good student, bad nurse...

caroladybelle, BSN, RN · Dec 8, 2005

I am a traveler and I frequently have those feelings. And I graduated in 1993.

I think that many of the best nurses have doubts about their abilities. It is just that the better ones see their shortcomings. They always see that they could have done better, ignoring "the good enough".

Some nurses are happy with the "good enough".

gauge14iv, MSN, APRN, NP · Dec 8, 2005

The mantra that saved me from myself...

Nothing has to be perfect, it only has to be excellent.

That phrase taught me a whole new way to live and a whole new way to practice. I had a very wise preceptor in a unit I went to work in after actually LEAVING nursing for a year for all of the feelings you describe. And I had been out of school over 10 years at that time.

When the pressure of perfect is gone, you are free to do everything in excellence.

I agree with other posters though that your manager and preceptor need to give you specific items on which to approve. Where are their expectations not juving with yours?

nursebear168 · Dec 9, 2005

We both have the same background,good student with a good GPA,graduated in May 2005, passed NCLEX 75 the first time,and working in an extremely high acuity unit.But it doesn't seems matter in the real world, I got out of orientation 1 month ago. In my opinion, I think you would learn how to put things together more than when you were preceptoring. It was very scary working by myself the first 2 weeks. It sounds weird may be because I tried very hard to finish my shift w/o leaving too many messes behind. Changing hospitals (not a option for me because I have a one year contract, changing to another unit has always been on mind, but I may be jumping from "the lion's den into the tiger's mouth".So I chose to tough it out :) I have been through so many incidents,mistakes, etc, and I learn everytime.Well! we are in the same boat.Just hang in there............... :uhoh3: :uhoh3: :imbar

wellsee · Dec 26, 2005

Whatever you do, don’t let them make it about you. Working as a nurse takes a while regardless of your specialty. I am always learning and changing my style. And excuse my cynicism, but hospitals are kind of a screwy environment (according to my friends who do other things).

I’m a 20 year ICU nurse from a large city and all my work was in very high acuity hospitals with heavy loads of patients. I still remember how awful it was when I started—and this is when they were doing that archaic trial by fire method of training nurses that I hope to one day see eradicated. And I’ve also noticed that when I go to a new job, it’s almost as hard. Remember, some of the preceptors that you come across do not know how to teach. And they may also not understand that everyone has a different style of learning. I just started a new job (I moved to a smaller city) at a smaller, much lower acuity hospital (and very backwards) after taking some time off, and I had a hard time. But when I dissected the situation, a small part of the problem was me (for not working for a year), but a large part of the problem was the system (the incredible noise in the unit, unprofessional if not bullying behavior of staff, a preceptor who didn’t know pathophysiology or even policy who was also tired because she was coming in off 16 h shifts, dump assignments, and a preceptor who was also fairly subversive i.e. trying to tell me to do things that were wrong and then saying it was my idea, changing my drips when I wasn’t looking and blaming that on me, hiding my worklist, and a lot of other games. After a couple of weeks of this, the nurse manager was trying to push me off orientation, and querying me about what was my problem. I told the nurse manager what was happening, and I happily resigned because I knew things would just get worse. Especially after seeing some of the dangerous assignments given to some staff nurses who were not in a certain clique.

And I hold myself completely blameless. But even with the 20 years I’ve got under my belt, I began to think that I couldn’t do it anymore. And then my nurse friends back home (a nationally ranked hospital, mind you) reminded me of all that I had done. And they also reminded me that this wasn’t a very good hospital (staffed 50% with travelers as they could not retain their staff), that the nurses were very much interested in protecting their overtime, and that they probably needed to protect their incompetence (no longtime staff likes to be upstaged even if it is in the interest of the patient). Not a very nice thing to say, but I’ve seen it happen before.

And nurses are definitely known to "eat" their young (or the newcomers or sometimes basically whomever). And some systems I’ve worked in are just a set-up for failure. Just hang in there, keep your cool, stay detached (you are not your job), and be professional. If need be, start documenting stuff that is going on in your area to cover yourself. Or leave and find another area. Every unit and hospital is completely different. Discretely find some people who you can network with. Just remember that nothing you do that is less than your expectations is a failure.

I just wish someone had mentored me as to what nursing was like and had taught me about politics (and a lot of this business is politics) and managing my stress levels. I used to (and sometimes still do) take it very personally and let it ruin my life. Please don’t make that mistake!

Chaya, ASN, RN · Dec 26, 2005

SophiaJoy, please bring us up to date. You've been in my thoughts-how have you been doing the past few weeks?

My situation when I got out of school was very similar; great on paper but struggling when it came to prioritizing and juggling a number of equally urgent tasks at the same time. For me it really was necessary to start out in a more generalized, less acute atmosphere the first year or so.

Anyway, let us know how it's been going. :nurse:

eg2002 · Dec 27, 2005

i worked medical & surgical floors over 20 years initally as an "excellent nurse" to all of my patients. The last years I provided excellent care daily to 1-2 patients and rotated the patients daily because the demands became unreasonable. Complete your assessments within the first hour if possible. Eyeball everything you have to do while completing assessments. Set up and administer meds by the 2nd hour. Complete a first charting within the first 4 hours and documentation. I worked agencies and probably over 50 facilities. The "good" nurses on the medical and surgical units know how to chart timely, and heaven only knows what they are really doing. Help your coworkers and they will help you. I changed to dialysis chronic working with four patients, then to acute working with one. Your are taught everything you need to know, and you will have no problem completing your tasks. I also worked with children in psych and completed my tasks. There are hundreds of areas to work that are not stressful. Pray and search. I don't believe you are the problem and I think it a shame you were given that feedback.

