It Gets Better...Right?

[Amethyst_RN]

My first 3 days working were great. I was learning the ropes, soaking up everything anyone said, taking copious amounts of notes, asking questions, and generally just observing what the nurses actually do when it comes to taking care of the patients. I was excited to come in. The past 2 days, however, I've wanted to break down and cry. Things were really hectic and staffing was a bit of an issue so everyone was kind of stressed out. Discharges. Admissions. Medications to be passed. I felt completely overwhelmed and incompetent. Every time a patient would ask me for something, I would say, "Hold on, let me just ask the nurse". Then I'd feel stupid because I'M the nurse. That's ME. My preceptor was holding down the fort AND trying to make sure I was doing okay. I felt bad. I tried to help as much as I could. I asked questions if I was unsure of something. I just kept it moving. At the end of shift, my preceptor thanked me and said I did a really good job and stepped up when it was needed. I appreciated that, but at the same time, had no idea exactly what I was doing. If that makes sense. There's so much I see them doing (calling the doctors, putting in orders, etc) and I wonder if I'll ever be able to move about independently like that. Doing my work. Taking care of my patients. Making sure everything that needs to get done is done. Right now...it doesn't feel like I will.

I love mental health. I love this hospital, even though I've only been here about a week. The people I work with are all fantastic. They're supportive and friendly. They don't mind answering my questions. I can come to them if I ever need help or anything. Everyone works well together. I just feel so ill-equipped and like I don't belong. I had the thought twice the past 2 days that maybe a hospital isn't right for me. Maybe I need an outpatient environment or clinic...something less hectic, which makes me feel like a failure. I've been telling myself to just breathe and relax. I'm a brand spanking new grad. Of course I'm going to feel incompetent and lack confidence. This is all new to me. Once I've been at it a few months, it'll get better. Sure, it might still get crazy, but that's the thing. I wouldn't mind it as much if I just knew what to do. Which, again, can only come with more experience. I get it. I just don't like not knowing what to do and why. I don't like feeling lost. I don't like feeling dumb. I want to do a good job. I want to be a great nurse, and right now, I don't even feel like a nurse, period. I feel like a regular person that somehow got RN stuck after her name and now has to keep up the charade.

I've read so many threads here on new nurses, new psych nurses, psych nursing, and anything that had something to do with feeling scared, anxious, overwhelmed, or terrified. I know I'm not alone in feeling this way. I just really hate it.

[verene, MSN]

Amethyst, I think what you are feeling is completely normal. I'm another new grad (~5 months of RN experience). There are days when I've totally got it down and really feel like a nurse and days when I can't believe I ever graduated nursing school and feel like I have no idea of what I am doing.

When I first became a CNA several years ago, I found the first 3 months or so were horrible, I wanted to do a good job but I struggled every day and the work was brutal. Some where along the way though things became easier and easier, I didn't need to ask so many questions, I was comfortable in my work, confident in decision making, and felt like I was doing a good job.

The first 2 months of my RN position, I had a lot of rough days, there was so much to learn and some times really wondered what I had gotten myself into, but I leaned on that CNA experience to tell myself to give it another month or two and that confidence comes with time - and it does! I still have a lot to learn, still ask questions all the time, but my confidence is growing, my questions more refined, more and more I can answer my own questions by remembering where a resource is located, and I generally have more good than bad in any given shift.

Give yourself some grace - you are completely new, you are learning everything from coworker dynamics to nursing assessments, to how the copy machine works! You survived your first week of being a nurse! You *are* finding things about your job that you enjoy, and I bet you know more now about your working setting and patient population now than you did that first hour you set foot on the floor. Think how much more you will know in another week, in a month, in a year from now!

An important thing to remember is that any new job (dream job or not, nursing or not) is going to create stress for you, it can be exciting and wonderful and still create stress, simply because so much is new and your brain and your body are adapting to new routines and experiences. Recognize this and make space to process, de-stress, and incorporate activities into this new routine that help you recharge.

