Take your breaks. This should not be your least concern. If you do not take proper care of yourself, you cannot take proper care of your pts. Twelve hours is too long for me without a break, and I am sure with 8 hours that you are legally required to be getting at least one break. This is probably off the clock, but I am sure you need to eat, get a drink, go to the restroom, and take a mental hiatus from the job. You will come back more focused and energized, which will make you a better nurse. It sounds like you may need to speak up about this. Ask how they determine meal periods on your unit. Do you need to sign up or cover each other's pts? Tell your charge nurse/preceptor that you need a break. Sometimes I have had to say that I will fall over if I don't eat something in the next 5 minutes. Best to give them proper notice before they are short a nurse
As far as your 15 days of orientation with your preceptor, that seems about right to me. I had 18 days (maybe the rest of the world says six weeks, but it was 2 12hrs and 1 8hr a week, so 18 days total) with my preceptor. Some other new grads got twice that amount. I think it is determined by your performance and abilities. I don't know about the full load. Most nurses seem to have trouble with that. Thank staffing ratios for that. You are licensed to do your job, and the state determines how many pts you can be assigned. Speak up if you need help, feel unsafe, or are behind in your assignment. Sometimes the work keeps getting piled on until you push back. Know your limits and find your voice.
To quote you "I've had 11 days with a preceptor and was just granted 4 more. I get the impression they're hoping I'm going to indicate I'm ready after that point." In nursing, it is best to be straight forward and proactive. If you are not ready, then tell your manager you are not ready. Set three goals with your preceptor each day, and review your progress with your preceptor before you leave. Then meet with your manager and preceptor to review your progress. Their feedback will guide your learning. At the end of my time, I did not feel ready. I met with my manager and preceptor to discuss this. They both gave me specific examples of my performance that indicated I was functioning as a competent nurse. It made me feel a little better, but I was still nervous as all get out!
Are you the only nurse who will be working the shift on your unit? If not, then identify who is available as a resource for you. Know your policies and procedures, and know who to call when you are unsure of what to do. I have asked doctors about things I don't know (can we say clogged nephrostomy tubes?) and was direct. "I am the nurse caring for pt x. This is the problem (state assessment). I have limited experience with (state nature of problem). None of the other nurses here have worked with this before. What would you advise?" Of course, only do this after you have done your research, utilized your other support systems, and have come up empty handed. I am sure many times the doctors must think I am an idiot, but I personally never feel bad for asking. Better safe than sorry when there is a life on the line. My pride is expendable, and it makes for good stories at the dinner table.
As far as feeling confident, I think that takes awhile. I am finally getting comfortable with the idea that I am a nurse. I have been on my own for 5 weeks (15 days if you prefer :wink2: ) and still have times where I feel that I don't know enough. But everybody started at ground level, so try to keep your chin up. It is a leap of faith, but you are never alone. Please keep us posted when you are on your own, as I would love to hear about it. Best wishes! And take your breaks! Robyn