new nurses considering quiting?

JHansen · Sep 10, 2008

oh wow take a step back take a breath. If you are having this sort of reaction to your current situation DO SOMETHING, talk to your other nurses, your manager, consider going to a floor that isn't so stressful. DO NOT QUIT! I can not stress that enough, you worked your ass off to get to where you are, you let yourself get to a point where you just shut down and break. Do your self a favor, talk to people, it seems trivial but seriously sometimes just giving voice to your concerns does so much to your morale, for me its very relieving to just get it off your chest.

Something I do when I get really stressed from work and I come up on a 2 or 3 day off, I go camping in the middle of no where at yell at the top of my lungs everything I want to get off my chest. And it works, atleast for me. I hope some of this helps you, main thing is don't let it get to you.

Josh

MoriahRoseRN · Sep 10, 2008

I am sorry you are feeling so miserable, and I feel for you. I wish I could give you an answer on what you should do. What I do want you to know is you are not alone, and I am wishing the best. Hopefully someone else will post their experiences, and give you some more ideas on what to do.

bossynurse101 · Sep 10, 2008

Ahh baby girl, not to fear. Give yourself a hug for getting this far, we can all attest that it isnt easy getting through school and passing boards. You have made it much further than some. Do you have a supervisor or a charge nurse you can have a heart to heart with? Sometimes we are much harder than ourselves than anyone else - why do you think we do our own evals half the time!? I started out on a hellistic floor myself. It was GI/GU surgical and EVERYONE had a zillion IV's NG's GT's, PCA's, TPN, Epidurals, etc etc. Shame on that hospital (mine) for throwing a brand new nurse onto one of the hardest floors in the hospital. I got through it tho, and what didnt kill me made me one tough nurse. I dont reccommend that for everyone. Why shd we need to get baptized by fire? Ask about a less hectic floor until you feel more confident. That kind of nervousness only snowballs and that isnt good for ANYBODY. Good luck and let us know how it goes. :loveya:

sunshineyday · Sep 10, 2008

I am sorry to hear you are going through this. I also graduated in May and share a lot of your frustrations. But there is one big difference. The nurses on my floor are cut-throat, take pleasure out of picking out the slightest details to critique, and address me like the idiot they think I am in front of my patients. My advice is to stay where you are because you said you have a supportive environment and that is more than a lot of new grads can say.

Halinja, BSN, RN · Sep 10, 2008

Before you quit...talk to people. Other new nurses. Other older nurses. I felt the way you do. My friends felt the the way you do. I remember one of my fellow nurses that has been a nurse forever said she felt that way for over a year. She's one of the best nurses I've ever seen.

I know it is hard. But you will learn. You will get faster. You will start to feel more confident.

When you get home, pick out one thing you did right during the day. Think about that. Yes, there were probably things that went wrong. But you did something right, didn't you? After a while find two, then three. You will be surprised. Some day you'll realize that the rights way out number the wrongs.

Hang in there. Talk to people. You are not alone.

pricklypear · Sep 10, 2008

You're right - the first year DOES suck. It sucked for me, and for lots of other new nurses. You are expecting too much of yourself. You are NOT going to have the comfort level of the experienced nurses you work with for several years. That's OK!!!!!

It sounds like you are in a supportive environment. Take advantage of that. Ask questions, let someone know if you are feel that you are drowning in your assignment. Many times you may FEEL like you are floundering, but, in reality, you are doing just fine.

Two and a half months is still pre-school for a new nurse!! Ask someone you trust to tell you what they perceive as a problem with your performance. Is it time management? General knowledge? Organization? Or simply a lack of self confidence? Most experienced nurses enjoy the opportunity to mentor. But you have to be willing to ask questions if you're not sure. Think things through, then ask. "My pt's HGB is low, and there are no labs ordered for tomorrow. I think I should call for orders, do you?"

I wish you all the luck in the world!! I remember what it was like to be a new nurse!! :rolleyes: HANG IN THERE!!!!!!! It's OK to go home and cry, most of us did at one time or another!

back2bRN · Sep 10, 2008

Taking a big breath is really the best place to start. I also find that going to someone whose opinion is of value to you(your orientation buddy, or someone else you have really gelled with) and ask them for some honest feedback can be of help. We tend to be our own worst critic. Remember,you are a baby in the field of nursing and try not to give up. I know I have felt exactly the way you are describing. I know it feels overwhelming right now, but you do have the knowledge, you really do it is now a matter of application. Also, ask your self some questions:

Is this where I should be right now? Why or why not? What are my strengths? How do I build up my weaknesses? What part of nursing gets me up for my shifts? Focus on some of those things and don't be so hard on yourself. Get some hobbies, read, garden, create. Know you are not alone!!!

