I really need help!

PedsRN03 · Oct 20, 2005

Hi Jahbing!

I have been a nurse for 2 years and went through (and sometimes still do) a similar situation to what you are experiencing. I always got A's in theory in school, but fumbled in clinical. Just recently I passed my PALS course with flying colors missing nothing on the exam, and the instructor was impressed with my performance in the simulation, however in the couple of real situations I've had where patients have become critical I have completely fallen apart (once even to the point that the charge nurse took me away from the patient and assigned them a different nurse).

I think it is good that you recognize your weekness and the things you need to work on, but you are being way too hard on yourself. Hospital floors are very busy and very hard places to work, especially when you are just learning the ropes. Have you talked with your educator, manager, preceptor, etc. about how you are feeling? Have they approached you about your performance? 8 weeks of orientation for critical care and only 2 weeks on your home floor for a new grad seems kind of short to me. Especially since some of this time was spent in a classroom and not actually working on the units. If you aren't feeling ready to work on your own perhaps you can ask for some extra time on orientation. If they are giving you patients of higher acuity right now, maybe you can ask for less acute patients while you work on your skills an time management. If you are on day shift, you might want to consider switching to nights for ahwhile. On some floors night shifts are a little quieter.

I would still give yourself a little while to adjust, but if you still dont' like the pace of the hospital you could try a different floor or move into another area of health care, such as public health or health education. And please take care of yourself! Seeing a therapist may be a good outlet to help you deal with your stress.

Good luck!

Bambury · Oct 20, 2005

I too think you are being overly hard on yourself. There's a negative cycle going on in here. You feel overwhelmed, so you start making mistakes, and the mistakes you made make you even more overwhelmed, which again, leads to more mistakes. Perhaps, you can try and do what I do whenever fear creeps in. Focus on one thing to do at one time. Afterwards, after you've checked off on what you were to do, move on to the next thing, and then focus just on that. Eventually, as you become more adept at what you are doing, you'll be able to multitask.

Perspective is really important in your situation. Think about it: you are a NEW RN. It wouldn't make sense to measure yourself to others. As soon as you do that, fear just attacks you. The better thing to do is to approach some of the nurses that you'd be working with that day, and say with respectfully and humility "I'm still getting acquainted with this whole nursing thing. And I'm fearful half of the time when I'm working with the pts. If it is alright with you, I'd like to come to you to ask for help and questions." Again, don't make unfair comparison. You are a novice, and you will be making novice mistakes. Just don't forget to learn from them. And always ask lots and lots of questions and lots and lots of help.

cjblu · Oct 20, 2005

Hey there. You sound exactly like me! I too am just coming to the end of my orientation on a tele floor. I feel as if I am taking steps backwards, not forwards. My preceptor assures me that I will be fine on my own, but I think she is delusional. I miss orders, I am confused about when to "sign them off", and I am still foggy about the details of our computer MARs, charting, or basically how things "flow". I get so overwhelmed, and like you, I am way too hard on myself. I think so hard about the little things, and I have this desire to understand everything down to the smallest detail in order to feel confident. I feel like I am really missing "the big picture". I even went to a psychologist last week, because I was coming home crying and worrying way too much after leaving work. Tonight, though, I had a real connection with a patient, a very crabby elderly guy. As he was getting ready to leave, he asked the aide if he could say goodbye to me. He even waited for me while I was finishing up with another patient. I realized that I do make a difference in people's lives, and all that other stuff will come eventually. If you love the theory of nursing (also like me), then you love helping people and connecting with people. Just keep that in mind when you are struggling with the paperwork and the time management. A nursing professor once said to me, "Slow down, and remember be present with your patients, they are what you are here for". Thank you for posting your story, it's nice to know there are others out there who feel like I do.

Tweety, BSN, RN · Oct 20, 2005

Please don't compare yourself to those others. You will like them one day and a new grad nurse will be looking at you in awe. Allow yourself to be a new grad. Accept the help of others. It takes a full year to feel comfortablel and confident.

(Those other people around you aren't perfect, they stamp the wrong patients name too.)

