As my title states, I'm starting to change as a person. I'm in nursing school right now. I'm in a 2 year program and I'm almost done my second semester. I have one more year(8 more months of actual school) until I graduate. Right now I'm doing my clinical rotation on a med-surg unit. I'm doing well in school. I have a high grade percent average which is great for this semester(I've heard it is the hardest semester for nursing students). The problem is I'm changing as a person. I remember when I first got into nursing school, I was so excited, thinking I could make a difference and get paid a decent pay in return. I was a empathetic, honest genuine person. Now, I feel like I'm losing that. A few days ago I got in trouble in clinical for almost giving the wrong med to a patient. I understand that is partially my fault and in no way am I denying it. But in my defense, I'm am a nursing student,I've only been on this med surg unit for 2 1/2 months, twice a week(no orientation, nothing) and I'm still learning and it was the first time I had 4 patients and a lot of the medications to be given under a short time span. I did so many other things right. I was overwhelmed and I felt I was just put into the tough situation without much help. Is this what nursing is like? Your put in a tough lose-lose situation and when things don't go right its all dumped on you? I cried all the way home. To make matters worse, most of the patients treat me like a maid and their familes and many of the nurses that work there I feel don't like the student nurses for whatever reason(s). I feel like now I'm starting to become less empathetic and very much guarded. When patients tell me their sad stories I feel like I don't really even care much anymore nor do I even want to listen. I just wanna get things done and go. I'm always worried about my health(which is #1 to me) and my body feels so tired all the time. I think about nursing 24/7 and all the things I could have did, should have said, and should have not have said, so even when I'm not physically there, I'm mentally there.
Its sad because I spent 6 years of my life to get to this point. I'm in so much debt and I honestly feel so disrespected, miserable and sad all the time. I feel like I have to keep my head down. I'm starting to forget what its like to smile:crying2:. Is this was nursing is really about? If it is, someone please tell me now so I can get out now while I'm ahead.
1) 4 patients is WAY too many for a 2nd semester student. You realize there are units where the actual RNs take 4 patients? It's just not reasonable to expect a student who has only been doing this for a semester or two to be able to take on that kind of load and not make a mistake. The miracle is that this is the only time it's (almost) happened!
2) As everyone else has said, it does get better. I'm not an RN yet (about to graduate) so take it for what it's worth, but I can tell you that two patients at the beginning of this semester kept me running and frazzled all day, but by the end of the semester, 4 patients were not such a big deal. You just need more time to hone your skills so they don't take as long, and the more exposure you have to all the meds the more you'll remember them, what they're for, what the side effects are...it makes it harder to make a mistake like that because you'll be more familiar with meds as you give them more. Plus you'll have more time to prepare meds because it won't take you as long to do the other things you have to get done in a shift. You aren't behind, you aren't deficient, if you can even get through the day with 4 patients at this point, that's really amazing!
3) As far as the patient/family treatment, know that every unit and facility has a "personality," and things can be very different from one unit to another. Some of it may depend on the type of unit you're on right now. As you get more experience on different units while you continue through the program, you'll get a feel for what different areas are like. Same with the nurses you work with. For some reason, most of them seem to forget that they were students once, too. And some of them just don't have the personality or patience for teaching. Doesn't mean they're bad nurses, just not good teachers (which is a little unfortunate because we are taught that education is such an important part of what we do). Still, there are usually at least a handful of nurses on the unit who are good teachers. Learn to learn who they are and try to pick their patients. When I found a good nurse, I would come in and take all of my patients from her so that I could also be learning how she handles her day, and then she got a bit of a break because for a good chunk of her patient load, all she had to do was to check in on them without worrying about providing much of their care. It made her day easier so she was glad to see me, and it made it easier for her to spend some time teaching me.
