Hospital New Grad Orientation. I feel like quitting nursing.

[PinoyRN123]

Hi everyone. I want to get some advice. I got hired as a new grad RN at a Surgical/Transplant/Step-down telemetry unit and on my 2nd week of orientation. Prior to getting this job, I worked as a nurse aide at the same hospital for a few years and as an RN for 1 1/2 years at an LTC facility and home health. I thought I was going to adjust fine since I had various experience, but I was wrong. I'm so overwhelmed by the number of things to learn, and I feel so incompetent. I'm so depressed right now and feel nervous/anxious every time I go to work that it makes me wanna quit nursing. I don't want to go back to LTC either because I felt very unsafe taking care of 25-30 residents on your own. Is it normal to feel this way? I'm starting to doubt that bedside nursing isn't really for me. Should I change my career? Is there any nursing-related job that is not bedside nursing that maybe I can apply to?

[mmc51264, BSN, MSN, RN]

I think it is normal to feel this way! My biggest pet peeve is that so many new nurses are not really prepared for what nursing really is. I precept a lot of new nurses and I see it all the time.

Try to relax and learn all you can. You are not expected to know everything right away. Ask questions, get clarification, if time allows, ask for rationales. There are going to be some nurses that can't be bothered, but there are plenty that want to help you learn and will answer your questions. Use the skills you already have already learned and try not to be so hard on yourself.

I was one of the few that got a specialized residency for 6 months, to be oriented to orthopedics. It was great. Find someone you can lean on as a mentor. That person is out there.

Hang in there!!!!

[Nurse SMS, MSN, RN]

Your title says "new grad" but your post says you worked for 1.5 years as an RN....

If you have 1.5 years of experience, regardless of where that experience happened, you aren't considered a new grad anymore and you won't get a new grad level of orientation. This will mean a steep and anxiety inducing learning curve for you. Everything you are feeling is normal and you WILL get the hang of it.

Any time you change specialties you can expect one to two years of feeling like a new grad again. Make sure you are taking good care of yourself outside of work and developing good working relationships with experienced nurses AT work so that you have people you are comfortable going to with questions. Get the time management piece of it down and you will find things get much easier. Hang in there. This is a great opportunity, but its going to feel icky for a while. Take note of all the little victories. You will have some each day, but you have to make your anxious mind focus on them consciously.

As far as the time management part - After you get report and check on your patients, sit at the computer. Take a piece of notebook paper. Put it landscape orientation and make a column for each patient you are assigned, writing the room number at the top. Along the left side, make rows labeled for each hour of your shift, from 7A to 7P or vice versa. Under each patient, in the hourly slots, record the things you KNOW you will have to do throughout your shift. Meds, blood sugars, any tests that are scheduled, any timed things you can plan on happening. Keep it simple - the term "Meds" is sufficient, not writing out each medication. Then, as you go through the day, you cross things off as you do them. This will let you see where you have some gaps in which you can do a dressing change or ambulate someone or do your charting, etc. Its super helpful in calming your mind, which in turn is super helpful in managing anxiety. When orders get written, you add anything pertinent to this "brain". Same with if something get canceled, you cross it off.

Hang in there. You have not been there long enough yet to know whether or not this is for you. Its humbling, I know, but you WILL improve, faster than you think you will.

[panurse9999]

My best guess is that you have a preceptor (s) who do not have the first clue of how to share knowledge, teach, and keep a new person motivated. Or they simply just do not want to teach/ orient, but they are forced to, because no one else has enough experience. I've experienced both. This is an industry wide problem, and why there are so many nurses that never even transition from orientation to staff. When I was a brand new nurse I had my confidence ruined by a truly miserable person whose only real talent was employment sabotage. In other jobs, my "orientation" was 30 minutes of supervised medication administration on a LTC unit. Other places, I was handed the keys to the cart, with no orientation. My best advice is to stick it out for as long as you can, and hopefully it gets better and less stressful.

[JKL33]

1. Put one foot in front of the other until you have powered through this.

2. Work closely with your preceptor. You do have some experience but in my book this transition deserves a good orientation. Hope you are getting that.

