just a little stressed

sticknurse · Jul 31, 2007

You will be fine. DEEP BREATH. We all seem to expect exceptional organizational skills upon receiving the diploma. These things happen with time. Don't give up. Find a mentor who you can look up to. Who's the most efficient nurse you know? In the end, you'll surprise yourself. You'll look back in a year or so and wonder why you were panicking. Keep priorities in mind. Anyone in danger? Carry a small notebook and jot notes, be careful to guard your time wisely, and be the "smiling nurse" that will keep the complaints to a minimum if you are late due to inexperience. Nice makes up for alot. Good luck.

nyapa, RN · Jul 31, 2007

1. Whats wrong with asking questions? Shows you want to get things right. Even if you know the answer you are clarifying it. The number of times I've done the same and said "I'm sorry but I've got a stupid question to ask", only to have a nurse say, "there are no stupid questions, just stupid nurses. Ask away" or "its better to ask and get it right then get it wrong".

2. What is your hospitals policy re working with a preceptor? Have you gone above what is expected? You have written that you have taken all your preceptors allocated patients - are you not supposed to? If not, perhaps you should take less, or let her shadow, or whatever policy dictates.

You have only been there a few days in your new role. I come from a similar situation as you where I am now working as a new grad RN in a hospital where I have worked as an EN for years. For me, the change in role is almost like having to prove myself again sometimes to ppl I know in my previous role, ppl who respected you. And having worked there before has also made me more aware of the implications should something goes wrong, so I try really hard to 'get it right'. Are you the same? It is hard to keep the concept in mind, but both of us are still learning. And you are only two weeks out. It takes time to develop time management and prioritisation skills.

As for being personable; that will possibly return once you are more confident in your role, as you are probably concentrating on physical care, liasing with fellow team members and allied health professionals etc etc. in order to ensure wellbeing of your patient, oh and the fact that you are thinking of your other patients while you are dealing with one :)

P.S. to top it off... I take the freaken NLCEX tomorrow

Say no more...no wonder you are stressed!

Best of luck. Oh and do you go home and think about work as well? That is my worst mistake. I have woken up in the middle of the night thinking "OMG, I didn't do that!" only to ring up and have the night nurse crack up laughing and asking why was I awake at 3 in the morning? I've found swimming and riding my bike has helped; it actually helps one concentrate one's thoughts away from work

mycatmax · Jul 31, 2007

Yes i do go home and think about my day.... I remember little things that i forgot to do... like writing down a output. It drives me crazy and makes me feel bad about the job I am doing.

I started having dreams at night about nursing. two nights ago, I was dreaming that there was a beeping IV pump somewhere and i couldn't find it, when i woke up and my alarm was going off.

The dream before that was about me shooting myself in the leg, my leg was just dangling and when I was in the ER my IV infiltrated and i couldn't get any pain meds.

Crazy dreams and crazy thoughts I guess.

As far as taking on all of the patients that were assigned to my preceptor... I just feel like that is how i will learn to organize and prioritize. If it is all thrown at me and i have to deal with it, I will find a way. I also ask to carry my preceptor's phone. It's not required to take the full assignment, but I just feel like that is what is going to help me.

I know I have the ability to do this, but it's just so stressful during this time when you haven't learned your skills yet.... the skills you can't really learn in nursing school.

Thanks for the comments!

NursingAgainstdaOdds · Jul 31, 2007

You are being way too hard on yourself! You've only done 3 full shifts, of course you still have questions and still need to learn a lot w/ regards to organizing and prioritizing. I think you're right on track.

Hope the NCLEX goes well! I'm sure it will. :)

jjjoy, LPN · Jul 31, 2007

I do think it can be useful to just jump on in. I never got much out of having only 1-2 patients to deal with. It does nothing for helping manage priorities. I personally would've done well to stick with 3-4 for several weeks! I would've done well to try 5-6 for a few days and then go back to 3-4 to have time to try things different ways in a less hurried shift. Instead, once I had shifts with more than 4 patients, it felt like running on a treadmill that never slowed down! But with just 8 weeks of preceptoring (they made it sound so generous... two whole months!!), as well splitting time between orienting to day and night shift, they were pushing me hard to get to a full load ASAP.

The thing is that while here people are often very supportive reminding newbies that they shouldn't expect themselves to have it all together yet, on the floor, the newbie can often see their new colleagues impatiently waiting for them to have it all together. I remember hearing nothing but "You'd better learn to prioritize/be faster, because in X (8, 6, 4, 2) weeks, you'll have to handle it all yourself." Nothing like "We don't expect you to have it all together for at least a year. We expect you to regularly ask us for help because we know that you'll still be figuring this out for the next six months or so." It's intimidating!!!!

