Fresh Meat....New Nurse in need of some advice!!!

jean333 · Dec 7, 2007

Wow..I know exactly how you feel. Its my first week on the job only its in a doctors office and I am so overwhelmed. Its a large one and very fast paced. All the other nurses have 10 years experience on me. Clinical were nothing like this and I feel like I am never going to get it??? There is so much more to learn and they didn't teach us a lot of this stuff in school. Anyway I know we just need to hang in there. I have heard it takes at least 3 months to begin to adjust and at least a year to find your rhythm. I thought the same thing as you though...wondering how I got myself into this. Some of the nurses told me today that the last LPN's quit right away but I don't want to quit. I want to be a nurse and one day after I get more experience I want to go after my RN and work in emergency..I must be nuts..talk about pressure Right? Hang in there.

Jean

joprasklpn · Dec 7, 2007

Just remember everyone was new to nursing at one time, so keep your head up and try not to worry about it. Heck, I'm still learning and I've been at this awhile.

Diary/Dairy, RN · Dec 7, 2007

I am still learning too - give yourself some time - it gets better as you are better able to get organized.

Daytonite, BSN, RN · Dec 7, 2007

hi, l0velynurse, and welcome to allnurses! :welcome:

congratulations on your new job. it's in long term care, isn't it? that's the only place i know of where charge nurses get 20+ patients to care for. i have to tell you that 20+ patients is not a bad patient load. some nursing home nurses have to do meds and treatments for 50 patients!

3 weeks is too early for you to judge yourself in relation to your performance. even as an experienced nurse, it takes more than 3 weeks to get acclimated to a job. you're a brand new nurse out of school and you should not expect to be a top performer at the end of 3 weeks, 6 weeks or even 3 months. yes, you need more time to get used to things. it takes time to learn to organize and become familiar, confident and competent in everything that you are going to be expected to do in the job of a charge nurse. being a charge nurse is a huge responsibility and nursing school does not prepare you for it. most of it you are going to learn on your own and it is going to take time--lots of time.

if you quit then you will go to another job and probably find yourself in the same situation.

you do not have to compromise your ethics and take short cuts like you see some of the other nurses doing. i never did and i started my career in long-term care and often worked in nursing homes over the years even though i was a hospital rn. it is a personal decision you have to make. what i did during my career was learn to become a very good organizer. that is what gets you through. nursing school doesn't teach you very much about organizing your workday either. there is time to fit everything in, you just have to make the time and learn how to multi-task. this takes time to learn. i've spent my entire career working on perfecting my organizational skills and so will you.

one thing i can offer is that you should ask that you be assigned to one permanent nursing unit and shift. as a new graduate you need the stability and routine of being on one unit all the time to help you learn the routine and get organized.

one of the first things i did was start making todo lists of the tasks i absolutely had to complete each workday. i worked on them at home and wrote them on the back of my "brains" (report sheet). as i accomplished these absolute tasks that had to be done i would cross them off. that way, the most important stuff always got done. you can always add something to the list that might come up during the workday. or, when you get home and you review how your work day went, you can add something to the next day's list that you have found you needed to add onto it.

http://www.ehow.com/how_3812_make-list.html - how to make a todo list
http://www.mindtools.com/pages/main/newmn_hte.htm - time management from mind tools

the main things you have to do, pass meds and get treatments done, should be a focus of your day. think about how you can speed things up. which patients take their pills easier and quicker? do them first. which patients are easier to target when they are all together in a bunch in the dining room? do their pills when they are eating. we used to change the times of the meds on the patients who required a lot of prep time (such as crushing and putting them down g-tubes) in order to get them off the main med pass times. that way we kept in compliance with the state laws requiring the one hour leeway time in passing meds to patients. there are many strategies that you can incorporate to get things done that you are not aware of, that many of your colleagues many not be aware of, but during a lifetime career of nursing you will learn--and it won't be from nursing school. these will be things that your common sense and life experiences will tell you.

all i can say is hang in there. 3-weeks is too early to judge. you need to be at this for several months, like 6 months before you decide to throw the towel in. if you are in long-term care you might want to check out the posts or ask questions and advice on the geriatric and ltc forum of allnurses (https://allnurses.com/forums/f22/). also, i wish you wouldn't refer to yourself as "fresh meat". hold your head high and stand up for what you know is right. i did and i worked in a ltc with a bunch of rats. in the end, i was the one doing the right things and they were the ones ending up getting into trouble. these kinds of people always do eventually. when you do things the right way you don't have to spend your career always looking behind you to see who is watching what you do and trying to "catch" your mistakes and wrong doing. not only that, but you might go home tired, but you go home with the knowledge that you did things the right way. believe that is a much better way to live.

L0velyNurse · Dec 7, 2007

Thank you so much Daytonite! I really needed all the advice I can get. Everyone is right I just need to hang in there. Yeah, long term care is really hard for a beginner like myself, but I was thinking it would be the best place where I can learn the most in this career and better myself as a nurse. I will try that ToDoList..thank you for the tip. I like to be organized too. I just need to find my rhythm and pace myself. Once again THANK YOU! =) Hopefully I can keep you updated on how things go from here @ work.

Lance67RN · Dec 24, 2007

Hello.. im Lance.. im new to the site. but before i worked up my profile and all.. i felt i just had to comment on this. I have had one experience where my preceptor was an "eat their young" type. but the problem is.. learning organization comes difficult for me. The hospitals are just no help in teaching either. Just recently i left a hospital that promised 3 months of training. I had advocated that due to the poor experiences in my two previous locations. The 3 months went to no more than 11/2 months in orientation. Then when on the floor orientating. It suddently went to just 21/2 weeks. The hospitals are not giving time for a new nurse to learn! I'm about to give up on nursing myself. I can really relate to the original post except, at least it seems the place of employ is giving a person time to learn. No wonder there is a nursing shortage! Get the warm body on the floor ASAP. Anyone have any suggestions as to learning organization? Any websites, particular areas of nursing that are good for a relatively new nurse to start out? Any ideas at all would be great. Because Im really about at the end of my rope. I have admitted my weaknesses. But looking for a place that will help overcome that and really really help make me a good nurse.

Daytonite, BSN, RN · Dec 24, 2007

hi, lance67rn, and welcome to allnurses! :welcome:

it's too bad that your employer is not holding to their promise of keeping you in orientation (did i understand that correctly?).

learning organization is not something that is easily taught or learned. nursing schools, as a rule, barely touch on it. it's kind of an on-the-job learning thing. i will give you websites where you can read about organizing your time:

http://www.mindtools.com/pages/main/newmn_hte.htm - time management from mind tools
http://www.ehow.com/how_948_manage-time.html - how to manage your time

the thing is that time management (organization) is very customized to the situation you are in. i started out in every job by making a todo list. (http://www.ehow.com/how_3812_make-list.html - how to make a todo list). i did these at home when i had time to relax and think about what had gone on during my day at work. you also have to arrange the things on that list in the order they need to be done and in their order of priority. this also takes some thinking and reasoning on your part. the first list won't necessarily be perfect. so, you incorporate changes into each list as you make it. now, 25 years ago when i did these, i had to write them out by hand. in today's world, you can use your computer to help you by composing these lists in a file that you save so it is a very easy matter to edit them and print them out just before you head off to work each day. as i accomplished tasks on my todo list i would cross them off. just the exercise of sitting down each day to re-think your day and how you would re-organize it is very helpful in teaching you organization skill and prioritization. you will find that you will make errors in judgment. but, that is how we learn. incorporate what you have learned from your errors into your thinking and move forward. it's how we all did it.

the hospital, unfortunately, as an employer is looking to get "work" out of you and not be a "teacher". you are expected to perform as an rn. much of your learning has to be on your own, but there should be some resources available to you. as an orientee, you should be able to request the opportunity to be able to do specific procedures that you need to get experience at, and your preceptors and manager should be making those opportunities available to you. that is part of the orientee experience. however, you are still going to be expected to perform as a staff nurse. sorry. there should also be a policy and procedure manual that you can consult with regard to procedures. a good fundamentals book or going through nursing journals for information on specific procedures will be helpful. some of this will just have to be done on your own time if the hospital will not provide the time for you.

i worked on a stepdown unit for some years. we had a lot of patients with chest tubes coming out of the icu and at first i was scared to have them because i didn't know squat about caring for chest tubes. neither did any of the other nurses i was working with. it was really an appalling situation. how could all of us be caring for these patients and not know what we were doing? i finally spent one of my days off going to one of the best health science libraries at a local medical school and pulled every nursing journal article i could find on the care of chest tubes and copied it. i went home and started reading, reading, reading. by luck, a couple of medical company reps decided to hold a 4 hour seminar on, of all things, chest tube drainage systems! i was right there to see what they had to offer. by the time i was done, i knew a lot about chest tubes, drainage receptacles for them and how to handle problems with the tubes and the drainage systems. and, that, is pretty much how you have to take responsibility for your own learning now that you are out of school. no one is going to tap you on the shoulder and say, "it's time to go to class on how to suction patients on a ventilator." you will have to take the initiative to do it on your own. or, like i have seen in so many nurses i have worked with over the years, forever walk around work hoping that the situation never comes up because you haven't a clue as to how to handle it.

i had a professor tell me after we had graduated that the most valuable tool students really take away from their education is how to find answers on their own. that's partly why we had to do all that research in the library. it's funny, too, where you will sometimes find the answers to questions that you have. everyone and everything is a potential resource for the answer to a question. ask others about how they organize their work day. some will be happy to share; some won't. latch onto the ones who are helpful.

hope that helps you out. good luck with learning to organize. it will be a career long pursuit, but it does get easier to do as you become more experienced at it and become more familiar with hospital protocols.

**Elektra6, ASN, BSN, RN** · Dec 24, 2007

LovelyNurse:

It IS possible to speed yourself up without compromising yourself especially if you have the same set of residents all the time. I used to give the residents their meds out of order of the MAR. For example: I saved the "night owl" residents to the end of the med pass and get the early birds at the start. Our facility had a 2 hour window before/after dispensing time and I used that to my advantage. (I worked 3-11). Keeping a to-do list like the other poster suggested is a must, you'll never forget anything!

Have faith, it will never be easy, but it will get EASIER!

lil' girl, LPN · Dec 24, 2007

Yep! As soon as you get your rhythm down it will get easier. And if you can get a regular cart and not have to move around it will get easier. We all had the heebie jeebies at first. You aren't the only one and won't be the last. Hang it there you will make it. Good Luck!