4) Recognize that most of nursing school is really med-surg school. There's a good reason for that, but it doesn't mean that you have to make it your career. Most nurses will say that if you want to work in a specialty unit, you're best off starting out in med-surg and moving on after you really firm up those basic skills. But then the world is your nursing oyster! There are SO many different things you can do as a nurse where many of the hassles you face in med-surg don't exist. I have nothing against med-surg, it's where I'm starting myself, but after having done a summer externship in the ED, I can tell you that the day goes very, very differently in different specialty areas. I'm not saying easier or harder or better or worse, just different. I also felt very overwhelmed my second semester, and very much doubted if I had made the right decision by going to nursing school, but then I did the externship and discovered there was a place where most of what I was frustrated by in med-surg didn't exist! For example, in the ED: it would be really unusual to have to give someone a bath; same with meals; for meds you're pretty much just giving the meds that the doctor orders, as he/she orders them, no such things as "scheduled" meds or "home" meds, just meds to treat what they came in for, and they're kept on the unit so there's really no such thing as not having a med available when you need to give it; your care is usually much more focused, really looking at the c/o of things related to it; you don't have two weeks worth of charting to browse through to try to figure out what's been done to your patient and what's been missed that you need to take care of; and so on. These "benefits" also bring about "challenges," but the point is they are different from what you deal with in med-surg. Or think about OR nursing, there your patients aren't even conscious most of the time. Different benefits, different challenges, but maybe more suited to you. Specialty areas come with their own hazards, but you may find that they are hazards that you can live with better than the ones you face in med-surg. Think about L&D, a lot of the same kinds of benefits that you see in the ED except you probably have a little more information about your patients which you may like; you can learn that one thing really well and then apply your knowledge across a wide range of levels of acuity and complications. Different areas have different pros and different cons, so don't worry if you have a hard time tolerating the pros and cons of med-surg; you may find that you change your mind once you are more advanced, or you may decide to make a career in a different area, there's nothing wrong with that.
5) It's totally normal to see a personality shift when a person is under a lot of stress. You see it in your patients all the time, and maybe you just don't realize it because you don't have a way to know their "baseline" personality! This has been a hard semester for you, you feel the stress, and it shows. Not the end of the world. Don't assume your whole career will be like this, it won't. If it seems that way, then you find a different area that's a better fit for who you are.
6) It will be so much easier on you when you don't have your instructor with you all the time. It saves a lot of time. Just trying to coordinate the logistics of getting your instructor to be with you at just the right time, be prepared, have all these meds for all these patients ready to go, it's a lot to manage, it's very stressful, and it doesn't work that way once you're on your own. You do lose that safety net, but instructors don't always catch mistakes anyway. Besides, you sound like a pretty vigilant person, I would think being on your own would just make you more conscientious about your meds. Many facilities these days have electronic MARs, and some of those require you to actually scan the meds against the patient's armband before you administer. It's still not foolproof but it goes a LONG way towards getting the right dose of the right med into the right patient.
7) I may get flack for this last bit of advice, but it's worked for me. By this point, I have learned that I really gain a lot by plastering a big smile and sweet attitude on before I go into a patient's room. Sometimes I feel that way, sometimes I fake it, but it's part of my "uniform" by now and it really works. Patients generally relax more with a friendly nurse. It gives them extra confidence in me, even if it's not warranted! That means they will hassle me less, things will go smoother and take less time. I always make a point to stop for a moment during the assessment, when we're making chit-chat, and talk with them for 1 or 2 minutes without doing anything else at the same time, just give them those few moments of undivided attention (even though it's painful because I'm ALWAYS in a hurry!). And I always assure them that if there's anything at all that they need, your call light is right here, just hit the red button and the clerk will let me know, I'll come take care of you. I know this is all a little counter-intuitive when you're trying to save time, it's a small investment of extra time and a bit of a leap of faith, but I can say that at least in my experience, all of this generally saves me a LOT of time later in the day. Patients seem to be a lot less needy if they feel confident that they're not going to be forgotten about. That really seems to be a big concern for them, and if I'm reassuring them throughout the day that I haven't forgotten about them, they seem much more likely to wait until they see me again (because they are confident they WILL see me again) to ask for whatever it is they want. You have to draw limits or some patients will talk your ear off, but generally I find it works to my advantage time-wise.
I'm sorry things are rough right now, but they will not stay that way forever! You will only have more and more options once you are finished with school. You don't have a lot of choices right now, but that gives you time to experiment and see what works for you. Good luck! Your current circumstances are just your situation right now, it is not a prison cell, it is not your destiny! You can do this!
