long-winded musings on my tumultuous first year of nursing

[inthesky]

It has been 1 year and 3 months since I started my first nursing job. It has been an extremely dramatic roller coaster of events and emotions. Nursing is the most love/hate entity I have ever experienced. I started psych right away. Med-surg is the 'preferred' way to begin, but I get tired of the 'shoulds' of life, and do what I want and what will make me happy. The medical part of psych nurse has been an uphill learn, but I've climbed it with help from other nurses, my own determination, and all that lovely stuff which I had not forgotten from nursing school =P.

Jan: Passing the NCLEX and getting my nursing license is one of the most exhilarating happy experiences of my life. I cried when I saw my license number written beside my name online for the first time. Nursing school was a very rough eye-opening experience in itself.

Feb-March: first job! Not unlike other new grads, it was terrifying, but not something I felt I could not do. I was so fortunate to get an amazing preceptor. He taught me how to be a nurse and embodied the kind of nurse I wanted to be. He encouraged confidence in myself. He was kind enough to allow me to schedule myself for nearly all of his shifts after my preceptorship. I still think of him in my practice and keep contact with him even though I work at a different hospital.

April: I'm on my own! I'm expected to serve as a fully functional nurse. I don't think it is actually possible for a new nurse with 8 weeks of experience to complete the exact job of a 10 year experience RN. I'm slow. I'm awkward. I get stressed and overwhelmed. I have trouble delegating the techs because they don't yet respect me. Everyday, I come across some situation I have never dealt with and don't know what to do. My preceptor is proud of me and tells me that he enjoys working with me and my patients give me good feedback. I can do this...I'll get the hang of this....eventually. The responsibility of all this way weighs heavily on me. Nursing is hard!! =P

May: I continue to schedule myself with my preceptor. Night shift is beginning to wreck my health and my moods. The quality of my work continues to improve. I make my first med error (milk of mag instead of maalox). I watch vigilantly after my patient with horror as the nurse I am working with laughs at me and truly doubts an episode of a fatal poop. My patient enjoyed the extra attention and never actually had a bowel movement =P. I get into the routine of things and feel less like an idiot every night. I get a good 90 day performance review.

June: My nightshift health issues culminate to the point in which I need to take medical leave. You're in trouble when you haven't slept well for months and mixtures of ambien, seroquel, and benzos fail. I lost nearly 15 pounds of a small frame due to gastric issues. My mood goes to crap and I panic that I failed nursing and try and come up with other career options desperately. Nursing is supposedly a career of so many opportunities, but a BSN is a bit of a dead end if you don't want to be a nurse. What do you think of a career that you love and hate at the same time?

July: A bit of luck and some "reasonable accommodations" and I get a daytime job at the sister hospital. After a month of leave, I'm physically much better and ready to work again. Dayshift is not like nightshift and the stress of the activity and constant demands is overwhelming. My job responsibilities at the new unit are also very different and I end up needing weeks of unexpected orientation. I was close to walking away from the job entirely in defeat and demoralization. I come to the realization that it is completely unfair to expect a new nurse to fill the shoes of an experienced nurse completely and that my job is stressful and unenjoyable. Not only am I miserable, I wonder whether I am even capable of keeping up here.

August: I get used to the routine and finally begin keeping up. I get very good patient feedback. For some reason, management decides I'm ready to be charge nurse, probably due to necessity. More orientation. People begin to look at me like I'm retarded for more orientation. The new nurse excuse burns itself out after awhile.

September: I survive my charge nurse shifts with great pride in myself. Although nothing bad happens, some nurses gang up on me and I nearly get fired for being 'unteachable' and 'challenging' to others. I keep my job because my patient feedback is so positive and my work is close to error-free. No one had ever said anything before so I am completely blind sighted. Apparently I was asking too many questions and people were getting offended when I asked why I was doing something rather than blinding doing it. I acted in the very same manner with my preceptor and he found me refreshing and told me that teaching me helped him to become a better nurse. I worked hard to make the necessary changes no matter how unfair I feel I was treated. I bitterly resent that I begin to learn much less from my job as I am afraid to ask questions and clarification. I contact my original preceptor in tears and he re-energizes my confidence.

October: The fire at work eventually calms down and I gradually stop anticipating every shift with dread and anger. I hate my job so much that I burn inside, but my patients still make me smile everyday and I feel like I do make a difference. I begin to feel nursing competency and experience gradually creep in. I come home to my boyfriend going on and on about how much I hate my job and then afterwords about how excited I am about some of my patients getting better and regaining hope. Love/hate... I turn in my applications to nurse practitioner programs. Psych is my calling, but inpatient nursing is not.

