New grad on busy med surg floor needing some advice.

[CM91]

I recently graduated nursing school in May of this year and I'm now working on a med surg floor at a smaller hospital. I was with a preceptor for 6 weeks and just recently started working alone a couple of weeks ago. I have 5 pts every day and feel totally overwhelmed to the point where all I do is stress about work (even when I'm at home). I just constantly feel behind, like I'm never going to get all of my charting done, and like I'm going to miss something with one of my pts. I feel that I am doing everything in my power to be a better nurse but I always feel so behind and overwhelmed. They say it gets better but it isn't. Any advice would be greatly appreciated... I dont know what I am going to do if it doesn't get better...

[cleback]

It takes about a year to feel comfortable. Six weeks isn't enough time to tell that it isn't going to get better.

This is normal. Fortunately, you only have to be a new grad once.

[City-Girl]

Take a deep breath and remind yourself that you've only been off orientation a few weeks. It takes time to get your groove. As the previous poster said it can take a year before you feel comfortable. While I'm not sure what type of rapport you developed with your preceptor, just because orientation has ended doesn't mean you can't reach out for questions. Observe how the other nurses around you practice, there's often helpful ways you can make yourself more efficient that you may be able to observe from one of your peers. Ask around to see what others use of a report sheet, organizing your patients and tasks at the beginning of your shift can be helpful. Try to complete a quick head to toe assessment on each of your patients early in the shift so if there's a change in status, you'll catch it early and may prevent a patient from circling the drain. We've all been there and it does get easier with time. Good luck!

[CM91]

Thanks so much for the advice, I need all I can get! It just seems like I'm never going to get to where I need to be rightnow. I'm constantly having to ask my charge nurse to help me with things when I have 5 patients at this point. I just keep telling myself it will get better.

[Emergent, RN]

This sounds about right. Totally normal...

[KHT]

We all experience that as a new grad fresh off orientation ... it truly does take at least a year (or more for some) before you will experience the anxiety levels go down. It's also not uncommon for more "experienced" nurses to switch to a new hospital and find themselves reliving those feelings again. One can never plan their day in the world of bedside nursing. You will find what works for you and learn to find efficiencies in your work flow but that takes time and experience ... I know it is difficult right now but that is completely normal! Take a deep breath and just take it one shift at a time. There are nurses who have years and years of experience who still have questions so don't be too hard on yourself. In fact, if you were not asking questions as a new nurse, I would be concerned. Also realize that sometimes, the assignments aren't exactly fair (depending on the charge) ... and that may put a wrinkle in your workload too but you will also be able to recognize that in time if you haven't already.

[SaltineQueen]

It will get better, it just takes time. Make sure you have a good "brain" (report sheet) to keep you organized. As much as possible chart at the bedside right as/after you do something. Keep reaching out to your preceptor if you feel comfortable. In those times where you may have a few minutes to breathe, talk to other nurses about their patients with diagnoses you may not have taken care of yet. Learn about associated labs, tests, red flags, etc.

[Jedrnurse, BSN, RN]

Do you have an exercise/physical activity that you can "double up on" during your off time? It's a good way to burn off some of the anxiety that you're feeling even when you're not at work.

[psu_213, BSN, RN]

Just about every new grad has experience that overwhelmed feeling, and you just have to work through it. It will get better

I definitely agree with the brain sheet. If you search AN, there are quite a few examples of sheets--find what works best for you. You can also ask some experienced RNs on your unit what you use. They may say they don't use anything, but I think having a formal brain sheet for each patient, that is set up the same for each patient, is the most efficient way (for me anyway).

You will learn the time management with experience. For example, I learned in my first job, that I was best assessing all my pts. and then charting before starting my med pass. This was the best approach given the flow of the unit with admission, transfers, discharges, etc. On another floor, I learned it was best to pass meds first and then go back and chart assessments. You will learn what works best for you.

Give it time. Good luck to you.

[mushyrn, BSN, RN]

As long as the provider for your patients isn't new, too, it should all be okay. Haha.

[Kooky Korky, BSN, RN]

5 patients is a decent number if you aren't expected to do total care. That is, if you have an aide to do VS, glucose, ambulate, bathe, toilet, feed, baths, beds.

With no aide and working Days (i am assuming), five is too many, so it is understandable if you are overwhelmed now.

just keep on going, learn some shortcuts. Arrive early if that might help.

Good luck.

[Estateboy, RN, EMT-P]

WOW! I could have written that post! I've been an RN for three months and am so glad you posted your thoughts. I also work at a very small med-surg floor and find myself asking experienced nurses lots of questions and have never been given grief for doing so.