I still don't know what I'm doing!!

[canche]

Almost 2 years into this job and I have days where I feel like a fish out of water. I have no clue what I'm doing with certain patients. I've got a lot down, I'm comfortable with most patients, but sometimes I'll get something weird and out of the norm and I get immediate anxiety because I have no clue what to do and rely on my co-workers to help me. I suppose this is normal, but I want to hear from you experienced nurses, how long did it take for you to feel really comfortable in your position?

[NurseHeart&Soul, MSN]

Canche,

Emergency nursing is a TEAM event. It's okay that you ask for help. Be gentle on yourself. My personal opinion is that you will never be completely comfortable with everything. Weird never seen before cases come through the door and they aren't nicely packaged with a diagnosis and bow on top. Maybe one co-worker will say they have seen something similar before, while others feel like a fish out of water as much as you do (though they may not be saying it or may have become used to the feeling). Are you referring more to types of diagnoses or being overwhelmed by different procedures etc.?

I'd say I probably became the most comfortable when I started working in charge (can't remember when that was exactly), because I quickly learned who my most reliable resources were, even more about policies and procedures, and was exposed to so many more cases and types of cases by merely being able to walk into every room at any time.

If you're concerned about procedures, if you have down time at work (what downtime you're thinking???), look over your emergency carts, review set ups for anything you aren't comfortable with (ventriculostomy, CVP, infant warmer, transcutaneous pacemaker etc.).

Please read my most recent blog titled 5 Things I Wish I Knew as a New Graduate Nurse. I realize you are not a new grad, but the "Book of Brains" is exactly how I worked to become that resource person and not the fish out of water. And the second time you see some of those unusual cases, hopefully you have a few notes of what worked, what didn't etc... to refer to.

https://allnurses.com/general-nursing-discussion/5-things-i-1083307.html

You will begin to feel more and more comfortable in time. Seek out as many experiences as you can and don't beat yourself up. The nursing profession is an endless learning process.

[DeenieRN]

Just remember you aren't supposed to know everything! The day you stop learning, is the day you should try doing something else. I get those pts that totally throw me off, and I love it, I keep learning, they are my challenge. That's what I love about the ER and the main reason I switch from CVSD to ED. I didn't want cookie-cutter diagnosis, I wanted to see more. Don't let anxiety get the better of you, turn that energy into enthusiasm, and learn. It'll make you are better nurse if you use this approach and you won't feel frazzled when faced with a new situation.

[Tammy Nightingale]

I have been a bedside emergency department nurse for twenty-seven years. My comfort level increased after working in a trauma center. I needed about eight years, but I still learn something new every day.