How is everyone's first year going?

vintagemother, BSN, CNA, LVN, RN · Jun 13, 2017

I'm a new RN, with almost 1 year of work experience. I worked as an LV/PN prior to this for 1 year and as a CNA for about 2 years before that.

I've felt very comfortable in my role from about the 6 month mark; though some weeks are better than others. I feel that I have a lot to learn still and often wish I knew more- for example, the best nursing interventions for certain situations sometimes are difficult for me to determine, as each RN I work with has a different opinion.

I work nights, which means there are fewer experienced nurses and basically no supervisor available during the shift to answer questions.

In terms of being healthy, I prioritize my sleep. I also eat very healthy meals on my work days and nights. For me, this is high protein and complex carbs (veggies only) and no sugar! I find this helps to sustain my energy and keeps me from eating unhealthy options for the most part.

Exercise is a goal, but I haven't implemented it. í ½í¸±

As far as the things you've mentioned such as disillusionment, honeymoon phases, etc; I think the reason I haven't been severely impacted by those is because I went through these emotions and feelings as an LV/PN and CNA. Also, in my RN program, the professors taught us about these issues as part of the final semester. I took their words to heart.

I practice mindfulness and do some cognitive behavioral techniques to try to control stressful feelings. I'm prone to anxiety and work hard to prevent it from impacting me severely.

I've intentionally developed good work relationships with my peers and also have friends I can go to with concerns and to ask for advice from.

pmabraham, BSN, RN · Jun 13, 2017

Hello. I'm two months off orientation as an RN on a busy cardiac telemetry unit. Currently, I'm working a split shift between day shift (typically a 12-hour day: 0700 to 1930), and evening shift (8-hours: 1500-2330).

Every day offers excellent learning opportunities ranging from how to best communicate with patients, families, and providers to how to manage different types of IV drips et al. especially learning to manage one's time.

Like the previous poster, I wonder if I'm currently in the honeymoon change. Whether that's true or not, I do hope I can avoid becoming jaded. I enjoy serving my patients; though there are times when I have an incredibly call-bell heavy patient who frazzles my nerves.

For time management, I worked out a personalized brain sheet that seems to work out well on my folding clipboard that I carry with me through the shift. I'm still working on the critical thinking portion of time management as to whom to see first, when to hang what first, etc.

Yesterday, the clinical nurse manager did a mini interview with me to determine how things are going off orientation, how I like my job, the nursing field, etc. In summary, I shared I wish I went into nursing sooner; I love the field, my job, and the unit where I work.

SaltySarcasticSally, LPN, RN · Jun 13, 2017

This is a great thread, I am well behind all of you, I just passed my RN boards 3 weeks ago and start my job next week in a step down telemetry unit. I will be on day shift and was an LPN for 8 years prior to this so I am hoping my LPN experience will help some but I would by lying if I said I wasn't super nervous!

I think the hard thing for me was that I knew my LPN skills in and out at the end of 8 years, had confidence in my abilities, and knew how to prevent mistakes. But now I am going back to the bottom again and that scares me more than anything really because I know how sharp the learning curve is the first year. So I am definitely going to keep good tabs on this thread to get good advice :)

Purple_roses · Jun 13, 2017

I'm a new RN, with almost 1 year of work experience. I worked as an LV/PN prior to this for 1 year and as a CNA for about 2 years before that.
I've felt very comfortable in my role from about the 6 month mark; though some weeks are better than others. I feel that I have a lot to learn still and often wish I knew more- for example, the best nursing interventions for certain situations sometimes are difficult for me to determine, as each RN I work with has a different opinion.
I work nights, which means there are fewer experienced nurses and basically no supervisor available during the shift to answer questions.
In terms of being healthy, I prioritize my sleep. I also eat very healthy meals on my work days and nights. For me, this is high protein and complex carbs (veggies only) and no sugar! I find this helps to sustain my energy and keeps me from eating unhealthy options for the most part.
Exercise is a goal, but I haven't implemented it. ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½
As far as the things you've mentioned such as disillusionment, honeymoon phases, etc; I think the reason I haven't been severely impacted by those is because I went through these emotions and feelings as an LV/PN and CNA. Also, in my RN program, the professors taught us about these issues as part of the final semester. I took their words to heart.
I practice mindfulness and do some cognitive behavioral techniques to try to control stressful feelings. I'm prone to anxiety and work hard to prevent it from impacting me severely.
I've intentionally developed good work relationships with my peers and also have friends I can go to with concerns and to ask for advice from.

I can definitely see how LPN experience prior to RN experience would ease the transition.

Just out of curiosity, how long did it take you to feel comfortable with common nursing tasts, such as starting IVs? I know that this isn't something worth working myself up about, but I just feel like I suck at them and forever will lol. I think my biggest fears are freezing up during a code (or something like that) and these little insecurities about skills are just annoying little add ons.

Thanks for responding!

