New grad sinking fast

  1. Hi,
    im a new grad nurse and am in terrible need in of some advice. Please any advice is welcome!
    I just started orienting on my floor 2 nights ago. & I have to say I am already bombing it. My first night was ok but the second night I was orienting on a PCU & that's where things went bad.
    To get to the down and dirty I was an absolute mess. I slowed my preceptor down considerably. Like to the point that I think she may be missing some things because of me. I charted on one patient and managed to miss key components on that. & it's not from not knowing about the pt. It's mostly because idk how to work the darn charting system. In clinicals they had Cerner system which was SUPER easy to use. This hospital uses meditech & I'm struggling tryna figure where everything is.
    On top of that, I feel like my hand has to be pretty much held. I don't think I'm making the transition from nursing student well. I've made med calculation errors ( I always review with my preceptor tho), messed up on looking up what meds should be given at a certain time, but the point is I miss key things. I can't look thru 6 pt orders on a chart that I barely know as fast as I should yet. Therefore since i don't have time to look thru everything, I barely know what's going on.
    I just feel like I'm too slow of a learner & perhaps acute care isn't for me. I mean I couldn't even put the yankauer to the suction on correctly, I'm struggling with how to use the pumps, how to run the meds, how to set up tube feedings. just all the simple stuff a nurse should know. Today my preceptor told me I wouldn't be getting not even ONE pt to myself. Mind you its my first week but I can't even progress to one pt. Most ppl at least make it to 3. I wouldn't be surprised if they fired me in this week.
    my preceptor is pretty nice. But you know how gossip is, especially in a hospital. & I feel like I'm just following her everywhere & ppl are looking at me like "why are you following her every footstep".
    even the patients can tell I'm new, which is bad. Has anyone else been in this situation? Should I request to go to a slower unit ( this floor is known to be the hardest floor in the hospital), or should I just try to work somewhere else entirely? I want to be good at this and work in a hospital! but I really starting to understand if ain't meant for ya , it ain't meant for ya.
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    About Sheika34

    Joined: Jul '18; Posts: 16; Likes: 8
    from AL , US


  3. by   Luckyyou
    You've been a nurse for 24 hours. Stop being so hard on yourself. You will learn.
  4. by   Sour Lemon
    I hear that you're unsure of a lot of technical things. That's the "easy" stuff that you can learn in time.
    If you're slowing your preceptor down, that's likely because her assignment is too heavy considering she has a new graduate to work with. It's not something you have control over, unfortunately.
    I don't hear anything that makes me feel like you can't do this.
  5. by   Miss.LeoRN
    You sound just like a new grad. Welcome to being a new grad. You'll mess up. You'll forget things in the charting system. You'll slow your preceptor down. You'll have your hand held. Don't take that personally. You're supposed to. You'll forget how to hang something or what settings to turn the pump to. You'll be unsure of what meds you can give, how to give it, and ask countless questions that any other nurse should know. My preceptor told me "better safe than sorry". Question everything and anything, don't feel stupid. If she had a question and I couldn't answer it (like, what a med we spent two seconds on in school was for or how it would help a particular patient) she went over it with me. I was lucky to have a wonderful preceptor and when she wasn't on those who filled in were equally as great. I hope you do as well. My Educational Outcomes Director was constantly on me asking me how things were going with my preceptor. Now, that wasn't to say there weren't some days where I stepped on my preceptor's toes or made her eye twitch. Of course I did. There's a fair amount of "I want you to develop your own methods and ways of doing things, while at the same time, doing exactly as I show you and tell you". And I understood this. My screw up isn't just my screw up, it's hers too. My first week was pretty much shadowing and learning the system (we have Cerner), that next week I had two of our 4/5 patients. No one ever said to me "wow, you've been here two days, you can't handle your own patient load yet". If I felt like the patient was giving me a strange look all I said was "Hi I am Miss.Leo, I'm new to (facility name) and orienting with (preceptor name) today."

    The third week I was doing all the charting and most of the care, as well as (trying to) give report (she'd had way more time to look through the chart and even pin down doctors for questions than I did and would help out), though my Preceptor was over my shoulder the entire way and she still made sure to be right there when I gave meds. Some days were seriously hard. I was expected to hit the ground running and get right to it, sometimes without a full picture of the patient. Some days I went home and my mind was blank because I wasn't even sure what I accomplished that day. It wasn't until Week 5 that she was letting me go my own and then following up afterwards.