And no matter how forgiving is oneself in terms of giving oneself time to get it, the reality is that the newbie may not be able to complete all of their work - and may not be able to do this consistently for many months. Yet this work involves people's lives and legal documentation. How can the newbie feel good about their progress when they still aren't able to fully perform their job functions? That's why I'm advocate for nursing residencies, where the newbie's job description (and performance expectations) is different from that of the experienced nurse. This can be a lower paying position that allows the new nurse to build on his/her skills without the full responsibility for a full load of patients.

shmoofins · Aug 12, 2007

The thing is that while here people are often very supportive reminding newbies that they shouldn't expect themselves to have it all together yet, on the floor, the newbie can often see their new colleagues impatiently waiting for them to have it all together. I remember hearing nothing but "You'd better learn to prioritize/be faster, because in X (8, 6, 4, 2) weeks, you'll have to handle it all yourself." Nothing like "We don't expect you to have it all together for at least a year. We expect you to regularly ask us for help because we know that you'll still be figuring this out for the next six months or so." It's intimidating!!!!
And no matter how forgiving is oneself in terms of giving oneself time to get it, the reality is that the newbie may not be able to complete all of their work - and may not be able to do this consistently for many months. Yet this work involves people's lives and legal documentation. How can the newbie feel good about their progress when they still aren't able to fully perform their job functions? That's why I'm advocate for nursing residencies, where the newbie's job description (and performance expectations) is different from that of the experienced nurse. This can be a lower paying position that allows the new nurse to build on his/her skills without the full responsibility for a full load of patients.

Wow, that is exactly how I feel. I've been off orientation and on my own for like 2 weeks now and lately I feel like I'm always messing up. Like I'll forget to document something or document it wrong (we just switched to a new computerized charting system so I'm trying to get used to not only nursing but also this system...aah!) or not do something...it's so stressful. Then I go home and all I can do is think about all the stuff I did wrong. I know it takes about a year to feel comfortable and get it all together but this is really stressing me out right now.

The nurse residency thing sounds great, I wish my hospital did that. It's so hard being an inexperienced nurse, but still being given the same responsibilities and expectations as the more experienced nurses. The nurses on my floor are good about helping me and being patient with my questions and stupid mistakes, so I guess I'm lucky in that respect. I'm still on my probationary period though, so I'm constantly scared they're gonna get fed up with me and just fire me. I just want to get through my first year, I think then I'll feel more with it.

deeDawntee, RN · Aug 12, 2007

I think what you are experiencing sounds very normal to me!!

A couple of things I would suggest, is as you become more confident and secure, you will be able to use some "nursing judgment" in the depth of your assessments. Some patients will take more time to assess and other pts a lot less time. If you have a patient going home today, your physical assessment would logically be brief, but assessing what education the patient needs before you discharge him would take priority. Remember, that your vital signs alone (which include O2 sats and pain) will tell you A LOT of how your patient is doing. What do you need to focus on? When you come into a room and talk to a patient, you will be able to assess a lot about their neurological function. I believe that when we walk into a patient's room we are assessing that patient.

Please don't hear me as telling you NOT to do thorough and complete assessments on your patients, I am not saying that at all. But as you become more experienced, you will be able to do a very thorough assessment FAST. I work in the ICU now, and my basic assessment that I do on everyone takes less than 5 minutes, then of course, time is added onto that depending on what they are there for and what kind of interventions they have going on. (like vents)

Be patient with yourself, I have the sense that you need to start trusting yourself as well. If you think about it, you have been around patients enough that you can tell something is wrong just by looking by them. Or your gut tells you something is going on.

Good luck with NCLEX!!! Give yourself a good 6 months to a year to feel that you have really gotten the organization thing down, it doesn't happen right away.

:yeah: :yeah: :yeah:

you can do it!!!

mycatmax · Aug 13, 2007

Thank you for all of the encouragement. I know it takes time to learn the organization, judgment, priority skills, but i just find it frustrating that i can't have them NOW. I guess that is what makes your first year difficult. Oh and I did pass NCLEX, so now I am an RN :)

deeDawntee, RN · Aug 13, 2007

congratulations!!! rn!!!!

:nurse: :nurse: :nurse:

:yeah: :yeah: :yeah:

:bow: :bow: :bow: