I think I want to quit nursing...

Anna Flaxis, BSN, RN · May 15, 2016

Sounds like a rough night.

My first piece of advice is to familiarize yourself with your facility's Policies and Procedures- where they are located (most places these days, it's on the company's intranet) and how to search them to find what you need. It might also serve you well to have a nursing procedure manual (Lippincott's, Mosby's, etc.) handy at work. This way, when you need to do a procedure that you don't know how to do, you can look it up in your facility's P&P and/or refer to your procedure manual.

Second, you might have to be specific when asking for help from your co-workers. Ask them to do a specific task, such as "Can you pass meds in rooms 10 and 11 while I start an IV in 12 so I can get her back on her Cardizem gtt and start her blood transfusion?". A co-worker could see that you're struggling, but not think of a specific way to help you unless you ask.

Lastly, and I saved this for last because it's probably obvious to you, triage your care. What is the thing that's going to kill your patient the quickest if it doesn't get done? The patient requiring a Cardizem gtt and a blood transfusion who has no IV access would be #1, right? A Foley irrigation can wait if the Foley is draining. Obviously, if there are clots blocking the catheter, it needs to be tended to sooner rather than later. But if it's draining and the patient is not experiencing bladder distention, it can wait a little bit. Routine meds are important, but you do have a window of time in which to complete this- it does not have to be at the exact scheduled time. Many facilities give you a two hour window- an hour before and an hour after the scheduled time- in which to complete this. And while it is important to keep patients with incontinence clean and dry in order to prevent skin breakdown and preserve dignity, you do have some time. If the patient is able to help by rolling side to side in the bed or lifting their hips so briefs can be changed, then one staff person can safely provide incontinence care. If the incontinent patient is truly dependent and unable to assist by rolling side to side or lifting their hips, then yes, someone needs to help the CNA, but it doesn't have to be you if you are busy starting an IV and hanging blood. A co-worker can help, or the CNA can wait until you are available.

You will learn to be more efficient as you gain experience. For instance, since you have to wait until the blood bank has the blood ready before you can hang it, you can do other things while you're waiting, such as the Foley irrigation, or passing meds to a patient or two. While you're in the room for the first 15 minutes of the transfusion monitoring for s/s of adverse reaction, you can be catching up on your charting, or you can give the patient's routine meds a little early (if within your facility's acceptable time frame), or researching Foley irrigation procedure (if you haven't gotten to that yet), etc.

I can honestly tell you that it will get better, but I'd be lying if I said that you won't have any more rough nights. Nursing is hard, and being a new grad is overwhelming and terrifying. The first year is tough-with-a-capital-T. But if you stick with it, keep trying, learn from your mistakes, and just keep showing up, one day you will look back and see how far you've come, and you will be the experienced nurse mentoring the new grads.

miscangelious · May 15, 2016

_{thank you so much! I think it was a rough night and I'm just gonna keep trying to be more organized and manage better. Last night went better and hoping for a better night tonight! I just hope it does eventually improve, yano?}

TNT_RN09, BSN, RN · May 15, 2016

Cardizem gtt on a regular med surg floor???[emoji15]

Anna Flaxis, BSN, RN · May 16, 2016

Cardizem gtt on a regular med surg floor???[emoji15]

It's a telemetry unit. And Cardizem is not that difficult. It's totally doable on a tele unit.

Anna Flaxis, BSN, RN · May 16, 2016

It will get better. ;-)

Little_Bear2013 · May 17, 2016

@Anna

Thanks.

I kind of needed to read this tonight as I'm currently orienting as a new grad for a night position but will be on days temporarily till I transition over but with it only being my 2nd week on the floor, especially after the 1st week went SOO SMOOTHLY but this time WAS THE MOST CHAOTIC it felt like, especially with really caring for only one person, that person drove me UP THE WALL and couldn't even get things done because they wanted this this, that that, and now now with call light going off every 10 mins for pain meds or 30 mins before the next one was due, needing a new IV and EVERYTHING!! So just felt awful as it didn't allow me to even help my preceptor with other med passes or assessments or learn other new skills most of the morning. My preceptor says I'm doing good but all day I just felt awful or at least until afternoon / evening then I was able to start helping with other tasks, so I think I should keep sticking in there.

