Losing confidence...

Being a new nurse is hard...keep your chin up and know that you are doing a great job! Take a deep breath and give yourself a few seconds to think things through. Make a point to sit down and go through your chart checking your orders on a regular basis. If you see a doc on the floor that you know is seeing your patient then follow up with them. Now I do not know how it is on the floor when you have so many patients, but I do try to talk to each doctor about my patients and go over orders with them, obviously this is not always possible.

Try writing out a timeline of your day...like 0800 meds, dressing changes, assessments....0900 meal, blood sugars...etc and add chart checks into that mix. Remeber people are going to pull you...now if you are in the middle of a task and someone comes to tell you that you need to do something else, unless that new task is life and death, tell them thank you and finish what you are doing and go attend to the new task when you are finished.

Deep Breath....you can do it.

Hang in there, it will get better. I'm in my 9th month of working in the ICU, I'd say in the last couple of months I've become comfortable. I actually look forward to going to work. Switching to nights has made a big differene. The pace is much slower.I'm able to get things done.You'll probbably find there are fewer meds to administer, less procedures.Try and make a planner for yourself, write down all the tasks that you have to do every shift and check them off.Even the very basic ones, like printing EKG strips, you do end up forgetting especially in the beginning. I remember I had a check box for signing my name on the flow sheet! I'd also add to this based on the report, like new labs that need to be sent or questions to ask during rounds.

Good luck

I know exactly how you feel. I too was on orientation and had to stay on orientation for a couple extra weeks then was sent to nights. Nights are slower and you have time to think and organize. I can suggest when you start nites what I do is get my paper with my pts ready with looking up meds and times of meds and writing them down. I also write things like assessment, chartcheck and end of shift. And I cross them out as they are done. One last thing I do is write my 0600 meds on a sticky note so I know what is due at end of shift. Good luck, you just have to get thru it I know it is very hard but if I can do it anyone can. I am my worst critic and I get upset at myself when things do go exactly right. If your nurse manager says you are a good nurse believe it. They would not be putting so much time and money into you if they don't think you can make it.

Jka, I know just how you feel. It sounds like you are telling my story! I work on a med/surg floor. I'm in 4th week of orientation. I am up to 5 pts and have to get to 6 by the end of orientation which is in another two weeks. I too will soon be put on nights which will be my permenant position. Having to admit and discharge pts and deal with orders, tasks, making sure pts are medicated at the appropriate times and dealing with abnormalities is all taking a toll on me too. I can remember when I had one, two even three pts and I was thinking, "this is not as bad as it seems". Then I got a pt who was dying and the family kept me in the room nonstop. If it wasn't for my preceptor who helped to effectively communicate with the family, I don't think I would have been able to keep it together. In the midst of the family needing me, I had 3 other patients to deal with. We can make it though, we just have to learn from our mistakes, ask questions and keep looking at meds due, orders and labs at least every hour if not more.

I will be starting my first job on a med/surg floor soon and can see myself saying these things in a few weeks. The followup posts are very supportive and comforting to read. I too will try to use the advice offered to get through the difficult first months. Good luck to you. It is obvious that you care about doing the best job possible. :wink2:

just keep working. dont focus on the little things that are nagging on you and "what you arent getting done" and focus on what you have accomplished so far. i dont mean to not worry about not getting all your work done. i do mean that just realize that as my preceptor told me when i had my mental breakdown (just a few weeks ago) that nursing is a 24 hr a day job and you can only do so much. you have to realize that in this job things usually dont go according to plan and you have to learn to go with it.

things that have helped me:

i WRITE EVERYTHING DOWN. i even spent a few hours at home one night making myself a daily work list (several line for each hour where i can write in meds/doses/things to be done that hour like half rate tpn etc, reminders of when i need to do assessments, chart I/O, boxes for each set of vitals, a section for iv access notes, and misc activities like dressing changes, cap changes etc). it has helped my organization tremoundously!

as i take off orders i also write them on my paper that same second so i dont forget a new order

dont hesitate to ask for help when you need it. i make it a point to check with everyone else to see if they need help when i have down time, and when i need help myself i try to see if my coworkers can help with little things (like turning off a pump, checking a pt etc)

believe me, ive definitely felt incredibly incompetent at times too, but i realized just this week all the things im doing now that gave me a panic attack to think about in orientation.

you just have to keep doing things as best you can and suddenly youll realize that youre doing what you were worried about, and doing it well!

hang in there!

The first 6mos to 1 year I worked the floor I kept a small note pad with me at all times. Things I HAD TO GET DONE were written in red, things I want to get done ASAP were black and things I could get to when I had time were pencil. The list got longer and shorter as the night went along, but I didn't have to worry about forgetting something if I got distracted. On a separate page I kept notes of things I HAD TO TELL the next shift- not general report but odd-ball things I wasn't going to recall after a long shift. After a couple of years I didn't need the portable brains any more. Organization and priority setting are the biggest hurdles you are going to face as a new RN. It will take a while before you feel you are up to speed- but if you have a good skill base it will come in time. Sounds like your preceptor isn't too pessimistic about your skills. Based on that, I bet you wil do fine. You will be suprised what you can do when it's your team and the patients are depending on you for thier care.

Nights will be a little less overwhelming for you, but still busy at times, but much more conducive to learning. I felt the same way you do and just now getting more confidence, and I'm feeling like a good nurse and pt advocat. It will come, be patient and keep an open mind. Nights will be good for you. Just wait and trust me, it will get better. God bless you, I know it's stressful but you most certainly will get it.

jka - seems like you've got some good advice so I don't need to go there (like I know how to do anything anyhow?).

Seems there's more tho than meeting the task demand. Your confidence in your self seems perturbed.

Ok - so the preceptor cried - I think s/he must see something very special in you to care so much. I'd wonder what it was but I'm pretty sure I can tell already.

You've got the aptitude.

The manner and motivation to be a good nurse.

You might be slacking on the method - but it'll come.

There are too many nurses who have good method but absolutely no manner and little motivation.

Method you can learn.

Manner - you are gifted with.

Because of that - you'll be fine.

Oh the days of orientation. Seems so long ago (about 6 months). I tried to stay on orientation a little longer and my preceptor just kept saying "why? it will prolong the inevitable." My bad nights 5 months ago are different than the ones I have now. I deal with them better from shear (little) experience! Just think how things will be a year from when I began, or in a few months if I already feel this much better. And I felt just as bad as you starting out. I would go home crying, feel depressed at home, sulk on my nights out with my husband, look up different degree programs, etc etc. However don't get me wrong, when I have BAD nights or so I lose just about every bit of tiny little confidence I have. But things are not as bad. That's all I have to say about it.