[Heylove, BSN, RN, EMT-B]

You're going to be okay. Take a breath. It's only week one! My first admission took me six hours to complete. Now I can do one in about an hour. All of what you're learning takes time. Know that other nurses are there to help you through this and will not expect you to know everything, even six months from now.

What really stinks is when I had patients (who are kids, mind you!) ask me "you must be new?"

[Amethyst_RN]

Thank you for the replies. I know you're right. I actually did have trouble with the copy/fax machine, haha. I definitely know more than I did my first day, and I do take some comfort in that. It makes me hopeful that I, too, will be able to work confidently a year from now. For right now, though, I'm dreading work.

Reading posts about others that have felt or currently feel the same helps so much. It's easy to feel alone and like you're the only one struggling. Makes it worse, I think. Maybe that's why I feel so awful about this. The nurses I work with have all been there for at least 3 years and seem to get through their shift so smoothly (well, as smooth as a shift can go on the psych floor). I watch them in awe because I want to be able to work like that. Yes, I know they didn't start out that way. They learned just like I'm doing. It's just hard to be the only one struggling to stay afloat. I wish there was another new grad on the floor. Someone in the same boat. We'd be going through the same things and could support each other and all that. You know?

[LisaNICUrn, BSN]

What you are experiencing is completely normal, not only are you new to psych, you are new to nursing, period. You are going to do everything slow, people are going to get things done quicker than you, leave before you, but you'll get the hang of it. Sounds like you have great coworkers with you, don't be afraid to ask for a little help. And give yourself a break, expect that you will not be an expert right away.

My advice? Think back on your first days, what gave you the most trouble (besides the fax/copier lol) and what kept you "off your game?" Mine was always PRN meds. I'd go out in the morning and pass meds, do my assessments, sit down to chart, and 10 minutes later, someone wants a PRN, then the next person wants a PRN, and the next. I felt like all I did was pass PRN meds all day. So before I gave meds, I wrote down what PRNs they had and when they could have them. Then any that were avail, I had with me when I passed meds (cause who doesn't want their prn anxiety or pain med, and you could always return them to the pixis) and I told them when their other PRN meds were avail, that way they didn't bother you for it, at least until it was close to due.

Keep a little cheat sheet and when you are talking to them, write down things you need to chart so you don't forget. The hardest thing for me to realize was I didn't have to chart right away. That's one of the most time consuming things. I didn't what I needed to do, and charted when I had time. As long as you keep little notes, you'll be fine, especially times. I had a "brain" sheet because dealing with 8 or 9 patients, it all starts to blend in by the end of the day.

Also, I learned my best friend was my unit secretary. They always know what when where, because they are the heart of the unit. The psych techs are very important as well. They can be your best friend or your enemy. Hopefully you have some strong techs who can handle things on their own and know when to include a nurse, and more importantly, don't start problems.

Bottom line is, you seem like you still like psych nursing very much, so just give it time. Be easy on yourself. The biggest worry I would have is manipulative patients who know you're new trying to take advantage of you. Seek guidance for that. Techs are your eyes and ears, and you always you're your other coworkers. Take their advice, learn from them, and you'll be a pro in no time.

[verene, MSN]

I wish there was another new grad on the floor. Someone in the same boat. We'd be going through the same things and could support each other and all that. You know?

Do you have classmates you've kept in touch with? Some of my friends from nursing school and I try to get together about once a month or so to catch up and vent. Even though we don't all work in the same settings it normalizes a lot of the struggles and insecurities around being new.

[AnnieNP, MSN, NP]

Consider your first year on the job as your last year of school! Yes you are working, but you will be learning a great deal. Good luck.

[LookForward]

It does get better. I cried every 2 weeks during the first 4 months then most of the tasks become routine. You are dong so many things for the first time. I started to feel competent by 2nd year.