Just need a little emotional support this morning!

nursemike, ASN, RN · Dec 28, 2007

After a particularly messy night in orientation, my preceptor remarked that it had been a really good night. My expression must have belied my amazement, because she went on to explain, "No, really. Nights like this build character, and it's good to have some of them in orientation. These are the nights when you really learn."

As usual, she was right. I still have some "character-building" nights, from time to time, and I still don't enjoy them, but I get through them, and I do learn from most of them.

There are, of course, several kinds of bad nights. Sometimes I have several "busy" patients and more to do than my organization skills are quite up to. Sometimes patients who aren't medically complicated, but behavior problems--climbing out of bed, pulling IVs, and I spend the whole shift "putting out fires." Neither of these is terribly upsetting, anymore. I may end up charting an hour past the end of my shift, but nobody dies.

The ones that most distress me are the times when I find one satting in the low 80's, or with A-fib in the 150's, or very confused when they were fine a couple of hours ago. My first step in such instances is to let the charge nurse know what's going on, then the doctor. They are as close as we have to a Rapid Response Team at our facility. In most cases, we're able to intervene and get the patient stable, but if the patient needs moved to ICU or something, it's best to have people aware of the problem early. Plus, the CN can call in other resources while I'm busy with the patient, or make sure any other pts get their meds.

None of these bad shifts are fun, while they're happening, but I do find I'm better prepared the next time. It isn't really so much about building "character." Presumably, we already have character. But it does build skills and expand our knowledge in ways that a shift where everything goes smoothly never can.

Nursing is stressful. Sometimes it's good stress, where you're working your butt off and staying ahead of the game. Sometimes it's bad stress, where you're working your butt off and still falling behind. Once in awhile, it's really bad stress, where the best you can do isn't good enough. About the best encouragement I can offer is that one does eventually find that some problems that are overwhelming, today, will be manageable, tomorrow. But patients do have a gift for coming up with whole new problems, including some where the best anyone can do isn't good enough. The biggest difference between an experienced nurse who always knows what to do and never gets flustered and a panic-stricken newbie is often simply that the experienced nurse has already completed her panic-stricken newbie phase and has enough really bad shifts behind her to take them in stride.

We really should have learned to drive big rigs.

danissa, LPN, LVN · Dec 28, 2007

Melbel...(((((:icon_hug:)))))

We all have the times that are rotten beyond belief, you are not alone, questioning why you are doing this to yourself. Then...good stuff happens, you get why you are doing this, it will come for you, I'm sure. Just keep your chin up hon, paddle furiously beneath the surface, and you will get there!

Good Luck and mega Hugs!

Tait, MSN, RN · Dec 28, 2007

Nursing for me has two types of nights.

Confidence and no confidence.

I take them each in stride, and when it all gets hellish, I stop by a favorite patient on my way out the door home and chat about the weather and their grandchildren to remind myself of what makes this job so satisfying in the end.

Stick to it, the organizing, slipping up, evil-eye giving patient nights will come and go and happen further apart, but in the end you will have a career you have worked hard at, and that helps so many people.

Tait

paxpax · Dec 28, 2007

OH MY - you message resonates with me MelBel

I am a new-grad nurse - mid-career change. I was on my own (no preceptor) for the third night last night. I got a little of everything that makes you 'behind' last night. Needy patients, needy families. Patients whose medical conditions are a bit beyond me feeling confident. (After some research online, I learned that perhaps one patient should have been in the CCU). At the end of the night I felt like I worked hard, but didn't really do anything right. Had difficulty with straight cathing a female and had to ask for help. The heavy sighs and rolling eyes didn't make me feel good. Woke up in the middle of the night last night KNOWING I didn't transcribe some meds correctly last night. Next shift does a check, but I fear that when I get to work I will be read the riot act. When I gave report to the 11:00 p shift they had lots of questions I didn't have the answer to. There were GOOD things that happened though, I sent the needy families home feeling their family member in the hospital was cared for. I am good at the interpersonal, but I have so far to go still on the technical and the organizing. Even though I'm a guy, I still respond to all this emotionally. MelBel - I've started a journal called "I've learned". Every night I try to write one thing, but often it is at least three things.

