I'm a very new, very green graduate nurse. I graduated back in May 2005 and accepted a position on a step-down unit. I've been on the floor for roughly 4 weeks. I'm a fast learner, and I can make it look like I know what I'm doing...but sometimes that's the problem. Sometimes I dread going to work or I can't sleep the night before because I feel like I don't know what I'm doing, but everything thinks I do. The worse thing is, it's not even the nursing care that's confusing me. It's the communication with the doctors and the clerical work. The patients on our floor have multiple teams working with them, and I never know which one to call or if the other teams need to know about certain things. Sometimes I feel like a secretary bouncing around between internal medicine, cardiology, surgery, etc. Everyone says I'll learn all the doctors in time, which I'm sure I will. But it's frustrating when they're already expecting me to be collaborating with people I can't identify. I have to literally stand by my patient's door and wait for someone unfamiliar to come up and try to enter so I can find a certain doctor to get an order. I also got chewed out by a doctor who was attending for a patient's neurologist because internal medicine said she was ok to be discharged, but the attending had no clue about the patient or the history. He asked me to explain it to him, which I did but then he asked me to read the neurologist's latest progress note. The note was a few days old, irrelevant, and illegible. He got frustrated because I couldn't read it, and I decided to not discharge the patient because no one knew what the hell was going on. Honestly I feel so relieved every time I get off the floor, it's scaring me. I find myself reading more and more into PA programs. I really like nursing, and I'm pretty good at the nursing care, but I can't stand being treated like a dog. It's different if a patient is upset and taking it out on me, but I would expect other healthcare providers to be somewhat humane. I feel bad for the poor MD who makes me explode...So what's your advice? I know I'm probably telling an old tale, but I need to know how to handle this. Or I need to know what I can do to proactively move forward. I watch the other nurses and they just seem to know what to do or who to talk to.