Looking for tips for a stressed new nurse.

[gatoraims RN]

I am a new hospital nurse. I worked in a clinical office setting with a ton of autonomy my first year of nursing. I love the job but wanted to try acute care nursing. I am a new (3mths only 3 shifts out of orintation) med-surg nurse. I love my co-workers and director. The floor really has a handle on team work. The other nurses say I am doing good but I disagree.

My First shift on my own was so stressful. I had a pt on a heparin drip (never had one during orientation but I did learn how to calculate the drip), a etoh pt who was on lipids and not listening to us on fall prevention, an elderly confused pt who was very agitated who would not take his meds, a new admin, a post-op day 2 colostomy, and alertx3 elderly pt whose biggest want was to call and tell his wife goodnight ( thank God for this pt). All the others had me on my toes.

I thought I understood an order for the heparin pt. She had an INR of 1.9 had Coumadin and the heparin drip was going at 22ml/hr. Her infusion finished and the next bag was in the mar for 1600. It currently was 0500. So stupid me thought because she was close to a theraputic level for herbINR that the next infusion would be at 1600 and we were weaning her over to Coumadin. I did not hang a new bag. The next nurse chewd me out for stopping the heparin. I felt the size of an ant. I did tell her I was confused by the mar and asked her to tone her voice down. She re grouped and explained to me not to stop heparin and I can hang a new bag even if the mar has it hours later.

My my last shift was just stressful. I had 3 elderly pts with cdiff, 1 with Mrsa , an elderly with a peg tube and on jevity, and a new admin. Everything went smooth until 600. Then lab is calling me for critical K. I had a dr calling on my admin because his admitting dx was an emergency surgery type dx and was I the nurse sure it was this dx. I explained to him I was going by the ER docs dx and could give him my assessment. According to my assessment it was hand in hand with the admiring dx and an emergency surgery as the pt could now have an amputation. ( ended up not being the dx that was an emergency surgery after all but again I felt like I let my pt down because of what ifs) I had never heard of the dx, non of my co-workers either. It was our understanding it was an infection and would be treated with ATB therapy.

I put put the orders in for my critical lab pt, pts had new fluids hung, all in need had bed baths, all had Their am meds but I did not start meds for my critical labs. I just passed it off in report because pharmacy had not verified the order yet.

I left eft and felt like I was leaving a HUGE mess for the oncoming nurse. I wonder if acute care nursing is even for me. I like my job but wonder if I was made to be a hospital nurse. I know there are many threads about the stress new nurses experience but I don't want to be the slacker nurse or the ignorant nurse. I hate thinking that is what I am. 😢

Thanks for letting me vent. Sorry for any typos, trying to type this while holding a curious baby.

L

[NightBloomCereus]

I'm a new hospital nurse too, just 3 days off orientation too. Are there other nurses around? I run everything that is not routine by another nurse. Even if I think I know what to do but I'm a teeny bit uncomfortable. Even if they're annoyed and look at me like, "I can't believe you're asking me this." I ask anyway.

I'll say something like, "Hi, sorry to bug you, I have a quick question. My patient just xyz, so I should xyz, right?" If I have someone who has something I didn't have during orientation, I'll say to the charge nurse at the beginning of the shift, "This is the first time I'll have someone on a heparin drip, so is it ok if I find you if I have any questions? How can I get a hold of you tonight if I do?" Or just asking someone who you know to be a good nurse, "My patient has this critical lab and the pharmacy has not verified the order yet. Our shift is almost over. What do you think I should do?"

And then I'll always find those people who helped me and thank them for their help, even the grumpy ones. I've never had a nurse not answer my question and I ask about a dozen a shift.

I also had very tough assignments at the beginning. Feel like they threw me to the wolves! But just ask, ask, ask - this is what will keep your patients safe. We can't get everything during orientation. Good luck. I think the way we're feeling now is normal.

[EmeryRN]

Bedside nursing can be difficult! I didn't think I'd last 6 mos on my floor when I started but I'll be there 3 yrs in a few months. ALWAYS ASK FOR HELP! Even if it's advice. I STILL do. You will get your flow down, with prioritizing and time management. It takes time. I felt like I was drowning most shifts when I started. And I used to cry before and after most shifts because I was so stressed. I basically pushed through and things are better. I still think I probably should try somewhere or something else in nursing, which is a reason why this career is awesome, so many paths. Keep at it. You'll find your niche.

[HouTx, BSN, MSN, EdD]

Sounds like you're doing just fine. In 6 months or so, you're going to be that "good nurse" that the newbies will seek out when they run into problems. Just a caution.... please refer to your organization's policy and procedures. It may be quicker to ask someone, but if they are misinformed, you could very well end up violating a policy without even knowing it. And, ignorance is never an adequate excuse.

Hang in there - it will get better before you know it.

[VANurse2010]

Other than the heparin drip, I don't really see anything major (and truth be told, the heparin drip isn't that big a deal either - but please understand your duration and mechanism of action - there's a reason heparin has to be given as a continuous drip.)

You don't need to give all the baths; it is not solely your responsiblity.