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newRNinthecity newRNinthecity (Member)

Help a Stressed New Med-Surg Nurse

Med-Surg   (5,327 Views 13 Comments)
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Any advice for a stressed out new grad?

I'm a few months into orientation on a med surg floor and I am so stressed out. I have heard that the first year of nursing is hard, but I am already questioning whether or not nursing is the right career for me. I spent 4+ years of school for this, am contracted to over a year at this job (or I owe money), and it is not at all what I expected. I feel like there is no holistic care being given, and like I am not really helping my patients. I thought there would be more "hand holding" and holistic care. I love helping others, so I thought nursing would be a great career for me...but I don't feel like I am doing that.

On top of that, the job is stressing me out in all areas of my life. Five patients is a lot, and I feel like all I have time to do are the very basics. My preceptor says I am doing alright, but I need to be more confident when I am on the floor. It is really hard for me when I feel like I don't know much and I am so nervous. I feel like I am on edge for the 13 hours I am there. I try so hard, giving it my all for the entire shift, but feel like it is never good enough. I come home feeling like a horrible nurse, and I have cried on the car ride home a couple times because the day was just so stressful and overwhelming. I already am feeling like I will burn out at this job.

Part of me is glad that I am contracted for a certain amount of time, so I have to stick it out. But I also dread sticking out another year if this truly not the job I was meant to do. I think about how stressful work is on my off days. The night before, I can't sleep because I am so stressed out about work the next day. Driving to work, I sometimes feel nauseous. Sometimes at work, I feel so overwhelmed that I don't even know where to start. I just freeze.

I really want to be a good nurse, but at the end of the day this is just a job, and I think to myself - why am I so stressed out in all areas of my life because of my job. I need a job to pay rent, buy food, and live life. But this job is so stressful.

Any advice?

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What you are feeling is absolutely normal for a new nurse. I promise it will get better, it takes about a year for you to feel confident with the care you provide. I don't work med-surg, but 5 patients seems to be the norm.

I am sure you know more than what you think you do. There are multiple threads on AN regarding new nurses, you might benefit from reading them. Are you struggling with one thing in particular?

Take a deep breath, you can do this.

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Thank you! I seem to be doing alright with getting all the basic things that need to be done, done. I'm not a pro at time-management and prioritizing after a couple months, but I think I'm getting better at that stuff every day. The biggest thing that has been mentioned to me is my timidness and the need for me to be confident. I'm not really a shy person, but the responsibilities of nursing make me nervous. I've never had a job where my actions can greatly affect a persons life before. I also struggle with communicating with patients and sometimes physicians. It is sometimes hard for me to see the overall plan of the patient. Usually I am so busy that there is no time to look at the paper chart with progress notes, then a physician or manager will ask me something about the patient that I don't know the answer too.

What does AN stand for?

Edited by newRNinthecity

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AN means all nurses as in this blog :)

I just started a new job in the ICU, Im also a new grad and I def know where you're coming from..everyday I'm at work I can't wait for the day to be over. I feel really overwhelmed and on the brink of crying. My preceptor tells me I'm doing good as well but I also feel like that's not really true. I really think that it gets better though, you build confidence in the little things everyday and that makes it better. Hang in there!!!!!

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Quite Frankly, med-surg is hard! The amount of patients you get plus the fact that the level of acuity you get isn't guaranteed and the patients can quickly change at any time plus the rotating door of admissions and discharges...it's just hard! I'm 2 years in and while I can "handle" it, I'm at a point where I just don't want to. But you're in your first year and you may reach a point where you love it. So hang in there, get your experience and if you decide it's not what you want, move on because all doors open to you at that 2 year mark in med-surg. Seriously.

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You really need to understand work will be fine in time, and if not you will find yourself in an other role - there are so many options so just ride out the wave so to speak.

What is more important is you need to understand how much of your own thoughts are responsible for your problems. Control is an illusion and worrying is like running a race in a rocking chair....pointless.

I highly recommend you take care of yourself outside of work via Yoga and Meditation. Learn to control your thoughts and not allow them to take over and control you.

Best of luck.

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Look for some "brain sheets" here on AN to get yourself organized; also learn to cluster care for your pts so you won't feel behind-that includes getting familiar to do a head-to toe while talking to your pts; surveying the room for safety etc as as on as you know who your pts are; it should take no longer than 2-5 mins to take a global look at your pt, listen to lung and heart sounds, listen to bowel sounds and check pulses; during this time you can also check skin while checking posterior lung sounds (and check their bottom out too to make sure there is no skin breakdown).

You can look at the chart before or after your assessment; or rather in report so you know the highlights; it is important that you have some idea what the plan of care is; it will help guide your assessment and interventions.

You can do "hand holding"; however the priority is making sure the pt's needs are being met and they are empowered enough to manage their conditions; their needs are driven by your assessment and knowing about their condition so that all team members will know any changes and adjust the plan of care accordingly.

I also want to stress my own C's on being a good nurse: Competence, Consistency, and...CONFIDENCE!

If you are consistent with competency-meaning you are willing to learn, and have an idea of what you need to do for your pts, the confidence will grow. Confidence is a HUGE part of advocating for your pts-knowing what they need is the best "hand holding" that a nurse can do. Get that confidence up! :up:

Best wishes.

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I'm with you newRN..I'm also a new nurse on a med-surg floor and working with a preceptor. I've also been wondering if this is where I should be. I'm a second career nurse, so, a bit older, which makes me wonder if that's the reason why I tend to take a little longer remembering things.

On the med-surg unit, everything seems to go so fast (especially in the morning). I find that I'm simply trying to rush through med pass and get an assessment in, while trying to "keep-up" with whatever new orders the Doctor has placed.

A few days ago during my morning med pass, I has to "draw up" some medication, when it came to the evening pass, I truly had forgotten that I had done it in the morning, and therefore, how to do it again. I had to consult my preceptor, who reminded me again, which totally embarrassed me...A very humbling feeling.

Anyway, I say all of this to let you know that you're not alone. I hear all the time, that this will take a good year to feel comfortable.

Let's just hope we both get through that year! :)

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One thing I always do is read the doctors H&P. Go in a little early to look at labs and progress notes. Like Ladyfree said get a good brain-sheet! Good luck to you

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I am on my second year and I just switched from nights to days. I now have new stress just as I was beginning to manage the work load at nights, but I had to change to days because I was tired of feeling like a zombie. I also am stressed because there is so much more doctor interaction and I hate it when I feel like I do not know what I am talking about or when I am not sure if I need to call the doctor. I am just trying to be patient and take every day as its own thing without judging myself.

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Welcome to nursing. I mean that in a very warm-hearted way. This is what every nurse in every capacity deals with. This is the stark reality of the life of a nurse. Chronically short staffed, intensely crunched for time, I could go on and on. It isn't just your job I can promise you that.

I recall as a new grad going home crying from work (and I am a tough as nails woman), waking up in the middle of the night so fearful and anxious that I wasn't doing everything I needed and that I was gonna lose my license over nothing. And every new day I went into work and did my absolute best and you know what, eventually it clicks! There is so so much to nursing that can never be taught in school and as a nurse you will wear 50 different hats per shift and you learn both how to pick your battles and where your utmost attention needs to go.

Like another poster, I also like to read all H&Ps, consult reports, progress notes, as well as social worker notes. Thats the way to get a good clinical picture, and also allows you to give an accurate report. YOU CAN DO THIS. Hang in there and just know that the feelings you are experiencing we all went through and that tells me you will be a great nurse

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Great to see that we (most of us, at least!) are all in this together. Thanks for all the info!

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