Purple_roses · Jun 13, 2017

Hello. I'm two months off orientation as an RN on a busy cardiac telemetry unit. Currently, I'm working a split shift between day shift (typically a 12-hour day: 0700 to 1930), and evening shift (8-hours: 1500-2330).
Every day offers excellent learning opportunities ranging from how to best communicate with patients, families, and providers to how to manage different types of IV drips et al. especially learning to manage one's time.
Like the previous poster, I wonder if I'm currently in the honeymoon change. Whether that's true or not, I do hope I can avoid becoming jaded. I enjoy serving my patients; though there are times when I have an incredibly call-bell heavy patient who frazzles my nerves.
For time management, I worked out a personalized brain sheet that seems to work out well on my folding clipboard that I carry with me through the shift. I'm still working on the critical thinking portion of time management as to whom to see first, when to hang what first, etc.
Yesterday, the clinical nurse manager did a mini interview with me to determine how things are going off orientation, how I like my job, the nursing field, etc. In summary, I shared I wish I went into nursing sooner; I love the field, my job, and the unit where I work.

Hello fellow cardiac tele nurse!

Learning different communication techniques is also something I've been learning a lot about. So far I've found 3 general types of patients on my floor (I hate to generalize and I realize there are probably far more things to consider, but this is just what I've experienced in my super short time as a nurse).

--Patient number one is super receptive to patient teaching (one even took notes while I was talking to him), and is very serious about improving his health and wants to soak up every educational resource. These patients are so encouraging to get because I feel like I'm really making a difference.

--Patient number two has a super serious condition but doesn't seem to realize the severity of the situation and doesn't want to be bothered hearing about it. These patients are harder for me to accept because I feel like they'd be more receptive to lifestyle changes/med adherence if they fully realized what was going on.

--Patient number three has a super serious condition, fully realizes that she will die from it at some point, fully understands what changes need to be made, but has chosen to accept her "fate" without worrying about health. I have an easier time accepting this sort of patient because they have a good understanding of things and are simply making their choices.

I also hope I can avoid becoming jaded. I was a CNA for 3.5 years, and I feel that if I didn't become jaded then (working super hard for a barely livable wage), there's hope that I won't become jaded in nursing. I also have an amazing team that I'm working with and so far I absolutely love my hospital and manager. I feel like I have good support systems both at work and at home.

Call bell crazed patients and patients who actually refuse to use the call light (despite how many times I've shown them how to use it) are the ones that get to me. I don't like when patients come right to the nurses station to ask for OJ. I never let the patients know that I'm a little irritated, but I wish I could post a sign that says "this is the first time I've sat down in 3 hours, and every time I do sit down, it's to chart."

I'm very glad that you're loving the profession, especially after being so soon off of orientation. Good luck with everything!

Purple_roses · Jun 13, 2017

This is a great thread, I am well behind all of you, I just passed my RN boards 3 weeks ago and start my job next week in a step down telemetry unit. I will be on day shift and was an LPN for 8 years prior to this so I am hoping my LPN experience will help some but I would by lying if I said I wasn't super nervous!
I think the hard thing for me was that I knew my LPN skills in and out at the end of 8 years, had confidence in my abilities, and knew how to prevent mistakes. But now I am going back to the bottom again and that scares me more than anything really because I know how sharp the learning curve is the first year. So I am definitely going to keep good tabs on this thread to get good advice :)

You're right up to speed with me! I actually passed NCLEX after you, but my hospital let us work before we passed it.

I have a feeling that your LPN experience will help the transition. That's awesome that you got days! I couldn't find a single job that had a day shift available to new grads, but I'm ok with that because I really do love the hospital that I'm at.

Yes, being at the bottom feels very scary. I feel nervous about the responsibilities that come with being an RN, and I'm so nervous about messing up in a critical situation. But just think, in one year, we'll be able to come back to this thread and see how much we've grown and learned!

firestix7 · Jun 14, 2017

I am a new RN, 6 months in (2 months off of orientation) in the ICU. I feel like I'm experiencing phase 2 and am disillusioned/ depressed/ unhappy.

I don't mind serving patients and feel like customer service experience is on my side, however I feel overwhelmed and like the ICU isn't a good fit for me. I definitely enjoy the knowledge aspect and the continuous learning and challenges (even though I feel a mixture of complete inadequacy and terror most of the time) I don't have a huge support system around outside of work which I feel makes it ten times more difficult. For me, its the futility that really is getting to me and also being caught up in the 'details' of ICU. Sometimes I wonder if I am not "type A" enough for ICU. I have 6 years experience of working in ERs as a medical scribe and always enjoyed the fast paced environment and variety. I even attempted to switch to ER at my current hospital (I am grateful that I feel comfortable speaking with my clinicians in regards to feeling out of place). Unfortunately, they will not let me switch to ER at this time. Trying to stick it out because I know it will be the best for my resume but am feeling super depressed and just not myself. Doing my best to Eat right, get as much sleep as possible (being a night shifter and all), and exercise- I practice yoga as much as possible. Hoping to feel happy again soon.

pmabraham, BSN, RN · Jun 14, 2017

Hello Purple Roses:

I appreciate the 1st category of patients the most because I really enjoy the educational aspect of being an RN. I do have trouble with the latter two groups, though I've not gotten any of the 3rd yet. The other week I had one in the second category where they came in with a SBP > 200, severe headache, double vision (thankfully negative for CVA and related). I came into their room, their most recent (~ 15 minutes ago at the time) blood pressure was approximately 17x/xx and they start telling me that if a doctor doesn't see they soon (it was around 8 AM) they were going to leave (AMA). I share we are working to get your blood pressure under control, and the patient shares that the 17x is less than the 200+ they came in with... SIGH. Got the patient to stay, but then caught them trying to leave our floor to go for a smoke; then didn't want to hear how smoking impacts blood pressure.