I'm a student like you, graduating at the end of the year, fingers crossed. I found the first year or so of nursing school to be quite a drag, my interest peaked when we started doing mental health and critical care. There's more areas of nursing than medical/surgical and they each have quite a different feel to them. Stick it out and experience/a few other areas of nursing. Maybe you're like me and medical/surgical just isn't the best fit.
Hello. Before you further consider getting out of nursing, I would encourage you to get some counseling. nursing is tough, yes. but if you were drawn to a profession that helps others, then you would likely end up in a similar people oriented profession. getting insight into your people skills or any lack of would help you anywhere. Also- your concern over the near med mistake is a positive thing. Some people would not even care. Good luck.
I read all of this and remember back to my 3rd semester clinical instructor that "made" me feel as if I wasn't cut out for nursing even after I had been in it for 20 plus years. I have recently become a RN and have frequently been questioning if I still want to do it. I know they talk about "reality shock" and all that in nursing school but nothing really seems to prepare us for the real world as we encounter it so to speak. it is unfortunate that we don't get much recognition for what us nurses provide to patients and sometimes it is quite the contrary. I take pride in small things such as a family member thanking me for being so gracious to them and sometimes that is the only real satisfaction we get in the midst of a chaotic profession.
Specializes in Management, Emergency, Psych, Med Surg.
Everyone feels like this sometimes. When you are new, no matter what they taught you in school you have to learn how to relate to patients in a different way. We all have situations that make us feel like a maid, but you can learn how to control that. One way that I do that is that I come into the room and introduce myself as the registered nurse who will be caring for them. I then give them the name of the CNA that is assigned to them. And I give them a little information regarding what I will be doing for them. This helps to establish a boundary. It will be stressful at times and you will feel like a total failure sometimes. But hang in there. When I started nursing, it was hard at first, but one day, about 6 months into my job the light went on and I started to feel like I knew what I was doing. I have had this experience each time I have started a new job. It gets easier. Hang in there.
I was depressed as hell during nursing school! It's just SO demanding, plus most of us have/had to work and you got family always wanting to talk to you, and you're trying to learn all this highly important stuff in such a short time. In my opinion it's really easy to get the way you are...
But after school it got a lot better for me. It's worth the hell you go through, trust me! And nobody gets nasty with you because they dislike your or anything... it is just so important to do things right. These are real people we are dealing with, so that's why people might get on your case about a seemingly small thing. I just take the verbal beatings and learn from it.
I remember once I got ripped a new one by my teacher the first time I ever got to give a med because I forgot to check what the patient's creatnine level was. But darned if I ever forget to check it again for that med! I thank her everyday now for yelling at me ^_^.
I agree with what the others have posted about working as a nurse so I'm going to focus on something else: You mentioned feeling sad and not being able to smile, feeling tired all the time, etc. What are you doing to recharge YOU? Obviously you are studying a lot, because you mentioned a high GPA, but you don't have to spend a lot of time and money to give yourself a break. Taking a walk, taking a bath, watching a movie, or reading a trashy novel that has NOTHING to do with nursing(my personal fave) will help you keep your sense of self intact.
I don't think this gets emphasized in nursing school enough-I know it isn't in mine. We have a stressful profession and we pour ourselves out for our patients every day, but most of us learn the hard way, IF YOU DONT TAKE TIME TO UNWIND, YOU LOSE THE ABILITY TO BOUNCE BACK.
Summersent, please keep posting and let us know how you're doing. We're rooting for ya! :nuke:
I am so sorry you are feeling bad about yourself right now. You may have already heard this, but nursing is not what you "do", it is what you "are". Nursing education is intended to change the way you feel about the world in general, and yourself in particular. Most people don't realize this until after graduation.
I actually think that you are feeling this way because you are probably more insightful and self-aware than your fellow students. As an educator, I feel that you are processing your entire experience rather than just going through step-by-step. Trust me when I tell you that this is not a common ability - but absolutely necessary to become a highly proficient nurse.
Your instructor's reaction to your medication near-miss was way off base. In my organization, we would have called it a "good catch". We acknowledge and celebrate efforts to maintain safety & quality - especially when a person not only exercises sufficient vigilance to interrupt his/her own routine actions to realize that something is wrong but also the personal integrity to report it.
