Nervous about graduating

[Mommy TeleRN, RN]

I am a student set to graduate in May. The way my program is set up we of course had foundations, then peds/OB, now mental health and medsurg I, and in the spring Medsurg II. I have already had pharmacology and patho.

I also have been working the past 4 months as an intern on a Telemetry floor. The floor runs really well, is typically well staffed, and the staff have been really supportive and nice to me and offer to explain any question I have and let me watch lots of procedures, often seeking me out so I can watch.

But I keep having really nervous nagging feelings lately. I make good grades, have good reviews and recommendations from my clinical instructors and had one review with a clinical instructor who was very praising to the point I didn't think my head would fit leaving her office lol. I told her I feared because I made good grades I would be 'book smart' and not be good in clinical. She told me no way, that I was well rounded and that I should pursue my education to the fullest and consider an advanced practice degree or teaching... which is WAYYYYYY putting the cart ahead of the horse lol.

Ok so here is where my worry comes in: I feel like I STILL have no clue! lol I don't really feel like I'm retaining things. I don't know if it's just because I'm learning gradually that I don't FEEL like I've learned anything lol. And I don't really see that other students know more than I do. But it's just I don't feel that I will be ready to take on all that responsibility as a RN. I keep hearing really scary stories.

I heard two different stories of heparin errors..one at the hospital where I work and one where I do clinicals...where patients died. Then I read the heparin error in that NICU that was in the news. Well needless to say I'm going to be SUPER cautious giving heparin! But anyway... stories like these really scare me. Even though I've had pharm I still can't remember the names of most of the medicines, much less all those side effects to watch for. And what is compatible/not compatible. I guess I feel like I should already be a walking PDR or something! lol

And then there is all that paperwork! And judgement calls. Knowing what exactly is independant nursing actions. Granted I still have plenty of careplans to write to help me figure these things out lol.

Is this normal to feel this way? Of course I'm ECSTATIC I graduate in just 7.5 more months...but on the other hand I'm TERRIFIED I graduate in just 7.5 more months! lol

I am adamant that I will only work in a very supportive environment when I graduate, which as I've said so far the floor I'm on seems to be. Many of my fellow students are interning at another hospital that pays more, but has a VERY bad rep for poor staffing, even sometimes going into the double digits. On the telemetry floor where I work the staffing ratio is 5:1 days and 6:1 nights with a CNA for every 15-20 pts. And they have a long orientation too with a dedicated nurse educator. So I feel like it's the right track...but I can't shake this fear of being responsible for harming another person by not being knowledgable enough.

Will I ever feel confident?

[Markthemalenurse]

Totally normal feeling. Once you graduate and working as a nurse you will start to become more comfortable. Just don't expect to become comfortable overnight - it takes time. If you were to ask any nurse out there how they felt after graduation almost all of them would say they felt the same way you do. Heck, I even felt that way when I graduated. It took many months for me to become comfortable just don't become to comfortable (because that is when accidents happen). Keep with it and you will be fine.

[Tweety, BSN, RN]

Yes, it is quite normal to feel this way....because the fact of the matter is that you don't have a clue, until you actually do it. :)

Seriously, you'll do fine, it takes a long time to get comfortable and confident and we all felt that way. However, there's always something to learn, some new drug, some new syndrome, some new way of doing something.

Good luck!

[Elisheva]

This is exactly the way I felt in the last six months before graduation. I only WISH I had known it was normal. No one else in my class was admitting to feeling this way; I thought they were all so confident. I know better now but knowing then would have made a big difference in how I approached nursing.

Good luck! Try to enjoy your last six months. Nursing school is one of my happiest memories.

[BlueEyedRN]

I couldn't sleep the night before my first day of work on the unit because I was scared to death. I had heard way too many times how nursing school is nothing and that your real education starts when you actually become a nurse. So I was pretty freaked out. But that first day turned out to be comforting rather than horrifying. I was completely overwhelmed with the charting system and the equipment I'd never used before and all the new people I was meeting. I could see another new nurse in the next room learning a new procedure and struggling with it. And then a doctor started yelling at my preceptor. But I got in there with the patient and I was able to calm down and I actually knew what to do. I checked all the lines, did a head-to-toe, replaced some IV fluid, talked to the family a little bit, and just everything I did as a student came back to me and it felt much more natural than I thought it would. The basics really are important and I kind of grabbed onto that as a lifeline with all this unfamiliarity. And everything I learned about disease processes came to my mind as I reviewed labs and assessments. I was totally able to relax.

