I just want to cry!!! I'm VERY overwhelmed!!

Published

Hi All-

I am a "brand" new nurse of about 7weeks. I am orienting in the ED, my "dream" unit, and I am feeling like this was a huge mistake.

Nursing is a career change for me, so I have had NO previous medical/health related experience and I think it's really hurting me, so I've been told and I'm also thinking it myself. I was pulled into the educators office on Tuesday and told they were giving me two more weeks on the unit with another preceptor, to see what their opinion was, to see if I was going to make it in the ED. Apparently, I am lacking in skills and some educational areas for the ED. Well, needless to say, I was totally thrown for a loop when I was told this. I felt as though I was coming along pretty well. Also, prior to being hired, by the way they knew I had NO previous health related experience, I would have up to 6 months of precepting if need be, and I was now told it is 8 weeks, but they will allow longer if needed. I thought I was just going to LOSE it when they told me this.

They told me I may be better off working on med/surg for a year to get experience and I could come back to the ED at a later point if I wanted to. Do I look for a positon in this hospital or look elsewhere if I take this route or I am forced to take this route???

I need some advice/suggestions please, on what you all think I should do. I'm feeling like the med/surg might not be a bad idea after all, especially since I have NO previous experience. Most of their "new" nurses have been techs in the department for 5+ years, so they are very comfortable when they transition to their RN positions.

Overwhelmed here, please share your thoughts!!

Up Vote Up Vote ×

Oh man, I feel the same way. I'm on an intermediate med/surg floor and got the talk last week. They're moving me to nights next week to see if I can handle that pace better. I think my problem is that the patients I have can get very sick really quick and I don't have the confidence that I'll be able to catch everything. I know when things aren't right but I'm terrified that as I'm dealing with one crisis, another will pop up in a different room.

I want to talk to my educator more about this but I'm afraid its going to be taken poorly. I love my floor, what if I get stuck on a crummy one? Will I be able to come back in time? What positions are available? I don't want 6 patients (4 is apparently too much for me right now).

How do I explain to the new manager why I'm looking for a different position?

Best outlook I can share with you is that if you consider this a career, then taking a year to improve yourself ain't the end of the world. You'll still have a job and you'll still be paying bills and you're still learning good stuff.

Good luck

Up Vote Up Vote ×
Specializes in Med-Surg, ED.

The ED is a tough place, and it must be especially hard for a new grad with no previous experience!

I am a nurse now for 2 years and new to the ED myself, and it was quite a learning curve for me even with my M/S experience.

I am surprised they are giving you such a short orientation...where I am the GN's get TONS of orientation..way more than 8 weeks, which is what I got as an experienced RN.

The ED is completely different than the floors in terms of pace, patients, and paperwork. You will no doubt have already figured out that the pace is very fast and that patients turn over rapidly (on a good day lol. Sometimes you have an assignment full of 'boarders')

The paperwork and assessments are all more compressed as well.

I know that the ED is your dream floor, but I can't stress enough how very much I learned on the M/S floors that helped me transition into the ED. Maybe you want to shadow someone and see what its like on the floors? If it works out better to go work on the floors instead of the ED, it doesn't mean you are a failure, it just means that you are green still, and have some more learning to do (as do we all when we are brand new!) The pace on the floor is fast too, but not as fast. The patients are often the same patients over several days...so you get to know your patients and know the routines. And the patients are generally having similar complaints...unlike the ED where your patient in bed one might be ketoacidosis and in bed two might be an accidental amputation...you have more time on the floor to learn how to be a nurse....giving meds, starting IVs etc..the basics that they teach you in school but that you really learn on the job.

If you choose to stay in the ED, definitely advocate for yourself to get a longer preceptorship. And look at the nurse leaders or charges, find one you like, and watch how he/she does things. And ask questions...tell them you want to learn. Let them know you are really willing to work.

Either way, it comes down to your decision. I am sure you will do well whichever way you go.

Up Vote Up Vote ×

I'm sorry you are feeling so overwhelmed! I wish I could give you a hug. It sounds as though they expect you to be off orientation soon, which stinks since you were told 6 months originally. Even though you may get a little longer than 8 weeks if needed, it sounds to me as if there will be little tolerance by managment or whomever if you require anywhere near that 6 month amount, as it may appear to be of inconvenience to them.

