*Sigh* Can't wait to get past this...

[Bumashes, MSN, APRN, NP]

Okay, so I've been an RN for 2 months now. I work on a BUSY med-surg floor with 12 hr shifts on nights. Our hospital is too small for the community that has grown around it, so there are plans to expand, but for now we stay packed to the rafters.

Anyway, I'm at the stage in my career where I cry a lot when I go home. You know, because either I feel like I forgot so much or didn't do enough or whatever. Even though we have an excellent ratio (4:1 with an occasional 5th), the kinds of pts we get go anywhere from "just here for a day" all the way to "I need to be in ICU, but there aren't any open beds." For example, one night I had a 23 hr observation pt, a lap choly pt, a lap choly & Nissen pt, and a GI bleed pt. This was a pretty good night for me. On the other hand on another night, I've also had (1) a dementia amputee who kept crawling out of bed/ pulling out IV's/ pulling out catheter and the docs didn't want to do anything to stop it, (2) a major surgery with a PCA and 20,000 other meds due to past hx, a rising temp and lessening urine output, (3) a new admit coming on who speaks no English with new onset Appendicitis, (4) and a woman with a trach and tube feeds in what I will call an "awakened" coma because her eyes were open and she could scream but nothing else who had to have neuro checks Q1hr and meds Q1hr.

Now, I have an awesome preceptor. But at this point, I have told her to just wait for me to come to her because I want to do it all on my own for now and just use her for questions and back-up. Because, hey, she won't always be there, right? And my other co-workers are very supportive as well, but they have their own load just like mine. We do primary nursing, so we're all off in our own little worlds most of the time.

I'm just writing to get some of the stress out. Almost every night when I go home, I think about everything I missed or might have missed. Things I could have done or didn't get to do. Like with the "awakened" coma lady, She needed mouth care and other basic things done Q1-2hrs like how they do in ICU, but I did not have the time. It makes me sick to think about it. At any rate, I just wanted to write about it and get some therapy from putting my frustrations into words. Thanks for listening!

:typing

[Okami_CCRN, BSN, RN]

My advice to you is things will get better, you will learn to handle the stresses of your job in time, you dont know how many new RN's ive seen cry in their preceptors arms and be great RN's.

and if you did not get to do mouth care or missed something, guess what nursing is 24 hours if you could not do it pass it on to the next shift. I really do hope and wish you the best of luck

[Virgo_RN, BSN, RN]

Par for the course. Give it time, and don't beat yourself up.

[RN1982]

The first year is always the hardest I feel. It will get better. Just give it time.

[Nurse Salt]

I remember the first few months I would leave work and make myself sick with worry over what I forgot or didn't do... Truthfully, you get over it! Now when I leave work, I LEAVE WORK. Unless I forgot to chart something important, or do something dire I don't usually give it a second thought... Find something to take your mind off work, I used to lose myself in classical music driving homem The lack of angry beats or words enabled my creative mind to wander as my analytical mind had nothing to process. Finding a hobby may help too, I picked up tennis. A hobby gives you something to look forward to because, trust me, for the next several months you WON'T be looking forward to work. Then one day you will realize, "Hey, I don't dread this anymore! When did that happen?"

Good Luck, and hang in there!!!

[Dolce, RN]

Now when I leave work, I LEAVE WORK. Unless I forgot to chart something important, or do something dire I don't usually give it a second thought...

This is really the best advise. After your shift ends and you get in the car take a deep breath and tell yourself, "I did the best I could." Every new grad has a crisis of a first year. It is a terrible experience and the learning curve is outrageous. All you need is the tincture of time.

[NurseyPoo7]

Q1hr neuro checks should be in the unit.

I work on a neuro floor and anything more frequent than q 3 hr neuro checks go to the unit.

[pirap]

I put a year in med/surg with often 7 pts a shift. Things get hectic I know. Just hang in there...you are so new. If this is not your type of nursing--learn EVERYTHING you can, do the best you can and when you go home don't worry about it. Your "grove" will come with time and experience and many of the things you are fretting about will be a distant memory!!

On the MS Gulf Coast, huh? Man I wish...I think I would stop at a local casino and throw a few back with a that $50 that is burning a hole in my pocket.... (We used to vacation there every year for 1-2 days and then journey onto Florida to the beaches with the kids for 2-3 days..Casino Magic was our spot...still there but not to play anymore..sorry just a side note!!!!!)

Hang in there!!

[wooh, BSN, RN]

You're gonna hear a lot of "It gets better." Because it really does. The funny thing is. I went from "couldn't keep up" because I was new to "totally on top of things" because I got comfortable, to "couldn't keep up" once I was a bit more seasoned enough to know things I can add to what I'd been doing to be a better nurse and I'm back at "can keep up" for the most part. Of course, the "can keep up" also was helped by moving to a different floor where the patients are just as tough, but they recognize the acuity level and most days I have a patient less than I used to have.

I think a big part of growing as a nurse is the recognition that you are only one person and sometimes things just have to slide. And learning what can slide and what can't. Granted, soon you'll be thinking faster. But you're not going to be able to get it all done every single day. There are going to be a lot of days, especially on a med-surg unit when you aren't going to feel like you helped make your patients better, but instead just kept them alive. If you kept them alive, feel free to go home and leave work at work.

[psalm, RN]

My first couple of months I spent crying on the way home from work...or feeling so depressed that I couldn't seem to get the hang of it. Make sure you are getting a break, eating and hydrating. Do something physical after work, even if it is a good stretch session. Hugs, as you adjust. You sound like a caring professional.

[RN1982]

When I first graduated and started my internship on a progressive care unit, I probably cried my first three days. My preceptor was wonderful and I liked her and then management changed my preceptor to another nurse who had just been out of school for maybe 2-3 years herself and she was nit-picking at me over everything. Things like "I'm disorganized", "I'm not compassionate enough"...My personal favorite was when she made up a story about a doctor saying that I lacked compassion...I read all the stuff in my employee file two years later right before I quit that job and moved on.

Being a new grad is tough. It was especially hard for me because I was a new grad on the unit I worked on as an aide and everyone is holding you to higher expectations. The aides treated me bad because they felt that since I was an aide before I could do everything for my four patients who were heavy, by myself and shouldn't dare ask them for assistance. It was just rough and I probably cried for a good four months every day after orientation.

[rhondaa83]

WOOH, I am absolutly going through the same EXACT things that you were writing about. Just when I feel comfy, I take on more to be a better nurse, then you feel comfy again, and then you take on more. I am a couple of months young on the floor (LTC) and you have hit the nail on the head. Rhonda