Wow, you new nurses !

ann945n, RN · Oct 22, 2008

Hmmmm perhaps a little more compasion. Remember when anyone starts a new job especially one where people lifes are in your hand, can be very stressfull and scary till one gets comfortable. new nurses need lots of support so they can become well seasoned nurses. nothing wrong with that.

Dolce, RN · Oct 22, 2008

Nursing is no more stressful now than it was in the 80's. Sometimes I just want to say , put your " I'm a nurse now, panties on" , stop whining and start learning. If you didn't learn it before you got to the hospital, you need to learn it sometime.

I've been a nurse for a little more than 4 years. I was extremely stressed when I first started. I don't think it had anything to do with a lack of education or clinical experience because my nursing program was considered strong in both those areas. I had a well rounded clinical experience. However, the real world of nursing is still hard to adjust to, no matter how good your nursing education is. In the real world of nursing you don't know who your patient is the day before, you don't have a clinical instructor you can call to ask any question to, you don't have post-conference to debrief and de-stress, you don't have a primary nurse to fall back on.

Obviously I can't say what nursing was like in the 80s, but I just can't help but think that nursing is more stressful now. We have greatly advanced medicine since that time. We have more drugs now than we have ever had before. The treatments we provide are very advanced. The patients are sicker than ever. But, most significantly, charting has absolutely gone through the roof. The amount of documentation required these days is absolutely ridiculous. If patients knew how much time we spent charting on them versus how much time we actually spent with them they would be shocked. I'd like to hear other experienced nurse's opinions on this, because I really do think nursing is a different ball game than it was in the 80s.

madwife2002, BSN, RN · Oct 22, 2008

Yes I think you are right there are a lot of stressed out nurses who are new I think I read recently that the average burn out time for new nurses is 4 yrs. I personnally dont think their training prepares them for the work they have to do, nor do I think they are adequatly preceptored post grad. 6 weeks is what they get in most facilities post grad and it does not in any stretch of the imagination prepare them for much.

Doctors in my opinion are getting nastier and nobody hardly ever challenges them when they are badly behaved, so when they have no time or patience with the the new nurses and nobody supports them because they are frightened to or they just dont care-then stress levels are raised. To be truthful I dont think nurses are paid a great deal to put up with such awful behavior neither do I think RNs have enough vacation time to cope with the stresses and strains of the job. Students are not exposed to real nursing because they do not spend enough time working on floors dealing with real life pts.

onyx77 · Oct 22, 2008

I think the problem is the fact that the 'real world' is SO much different from the 'nursing school world.' We are taught to do things the 'proper' way in school and we come into the 'real world' and find that things are SO completely different than what we were taught. We have things ingrained into our heads and that very same thing is completely different when we get to the situation in the 'real world.' Another thing that one needs to remember is that as nursing students we (most of us) didn't have any more than 3 or 4 pts in a hospital setting and about 10 in the LTC setting. When we start our first jobs we are thrown into a full pt load and many of us don't even have experiences with so much as updating a DR. It may take some time, but most of us will get through it.

About 3 months into my job I wanted to quit because I was so stressed out and didn't know how I was going to get all of this stuff done. It wasn't a good time for me. I spoke with my unit manager and told her that I often am scared to ask the things that I am unsure of, because I am made to look stupid. And that often times I felt that some of the other nurses forgot that I wasn't just new to the facility, but new to nursing period. We are taught a lot in school, but we cannot be taught EVERYTHING in school. Most learning is done on the job, including that critical thinking. Yes, we do critical thinking in school, but most of us have never had that critical pt crash on us prior to work experiences. And some of us still haven't had that experience. But, we will learn! In school we are taught about reality shock and it hits some of us harder than others. I think a big contributor to the stress of reallity shock is how the experienced nurses we work with (or our preceptors) treat us. Some are more understanding and willing to help us learn more. Some think we just graduated and should know everything. I think if we all look back at our first year of nursing and remember what it was like for us, it might bring some light to what us NEW nurses are going through. What abou your first year in nursing would you change if you could? What did you like or dislike about your preceptors or nurses you worked with in that first year? What were things that stressed you out and made you want to quit? Ponder these thoughts once and pray for us NEWBIES!

Sometimes we need to be treated with "kid-gloves" and sometimes we need to learn the hard way! Sometimes we need to sink inorder to get the handle of things.