Just a note: from what I've seen, many new grads feel overwhelmed when first coming off orientation, but get into the swing of things on their own better than they would think. However, if your unit is encouraging you to try med-surg instead, they might have already made up their mind about you, I am sorry to say.

I work med-surg at my hospital but I know new grads get a 6 month ED internship. 8 weeks sounds so short for a new grad in ED but I don't know your situation nor the ED specialty. If you are not feeling even remotely confident, especially in a specialty such as ED, coming off orientation too soon would not be safe for the patients and would cause greater stress to you imo. I am finishing my first year on med-surg and I have learned more than I could have imagined. Going to med-surg for a year would not hurt, actually, it would probably help you gain confidence with time management, nursing skills, etc. Then you can move on to ED, ICU, or wherever else after that time if you like with a good foundation.

The first year goes by fast, let me tell you! This is all just my opinion, hopefully this helps. Good luck in whatever you choose to do!

Up Vote Up Vote ×
Specializes in Certified Wound Care Nurse.

I am right where you are... same experience level and everything.

Read my post entitled "Complaints". I made some mistakes over the past week - I'm exhausted and drained - and am so embarrassed that I don't want to go back to work and would just as soon leave the profession.

As far as I'm concerned, I think the knowledge level we're given in school (in many cases) isn't enough to truly equip us for the real world of nursing. I also think that nurses, for whatever reason, eat their young.

We all make mistakes - but for me - nursing is such an important profession that there is no margin for error. I am afraid that my name isn't "God" and that I will make errors. I am just not prepared for the reality of human life being in my hands. Then I hear that I shouldn't be too hard on myself - and when I finally ease up - I get hammered by other nurses.

I am exhausted. I am tired of caring. I am tired of being compassionate. I am totally empty. This isn't what I expected from nursing. I expected to do a good job - I didn't expect to be a failure.

Shawna

Up Vote Up Vote ×

OP, given that many hospitals seem to willingly hire new grads with little experience, promise them a long orientation period and understanding that they don't know much yet, and then turn around and push the new grad to be on their own ASAP, express "disappointment" in the new grad's progress, and then encourage them to try something "less intense"... well, you are not alone and I don't know how much I would attribute it to your abilities or to being the ER versus another environment. It's not like the typical med/surg unit is a low stress, low responsibility position. When I was let go after "not progressing" as quickly desired, I was advised to find something less intense to build my skills... except every other kind of position I enquired about was quick to emphasize that their area was NOT any easier than any other (and I don't think I came across as looking for a 'easy' job... just one where I could build up my skills and not feel just thrown in the deep end.)

Since many schools don't prepare new nurses to be up to speed within a few weeks, where is a new nurse to build up their skills to be prepared for the hectic realities of nursing? Currently, it's by cycling through a couple of orientations that don't work out. Not very cost effective for the hospitals and demoralizing for the new nurses. Sigh!! But what that means to you, OP, and other newbies who are struggling, is that it's not necessarily any deficit on your part that is causing the difficulty. When the unit manager says "you're not progressing quickly enough" or "your suitability for this type of work is questionable" - remember that they are thinking of their current needs. That is they need you to be at a different point, not that you *should* be at a different point by now based on your background. Does that make sense? My sympathies to you. Hopefully, in a year, you'll be looking back at this from much a better place.

Up Vote Up Vote ×
Specializes in LTAC/ICU/CCU.

deja vu... think i've said thiz bef0re, that we r s0 quick 2 thr0w r new nurses 0ut 2 sink 0r swim simply because 0f staffing issues! it suckz! we all d0n't learn at the same speed- 4-8 weeks! i am s0rry 4 each n every 0ne 0f u feeling thiz way, it's n0t fair. :nono:

Up Vote Up Vote ×

Thanks for the input everyone. it has been very encouraging. I'm trying to stay positive, but I do in fact feel like a "failure" to say the least. I never thought I would be thinking or saying this.

I will give the next three days a try. I should have more, but I have some classes scheduled for next week, so this will obviously cut into my time with my "new" preceptor which I don't think is fair either.

Anyhow, I will let you know how it goes.

Up Vote Up Vote ×
Specializes in Rodeo Nursing (Neuro).