Best wishes and hang in there. You will be o.k.

sjb2005 · Oct 20, 2005

I'm with tweety here. Hang in there. When I did tele and step down I was overwhelmed. Use your resourses and we are here for you too

JahbingRN · Oct 20, 2005

Thank you guys so much. Your replys mean so much to me. I am going to try to hang in there really. I just pray and hope that it works out.

perfectbluebuildings, BSN, RN · Oct 20, 2005

Please don't compare yourself to those others. You will like them one day and a new grad nurse will be looking at you in awe. Allow yourself to be a new grad. Accept the help of others. It takes a full year to feel comfortablel and confident.
(Those other people around you aren't perfect, they stamp the wrong patients name too.)
Best wishes and hang in there. You will be o.k.

Tweety... you are always so encouraging and realistic on this forum, truly an amazing person. Thank you so much always taking the time to reply to all our posts it seems like. I know you are not the only one, there are so many people who keep on keepin' on trying to convince us all we are going to make it. but you do stand out. You seem like you would be a great nurse for new nurses to work with. Your words really mean much more than you know, to me and probably other people too. I know you probably do not like all this wordy appreciation but too bad you're getting what you deserve! :) Truly, THANKS.

OK that was off topic but I had to say it. To the OP I only have about a month experience on my own. The first week was awful on my own, then it is getting more tolerable, but there are still many things I am very uncertain about but at least I am getting more comfortable about where to look for the answers. I am seeing that it will get even better. Good Luck!

mccmaeve · Oct 21, 2005

WOW-I appreciate all the advice and encouragement being given, because as a new and terrified nurse, I benefit too. You described exactly how I feel, and the kinds of error I make (stamping the wrong name...) I guess there are more than two of us!! I have been in orientation about as long as you, and out of orientation a week..it is alot to juggle. Hang in there anf I will too. I think Tweety is right. We WILL be just fine!

AMARTIN1 · Oct 21, 2005

Hang in there and don't give up!! I too work in a stepdown unit and can't tell you how many times I have gone home crying, literally feeling like I was loosing my mind and was I really cut out to be a nurse :uhoh3: !! I promise that it does get easier once you learn the unit and get your rhythm. As Tweety put it best, you really can't compare yourself to others but learn from the experienced nurses and develop what works for you!! OH! and for those days where you start to freak out and start to make mistakes, take a timeout and reevaluate yourself and what you are presently doing. I make a checklist of what each patient needs and it does not get checked off my list until it's done or passed on to another shift. It can't all be done in one shift so do what you can and it is okay when you run a little late. I have seen very experienced nurses who seem to always have it together, leave an hour and a half late, it happens. Our jobs are not easy and each patient has their own unique problems to deal with. You've made it this far and you will make it. God Bless :icon_hug:

KatieBell · Oct 21, 2005

Oh Yeah...

I remember doing stuff like that...because I just did some of it the other night!!!

Don't be so hard on yourself. Right now everything is coming at you quickly.

Try to let your support people know you are feeling a little overwhelmed. Most likely they will tell you that you are doing a fine job. It's easier for them to see your progress than for you to see it.

You have all the knowledge- now is the time to start putting it all together in practice. Note: I said to START...implying a long term process.

Another poster in another post suggested keeping a journal. I think its a great idea, especially in your first year of nursing- you can look back at your progress!

Best Wishes!!!!!!

toadie · Oct 21, 2005

jahbingrn i read your post and it sounds like my own orientation. i recently graduated. i had an 11 week orientation. i was hired into cvicu. my orientation consisted of three weeks of classroom, 2 1/2 weeks in a heart failure icu,3 weeks coronary icu and 2 weeks cardiothoracic icu, and two DAYS on my own unit. iwas then told that i was on my own. my first week i felt like i was still on orientation because ihad so many questions and needed help with many things. but, who wouldn't, i had almost no exposure to the pts i was to care for. i was completely honest w/ my nurse manager, assistant nurse manager and other nurses about my feelings.

i doubted myself everyday. i knew i was smart and knew many things about this area but what it comes down to is i have a lack of confidence in my clinical decision making skills. sounds like that might be your issue too. i think the best thing to do is try to educate yourself about your pts, ask questions of your fellow nurses. be honest w/ ur nurse manager, tell her if u think u need more time.:)