    By the time she said goodbye to me and passed me onto my night shift preceptor, I could hold down a full patient load, had no issues with charting, was skilled in tracking down doctors to ask questions (it was important to the floor that new grads felt comfortable paging, calling or talking to doctors, especially if they were gonna be night shift), and managed report easily.

    It all comes with time. As long as you are improving... you're doing fine. So you're first few shifts or even your first two weeks felt like a disaster. Are you repeating the same mistakes or did you learn from them? If you're struggling, let your preceptor know exactly what you are struggling with. "I'm not too familiar with this charting system, can you double check to make sure I've covered everything". Make a check off list for charting if you need to. Carry a clip board with notes of things you need reminders of. Mine had IV times, pump settings, important extension numbers, charting reminders, whatever I needed.

    So, in short... take a breath. You're doing just fine.
  6. by   HelloWish
    The expectations of yourself in such a short time are unreasonable. Learning to be a floor nurse after graduation takes months, not days! Even after a year you will still feel like a novice. You shouldn't have any patients by yourself yet. You need more time! Your level of learning is reasonable and you should be following your preceptor everywhere...that is what is expected. That is how you learn! You will get the hang of it, you just have to give yourself more time...
    Last edit by HelloWish on Jul 31
  7. by   cleback
    Deep breaths. I had only one patient my first week too. We had 12 weeks of orientation and was only expected to have a full patient load at week 4-6 (it was imc). You will slow your preceptor down... that's a given... and a shame that she is still expected to take a full pt load. For the charting or technical things, maybe sequester yourself in am empty room after a shift and go over orders, room set up, pumps, etc. Also a good brain sheet will help you decipher orders quickly. If you haven't made one, do it now and add to it as you progress through orientation.
  8. by   City-Girl
    So as you stated in your post you started your job as a new grad RN only 2 days ago. Usually for the first several shifts you should be mostly observing and absorbing all of the new info your preceptor has to share (and yes it's a lot). Don't feel pressure to take patient assignments straight away. As far as the technical stuff, your hospital should be training you the the computer charting system as well as the patient monitors. For any nurse starting a new job whether seasoned or brand new, it takes time to get your feet wet. It may take a while before you feel entirely normal in your new role. Take a deep breath and try to enjoy yourself a little, you've achieved your goal of becoming an RN. You'll learn something new every day.
  9. by   KelRN215
    You should not have 3 patients on your own within a week of starting a new job.

    When I was a new grad, I was in a new grad program which was 20 weeks long. We started with 1 patient WITH a preceptor and progressed to 3-4 independently by the end of orientation. There's a reason you have orientation. Heck, even experienced nurses got 6-8 weeks of orientation when I worked in the hospital.

    As far as the EMR system goes. You should not be on your own trying to figure out where everything is. Did you not have a class on it? Your preceptor should also be guiding you.
  10. by   Been there,done that
    You should just be observing now. You are not there to just provide patient care, you are there to LEARN patient care. I think trying to chart on a patient, without completing your computer training is a waste of time. Hopefully you will get adequate training on that.. could take weeks.
    You WILL struggle with the hands on for awhile... we all did. Don't worry about your preceptor... soon you will be actually helping

    Try to relax a little and learn.

    Best wishes.
  11. by   Daisy4RN
    Everyone has stated it well so far. You just need time to adjust from student to nurse and you will. I don't think there are any "slow floors". All pretty much the same as far as busy goes. You probably are slowing down your preceptor but don't worry about it, that is how it works. Give yourself some time, it will be fine!!
  12. by   iluvivt
    You must remember that nursing school only gives you the foundation and now you must build the house.You will be slowly building your house as you learn little by little how to actually practice the art of nursing.Once your house is built then decorate it as you find your place in the profession and what you are good at.Then you are constantly maintaining that house keeping it clean and current and it may need an addition or remodel as you change specialities.
  13. by   NurseBlaq
    Co-sign every response in this thread! Being a new grad on your first job and fresh into orientation made us all feel a wreck. However, it gets better with time. Give yourself time and don't expect to be a pro fresh out of school. I've been a nurse for years and still learning. You'll learn all the way to retirement and then some. Slow down, breathe, and become a sponge and try to learn all you can. Just remember, every nurse does what works for them. Watch your preceptor and learn the important things but you can always tweak them to suit you, except the nursing basics like patient care, infection control, safety, etc. but you get the point.

    Good luck to you.
  14. by   Boston RN
    You are struggling because your nerves are getting the best of you (been there). It's a process, you will get there.
    Print out your post and tuck it away. Read it again in 6 months, I bet you will be amazed at how far you have come (you will most likely get a good chuckle as well). Hang in there!