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I am struggling as a new grad! need advice!

Nurses   (484 Views 4 Comments)
by DH1234 DH1234 (Member) Member

912 Profile Views; 28 Posts

I have been working as a nurse for 9 mos on a step down unit. All of a sudden I am making a lot small/big mistakes in my opinion. I am so frustrated with myself because my time management skills are not improving yet either and we have typically 4-5 pts each night. I try to do very thorough assessments, and pay attention to fine details, but I feel like I get interrupted every time whether it is a phone call or another pt calling out. I do not know what do anymore. I go to work anxious and leave work anxious.  Let me give you example of my last mistake.

My pt was on chronic TPN. When i got hand off report, I looked at the bag but I not verify the rate w/ the off-going nurse or the MAR. Fast forward to when I was leaving my shift and giving a hand off report we signed off. Come to find out it was supposed to be going 25mL/hr faster, and the nurse before me was supposed to change it bc there was new orders; however, I failed to catch the mistake during my 12hr shift so ultimately it falls back on me. The more experienced nurse who I handed off to must have saw by my face I was devastated but she quickly reassured me it was okay and we changed it to the correct rate. But now I am freaking out because I am thinking back now.... should we have filled out a MIDAS report? I do not even think the pt is there anymore. I just do not want the other nurses to get trouble too because I failed to ask someone if we needed to do a MIDAS report. 

I feel like I am an incompetent nurse at this point. Do you think it would be a good idea to talk to my nurse manager about these concerns? For instance, should I tell her that I feel like I am still struggling? Do you think that I am on a verge of getting fired?

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"nursy" has 40 years experience as a RN and specializes in ICU, ER, Home Health, Corrections, School Nurse.

146 Posts; 704 Profile Views

If you read enough of these posts, you find that a lot of newer nurses are struggling, and all too often their performance issues are blatantly pointed out by fellow workers, making the nurses feel insecure and miserable.  You do not indicate that anyone has said anything thus far.  So  I would be inclined to think that you are harder on yourself, than anyone else is.  New nurses generally have a hard time their first year of nursing, so you still have a ways to go.  And, these days, even with the best time management skills in the world, nursing can be a struggle.  

If you have a really good nurse manager, it may be helpful to talk about it; on the other hand, you may call attention to yourself for no good reason.  I would suggest going to the nurses who you admire and think are especially good at what they do, and ask if they have any suggestions on how you can improve your performance.   I woudn't go around telling anyone about all the "mistakes" you are making, again, that may just bring negative attention.  Good luck!

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nursex23 has <1 years experience.

31 Posts; 1,066 Profile Views

Hi! I've been a nurse for about a year and a half now and I felt exactly the way you're describing. I felt like it wasn't normal to feel that way and I felt that I was unique in that I had a nursing license but shouldn't be a nurse. The truth is, we all feel that way when we start out. I realized that when we started getting new nurses after me and they felt in over their heads like I used to. I know it sounds like a cliche but it really does come with experience. 

As new grads, we're not expected to be the best nurses on the floor. We're going to make mistakes but that's when we need to slow down and make sure we are not going to cause harm to our patients. Just think that every time you're in a situation that seems daunting, you will learn from it and it will continue to make you a better nurse. That was the key to saving my sanity the first year. When I had a bad day, I thought, "Did I harm any of my patients? No. Okay, what did I learn and what will I do differently next time?" 

99% of those feelings went away and now that I'm in a new position in a new specialty, many of those feelings have come back but I just continue to think "don't cause harm and learn from everything." 

Your experience with TPN may seem like a huge mistake. But think about it critically; the patient didn't receive anything that harmed them or missed a life saving drug. In other words, you did not put your patient in mortal danger. I would not say you are an incompetent nurse at all. An incompetent nurse would find out that the rate was supposed to be 25mls faster and not see a problem.  Next time you have a patient with TPN, you're going to check and double check the rate and you will be a better nurse because of the time you missed the rate change. 

I would try reaching out to your manager to discuss how you are feeling. He or she may be able to reassure you and show you areas where you could improve. I would also use them to discuss policies. Find out if a report was supposed to be filed and know that next time if it happens, you need to file it regardless if someone is going to get in trouble. 

If your manager doesn't seem interested, I would try reaching out to another more experienced nurse. This forum has been there anytime I need to vent and have other nurses give me some perspective on a situation. Sometimes it helps to talk over things and get more personalized feedback. But I agree with the previous poster, don't go around telling everyone every mistake that you make. I would find someone you trust. Good luck to you and I can tell you are going to be a great nurse! 

 

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387 Posts; 5,258 Profile Views

When you're brand new, you're usually slow, confused, and error-prone. But you imagine that as you learn more you'll get faster and make fewer errors. 10 months later, many new nurses find themselves in your shoes, feeling just as slow and just as error prone.

Here's why...

As you learn more, not only do you become more practiced at administering nursing care, but you also start picking up on smaller details that you missed entirely when you were brand new. So you actually find and make more work for yourself in the process of doing your job better. Things take longer, even as you do individual tasks faster. Also, you now notice your own mistakes more often, which makes it seem like you're making more of em. Perhaps even your coworkers are more likely to split hairs with you over things they would have just quietly let slide a few months ago. 

It's part of the process of becoming competent. Give yourself a few years, not just a few months. It's a difficult job to do well. 

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