1styearsucks · Sep 10, 2008

well, its kind of all of the above. time mgmt and prioritizing mainly. the floor is kinda hectic, i reallly dont have time to get a good grasp on these issues such as time mgmt and prioritizing

HM2VikingRN, RN · Sep 10, 2008

Have you talked over your concerns with your preceptor?

kmoonshine, RN · Sep 10, 2008

I think many of us have been in your shoes. We're overworked, underpaid, and overloaded with patients. Its a big responsibility to go to work each day and be responsible for someone's life. Nurses can't just punch in at 7am and punch out at 4pm to go home for the day; we're constantly thinking about certain patients, stuck late due to staffing or other problems, and its all very stressful.

Specifically, what has been said about your "performance"? For example, is it a time management issue, the ability to manage mulitple patients, or is it your assessment skills? And what do you mean by "lack of knowledge" - are you finding that you are often telling patients "I don't know", or do you feel that you are just too busy to provide the care that you want?

Ask yourself "What uses the most of my time?"

Here are some suggestions:

1. Get a PDA with a drug guide (I recommend Davis's Drug Guide); you'll have a plethora of meds along with IVP rates right in your pocket. And if a patient asks you about a certain med, go ahead and say "You know, that's an excellent question; let me pull up some info for you" and just whip out your PDA and rattle off whatever the patient wants to konw.

2. Carry around a list of important phone numbers and utilize your resources. Make sure to call pharmacy if you have a quick med question.

3. Delegate what you can, when you can.

4. After getting shift report, poke your head into each patient's room to see how they are doing and get vitals right away. For the sick patients - if you have tele-bed monitors, put them on the cardiac monitor, cycle their BP, etc (btw, I don't know how this works on the floor because I've only worked ED, and I don't know if you need an order to do this or if patients get charged for this). Almost all of my patients get a BP cycling every 30 minutes. Prioritize and see the sickest first; also see immunosupressed patients first (so you're not exposing them to more germs).

Follow your ABC's: Is their airway patent or are they at risk for compromising their airway (as in altered level of mentation, confused, post-CVA, risk of aspiration)? How is their breathing - is it shallow, irregular, increased? How is their circulation - do they have delayed cap refill, are they hypotensive, is their heart rhythm different than before?

5. When getting beginning shift vitals, quickly listen to the patient's lungs and verify that their HR and SpO2 is WNL (make sure that their rhythm is the same as it was prior to admission, being either regular or irregular). While you are listening to their heart and lungs, encourage them to cough and deep breathe so you can get a good listen at the lower bases (and you can also chart "pt encouraged to cough and deep breathe"). Flush their IV with saline while you're in the room to verify patency.

6. Carry around a few saline flushes, a bunch of alcohol prep wipes, and put paper measuring tape in each patient room - therefore, you can measure incision sites, compare extremity sizes (if edematous, risk of DVT...), etc.

7. Make a point to ask your coworkers "what can I help you with"; hopefully they'll repay the favor when you need help.

8. If doing full hygiene care, assist the patient and at the same time complete your shift assessment.

9. Ask yourself: why is the patient here? For example, if they had an appendectomy be sure to focus on pain assessment, listen to their bowel sounds, verify that the dressing is clean/dry/intact, evaluate if they are nauseated/vomiting, etc. Peek at the patients legs and make sure there isn't any swelling or redness.

10. After each shift, choose a patient diagnosis and do some reading at home on the condition. That way, you'll be learning at a nice pace.

11. Get a mentor if you don't have one.

12. Recognize your strengths and weaknesses and ask your supervisors how you can improve your performance.

When I was a student on a med-surg floor, I made my own patient assessment printout - I had the piece of paper divided into 4 quadrants, with each quadrant containing the same info: BP=, HR=, IV patent? Y/N, IVF _____ on pump at ___ rate, pain=, dressing: site____ appearance___, Bowel sounds +/- in all 4 quads, etc. It helped me because I could see all my patients and write down the basics on just one piece of paper; I'd then chart once I made sure all my patients were settled...

Sorry for the long post, and good luck to you. It takes time to develop your own nursing practice - try not to be hard on yourself, and don't forget that this is new for you.

elizadream · Sep 10, 2008

I want to tell you I was a "full grown woman" (>35yo) when I ventured over to Nursing after being a Respiratory Therapist for 4 yrs.- and the first year of nursing was HORRIBLE. It was so demanding and demeaning! You must have a THICK skin to survive the abuse and a QUICK brain to prevent errors. You know that if anything happens, the NURSE is responsible for EVERYTHING! Go to your ICU or ER/ PACU/ Nursery/ and see if you can hang out with a nice nurse to see if that may be your place.

Being that you are young, you may find a more satisfying (decent) career that will fulfill you and make you happy in your life.