You're My Kind of Nurse! Have faith in the education/transformation process and realize that you will come out whole on the other end.
I'm going to have to respectfully disagree with a couple of the earlier posts.
1) Nursing does not necessarily have to be a profession where we're taught to be submissive. Sure we have to carry out physician orders, but in the nursing jobs I've worked the nurses are valued and our opinions are respected. We were taught the use our critical thinking skills to collaborate with physicians to treat our patients. In fact, in my first nursing job (in a large, university teaching, Magnet hospital) we were taught to be patient advocates. This meant that we were a member of the team with valuable input. We were taught to think critically and ask about orders we didn't agree with. Sometimes we're wrong but other times we're right -- it was all about learning and doing what's best for the patients. In my current job, our medical director openly tells the interns/residents that the bedside nurses are a valuable member of the team with a lot to contribute. They are taught not to ignore our questions/suggestions because we've been doing this longer than they have. Some of these are first year interns/residents while some of the RNs have been there for years. We are the ones who are bedside monitoring the patients for 12 hours a day. We get to know the patients in a way they don't see. This is a profession and we should be treated like professionals.
2) There's an age old debate that new grads should begin in a Med-Surg floor to gain organizational skills... But there have also been many successful nurses who have never worked in Med-Surg (myself included). I did a 3-month externship before graduation and I knew I wanted to do a specialty unit right after graduation. The key is to know yourself, your limits and find a good, supportive hospital that welcomes and nurtures new grads in a specialty program. Of course working in Med-Surg will help with organization, assessment but a specialty unit will also help with the same. There's nothing like finding a niche in nursing and feeling/knowing that you're "home".
Nursing is a very demanding and difficult profession with a ton of stress. We do get the bulk of what goes wrong, but we also get to hear/see and be there for our patients in a way that no other profession can. We are the ones who will hold their hands if they're scared. We can advocate for patients who can't speak for themselves.
solneeshka, BSN, RN
292 Posts
1) 4 patients is WAY too many for a 2nd semester student. You realize there are units where the actual RNs take 4 patients? It's just not reasonable to expect a student who has only been doing this for a semester or two to be able to take on that kind of load and not make a mistake. The miracle is that this is the only time it's (almost) happened!
2) As everyone else has said, it does get better. I'm not an RN yet (about to graduate) so take it for what it's worth, but I can tell you that two patients at the beginning of this semester kept me running and frazzled all day, but by the end of the semester, 4 patients were not such a big deal. You just need more time to hone your skills so they don't take as long, and the more exposure you have to all the meds the more you'll remember them, what they're for, what the side effects are...it makes it harder to make a mistake like that because you'll be more familiar with meds as you give them more. Plus you'll have more time to prepare meds because it won't take you as long to do the other things you have to get done in a shift. You aren't behind, you aren't deficient, if you can even get through the day with 4 patients at this point, that's really amazing!
3) As far as the patient/family treatment, know that every unit and facility has a "personality," and things can be very different from one unit to another. Some of it may depend on the type of unit you're on right now. As you get more experience on different units while you continue through the program, you'll get a feel for what different areas are like. Same with the nurses you work with. For some reason, most of them seem to forget that they were students once, too. And some of them just don't have the personality or patience for teaching. Doesn't mean they're bad nurses, just not good teachers (which is a little unfortunate because we are taught that education is such an important part of what we do). Still, there are usually at least a handful of nurses on the unit who are good teachers. Learn to learn who they are and try to pick their patients. When I found a good nurse, I would come in and take all of my patients from her so that I could also be learning how she handles her day, and then she got a bit of a break because for a good chunk of her patient load, all she had to do was to check in on them without worrying about providing much of their care. It made her day easier so she was glad to see me, and it made it easier for her to spend some time teaching me.
