Having an EXTREMELY hard time as a new Med Surg RN.

[Super Ultra]

I'm a new grad who was recently hired PRN by a large hospital on a med surg floor. I haven't even got a set preceptor but rather just follow whoever is around that wants to put up with me. One very experienced nurse has a habit of growling at me when I can't do something correctly. I missed during an in and out cath on a female patient and she acted as if I was the stupidest person in all creation. On my sixth day on the floor I had 4 patients, one of whom was NPO and going down for a right AKA. Stupid me, looked at the MAR and saw a huge list of PO meds and figured "well he doesn't get those, he's NPO" and I was correct...HOWEVER, since surgery came and got him late there was IV antibiotics, a finger stick, and some eye drops I failed to administer. The preceptor I had that day didn't seem too worried about it, but I feel terrible.

I don't want to do sloppy work or fail to care properly for my patients, but in just six days my time management, multitasking, and "thinking like a nurse" is poor. On my fourth day with one preceptor, I misread some orders and she hit the roof. I feel like I can't do anything right and I really don't know if I'm cut out for this. One preceptor said I lacked initiative but then she was like "maybe it's just because you're cautious." Darn right I'm cautious! There are so many things I haven't even done before. I have ZERO healthcare background other than nursing school. They tell me I get a month of orientation and I'm halfway through it and I've only spent 6 days on the floor. I really don't want to get fired, I want to be a GOOD nurse, but it's like my brain doesn't work. If I try to figure out something on my own, I screw up and get yelled at, or I do it right and no one says anything at all. If I ask questions I get treated like a moron. I also have another PRN job in LTC where I got 2 whole days of on the floor orientation before being tossed thirty patients to care for. I finally got that figured out, but hospital nursing seems even more complicated and the atmosphere is super tense! How in the world can I get proficient at this in two or three more weeks?!?

[wish_me_luck, BSN, RN]

Don't be too hard on yourself because that's what makes your confidence disappear. The in and out cath is something that anyone can miss as some female patients are harder than others (i.e. some have many children and their anatomy is not textbook anymore). I don't know the details of that; but sometimes placing a fracture pan under them (flipped over) can elevate the pelvic area and make it easier. The medications not given...I think I would have called surgery within that 30 minute medication administration frame before/after it's due and asked if they were running on schedule because you have a patient that has medication due and you need to know whether or not to give it. Also, seek out the charge nurse for help.That's what they are there for.

Take a deep breath. Hospitals are rough to work at. Many people experience similar circumstances.

[HouTx, BSN, MSN, EdD]

I know that it's a moot point for the OP, but this is why my organization avoids hiring new grads directly into PRN slots. They have to undergo a 'normal' new grad orientation first. New employees (not just new grads) deserve a consistent and comprehensive orientation. This just doesn't happen without a consistent preceptor & sufficient amount of worked shifts - both of which are nearly impossible to arrange in a PRN situation.

OP, I think you should arrange to meet with your supervisor/manager and talk about the issues you have raised. Be specific in your requests -ask to be shifted over to a 'regular' schedule for the remainder of your orientation.

Best of luck to you.