Also, @miscangelious.....I'm sure you've got more experience on the floor than me now at this point so I'm sure your doing a fabulous job, so keep up the good work and I'll be thinking of you and cheering you on when I go back to the floor later this week!

sugarwahine10 · May 25, 2016

Yeah when I worked on a telemetry/med surg floor we had cardizem gtts running on almost every other patient or amio, milirinone, integrelin, heparin. Blood going on one, foley irrigation on another, detoxer, alzheimer patient trying to pull out every line and fall, etc, etc, etc...good times. Can get so very, very hectic! It will get better for you as you gain experience.

Firebabe26 · May 26, 2016

First of all, I am concerned on the comments in the last paragraph. If you are thinking about hurting yourself, please go to employee assistance or the ER! Same for your friend. Nothing is worth hurting yourself over.

Secondly, put down the baseball bat on yourself!!! You are your toughest critic. As a "new grad" who is starting her second year on a busy telemetry floor some nights all I do is play firefighter - putting out fires. Yes, you WILL screw up. No matter what happens, how you handle the bad times determine your character and ethics. Did a patient get hurt? Permanent property damage? If not, it is going to be o.k. Now is when those habits of NOT bypassing the scanner for meds, or double checking a drug dose come into play. Because when it hits the fan you will eventually see you will be on autopilot. Next shift, help another nurse if you can. Build some friendships. You will eventually have a "circle of support" around you and you will like coming into work. If not, find another job! Btw. I have had 5 patients every night since out of orientation. You can do it!!!!!!

Duztyroze · May 26, 2016

I needed to read this thread! Thank you for posting! While I'm not a brand new nurse (4 years now)-I've never worked in a hospital and I'm only 2 months in on a busy trauma unit. I'm struggling. I find myself torn between wanting to be efficient and an asset to my team, and wanting to quit! I am terrified I'm going to make a mistake that causes a patient harm, but some days I literally drown in my assignment (still passing 8 am meds at 11), and staff have no time to help! Sometimes I don't know a procedure, and with nobody to help and no time to look-somethings just don't get done. I leave feeling like a complete failure and understand that the nurse relieving me is less than pleased. I want to learn, but how? I've been advised the floor is not a school, so I need to carry my own weight. I know my patients are not as acutely ill as the assignments of experienced nurses, so I feel even worse when I have to say I need help (even though I know the answer is "no", more often than "yes"). I too have spent too much time crying and sleeping since starting this job. I just want to learn all I need to know to provide good (even great) nursing care, without the dread that I'm going to make a critical mistake...I feel so conflicted. "Run" for the safety of the patients-but then never learn, or keep foraging forward-fingers crossed that no harm is done while I stumble along...

brimurse58 · May 27, 2016

I'm a new Grad RN I took on a job in LTC at a rehab center and yeah I might not have patients at high risk with meds but I have to manage care with roughly 25 patients. Take it for granted there not all on IV drips but they do have needs such as calling the doctors for new orders, fall risks, med passing, assessments, open skin tears, etc. one thing which works really well for me is at the start of a shift is to prioritize the patients using ABCs esp in a hospital.....lean on your CNAs cause they are your backbone believe it or not.....if a resident needs to be changed then wait on that take care of the meds first.....cause would u rather have a soiled patient or a patient whose heart isn't pumping enough due to not getting their IV drip.....always prioritize it.....go to your director too and say hey I haven't done enough of this yet I need to be adequately trained in it......cause if they can't provide the training and resources then that's a real **** headed DON.....things will get better just try to remain calm easier said then done but it does make a huge difference in the end

Keys2thebeamer · May 27, 2016

Any nurse who tells you they have never completed a shift without wanting to run out screaming and quit nursing all together is lying. We have ALL had those days/nights, and unfortunately for new grads, you may experience them quite often. But these tough situations teach you lessons on how to become a better organized and efficient, more resilient nurse. Hang in there, a year or two from now, I promise you'll look back and feel thankful for the challenges you face now :)

PS- To all questioning Cardizem on a tele floor: Yes, it can be hung on a tele floor, but it's usually only titrated in the unit.