I’m overwhelmed at my new job as an “experienced” nirse

[Hope Full]

Hello I am new to this site and I can use some advice. I recently made the change to switch hospitals and floors, swapping out of orthopedics for cardiac. I have been a nurse now for almost 2 years and been in this job for almost 3 months. Everyday has been a struggle. I feel so brand new. These past couple of weeks I have been unsure of myself and I feel as though I don’t know what I’m doing. It’s a different pace and much different acuity. I haven’t exactly found people that I can really talk to at work as of yet and the fact there seem to be clicks doesn’t help either. Some people say it will be okay but I feel uneasy about the whole thing. I really like what I am learning but I am feel as though I am may not be learning it fast enough. I could use some advice and perspective on this. Has anyone else had ever felt this way? What have you done? Are there ways or things I can do on my own to be better? My dream is to move forward in my career and including going to critical care and advancing my degree. However these past few months I have been doubting myself. I just don’t know what to do

[Rose_Queen, BSN, MSN, RN]

You may still be in inpatient nursing, but your entire patient population has changed. It is going to take you time to get up to speed with all of the new things you need to learn and do. Much like it probably took you around a year to feel comfortable as a nurse, it will likely take you nearly that long to feel comfortable in your new specialty.

Are you off orientation? If so, do you feel like you could continue to rely on your preceptor for guidance and answering questions even if they aren't right there with you? Is there another nurse, a charge, the manager, or an educator you can reach out to?

[Hope Full]

Hi thanks for your reply The thing I had a 5 different preceptors none of which where working with me during my 1 month orientation. The one I spent the most time working with only works weekends. I do ask for help often but I get overwhelming about situations that I have never encountered at all throughout my nursing career so far. I try to reach out but they make it seem because I am experienced I should just know things. For example I had recently a young patient who came in for endocarditis with a history of drug abuse. We suspected that this patient may have been using but no had no official grounds to do a search in the room. Again there was this level of expectation but again this is something I never encountered. So many more things to take into consideration. Let’s just say it wasn’t my brightest moment. How do you deal with such unexpected unexpected events?

[Wuzzie]

I think you are being way too hard on yourself. You are “experienced” but with not quite two years in you certainly aren’t seasoned. Have you heard about Benner’s theory of “Novice to Expert”. If you look at the process you’ll see you are exactly where you are supposed to be as an advanced beginner moving into the competent level. Please don’t misunderstand, I am NOT calling you incompetent. That is simply the name of the third stage of development. I feel like you and probably your preceptors have the expectation that you should perform at the third going into fourth stage and that’s just unreasonable not to mention setting you up to feel like a failure. Plus you’ve changed specialties so it’s really like starting over. The good news is over the last 2 years you have nailed basic nursing down so now you can focus on the nuances of cardiac nursing. One of the things I’ve done when I’ve found myself in in a situation like yours is to find a seasoned nurse (expert level on the Bender scale) who I think I might mesh with and start picking his/her brain. Or ask your manager if there is someone they think would be a good mentor for you. They hired you so clearly they think you have what it takes to do the job. I wish you only the best. Keep us posted on your progress. We may hand out some tough love at times but we really do cherish our new nurses.

https://www.health.nsw.gov.au/nursing/projects/Documents/novice-expert-benner.pdf

[Hope Full]

Hi I have heard of Benner’s theory but what I am realizing is they have expectations of me to be at the proficient level. I made sure to disclose my previous experience even before I was hired which is was no where near the skills needed here. It’s just kinda frustrating and some times I do feel like I’m being set up to fail. How do you combat those feelings that want to weigh you down?

[Wuzzie]

3 hours ago, Hope Full said:

How do you combat those feelings that want to weigh you down?

Like I suggested...get a mentor. When you feel supported and are learning and applying new things those feelings will start to go away.

[caliotter3]

I can’t emphasize enough what Wuzzie suggested, go to your manager and request they suggest a mentor. If they don’t provide you with a name, then start directing your questions to them. Notice I did not say to ask them if you can use them in that role. Why? Because it is their job to answer your questions and to supervise you in doing your job correctly. Best wishes going forward.

[speedynurse, ADN, BSN, RN, EMT-P]

In all honesty, going into a new nursing specialty is almost like starting as a new grad sometimes. As much as I would like to branch out of the ED, I am comfortable in my role and am almost afraid to try other specialties that I am interested in such as the PICU. Not only are you on a new floor with a different nursing specialty, but you have a new team. Sometimes, just that difference with having a new team can be overwhelming in itself. Do you have a manager or nurse educator you can talk to that can suggest some educational resources? Most of the time, many directors are fairly happy that they have new staff that want to learn and grow as nurses. Just a thought...

[Chief NP, MSN, RN, APN, APRN, NP]

Based your post , I am going to assume that you are very ambitious and want things quickly. You have to be very patient especially in working in critical settings. You cant acquire the needed knowledge in a short time. You mentioned that your going is to further advance your career, I am assuming as a provider or manager. Either way, due diligence and patient are two key factors needed here and it appears that you want it quicker than possible.

[LeMa88, BSN, MSN, RN]

This is how I have been feeling going from CCU to ICU, even though they are both considered crit care but the two have totally different patient populations. I definitely feel out of depth, way out of my element here- which is a shame because I really looked forward to this new experience. My preceptor and I never work together in the same shift, so I find comfort in some of the other senior nurses, hang on to them like floaties, ask them questions even just a little debrief in the corridor like "hi how are you doing? Have you settled in OK? " My answers have been "I have good days and bad days, today is particularly difficult" then they would pull me aside to just have a chat. But I have trust in these nurses. Only issue, they don't work often enough. And I find myself checking the roster in advance to see who I am going to be working with.