Lost

What exactly did you not succeed with on the floor?

I was charting late, passing meds late, feeling unsure on what to do on several occasions. I cried a lot when I felt frustrated or overwhelmed...not in front of the patients though. My manager said if I was off orientation she feels like I would jeopardize my license...which I thought I was practicing as a safe nurse. I had good nights and nights where I felt very scared to be on my own because I didn't exactly know what to do or say to my patient

I'm so scared to work at a hospital again.

Coworkers said I was doing fine...I just need confidence. How do you develop that when you are in constant fear or feeling like you are failing?

Ask for help and ask for feedback. Find good coping mechanisms. Experience and time will make those fears eventually go away. There's nothing you can do right now to instantly make all that anxiety and fear go away. Time management is probably #1. Not sure how you "triage" your patients, but I usually do the "easy" patients first (patients with low acuity such as hardly any AM/PM meds, not many orders for that pt, etc) then leave the tough patients last so I can spend extra time on them. Time management is key and catch yourself from doing repeats. For example, if you forgot to pick up a med, go get the med but think about anything else you need to bring in so you don't have to run back out again (IV tubing, water, snacks for pt, etc). I did that quite often when I started but eventually was able to group things up and it saves a TON of time.

Ask for help and ask for feedback. Find good coping mechanisms. Experience and time will make those fears eventually go away. There's nothing you can do right now to instantly make all that anxiety and fear go away. Time management is probably #1. Not sure how you "triage" your patients, but I usually do the "easy" patients first (patients with low acuity such as hardly any AM/PM meds, not many orders for that pt, etc) then leave the tough patients last so I can spend extra time on them. Time management is key and catch yourself from doing repeats. For example, if you forgot to pick up a med, go get the med but think about anything else you need to bring in so you don't have to run back out again (IV tubing, water, snacks for pt, etc). I did that quite often when I started but eventually was able to group things up and it saves a TON of time.

Towards the end of my orientation I tried to stop asking for help to show I was independent but I end up getting overwhelmed. It was a vicious cycle.

Boss suggest I go to a smaller hospital. Is that better for a newish grad? Someone said a smaller hospital is harder because less staffing

Hey holly, I am a brand new nurse like you with only a little over 3 weeks now of experience working LTC (but the hall I work is more like a step-down unit) and I typically have 29+ at night... yikes.

I do not know how the orientation goes with the hospital or expectations but I do know that you are new and everyone knows you are new. The best thing to do is if you do not know something to ASK. And you have to get the hang of things before you are fast at them so that includes med pass, documentation, etc. (I still am staying an hour to 2 hours late after my shift to make sure I am documenting anything I forgot, reporting to oncoming nurse, and calling MD for non-urgent things and sometimes I'll get asked "Are you okay?" No, I am never okay! You want to be done on time and be like that nurse who has worked 13+ years but you don't have that experience... it's hard to remember that every day.)

And in regards to being told you'd jeopardize your license... ask how? What is the patient to nurse ratio there?

I've learned a lot from talking to different nurses with different experiences... especially at my facility and they all say, "It will be the same anywhere you go." And that may be true for a lot of places. Unless you know for CERTAIN that a facility/hospital is well staffed, doesn't assign a heavy workload then you may be walking right into the same scenario. I've been reading a lot on these things because I am struggling with all that you are saying!!!

Keep in mind you are new. They need to remember that too and offer support where they can. I was told it will take me a while to fully adjust... and that the first year you will feel like you don't know what you are doing. (Lots of threads on this on here!!!!)

I look forward to hearing about how you are progressing and wish you the best! Talk to other nurses you may know or trust that work at the same facility. They can shed a lot of light on the situation.

GRRR - this makes me soooo angry.

My manager said if I was off orientation she feels like I would jeopardize my license...which I thought I was practicing as a safe nurse. I had good nights and nights where I felt very scared to be on my own because I didn't exactly know what to do or say to my patient

As an educator, I believe it reflects well upon a new grad when s/he is uber-careful. It is the job of a nurse manager to ensure that the newbie has adequate support & appropriate feedback to improve confidence in one's own abilities. Achieving confidence is the basis of a successful transition to practice. Use of scare tactics is cruel, counterproductive & can result in lasting damage in terms of career development.

FYI - the only thing that will jeopardize a nurse's license are the decisions s/he makes.

Manager fail.

Are you still working at the place? There is hope for you, regardless. I feel lost at times, too, as a new RN in an acute hospital unit.

Things that have helped me:

1) talk to people outside of work who can relate. I talk to a nurse friend from school and I reached out to a person I met at orientation who works at a different facility. They empathized and gave me tips re organization, time mgmt and playing politics.

2) I've started studying when I get home about any unclear issues-- med indications, procedures, etc

3) I made a checklist for all of my tasks to be done per pt per shift. Evidently, others just can remember what to do. But the checklist helps me immensely.

4) I've chosen to be courageous and when I go in to work, I tell the orienter/trainer "yes, I can take the full load, but I'd like you to be around in case I have questions. Please feel free to give me feedback on tasks you think I should be doing/ways to improve."

Holly, that first year in nursing is difficult but it does get better with time. Keep your head up and don't let your past experience make you feel ashamed. You are learning and it's impossible to be perfect. Don't be hard on yourself just keep working hard and one day you'll be the nurse you've always wanted to be.

I feel the same way. In fact we'll see how tomorrow goes (the end of my orientation) but I may walk out the door and not go back. I am WAY not ready for being entirely independent with 2 discharges and 2 admits (which all happen at the same time) not to mention an even newer nurse working with me and possibly one senior nurse for part of the shift. I am so scared for tomorrow

Update: My last day was Monday. This week I have been feeling all kind of emotions...from scared to feeling optimistic. I have applied to almost seven jobs. I tried to apply to places that were not hospital or floor nursing. Hopefully I'll hear something this coming week. I'm so scared to work on a floor, and I hope I don't have to do it again.

How is everything?

I got my first hospital job in september in a busy ER. I am almost at the end of my orientation and i am terrified !! I am doubting myself, can I really do this on my own? my preceptor still tells me I am not prioritizing my patients and my time managment skills are still not there yet. some days i feel like im drowning, other days I feel like i got a hang of things. I am terrified to be on my own.

someetimes i think of leaving and I wonder why i left my other job for this but I know this will help me with my nursing foundation and skills, and make me look more marketable.