4) Recognize that most of nursing school is really med-surg school. There's a good reason for that, but it doesn't mean that you have to make it your career. Most nurses will say that if you want to work in a specialty unit, you're best off starting out in med-surg and moving on after you really firm up those basic skills. But then the world is your nursing oyster! There are SO many different things you can do as a nurse where many of the hassles you face in med-surg don't exist. I have nothing against med-surg, it's where I'm starting myself, but after having done a summer externship in the ED, I can tell you that the day goes very, very differently in different specialty areas. I'm not saying easier or harder or better or worse, just different. I also felt very overwhelmed my second semester, and very much doubted if I had made the right decision by going to nursing school, but then I did the externship and discovered there was a place where most of what I was frustrated by in med-surg didn't exist! For example, in the ED: it would be really unusual to have to give someone a bath; same with meals; for meds you're pretty much just giving the meds that the doctor orders, as he/she orders them, no such things as "scheduled" meds or "home" meds, just meds to treat what they came in for, and they're kept on the unit so there's really no such thing as not having a med available when you need to give it; your care is usually much more focused, really looking at the c/o of things related to it; you don't have two weeks worth of charting to browse through to try to figure out what's been done to your patient and what's been missed that you need to take care of; and so on. These "benefits" also bring about "challenges," but the point is they are different from what you deal with in med-surg. Or think about OR nursing, there your patients aren't even conscious most of the time. Different benefits, different challenges, but maybe more suited to you. Specialty areas come with their own hazards, but you may find that they are hazards that you can live with better than the ones you face in med-surg. Think about L&D, a lot of the same kinds of benefits that you see in the ED except you probably have a little more information about your patients which you may like; you can learn that one thing really well and then apply your knowledge across a wide range of levels of acuity and complications. Different areas have different pros and different cons, so don't worry if you have a hard time tolerating the pros and cons of med-surg; you may find that you change your mind once you are more advanced, or you may decide to make a career in a different area, there's nothing wrong with that.
5) It's totally normal to see a personality shift when a person is under a lot of stress. You see it in your patients all the time, and maybe you just don't realize it because you don't have a way to know their "baseline" personality! This has been a hard semester for you, you feel the stress, and it shows. Not the end of the world. Don't assume your whole career will be like this, it won't. If it seems that way, then you find a different area that's a better fit for who you are.
6) It will be so much easier on you when you don't have your instructor with you all the time. It saves a lot of time. Just trying to coordinate the logistics of getting your instructor to be with you at just the right time, be prepared, have all these meds for all these patients ready to go, it's a lot to manage, it's very stressful, and it doesn't work that way once you're on your own. You do lose that safety net, but instructors don't always catch mistakes anyway. Besides, you sound like a pretty vigilant person, I would think being on your own would just make you more conscientious about your meds. Many facilities these days have electronic MARs, and some of those require you to actually scan the meds against the patient's armband before you administer. It's still not foolproof but it goes a LONG way towards getting the right dose of the right med into the right patient.
7) I may get flack for this last bit of advice, but it's worked for me. By this point, I have learned that I really gain a lot by plastering a big smile and sweet attitude on before I go into a patient's room. Sometimes I feel that way, sometimes I fake it, but it's part of my "uniform" by now and it really works. Patients generally relax more with a friendly nurse. It gives them extra confidence in me, even if it's not warranted! That means they will hassle me less, things will go smoother and take less time. I always make a point to stop for a moment during the assessment, when we're making chit-chat, and talk with them for 1 or 2 minutes without doing anything else at the same time, just give them those few moments of undivided attention (even though it's painful because I'm ALWAYS in a hurry!). And I always assure them that if there's anything at all that they need, your call light is right here, just hit the red button and the clerk will let me know, I'll come take care of you. I know this is all a little counter-intuitive when you're trying to save time, it's a small investment of extra time and a bit of a leap of faith, but I can say that at least in my experience, all of this generally saves me a LOT of time later in the day. Patients seem to be a lot less needy if they feel confident that they're not going to be forgotten about. That really seems to be a big concern for them, and if I'm reassuring them throughout the day that I haven't forgotten about them, they seem much more likely to wait until they see me again (because they are confident they WILL see me again) to ask for whatever it is they want. You have to draw limits or some patients will talk your ear off, but generally I find it works to my advantage time-wise.
I'm sorry things are rough right now, but they will not stay that way forever! You will only have more and more options once you are finished with school. You don't have a lot of choices right now, but that gives you time to experiment and see what works for you. Good luck! Your current circumstances are just your situation right now, it is not a prison cell, it is not your destiny! You can do this!