HonestRN · Oct 22, 2008

I do think that new nurses don't always get the hands on experience they need in nursing school and nursing today is harder in some ways than 30 years ago. Patients are more acute today with more cormobidities. Also a lot of new diseases and drugs to deal with. They have to learn just like every one of us has and they need patience from seasoned nurses to help them along and reduce the stress and burnout.

madwife2002, BSN, RN · Oct 22, 2008

I've been a nurse for a little more than 4 years. I was extremely stressed when I first started. I don't think it had anything to do with a lack of education or clinical experience because my nursing program was considered strong in both those areas. I had a well rounded clinical experience. However, the real world of nursing is still hard to adjust to, no matter how good your nursing education is. In the real world of nursing you don't know who your patient is the day before, you don't have a clinical instructor you can call to ask any question to, you don't have post-conference to debrief and de-stress, you don't have a primary nurse to fall back on.
Obviously I can't say what nursing was like in the 80s, but I just can't help but think that nursing is more stressful now. We have greatly advanced medicine since that time. We have more drugs now than we have ever had before. The treatments we provide are very advanced. The patients are sicker than ever. But, most significantly, charting has absolutely gone through the roof. The amount of documentation required these days is absolutely ridiculous. If patients knew how much time we spent charting on them versus how much time we actually spent with them they would be shocked. I'd like to hear other experienced nurse's opinions on this, because I really do think nursing is a different ball game than it was in the 80s.

I trained in the lates 80's and I can assure you the pts are not sicker, we had more cardiac arrests in fact on my floor we expected 2-3 a day because as you say it wasn't as advanced medically speaking re K and Mg levels. Nurses ran the codes and it was bloody frightening, as a student you were expected to work on the floor as a member of staff and each placement was 8 weeks long. RN's made up all your IV antibiotics, RN's did all the nebs for the pts and breathing treatments.

Pressure wounds were indescribably and far more pts had them. You did 2 hourly turns on every pt religiously and you never ever missed them. You empited the catheter bag as soon as you saw any urine in it not leaving it until it almost burst. All I's and O's were done by the nurses, all vital signes were done by the RN no such thing as 4-1 nursing you could have 10 pts. I could on and on. Oh yes and you never ever sat down because you were considered lazy so you found work to do.

shellsgogreen · Oct 22, 2008

new nurses need to be able to express how they are feeling, and it's a good thing they can vent here where people understand - i remember what it's like to be new and i was completely overwhelmed, but made the mistake of not talking about it with others who could have been a great resource.

websites weren't available in the 80's, so new nurses did not have this now valuable resource to gain advice or simply vent and as a bonus remain anonymous if they so choose.

Dolce, RN · Oct 22, 2008

I trained in the lates 80's and I can assure you the pts are not sicker, we had more cardiac arrests in fact on my floor we expected 2-3 a day because as you say it wasn't as advanced medically speaking re K and Mg levels. Nurses ran the codes and it was bloody frightening, as a student you were expected to work on the floor as a member of staff and each placement was 8 weeks long. RN's made up all your IV antibiotics, RN's did all the nebs for the pts and breathing treatments.
Pressure wounds were indescribably and far more pts had them. You did 2 hourly turns on every pt religiously and you never ever missed them. You empited the catheter bag as soon as you saw any urine in it not leaving it until it almost burst. All I's and O's were done by the nurses, all vital signes were done by the RN no such thing as 4-1 nursing you could have 10 pts. I could on and on. Oh yes and you never ever sat down because you were considered lazy so you found work to do.

Wow, this gives me a much different mental picture than what I was expecting. I guess I should have known this because I've read Echo Heron's books and I think they were mostly set in the 80s. The conditions and patients she describes in her books are downright frightening. Good thing I read them after I started nursing school or I might have been completely turned off to the idea of nursing altogether. I actually have heard that before about the codes. One of my more experienced coworkers told me that they used to code people all the time all the telemetry units.

coder · Oct 22, 2008

Where do I start?