November: a good month at work. I feel independent and capable and I'm better at handling the stress. I try and approach the nurse manager with excitement of mental health parity passed with the stimulus package and the mental health walk in March in hopes of helping to set up a team. She grows cold and tells me that the doc doesn't like NAMI and she already knows about mental health parity. There goes ever voluntarily talking to her ever again. I brought the mental health parity article to work and my co-workers were interested because they had not received the happy memo. Job dissatisfaction re-invigorated.

December: I am getting along well with everyone and charge nurse shifts are being considered again. I work my first charge nurse shift and of course a patient ends up being restrained twice at the last 30 minutes of the shift after a week of overtime and I cry at the stress of all the paperwork I have never filled out and out of pure exhaustion. People are disappointed and decide I'm still not ready.

Jan: A psychotic patient gets violent. I complete the necessary measures and even stay 2 hours after my shift to help out, but I am visibly scared at the incident. The night charge (who has a nasty mean streak) and a tech (who lied and actually got fired last week) filed verbal complaints against me to the manager. I almost get fired a second time. The manager says the worst thing any nurse has ever said to me "I've been working in this field for 20 years and I know that you don't have the personality to succeed here." I told her that I can overcome and the other manager said "no honey, you can't". they tried to trick me to quit, lying about all the outpatient opportunities which actually don't exist. I begged to keep my job anyway. They were obviously torn and hesitantly agreed as my job feedback was very good from the patients and by this time even good from most of the other nurses. The economy has entered the dumpster already and the job hunt goes nowhere. A day charge nurse supports me to keep fighting as does my original preceptor. She recounts her own tearful visits to the managers office.

Feb: A doctor chews me out for 'second-guessing' him. This is where I find out that the docs don't like me for being challenging. I apologized to the doc and actually thanked him for his honesty as this is one of the very few disagreements in which I actually got to work out without the managers punitive micromanaging fingers. The doc was satisfied and doc relations improved as I also made efforts to modify my behaviors. I was going to originally make a year anniversary survival post here in celebration, but I can't and feel deflated and disappointed.

March: I once again hate this job bitterly, tempered with my love for caring for my patients. I halt my job hunt as I wait for my NP program acceptances or rejections. I get accepted by all three universities and choose =). The fire at work begins to cool down. I find out that lack of initiative, ambition, and quietness are great for staying under the radar and I'm much less stressed nowadays. The decreased stress of working less hard actually improves my patient feedback. By now, I'm actually rather confident in my nursing competence and don't find a whole lot of situations in which I feel like I have no idea what to do.

April: I wait for the backlash for my lack of initiative and now occasional laziness and lackadaisical attitude. I sometimes feel guilty for giving my 90% versus 100%, but my disgruntlement outweighs my guilt. Apparently there are hotter fires in the helm and 3 techs are fired and that day charge nurse who supported me is back in the office for a supposed racial slur I believe was exaggerated by the claims of both the employees who almost got me fired. The manager begins to lash out at everyone and there is general unhappiness in the air. Another nurse tells me that I'm doing a great job out of nowhere which makes me very happy.

May: I'm looking forward to my first class in June as I prepare to go part-time. I have already given my notice to go PRN when the full time program begins in August. To my surprise, management is being very flexible with me. I'm so excited to get back into academia. My desire to grow is immense. I feel confident in my abilities. So much that, I feel strangled and held back with a lack of practice autonomy and close-mindedness. You never know what you will get each day you walk into the hospital, but I feel like I can eventually handle whatever comes at me.

Nursing has been an extremely tumultuous love/hate ride for me, but I have survived. In about 5 years, I will be an BSN, RN, PMHNP, DNP.

:monkeydance:

[jjjoy, LPN]

Thanks for sharing your journey so far. I'm glad to hear that you survived the trial-by-fire and are heading in a direction that you are excited about. Yeah!

I think you do a good job of articulating the difficulty that new nurses face when they are expected to carry the exact same workload as experienced nurses. Your story also demonstrates the importance of having mentors - experienced nurses who actively support you and who you can call on when you need a boost.

As you move forward and build your career, I hope you (and me, and others) will continue to advocate for better transitions for new grads and better working conditions for floor nurses.

[SummerGarden, BSN, MSN, RN]

every new grad can feel your pain. the one thing that keeps me going are similar stories... it is a reminder that what i o through with experience nurses who try to eat me is what all new grads go through... if experienced nurses survived so can i... thank you for sharing!

[sunnysandiego]

Oh my god! That was hysterical!!! Thank you so much for posting that - i needed it!