How Long Before You Felt Expert as a Nurse?

  1. I've been been a nurse for about 10 months. It was really hard in the beginning (REALLY hard, and demoralizing), but I've gotten better. Most nights I can roll through and get done what I need to get done and keep my patient safe. I'm still learning with every shift, but I'm getting better at asking the right questions and keeping my eyes open.

    But I'll still have a night where I'm confronted with a ton of stuff I don't know about and end up making a stupid, obvious mistake or two. I notice that other, more experienced nurses are calmer and seem to be working more efficiently, while I'm running around like an idiot, staying after to chart, etc.

    I know that you always have bad or overwhelming days no matter how long you're a nurse, but at what point did you feel expert enough to take it all in stride and know that you could handle whatever came your way? When did it become so instinctual that the fear new nurses feel went away?
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    About Pachinko

    Joined: Oct '03; Posts: 288; Likes: 127


  3. by   leslie :-D
    i felt relatively safe and more comfortable, after a yr.
    by the end of 2 yrs., i was cocky enough to think i had seen it all.
    11 yrs later, there are pts that still can knock my socks off.
    i've learned to NEVER attain a total comfort level.

    but in my assessment, i think you will be relatively comfortable (all things considered) within a couple of yrs.

    best of everything.

  4. by   ann945n
    Man oh man would I like to know the answer to that too. Ive been at nursing for 2 months now and while I too feel I make progress every day I still feel so slow and have sooo many questions. I too have wondered what the average length of time nurses have before they feel pretty confident and arent staying late all the time as well. It is nice to know Im not alone!
  5. by   MIA-RN
    I hope to never feel like an expert because then I fear I would be too self-assured and miss something important with a patient.
    However, you will start to feel more confident over time. I have been a nurse about a year and a half or so, and I have moments of confidence and moments of confusion...I think its all part of the process.
    I've heard it takes about 2 years to get to the level of confidence to which you refer.
    There is a book called "From Novice to Expert" I haven't read it but it deals with growing as a nurse.
    Hang in there!
  6. by   cmo421
    I do not think I will ever feel like an expert. I seem to always be seeing things I have never dealt with before. I do feel comfortable in my assessment skills and knowledge in certain areas. When you work the same area for a few years , you also will gain more confidence. After 22 years I left a facility I had actually grown up in as a Nurse. Went to a teaching facility in the ICU. I had been doing ICU for a number of years and felt damn good. Well let me tell you, I was a fish out of water. Many differences between a community hospital and a large teaching one. Even the small things like labs and equipment. Of course they where not being all that nice either. After three day shifts , I went on 12h. nights. Was suppose to be extra, but due to call ins , was solo.
    Well, I was in a room with a vented,bariatric pt. Tube feeding ran out, so I set up a new one with dye and pierced the bag and hung it. I was immediately covered with bright blue tube feeding. At the same time the head critical care doc entered the room, found me in tears. He thought it was so funny! Now it is funny,that night it was not! Moral of the story, we are always learning! Good luck !
  7. by   Medic/Nurse
    Well, I learn something new everyday.

    I did not have the same learning curve as a nurse as some do to my background. But, it still took me about 2 months until I was "comfortable" and organized in the ED.

    Even with my background (you would think it would have been a somewhat easy transition into a HEMS environment - but there have been days I FELT like I could not find my ^%$ with both hands! - maybe this was not the actual case - but, it FELT like it - my perception!) ALL jobs take an "adjustment" period. This is true even when moving from one speciality to another. (M/S to ICU to L/D to OR - or anything!)

    Ease up, be kind to yourself (and co-workers!).
    Take one day at a time.
    Learn something everyday.
    Get better everyday.
    Never make the same mistake twice.
    Delight in confident practice.
    Always ask questions.
    Accept compliments and small victories!
    Take classes and then apply NEW knowledge!

    You will get there.
    Remember where you came from - encourage those that follow you!

    Good Luck.
    Practice SAFE!
  8. by   VivaLasViejas
    Over a decade after graduation, I'm STILL waiting to feel like an expert.:wink2:
  9. by   deeDawntee
    All the very best nurses I know, never stop asking questions. Don't define yourself by your answers, but by your questions.

    The other attribute I have seen all the best nurses possess is the ability to say these 3 words: "I need help". That will be the fastest way to go from novice to competent to mastery that there is. There is not one expert nurse that I know who doesn't access and fully exploit every resource available. From IV resource, to Respiratory, to Pharmacy, to the Housekeepers....the very best of us, know how to develop relationships and use their expertise for the best treatment of their patients. A lot of new nurses think that the goal is the be self-sufficient, but that is only a small part of competence, the far bigger component of competence is using all the resources that you can. Also, you need to know when you are not going to be able to complete something on your shift, and to set it up in a way that the next shift can take it over. Nursing is 24 hours, you don't have to do it all in your 8 hour shift (or 12).