Of course, I still know very little compared to the experienced nurses, but I do know a lot from school and I can rely on that and know that the rest will come with time. Since then, I have had very frustrating and scary and unfamiliar situations, but at the same time, I know that I can deal with them because I have a knowledge base and lots of other nurses who do know exactly what to do. I know that I am very lucky with the unit I work on because everyone is very willing to help out the new kids. Not everyone has that. It does sound like your floor is a very supportive environment, however.

So, yeah, it's terrifying, but it is possible to look past that and focus on what you are learning instead of what you don't know. I love being a new grad. I have so far to grow. It's exciting. Good luck.

[Halinja, BSN, RN]

T

Nursing school is one of my happiest memories.

LOL, you've got to be kidding, right?

But seriously Mommy Nurse2B, I feel the same way. (I'm in my senior year, graduating in the spring, even had the same 'advanced degree' talk) You learn little bits of everything, but not enough of anything. It's frightening. But I'm thinking maybe that's a good thing. If you're nervous/worried, you'll be careful. You'll double check things. You'll look things up. That is WAAAAYYY better than being overconfident...because that is when mistakes happen. So...yeah, go ahead and be a little nervous. Maybe even be proud to be nervous. That means you really understand the consequences of a lot of things we'll be doing. Just don't let it overwhelm you! We'll get there...it just takes time, you can't be experienced with experience.

[colleennurse, ASN, RN]

You are very normal! I just graduated this last June and have been working for what 3 months now? I still feel like I don't know half the time. But when I come across something that I am unsure of, I just ask another nurse to come look with me or show me how if it is something that I have never done before. Nobody will expect you to know what you are doing or to feel confident and if they do they are unrealistic. Of course basics you should know. But how many times in nursing school do you actually get to do something enough that you will feel confident about it when you get to the real world? Not sure how your school is, but I think I did 1 foley through all of school, so there is no way that you would feel like you know what you are doing. The important thing is that when you get out there, you ask when you are unsure. Keep the patient safe, that is what I think! Most nurses will tell you it takes time to become confident as all of the other posters are saying, It can be tough while we are going through this period of newness. This is like no other job. You can have 2 patients with the same surgery/disease and they will present it 2 totally different ways. We all have to start somewhere. I can't wait for the day that I will be the experienced nurse showing a new grad how to do something, or reassuring them that it will get better. I just keep telling myself that if all these other nurses can do it, then so can I and so can you! Good luck and congrats at being at the end of nursing school, that is an accomplishment in itself!

[grandee3]

The feelings you are having now are very natural. I think I would be worried if you did not feel anxious or scared at this point. You are trying to combine being a student and a tech, this is not bad, its great. Sounds like the people you work with really believe you are doing a good job. I love to help tech's out, they are always so eager to learn. It makes me feel good inside. So, you see, you are helping us by watching us and having confidence in us as a mentor.

Hang in there, ask questions, use common sense and take every opportunity that comes your way to master your skills. Don't be to worried about time management yet, that will fall into place when you are out of school and in the real, wonderful world of nursing.

Welcome aboard!

[Little.Bird]

I am glad to hear that I am not the only one. I feel scattered simply caring for 2 patients. I cannot imagine being responsible for 5, 6, or even 8 patients! AAAAK! :)

[Markthemalenurse]

Yes enjoy yourself while at school. The saddest part about graduating is that you may never see the friends you made while there.

[NoMoreStudying]

I felt the same way (I graduated this May, had great grades, was told I'd be good.) And one of the nurses I work with, who wasn't even one I looked up to (although I did like her) told me "You know what? It's okay b/c you don't know anything. But neither did any of us either."

And it's true. You know a lot from school and it's a good foundation. You'll be amazed at how it all comes back, if you trust in yourself. But it's your new job that is going to orient you and show you how to manage care for 4-6 patients, while utilizing everything you learned.

As far as med errors, always have your orders with you and triple check them. It is scary how easy it is to make a med error, but if you take your time, you won't.

I also learned that i must finish one task to completion at a time. It forces you to prioritize and learn who can wait. If you're always flip-flopping, trying to be everything to everyone, you won't complete anythng correctly and fully. Sure, you feel guilty b/c maybe you could have medicated Mrs Smith 3 (or 20!) minutes earlier, but you would fragment your care and risk safety. Eventually you get quicker and you're really surprised with yourself!