If the 1st year is supposed to be so rough, how do you know you when it's not right?

HouTx, BSN, MSN, EdD · Jul 13, 2011

Sorry - no crystal ball, but I would strongly recommend that you prepare a list of specific "things that I need" if you are going to request an extension of your orientation. Just a vague "I haven't received all the stuff I should" is not going to work.... that gives the impression that you are not taking accountability for your own development. You don't want to do that. It's much better to have an action plan ready for discussion.

Compare your current progress with the orientation outcomes/skills checklist that was used for orientation. I do agree that 5 months should be long enough to begin to feel better about your job. Do you think you still have some competency gaps? Keep track of your anxiety levels and try to sort out the triggers. Is it lack of knowledge, skill, or confidence? Knowledge is the easiest to fix because you can do that on your own. Skill is a bit harder because that requires practice - try to arrange opportunities to practice in a controlled setting (with an experienced person close enough to coach you). Unfortunately, increased confidence only comes with experience.

There are some things you should avoid in the discussion with your supervisor. Although it may not be an issue with only 3 patients, for goodness sake, don't ask for a smaller or less intensive workload. That may seem to be the answer, but it won't help you develop your time management/prioritization ability. Don't paint yourself as a victim or blame your preceptor/charge nurse/manager. If your goal is to transfer to the OR, you need to establish a track record of successful competency development so they will be willing to invest in the huge amount of training required for periop when the opportunity arises.

Finally, is there a possiblity that your perception (of your performance) is not shared by your supervisor? He/she may feel that you are meeting all expectations and are doing just fine.

MICUBSNRN · Jul 14, 2011

HouTx gave great advice!

I, too, am a new grad and there are definitely good days and bad ones. I have a hard time with the barometer of "is it me, or is it just the shift".

In this day and age of nursing, we, as new grads, have been exposed to so many posts here on AN as well as stories from other nurses about the growing pains of our profession. We have all heard so much about how difficult it is, how we will feel incompetent, and how it is so stressful that going home in tears is more common than rare. But I think you posed a really great question here. What level of stress, agony, fear, and doubt is normal, and where does that line blur over to the other side of "maybe this job isn't for me".

I think one of the hardest parts is that with jobs not as plentiful as they once were, new grads are so grateful for employment that we take any job that we can find. And in terms of gaining experience and earning a paycheck that is a great thing. But, it also creates a level of fear and stress that can be bad. I know that I feel hypervigilant on every shift because I know that at the end of my orientation my employer has 3 choices. They can take me off orientation, extend my orientation, or let me go. Unfortunately, the power of choice has been reduced. While units benefit from less "job hopping" among new grads, the new grad is left at times with a horrible balance sheet of determining if it is the job for them without many options to go elsewhere. This is probably my biggest dissatisfaction with the current state of nursing.

I really hope some veteran nurses can chime in with answers to this question. Because it is hard to know if it is just the new grad jitters or if the unit is really not the right fit. I have a fellow orientee that I am taking a new grad ed class with that is in this exact situation right now. She absolutely hates her unit. And she is so depressed and sad because she doesn't know if it is her or the work environment. She worked so hard to be a nurse, and she never imagined that she would hate her first job this much. :crying2:

Hang in there bitz. Just know you are not alone. Sending you a hug!

bitz · Jul 14, 2011

Thank you for your responses. They are Very much appreciated. So nice to hear I'm not alone and to also hear from those with a lot of experience some suggestions to avoid pitfalls, etc... Thank you both! :redpinkhe

BrandonB779 · Jul 14, 2011

Also as another new grad, everyone has their days. I currently work in a Medical/Cardiac ICU unit with 14 beds where we usually have 2 patients, 3 if tripled due to a new admission (taking one pt from another nurse so she can have 1 not so acute and the new admit). I work w/ a preceptor and though I am very confident and everything in actions, I've had my days both as a grad and student on the floor w/ wow is this really for me? just have to take the time and really evaluate, I mean you went thru school and made it out ok, its just gotta get into the rhythm of everything and it will work out trust me, it will be rewarding, and yes you are def not alone, we all have em, and we know that somewhere out there someone can help us with it! Stick it thru, you'll make it out alot stronger and can use them as building experience for yourself down the road too