9 months of nursing & not confident

Elysianna, BSN, RN · Mar 15, 2017

I feel you, asjohnson02. I've been working as a nurse for 6 months, and still feel like my shifts are spent scrambling, trying not to miss anything, struggling to keep up. I see the experienced RNs around me chatting casually at the nurses' station, clearly caught up, and I'm racing to get everything done, read over labs, read over histories, make sure I'm not missing anything. And I wonder, am I ever going to get to where they are? Am I ever going to be so calm and nonchalant about this job?

It seems every shift includes finding out another thing that I should have been tracking/watching for/doing that I missed through inexperience. I've cried on my way home quite a few times. I often feel like I'm letting my patients down by not managing my time better.

I'm told, frequently, by experienced, kind nurses (I'm very lucky, and work at an amazing hospital, with a very positive, supportive culture) that it takes at least a year to get a firm grip on the time management piece of the job. Many of them have said it takes as much as 2 years before you stop feeling like an incompetent boob every day. I'm certainly still struggling with that feeling.

But then, I look back at the first few weeks, and can see how far I've come. I can handle the max nurse: patient ratio in my area and keep everyone alive, get meds passed, get care done, even if I am having to delegate some of that care. I've learned an incredible amount, even if I have lost some of the theoretical and anatomical knowledge that was crammed into my head for the NCLEX. I read nursing journal articles about best practice, and understand them, and can implement them into my plans of care. I am developing that "instinct" that tells the nurse that something's just not quite right with this patient, that makes me look closer, possibly leading to calling a rapid response. (I caught the first signs of an infarct the other night, potentially saving a life, certainly saving neurological function). One day, I'm going to be a very good nurse. That day is NOT today. But I can see it on the distant horizon.

Yes, I still make mistakes, miss things, feel like a doofus. But I'm making progress. SO ARE YOU. Cardiac is an incredibly complex, intense area. You are learning so much, even if it feels a bit like "one step forward, two steps back" for some shifts. You're getting better. And the fact that you posted this shows that you care, deeply, about gaining skill and competence, about making a real difference. You have the drive and the attitude, and you'll gain the skill. Take heart in that, grit your teeth, and keep doing what you're doing.

Everyone starts out feeling like a fool. Remember those experienced nurses who say, "it gets better" and "it takes time"? They say it for a reason. We'll get there, asjohnson02. We'll be amazing one day. :)

pmabraham, BSN, RN · Mar 15, 2017

I read nursing journal articles about best practice, and understand them, and can implement them into my plans of care. I am developing that "instinct" that tells the nurse that something's just not quite right with this patient, that makes me look closer, possibly leading to calling a rapid response. (I caught the first signs of an infarct the other night, potentially saving a life, certainly saving neurological function).

What nursing journal(s) do you recommend for new grad RN's? What were the first signs you saw of the infarct?

Thank you for sharing!

gizahon · Mar 20, 2017

Hi there,

I feel you, the first year of nursing is really tough. It takes years to feel like a nurse. I'm going through the same thing, so you're not alone.

Best wishes and may God bless us

DarkDiva · Mar 27, 2017

I was told by a friend on my floor who's been there about 2 years after graduation that she still has those days where she feels like she has no idea what she's doing. I'm only six months in but I find stuff every shift I had been missing, and I ask a LOT of questions still. I'm really lucky though, my co-workers are awesome and super supportive. They never make me feel dumb even when I asked my charge to walk me through administering a suppository because I'd never done it. And she's the 'mean' nurse on our floor :laugh: . I've been told by everyone that its usually a year before you stop feeling like a headless chicken. And I too envy those nurses who BS at the nurses station for hours while I feel like a crazy person. Some days I feel like I'll never be that competent. I have those days where I feel really good though, like when I caught a patient's pnuemothorax that the ED had accidentally caused when drawing fluid off for ascites. I left that morning feeling like 'Yeah, I can do this.'

conway13, BSN · Mar 4, 2018

Hey! I have been working now for seven months, going on five months of being by myself. I think your feelings are totally normal. I too work on a cardiac unit, its a mixed ICU and step-down. I mostly have step-down patients, or "very light" ICU until I gain more experience to take care of sicker patients. I feel like one day I feel okay and the next I feel like I know nothing. Just today I was thinking about how I feel like I need to work on critical thinking quickly when a patient is going south. Personally, I think you're having these emotions because you deeply care about what you're doing. I think its a good thing to question your practice and know what you need to work on because it will make you a stronger nurse. I would say just keep asking questions and absorbing everything you can. I too got really interested in the OR and told myself to give it a year before I changed. I feel like now I know I am where I am supposed to be. Cardiac may not be your thing and that's okay too, I think time will help you figure that out. If you ever need to talk, I'm here for you!

Chazzie_Made_It, ADN · Mar 6, 2018

Hi there, I am about to start my first job as an RN on a tele/pcu floor. I will be going through a novice nurse residency program for 12 weeks followed by a bridge to telemetry program for 4 weeks. I am hopeful this will help me be successful. But I am totally freakin' out either way. Did your facility offer an new grad/novice nurse program? I hope things have gotten better! Hang in there!