Purple_roses · Jun 15, 2017

I am a new RN, 6 months in (2 months off of orientation) in the ICU. I feel like I'm experiencing phase 2 and am disillusioned/ depressed/ unhappy.
I don't mind serving patients and feel like customer service experience is on my side, however I feel overwhelmed and like the ICU isn't a good fit for me. I definitely enjoy the knowledge aspect and the continuous learning and challenges (even though I feel a mixture of complete inadequacy and terror most of the time) I don't have a huge support system around outside of work which I feel makes it ten times more difficult. For me, its the futility that really is getting to me and also being caught up in the 'details' of ICU. Sometimes I wonder if I am not "type A" enough for ICU. I have 6 years experience of working in ERs as a medical scribe and always enjoyed the fast paced environment and variety. I even attempted to switch to ER at my current hospital (I am grateful that I feel comfortable speaking with my clinicians in regards to feeling out of place). Unfortunately, they will not let me switch to ER at this time. Trying to stick it out because I know it will be the best for my resume but am feeling super depressed and just not myself. Doing my best to Eat right, get as much sleep as possible (being a night shifter and all), and exercise- I practice yoga as much as possible. Hoping to feel happy again soon.

That sounds so stressful. I can't even imagine how hard it would be to start in the ICU and I don't blame you for wanting to switch to ER. I'm sorry you're in the disillusionment stage It is a very normal stage that so many new nurses go through, but the fact that others go through it too doesn't make ICU as a new grad any easier.

This is going to sound so odd, but there are apps out there that allow you to meet other people (for the purposes of finding friendship--not romance). The first time I'd ever heard of it, I thought it was so odd. But my cousin actually set up a profile and met a nurse with a few years of experience, and they go out for drinks every other week now. It's great for people who maybe moved away from their home state and don't know anyone in town. I do hope that you begin to establish a support system outside of the hospital though. I think it's so so important for our mental health. This thread is open for you to vent any time you need! I'll try to send you my best positive support vibes from across the web.

(((HUGS)))

Purple_roses · Jun 15, 2017

Hello Purple Roses:
I appreciate the 1st category of patients the most because I really enjoy the educational aspect of being an RN. I do have trouble with the latter two groups, though I've not gotten any of the 3rd yet. The other week I had one in the second category where they came in with a SBP > 200, severe headache, double vision (thankfully negative for CVA and related). I came into their room, their most recent (~ 15 minutes ago at the time) blood pressure was approximately 17x/xx and they start telling me that if a doctor doesn't see they soon (it was around 8 AM) they were going to leave (AMA). I share we are working to get your blood pressure under control, and the patient shares that the 17x is less than the 200+ they came in with... SIGH. Got the patient to stay, but then caught them trying to leave our floor to go for a smoke; then didn't want to hear how smoking impacts blood pressure.

That sounds so frustrating. There was one time I hit a little below the belt in a situation like this (but it was with family at least...I would never say something like this to my patients!)

But basically I have a relative who is a walking miracle. He was dx with heart failure a few years ago and was (at some point) told he had 2 weeks to live, but couldn't be on the transplant list (I can't remember why...I think it was a hx of drug use, but not current drug use...don't quote me on that though). He decided to come back to his home state to pass with his family nearby, and his home state is actually where he was granted a heart. Now he's back to eating HORRIBLY; his diabetes is out of control (which granted, is hard to control due to the meds he's on), his blood pressure is nuts, he's developed stable angina and sx of HF. I'm usually the nice guy in the family, but after a while of playing nice, one day I said "You know, you got that heart because someone died. And someone else who was on that heart waiting list died waiting for the heart you got." I know, totally below the belt. But sometimes I wish I could just pour knowledge and willpower into peoples' heads to help them stick with their health programs!

This brings me to another thought (total rabbit trail), but I'm really curious about the similarities between food addiction and drug addiction. Unhealthy eating habits play a huge role in heart disease; our patients know this (for the most part), but still choose the food, even though they know it could cost them their lives. It seems similar to drug addiction in that the patients with addiction know it's killing them and they want to change and want to be healthy, but getting there is just so hard.

Bubbly26, BSN, RN · Jun 17, 2017

I'm a new grad also. I will be off orientation next week. I think I am in stage 2 already. I am very unhappy with my job. I dread going to work now. My preceptor told me that it's normal to feel that way as a new nurse but I can't help but to stress over the job. I hope it gets better.