RoyalNurse · Dec 28, 2007

We really should have learned to drive big rigs.

:lol2:

Tait, MSN, RN · Dec 28, 2007

OH MY - you message resonates with me MelBel
I am a new-grad nurse - mid-career change. I was on my own (no preceptor) for the third night last night. I got a little of everything that makes you 'behind' last night. Needy patients, needy families. Patients whose medical conditions are a bit beyond me feeling confident. (After some research online, I learned that perhaps one patient should have been in the CCU). At the end of the night I felt like I worked hard, but didn't really do anything right. Had difficulty with straight cathing a female and had to ask for help. The heavy sighs and rolling eyes didn't make me feel good. Woke up in the middle of the night last night KNOWING I didn't transcribe some meds correctly last night. Next shift does a check, but I fear that when I get to work I will be read the riot act. When I gave report to the 11:00 p shift they had lots of questions I didn't have the answer to. There were GOOD things that happened though, I sent the needy families home feeling their family member in the hospital was cared for. I am good at the interpersonal, but I have so far to go still on the technical and the organizing. Even though I'm a guy, I still respond to all this emotionally. MelBel - I've started a journal called "I've learned". Every night I try to write one thing, but often it is at least three things.

Thumbs up Paxpax, journaling, reflecting, showing confidence and trudging on are the way to go!

scarlet · Dec 29, 2007

I know how you feel. Hang in there!

marie-francoise · Dec 29, 2007

I dunno... I'm really trying not to come to the conclusion that bedside nursing these days is mostly stress and misery, which would explain the nursing shortage. I'm just a nursing student, so could certainly be wrong, but I doubt it... Bedside nursing is so important, so needed, yet has become so stressful, it seems. And it seems as though one almost needs a martyr mentality to put up with it.

Understaffing due to managed care is one culprit, among many. And also dealing with the general public every day in very intense ways, lots of responsibility without commensurate respect, being treated like a maid, a mostly female profession, too much documentation required, etc., etc. Makes a desk job seem like paradise.

paxpax · Dec 29, 2007

I dunno... I'm really trying not to come to the conclusion that bedside nursing these days is mostly stress and misery, which would explain the nursing shortage. I'm just a nursing student, so could certainly be wrong, but I doubt it... Bedside nursing is so important, so needed, yet has become so stressful, it seems. And it seems as though one almost needs a martyr mentality to put up with it.
Understaffing due to managed care is one culprit, among many. And also dealing with the general public every day in very intense ways, lots of responsibility without commensurate respect, being treated like a maid, a mostly female profession, too much documentation required, etc., etc. Makes a desk job seem like paradise.

I left 24 years of desk jobs for bedside nursing. I don't want the the desk job back. By and large nursing is cooperative (and not competitive) and I like that. How many people does it take to reposition someone in bed? Usually at least two. How many people does it take to move a person from a cart to the bed? At least two again. How many people to hang blood? Two. I have had enough of working on corporate projects that only the people at the top got credit for. I have had enough of working for months on projects that get scrapped at a whim. I would rather do real hard work every day and my feedback is the appreciation from patients. For me, following nursing was following a 'call'; following a vocation. I had a much better night tonight, even with some of the same needy patients.

MelBel · Dec 29, 2007

Thank you all for your replies! My night was MUCH better. Not 100% better, but definitely an improvement.

I couldn't fall asleep after I got home yesterday morning, and had a hard time getting out of bed, but I sat in the parking lot for a minute before I went in, and said to myself "I'm here, it's either going to be bad with a bad attitude or bad with a good attitude". And it wasn't all that bad :)

I even took 15 minutes and gave a dying patient of mine a really good bath. It was a nice little break and a reminder of why I became a nurse. :)

Sabby_NC · Dec 29, 2007

Hang tough, learn from the icky nights.

There are times such as this but it does build you up and make for a better nurse I believe.

Don't give up ok? (hugs)