Frustrated with my first nursing job.

[poopprincess]

Hey! I'm new to AL (well been reading posts for 2 yrs but just signed up).

Nursing has been quite the experience for me and I am feeling what I read most new grads on here feel. Frustrated, disappointed, down, and inadequate. Not to mention the massive anxiety that comes into play. It's so bad that I feel like I can't think and I don't critically think like I want to. It's all I can do to carry out all my tasks. My husband isn't in the medical field, he is supportive, but he doesn't understand because this isn't his expertise. So here I am.

Graduated this yr. and got a job at LTAC. Wasn't my first choice but I embraced the opportunity to learn some skills and get a good foundation. My training was 6 wks. and in vent pts. so I only had 4 pts. Now I work med-surg and the ratio is 5-6 pts. It's expected I handle it because they are less critical, but they are NOT easier. I am 1 wk. on my own and I am at my wits end. At the beginning of every shift I walk into complete and utter chaos. I get started late and tone for the shift is set. I can never catch up. There are times I am still receiving report an hr. later! I ask a gazillion questions because I don't care if they think I'm stupid. I do care that my pts. are safe.

Nursing school doesn't prepare us for the real world. They give 1-2 pts. that we spend time with them and get to know them. We actually have time in clinicals to do pt. care and think about why we do things. Then we get jobs, and BAM! Culture shock. I knew it was like this, yet I am still shocked. My progress from wk. 1 is great, yet my 100% is still not good enough. Support from staff is 50/50. We have nurses in and out of this place all the time. They have problems keeping people so they use agency/travel nurses to fill in the spots. Usually I don't know most of the people I work with, and it's a toss up on support. Sometimes they are more than willing to help me and some don't even look my way when I talk to them. The next shift is not any more supportive. My last shift I stayed 1 1/2 hr. late because I was behind and the oncoming nurse was still making snide comments about things not being perfect. I know I set the tone for her shift too being behind, but I did the BEST I could. Starting my shifts late and then having things happen like clogged PEG tubes/PICC lines walking in the door will throw me even more behind. Most days I don't even get lunch even though it's taken out of my check. I do not want to be a lazy nurse, nor to I want people to dread coming in behind me. I am at a loss though.

I'm tired of crying every freaking day. I'm tired of the techs refusing to help me (most pts. are total care and many can't turn themselves) or telling me they did something and I go in to see it's not done. OR the facility giving me 5 pts. with a tech to help on only 3 (the easiest ones). My problem is not the extra work, it's the time management and my inability to do it all alone yet. If I'm in the room I try to cluster the care and empty the Foleys/ostomys and get BP for meds all at once, but sometimes I'm SO slammed. Sometimes I feel like I barely know my pt. at the end of 12 hrs. I wish I didn't get so frustrated. So there it is. I am not sure I like nursing. I love my pts. but rarely do I get to know them. I know that it gets better. I see the nurses rocking it. I ask them for tips for ways to get better. Honestly, I kinda wish I had stayed a dental hygeine major.

[HouTx, BSN, MSN, EdD]

Take a deep breath -- you're doing fine, Really. You appear to be a very conscientious nurse who is committed to delivering quality care. I'd certainly like you on my team!!

The situation you describe is pretty much normal for someone who is one week into working solo in their first job. You are not alone, not sub-standard, not a bad nurse. You're normal. As your skills improve over time, your ability to effectively multi-task will also improve. There's no shortcut, and no way to predict exactly how much time this will take -- everyone is different. The only way to get past this is by pushing through, and learning from your experience.

However, I would strongly advise you to focus on establishing control over your relationship with the techs. The assignments are made based on the idea that you will be sharing the work with techs... if this is not happening, you will always be swamped. First, address the insubordination - outright refusal to perform tasks as requested. This should be documented and taken through the proper channels, NEVER ignored. They will probably react negatively, but it doesn't seem like it could get much worse than it already is. Also, work on your delegation/supervision skills. Does your organization provide any classes or development in this area? Talk to your supervisor and request assistance to develop your skills.

Honestly, the situation you have described is fairly typical. In areas with high turnover and use of lots of 'temporary' (agency) the techs are usually the staff with the longest tenure... so it's easy for them to establish control of the workflow simply by intimidating the newbies. This is especially true if they have a lot of solidarity & re-enforce one another's behavior. I know that the nurse manager should handle this, but he/she can't do it alone.

[EDnursetobe]

I understand how you feel. It can be really overwhelming at times. I'm new too, and some days are better than others but generally I feel like an idiot. It's hard to feel that way all the time.

And I feel like I don't even know what "critical thinking" is anymore lol.

[poopprincess]

Thank you! It is extremely overwhelming. Sometimes I have a good shift and go home confident, and positive. Then I'll have a bad shift and my confidence is shook. I guess the best way to describe it is I feel like I am on an emotional rollercoaster. I do improve every week and I know that my inability to go with the flow is a weakness. I have always been praised in all my other positions for having a positive attitude, but I think my frustrations tend to get the best of me in this job. I have learned a lot and I know if I make it here for a while, many doors will open for me. This is my second career (food and bev for 13 yrs.) and I am used to being good at what I do. My organization does not offer classes on delegation/supervisor skills. I would jump on that in a heartbeat if I could. Maybe I can find a good book on that?

This wk. my goal is to get the tech's on board.They have been there for a long time and they treat me like I am an idiot. I have been nothing but nice to all of them, but they have no respect for me. I even had one tell a family member that the Dr.'s don't write orders for restraints (my pt. was restrained). I corrected her and showed her the chart after we left the room. However, I can not repeat of my last shift. My sanity will not take it. LOL Thanks guys! It felt good to just vent and get it all off my chest.

[noyesno, MSN, APRN, NP]

I'm 6 months in, working the 3-11 pm shift and I feel your pain/frustration. You are not alone.

I do notice things getting a tad bit smoother with time but it's 2 steps forward and 100 steps back. Kind of discouraging, if you ask me.

I really think things will get better as we approach the 1 year mark. Keep showing up, put one foot in front of the other, one day at a time, etc. If things don't get better by the 1 year mark, start applying elsewhere.

You sound like a great nurse. Hang in there poopprincess!:hug:

[netglow, ASN, RN]

This is my second career ...and I am used to being good at what I do.

I hear ya! You and me both.

[xtxrn, ASN, RN]

You are not expected to have the critical thinking skills that experienced nurses have, and if you get grief over that, remind whoever rags on you that you're still new, eager to learn more, and just want to do a good job. If they have a problem with that, THEY have a problem :)

If there is a way to note that you didn't take a lunch, do it. Maybe not all the time if it's going to stir up a hornets' nest- but remind the powers that be (I used to be in management, so not ragging on them) that you are worth more than free labor.

And yep- the techs need to listen. I went from being an AGENCY aide to being the house supervisor (only grad nurse in the building at the time- and hadn't taken boards yet....back in 1985) in a week. That was awkward- and one of the CNAs pulled me aside and let me know that they still knew how to do their jobs :) (not saying that's your issue at all- just that it takes some adjusting to being a nurse). You can ask them how they like to do things- and if that works with your scheduled stuff, let 'em do it. If not, explain why, and see if there's a way to keep communication open. A good CNA/tech is worth their weight in rhodium (highest priced precious metal). :two cents:

But keep up the good work. You're supposed to feel overwhelmed- that's very normal, it stinks, and it gets better :)