    Use this time to develop some routines. Learn how to do assessments systematically and fast. Develop for yourself what works, perhaps have a check list for yourself. One thing that took me the longest time to remember to check right away were my IV sites and if the patient had a foley, what did the urine look like. I was in the middle of charting my assessment and I would have to get up and go back in and check those things. Drove me nuts!! I set up a list for myself and I would keep it in my pocket and glance at it and it really helped with my efficiency.

    Be very patient with yourself. If your patient asks you something and you don't know, just say, I'm not sure about that, but I will look it up for you. It is OK. Patients are looking to you as someone who they can trust and confide in, not someone with a Doctor's knowledge. Be the advocate, not the expert. I never attempt to come across as an expert, but I definitely attempt to come across as concerned and committed to doing all that I can for that patient, including comfort and healing and that the Docs orders are carried out.

    That is a very good question, by the way. Remember we are defined far more by our questions, than by our answers. You are well on your way ......
  10. by   LanaBanana
    I ask this same question everyday! I've been off orientation for 3 months and feel like I'm constantly asking question. While talking with my manager last week I told her I often felt completely incompetent in my skills and nursing judgement. SHe reasured me that I was anything but incompetent. She said she always feels reasured, rather than put off, by new nurses asking questions. It's when you don't ask questions that you will make mistakes! I had nursing students 2 days this past week and it was amazing how much more competent I felt working with students. Here were people coming to ME for answers! I was able to talk them through procedures and talk about medications and totally soind like I knew my stuff.
    As for feeling like you can handle whatever comes along? I think that will just take experience. It's also in attitude - I always have to tell myself "I CAN get through this!"
    By the way, one of my friends just finished her first year as a nurse, and she assured me that after one year she definately feels better.

  11. by   santhony44
    As with some of the other "old" (career-wise!!!) nurses, I'm not there yet, either.

    Some situations I'm very comfortable in. In others, I feel like a novice. I don't think that's a bad thing. You always need to know that you don't know it all and can learn something new.

    Every time I change jobs, I have new things to learn. Even similar situations are not identical.

    You should start to feel more comfortable after the first year or two, but I hope you never get to the point you feel as if you know everything!!
  12. by   Pachinko
    Thanks for all the replies so far. I especially appreciate the comment about not making the same mistake twice, because that's sort of my problem. I'm feeling like I can't make the mistake once because someone may be hurt, depending on the mistake. That said, I don't think I've repeated my mistakes--I did make the dreaded medication error and have been hypervigilant ever since. Luckily, no one was hurt, except for me and my morale.

    Part of what seems to make it difficult is that, at least on my unit, no one talks about their mistakes. I guess that's human nature--you usually don't go around trumpeting your mess-ups--but it starts to feel like I'm the only one messing up sometimes. I've had a couple of extraordinarily generous and experienced nurses who talked freely about errors of the past (my favorite being the nurse who gave all of one pt's meds to the wrong pt...and this woman is one of my role models!) It's not taking pleasure in the failures of others; it's feeling like I'm not alone.

    Nursing is a second career for me, and I guess I'm still adjusting to the notion that mistakes in nursing are not like mistakes in marketing or retail or, basically, most other professions. There is a liability and high standard that are unique to health professions. I've never felt so ashamed of making mistakes at work nor so anxious about them.
  13. by   amberfnp
    I have been an RN going on 6 years now. I still have many days where I feel like I don't have a clue. That is one of the biggest reasons I chose to work in the ED. I work full time in an ambulatory surgery center and have since before I graduated from nursing school as a medical asst, so I got spoiled by the "Monday through Friday" hours and decided I did not want to work in the hospital full time/"on the floor". learn other skills, I chose to work in the ED. And almost 6 years later, I still learn something new every time I go to work!

    I agree with what others have posted that it may not be a good thing to be the expert. There are always things to learn and you should look for those opportunities.

    Cheer up. It will get better!~
  14. by   deeDawntee
    Welcome to the humility of being a nurse. We all make mistakes. If anyone acts like they don't, I would be the most concerned and afraid of them, because it is a farce. If people aren't talking, it is because of their own shame of past mistakes, you can count on it.

    You HAVE to be able to forgive yourself. You must be able to roll with the punches and keep going. It takes a very strong person to be humble and to allow imperfection. You do the best that you can. We are all "practicing" our profession. Practice, to me, implies attempting to perfect. Like a musician practices their instrument, to be good it takes practice.... same with Physicians.

    Keep breathing, be careful, but don't let fear overwhelm you, you must keep it in check...follow your procedures and you will be ok and so will your patients!!

    Another great question, by the way!!