New Grad-First Day in the ER--Feeling Overwhelmed and Foolish

Specialties Emergency

Published

I was so excited to start as a new grad in the ER. After three days of training (not ER directed, just hospital orientation) and taking two ECG/rhythms classes, I was introduced to the person I'd be with for floor orientation. I was so excited and felt like I would be comfortable with this nurse since she has a fun/outgoing personality. I am so eager to learn and want to be a great nurse. Unfortunately, my first day did NOT go as planned and I feel overwhelmed and completely foolish. I feel like they're already regretting their hiring decision with me.

I did my school preceptorship (64 hours) in the ER back in June and then took NCLEX in August, so I've been out of the clinical setting for about 4 months. Everything that could have possibly gone wrong (with the exception of killing someone) went wrong. Mistake, after mistake, after mistake. Things I was comfortable with as a student.

Here is a summary of my day. During all my experience in clinicals, I never left upset. I was crying the entire way home and cried for a good hour after getting home. I'm so overwhelmed and I feel like I'm letting the department down. I also feel like they just expect me to know how to do everything, and I don't. I just really need to get these feelings out.

1. Foley: My hands were sweating so bad, I couldn't get my sterile gloves on. I finally got them, but it took forever. Then, I was blank on what to do with antiseptic and even blank on what the syringe of lubricant was! I hadn't seen a foley kit since first year (I had done lots of straight caths throughout clinicals--just not foleys). I finally got the catheter in, but I was embarrassed.

2. I couldn't start an IV if my life depended on it! During my preceptorship, I was able to start them and take blood without assistance. It's like I completely forgot how to even do the steps. Plus, the person I'm with does things completely different than the person I precepted with over the summer which is frustrating.

3. Glucometer. Yeah, doesn't get much easier than doing a glucose reading...wrong. She asked me to find out what his blood sugar was and I was so excited, like "finally! something I won't mess up and can look competent at while doing"...While the machine was reading the results, I pulled the strip out (not even thinking!!!!), so of course, got an error message.

4. Went to connect IV tubing to the IV....couldn't figure out why it wouldn't go on...oh yeah, because I forgot to take off the cap. She teased me on this one and I smiled, but I was feeling so stupid.

5. Almost forgot to swab the IV port with alcohol before doing a saline push, but the trainer caught it and tried handing me a alcohol pad...that I dropped on the floor, so she got me a new one.

6. Put like four of the stickers for ECG on incorrectly because I couldn't figure out how to count the intercostal spaces. I've never done these before.

7. Was asked to reconnect a patient to monitoring...forgot to hit start on blood pressure cuff and didn't hook up the leads.

THIS IS ONE DAY!!!!!!! I FEEL SO FOOLISH. It looks even worst seeing it all written out. Any past experience you've had or hope you can share would be so greatly appreciated right now. I hate feeling this way. Plus, I have ACLS training next week and I'm terrified of that as well.

Did I mention I'm 6 months pregnant? Yeah, I'm just a wreck, lol.

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Hey, the good news is you got a lot of mistakes out of the way on your first day.

From everything I've read/heard/experienced new grads spend a good part of their first year feeling like an idiot. Don't worry so much, nobody besides you is going to remember any of those teeny mistakes.

I'm a new grad, too, btw. Three months in...I feel your pain.

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Specializes in Trauma, Teaching.

It takes a year for anyone, experienced or new grad to really get things in the groove in the ER. I think you can give yourself more than just one day ;)

Things that seem huge to you (the cap) are just not that much to the rest of us..... and sooner than you think it won't seem huge to you either. I stick the lines onto the EKG stickers first, then on the pt, that way you aren't pushing down on them to get them to connect.

Knewbie knerves is a disease that time corrects, (insert reassuring hug here).

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Specializes in SDU, Tele.

i am almost at my 6month mark and i do dumb stuff all the time. i work in stepdown/sx. i still cry. a lot of the nurses with 5+ years of exp. still cry. don't beat yourself. a lot of it is nerves and sensory overload(lol). its a new place, new job, new people--a lot is going on and it is hard to think straight. don't worry about it. :) you'll get the hand of it!

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Specializes in Emergency Department.

I've been a paramedic for a while... and I can honestly say that I've done wrong pretty much everything you have. Just not all in one day. Two or three days... yes. ;) Guilty as charged! I think it took a good 6 months to a year before the "I can't believe that they gave me a License" feeling gives way to a more comfortable feeling. You're still not comfortable in your new role, but you'll be less nervous and more confident in what you're doing.

From past experience, I figure that I'll be back in that "OMG, I'm not a student any more how the heck do I do this" role shortly after I graduate... and make a bunch more mistakes before I settle in.

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You will find your groove. And things will become second nature to you, because you will do them over and over and over. One day, you will read your post and at least smile. And heck, once in awhile I put my stethoscope in my ears backward and wonder why I can't hear a dang thing over that aortic position! :D Be nice to yourself. You'll get there. Just not as fast as you might like! Hugs to you.

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Specializes in LTC.

Hey, were all human. And we'll all make mistakes. I'm sure everyone in your ER has done some silly things and I'm sure they all understand the pressures of a new job. And, as was stated, no one will remember anyway! I'll tell you a dumb mistake I made when I first started my clinicals in school. I put my stethoscope over the patients chest to listen to their apical pulse and freaked out when I couldn't hear anything! Lol turns out the diaphragm of the stethoscope was turned wrong and the bell side was "on". Talk about feeling like an idiot! :)

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Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.

A.) Pregnancy brain. B.) Got all that crud out of the way! C.) You are feeling like we all did on day one.

Tell your precepter you had a bad day; I'm sure she'll see those things totally differently than you (i.e., not a huge deal in the scheme of things). Hang in there!!

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Specializes in Primary Care, OR.

Sounds to me like you had an awesome day with lots of hands on opportunities!!! Yes you made a few mistakes, I'm pretty sure everyone was expecting that and aren't making a biggie out of it.

Now that you "got the sillies out" as my kiddo would say, you can go back and kick butt!!

We all learn from our mistakes!!

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Sounds like you did great.

I still can't apply sterile gloves lol

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Specializes in Hospice.

The pregnancy brain comment is so funny because just last night one of my nurses (who happens to be 5 months pregnant) couldn't get her patients IV pump to stop alarming occlusion, come to find out her secondary tubing was clamped. ;) We teased her all night about pregnancy brain.

I have done #2-7 myself and I have been a nurse for a long time. Once I couldn't figure out why I couldn't get my patients o2 sats up the tubing was connected to the flow meter and the cannula was in her nose. Respiratory came to the room and the extension tubing I had placed earlier had come apart. I hadn't checked the connector....duh.:no:

If you leave your shift and everybody is alive, it was a good night.

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You're not foolish! You're just new and nervous. Take it each day at a time. Go into work with only one expectation: to learn. Nursing is about growth and learning something new and amazing each day. Some days you'll learn more than others. Some days you learn about patient care, a disease process, how to deal with family, how to do a procedure, etc etc. you did great your first day because you didn't quit! Chin up! You'll be fine. Don't be so hard on yourself. Like you said you've been out of the clinical setting for 4 months. It'll take time to find your comfort level. Orientation is overwhelming in any situation. Learn to laugh at yourself. Also if you still have your kit from fundamentals, go over some of your skills with a friend! Good luck, you'll be fine :)

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