Good luck ~

[PollywogNP, ADN, BSN, MSN, LPN, NP]

23 hours ago, PinoyRN123 said:

I got hired as a new grad RN at a Surgical/Transplant/Step-down telemetry

Wow! So even for a seasoned nurse Transplants would be challenging! What types of transplants? And this is a "step-down" unit? What is the nurse: patient ratio? How many weeks/months of orientation were you promised? Every week should introduce more gradually, work with your preceptor. You should have skills checklists. Is there equipment or procedures that are new to you? etc.

[Snatchedwig, BSN, CNA, LPN, RN]

Of course its normal. Your in information overload right now but once you get through its gonna benefit so much by resilience. Please rely on a mentor and take it DAY by DAY. You can do it boo!

[AnnieNP, MSN, NP]

Relax, you can do this!!!!!!!!!!!!

[liberatedcow]

Your situation is where i find myself. I thank you for sharing because you give me some peace in lots of frustration.

You sound like a sensitive and self-conscious person. Considing this (hopefully true), you care a lot about your patients and aren't in it for the money. You probably put yourself in your patients' shoes and want to give them the best you're able. Assuming this is the case, you are one of the most important people in the field of nursing. While you may not satisfy the business side of health care, specifically in unrealistic efficiency, you carry on the extremely important and fundamental aspect of loving your patients. If this is the case, know that you are extremely valuable and appreciated, and that the patients and your co-workers need you more than you know.

Please don't leave if you are frustrated simply because of feeling inadequate. Time is limited, and you must do the best you can. You are likely doing far better work than you realize. I hope that God gives you clarity and peace of mind to continue to bless the patients you serve.

[dennis8, ADN, BSN, CNA, RN]

What you feel is normal for any nurse who is new to the hospital bedside. It will feel that way at first, but it gets better over time. Always ask your preceptor questions. Don't attempt skills or tasks that you aren't comfortable doing unless your preceptor is around. In terms of non-bedside nursing, getting those kinds of positions will require some years of bedside experience for the most part.

[Bearcat-RN]

On 7/29/2019 at 7:55 AM, not.done.yet said:

As far as the time management part - After you get report and check on your patients, sit at the computer. Take a piece of notebook paper. Put it landscape orientation and make a column for each patient you are assigned, writing the room number at the top. Along the left side, make rows labeled for each hour of your shift, from 7A to 7P or vice versa. Under each patient, in the hourly slots, record the things you KNOW you will have to do throughout your shift. Meds, blood sugars, any tests that are scheduled, any timed things you can plan on happening. Keep it simple - the term "Meds" is sufficient, not writing out each medication. Then, as you go through the day, you cross things off as you do them. This will let you see where you have some gaps in which you can do a dressing change or ambulate someone or do your charting, etc. Its super helpful in calming your mind, which in turn is super helpful in managing anxiety. When orders get written, you add anything pertinent to this "brain". Same with if something get canceled, you cross it off.

This is great advice. Im a new grad in a medical ICU. I was lucky enough to get a 6 month orientation, and just recently finished orientation and am officially on my own. Writing out the hours and what you have to do during each helps a ton. It makes it so much easier when you can see it all written out, and I find I'm less likely to miss a lab or med if I have a checklist to follow.

The other thing I've learned early on is if you have time to get something done, do it right then and there. It's really easy to want to relax a little bit during the shift, socialize for a few minutes with coworkers if the unit is a little slow, but use this time wisely. There have been multiple shifts where I am running around nonstop for the last 2 hours of the shift trying to get caught up before report. Make sure your charting is caught up, look ahead and see if there are any dressing changes you can do, tubing that needs to be changed, baths that need to get done. I've found that I would much rather have time to relax and take it a little easy during the last hour of the shift than be running around trying to play catch up before giving report.

[OUxPhys, BSN, RN]

Yes, this is normal. I started as a new grad on a high acuity step-down floor. I remember telling myself that after 1 year I was going to transfer to an ICU. 4 years later I am still on a cardiac floor but at a different hospital with a lower acuity. I enjoy it. It made me realize that I would probably be even more miserable in an ICU setting.

It sounds like it may be your preceptor. Are you able to request someone else? Just keep asking questions. Don't be afraid to ask for help. We all have been in your situation before.