I work on a med-surg (neuro/neurosurg) unit. Slightly more specialized than the true medicine or gen. surgery floors, but same general principle. It isn't easy. Orientation was tough, and I'd worked on this unit for several years in an unlicensed capacity. It's still hard work. But I think there are some advantages over ED, over even ICU. High on the list would be continuity. Most of our patient stays are several days, some even run for several weeks. It's typical to get the same assignment for consecutive nights, so even if the first is rocky, they've lost the element of surprise when you come back. If a routine procedure like a dressing change doesn't get done on your shift, the next shift will pick it up (and you'll do the same for them without complaining, of course!)

Not being general medicine or general surgery (seperate units, at my facility) somewhat limits the variety I see, but only somewhat. I've had patients on trauma service, nephrology, OB, and even peds. We often get kids, usually >6 y.o., on our epilepsy unit, and not long ago they sent us some regular peds (fairly easy ones) when the peds unit was full. I got to show one of my mentors how to set up a chest tube, one night, since I'd had the same pt the night before and had read the instructions (it was kind of an odd set-up, and even standard chest tubes have most of us scratching our heads a little. Unit wide, we might see them twice a year.)

Anyway, I think having a little time, here and there, to figure things out, and having co-workers who can spare a minute or two to advise or assist, is a huge advantage to a new nurse. For that reason, I think nights are a good place to start, too. It's still hard work, but you do miss a fair amount of craziness. Also, there seems to be a certain amount of camaraderie on nights that isn't so prevalent on days. The little bit I oriented on days, it seemed to me that you had to be so focused on what your were doing that it was harder to see what was going on around you--if a coworker was sinking, you were too busy bailing your own boat to even notice.

Another benefit for a new nurse, is that even after orientation, our charges nurses were pretty good about assigning patients according to nurses' abilities. Usually, they try to spread the hard patients and the easy patients equitably, but when a new nurse is still learning, they may get a slightly higher proportion of easier patients. Later, as you begin to show some particular strengths, you may tend to get more patients that need those strengths, but there's still enough variety that you don't become a one-trick pony.

I won't go quite so far as to suggest everyone should have to start out in med-surg, but I do agree with the conventional wisdom that it's probably the best way to develop your skills. If nothing else, the turnover is fairly high, so the experienced nurses are more accustomed to dealing with newbies. Of course, by your second year, you're one of those experienced nurses--it's a little unnerving when the next batch of hapless newbies is coming to you for advice, but if nothing else, you'll know who to ask.

ETA: Just for (rueful) laughs, I did a search on "overwhelmed." Didn't look past 190 entries, so I don't know how many there actually are. Point is, this is not an uncommon feeling.

Up Vote Up Vote ×

Thanks nursemike!! I have a lot to think about these next few days. Do I just tell them I want out or ride it out at this point??

Up Vote Up Vote ×
But I think there are some advantages over ED, over even ICU. High on the list would be continuity. Most of our patient stays are several days, some even run for several weeks. It's typical to get the same assignment for consecutive nights, so even if the first is rocky, they've lost the element of surprise when you come back. If a routine procedure like a dressing change doesn't get done on your shift, the next shift will pick it up (and you'll do the same for them without complaining, of course!).

You make some good points re: benefits of some med-surg units. When I worked a predominantly post-op unit on 12-hr nights, it seemed staff rarely had the same patients from shift to shift... due short patient stays, the varied staffing schedules, the floor layout, and the balancing of patient acuity among staff. And most nurses rarely worked more than two nights in a row anyway, so there wasn't a lot of chance for familiar patients, unfortunately. Also due to the ever changing combination of staff on any particular shift, it took that much longer to get a feel for each other and how to deal with the different personalities, strengths and weaknesses.

Looking back, maybe I'd have done better on a predominantly medical unit. I hated daily receiving patients new to me straight from surgery - groggy, pale, needing Q15 vitals... etc. I much preferred receiving patients in a state where I could talk to them, assess their chief complaints/medical conditions and any other issues.

Well anyway, just thoughts... : )

Up Vote Up Vote ×

I find it unfortunate that you have been mislead by this particular unit. However you can make the ball in your court. It may be beneficial to go to med-surg so that you can advance your skills in a less fast paced setting. Right now though my best advice would be to hope for the best and prepare for the worst. Since you are already overwhelmed it would be good to try to prepare yourself emotionally should they decide to tranfer you to a new unit. If you are not on the same page with your unit manager and current preceptor as far as your progress, then their perception of "what it takes" may not be the same as yours. Good luck~

Up Vote Up Vote ×
+ Join the Discussion