometimes not until you hit your 6 month mark or for others, sometimes not until you hit your 1 year mark. Good luck!