Dan.Ed · Dec 28, 2005

Sophiajoy; Hope you are feeling better. All the replies to your message look like good advice. One thing I noticed that you said that no one else addressed is that you said you were feeling depressed. It is very hard to think and act in a positive way when feeling depressed. If you are losing sleep, losing (or gaining) weight, can't smile (and really feel it), can't enjoy sex, or having problems with memory -- you may be clinically depressed...

Don't feel ashamed to ask your md for an antidepressant till you are feeling better.... let us hear from you... dan (sicu, neuro, psych, nursing instructor, home health, therapist)

Pekoe-RN · Jan 1, 2006

The mantra that saved me from myself...
Nothing has to be perfect, it only has to be excellent.
That phrase taught me a whole new way to live and a whole new way to practice. I had a very wise preceptor in a unit I went to work in after actually LEAVING nursing for a year for all of the feelings you describe. And I had been out of school over 10 years at that time.
When the pressure of perfect is gone, you are free to do everything in excellence.
I agree with other posters though that your manager and preceptor need to give you specific items on which to approve. Where are their expectations not juving with yours?

I LOVED this reply; thanks. I would also love to hear how you are doing Sophiajoy. I am just 4 weeks on my own after a 7 week preceptorship on a tele floor. I feel like I "don't get it" but no one has actually said it. Just how have they phrased this to you? What are the specifics? Is it passing meds? Is it assessing? is it time management? there are so many factors. I just feel so ... scattered and there are so many skills I still need to learn!!! But to think in terms of "excellence" rather than "perfection" - that makes a world of difference to me. Thanks gauge 14iv.

Nurse_Nikki_RN · Jan 4, 2006

I did very well in nursing school and passed the NCLEX in 75 questions. I enjoyed precepting and looked forward to starting my career. Now I'm 3 months into orientation on a surgery floor and just not doing well, either in my job or my life. It's not just my own insecurity--my preceptor and nurse manager agree that I just don't seem to get it. I especially struggle with time management. I may have taken on too much right out of school... I'm on 12-hour nights on a high-acuity floor, and am new to the city. I am becoming seriously depressed, ashamed and freaked out about my best-laid plans going so rapidly awry that I'm having a hard time functioning. At this point I am asking myself, "What in the hell was I thinking, that I could be a nurse?" What if I lose my first job? My self-confidence is zilch by now and the idea of applying for another job is terrifying and humiliating. Any thoughts, advice, comisser
Your story just about sounds like mine. I started out on Telemetry (big mistake). The I left the hospital all together for a Nursing home...slower pace, more patients and still, there are emergencies. Now they have me floating shifts and floors. In the month and change that I've been there, I don't know the patients that well adn they are on a gang of meds. I feel like I am not a good nurse because I am so slow and I feel like I can't remember everything. I have to be honest, sometimes I feel like floor nursing isn't for me...scratch that, most times:scrying: BTW, I graduated 6/05

Barb2000 · Jan 4, 2006

Nursing school is not easy, neither is passing the NCLEX, yet you did both. I wish you had a more supportive manager/preceptor. Maybe you and your preceptor are not a good fit. I have had preceptors (I have worked in 5 different areas in 10 years just to see where I really wanted to be) who worked great with others, yet their style didn't work for me. Can your manager help you transfer to another dept whose pace is a little slower so you can hone your time management? Don't let embarassment or fear prevent you from looking elsewhere, you are not the first nurse to move to another area to find the right place to launch their career. I remember wanting to quit my first nursing job, just felt too overwhelmed, and that I would never get it. But, luckily I was in the military, so that was not an option, and things did indeed get better. Hang in there, and keep sharing.

Nurse_Nikki_RN · Jan 4, 2006

Nursing school is not easy, neither is passing the NCLEX, yet you did both. I wish you had a more supportive manager/preceptor. Maybe you and your preceptor are not a good fit. I have had preceptors (I have worked in 5 different areas in 10 years just to see where I really wanted to be) who worked great with others, yet their style didn't work for me. Can your manager help you transfer to another dept whose pace is a little slower so you can hone your time management? Don't let embarassment or fear prevent you from looking elsewhere, you are not the first nurse to move to another area to find the right place to launch their career. I remember wanting to quit my first nursing job, just felt too overwhelmed, and that I would never get it. But, luckily I was in the military, so that was not an option, and things did indeed get better. Hang in there, and keep sharing.

They float me from floor to floor as it is, never asked me how I felt about working alone and would put me alone when they were short. I am working in a nursing home with 30 patients and one BP cuff for a floor of 60 people, no working thermometers and have to run all lover the place for meds..and the other nigh, there were just two of us on the floor. I am just not fast, IO know if I gave each person 5 min I would be done in 2 1/2 hours..but we have to figure in the G-tubes and the treatments. I worked 3-11 and went home at 2 am last night. I got offered a job by the home care place I worked at before becoming an RN. People keep on telling me that I need to do more time in the hospital, but I feel like for now, I don't want that right now and I feel like I can do that when I feel more up for it.

SFCardiacRN · Jan 4, 2006

Give yourself time. IMHO Floor nursing is the hardest job in the hospital. A lot of new grads get discouraged...at first...and then they start to take off. Good luck.