1. Nursing school provides a foundation for nursing, but, IMHO, it does not prepare a new nurse for the reality of working in a hospital. Working on the floor, even the new nurses just off of orientation are given a full load of patients (6 or more?), and given an LPN to "cover", who also may have 6 patients. Some of these patients have multiple comorbidities, a large number of medications, different diagnostic tests being ordered, families to be tended to, etc. As with any new job, there are protocols to be learned, and in the hospital, there seems to be a protocol for everything (for good reason). What I'm trying to convey is that this is a work environment like no other, and the learning curve is steep. Trying to meet expectations from patients, experienced nurses, doctors, etc. just out of school is a bit demanding and stressful. I don't believe many nursing graduates finish school with the false idea that nursing is going to be easy, but they also don't think they're going to be overwhelmed from the get-go; they just don't have any concept of how demanding things will be. I believe the solution to this problem is assigning new nurses an increasing patient load over time (months) until they reach the same patient loads as experienced nurses. Allow new nurses time to accomodate, learn, and hone their time management skills. When they reach the full patient load, they will have improved on many of the basic skills they'll need to juggle tasks and will be more prepared to spend more time on critical thinking, etc.

2. Remember that you've been doing this for a long time. Most of your day is second nature to you. Think of all the medications you're familiar with, procedures, charting/paperwork. Nursing judgments you make in a split-second are based on those years of experience. Remember all the improvements and changes that have been made in healthcare since you first entered into it. I don't mean any disrespect, but it's my hypothesis that there is a lot more to learn than there probably was 30 years ago, and that holds true for almost any profession. For example, in the computer/IT world, if you're out for 3-5 years, you are basically a "dinosaur". Many things change, many things improve, many things become more complex over time as a result of progress.

3. Money. Nurses are way underpaid for what they do. I think the majority of people go into nursing for the right reasons, but it can be very disheartening to be thrown into what healthcare is today, work as hard as nurses do, and not be compensated as well as they should. There are a ton of jobs/careers that pay better, less work, less stress, yet nursing still has a reputation for making "good money". We make decent money, better than some professions, but we're way behind where we should be. What I'm trying to say, is that it's difficult for a new nurse to justify the learning curve, mental/emotional aspects of learning to be a new nurse with the demands of the job.

4. I do not promote whining, etc., in any way. New nurses should be eager to learn, but please remember some of the points I listed above. Altogether, it can be a big pill to swallow.

5. Many of us come from different careers, so we have other experiences/viewpoints to draw from. I think if nursing is the first career choice, and the first real career experience, the hospital/new nurse environment may be more of an acceptance than those who have had another profession previously.

Just my perspective...

Dolce, RN · Oct 22, 2008

3. Money. Nurses are way underpaid for what they do. I think the majority of people go into nursing for the right reasons, but it can be very disheartening to be thrown into what healthcare is today, work as hard as nurses do, and not be compensated as well as they should. There are a ton of jobs/careers that pay better, less work, less stress, yet nursing still has a reputation for making "good money". We make decent money, better than some professions, but we're way behind where we should be. What I'm trying to say, is that it's difficult for a new nurse to justify the learning curve, mental/emotional aspects of learning to be a new nurse with the demands of the job.

I don't want to be argumentative, but I just don't agree. I make more money than almost all of my peers with a bachelor's degree. Yes, there are other occupations out there with better paying salaries. There are also a lot of professions that pay less. Personally, I feel well compensated for what I do. Teachers are required to have a bachelor's degree--many have their master's--and their starting salary is considerably lower than a nurse's. Nurses do not even have to have a bachelor's degree. Furthermore, don't even get me started on the stress level of nurses compared to teachers. I know enough teachers to know how stressful and time consuming of a job they have. Do we have a tough job as nurses? Absolutely! But, there are other professions that are just as stressful and don't pay as well.

nursemike, ASN, RN · Oct 22, 2008

I found my first year very stressful. After three, I feel like I'm getting settled in a bit, although the stress level is still higher than I expected. I find that many more experienced nurses feel the same stresses I do, including some who manage to look unflappable. But, no, most don't experience the same stresses I did during my first year, though most assure me they did in their first year.

I'm a new nurse, but not a new person. I came into this field knowing that life is stressful, and work is hard. I'm not sure these facts are as obvious to kids entering the workforce for the first time. I've agreed with many that working as an aide is a good preparation for working as a nurse, but just now I wonder if working at McDonald's might be just as useful, or even moreso: too much to do, too little time, few breaks, and irate customers. But if you fall short, you don't usually kill anybody.