New grad, first job on a busy med surg/telemetry floor and I LOST my cool

Nurses General Nursing

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Background: I was a good student. Graduated magna cum laude, excelled in class but felt my clinicals were a bit of a let down. I was basically used as a CNA when I went to clinical.

I graduated in May and got offered a job on a Med Surg/Telemetry floor six days after I graduated. My preceptor is okay. I know she is putting forth every effort with me. I've only had five floor shifts so far. The first 3 were spaced weeks apart because of education classes through the hospital so there was some disconnect there having such a span between training in the floor.

My preceptor is a good nurse. She is great with the patients. This is her first time to be a preceptor. I feel like she and I think very differently. I like her fine as a person i just don't know if she is a great fit for me. But I have been trying to make the best of it.

This past weekend I had two shifts back to back and I was DETERMINED to become vastly more independent. I was pulling meds without my preceptor, passing them mostly without her, charting on my own and doing a really good job with keeping up with the routine of things. She remarked early in the shift how shocked she was at how quickly I was improving and coming along. Then yesterday around the middle of the shift things started to spiral out of control. I got overwhelmed and panicky.

Throughout this orientation, my preceptor has told me she is "OCD and crazy about charting". She does a lot of double charting, sometimes I see the rationale, other times I don't. She's also really critical of those around her...she reviews their charting and pokes fun when she sees a spelling error (usually it's simply a typo). Yesterday she was halfway across the nurse station and hollers over at me (laughing) about a typo I had made. It rubbed me a little wrong...maybe I'm being sensitive....but I'm new. I certainly don't want people to think "Oh, there is that dumb new girl." I just didn't like the approach. Everyone could hear and it embarrassed me.

There really was a culmination of several things....me feeling like I didn't keep up well at the end of the day, wanting to do a perfect job, feeling nit-picked, feeling stupid about a few mistakes I'd made, a reprimand from another nurse that I tried to help by putting her patient on the bedside commode because nobody was around to help him (I had quickly earlier surmised she isn't well-liked and doesn't have the most pleasant or grateful attitude), etc. I was doing chart checks and my preceptor says, "You didn't document reevaluation of so and so's pain". There was a cutting edge to her voice. I could feel myself inside working up to crying...huge internal struggle to keep it together. She kept needling me and wouldn't let up and finally she said, "You're really ticked off at me, aren't you?" I wasn't at all...I was probably just acting awkwardly because I was on the verge of crying. That was it, and I lost it. I just busted out crying right there at the nurses station. It was like a dam broke.

I feel like an idiot for allowing my emotions to overcome me. I knew I'd have days like this. I knew the first 6 months-1 year was going to be draining and difficult. I never thought I'd not be able to keep myself under control though. I figured I could at least make it to my car before the tears came.

Just venting, evaluating, thinking. If you have suggestions, throw them my way.

Your focus is on the wrong area. It is not up to you to evaluate where you preceptor has been or is coming from.

She sounds like Mother Teresa compared to my first preceptor.

This is your time to learn and grow.. not take charge of your orientation.

You heard a "cutting edge to her tone''? Trust me, if you don't like HER tone of voice.. wait until a doctor, supervisor ,or family member starts snacking on you. When the missing documentation was discussed... how did it escalate to "needling'? Seems like all you needed to say was.. "I didn't get to it yet, .. thank you for pointed that out"..etc.

Breaking down in tears is not acceptable, you are not dealing with the stress of orientation. I hope you have an Employee Assistance Program.. and get counseling. Otherwise.. I really don't think you can succeed.

Awesome.

At least you're not a male nurse breaking down in tears!

To BrandonLPN's post... I agree to an extent because as guys and our social upbringing it's very common for your best friend to be someone you beat the crap out of over a disagreement (or vice verse). Of course this isn't applicable in a professional setting, I'm just making a point on the differences in gender socialization. In male dominated professions (fire fighting, policing) we tend to have things out in the open and be "confrontational" if the situation merits it, and otherwise, the ball-busting carries on without issue.

I'm not saying that it's wrong or right, but that just seems to be the reality. As far as the topic creator is concerned, high-stress situations can produce emotional outcomes, but it's professional duty to control that. You didn't want to be labeled as the new-girl-who-can't-spell, but now you may be the new-girl-who-has-emotional-eruptions. Take things in stride and don't let your confidence be so easily shaken Miss "magna cum laude," it's unbecoming. Sometimes you just gotta let things roll or take the time to have an adult conversation with someone about what you feel comfortable with as far as "joshing around" is concerned.

If you fear the stigma of being "up-tight" by having a conversation like that with a preceptor or a co-worker, well, maybe you should re-evaluate your position and consider the idea that you were being a little up-tight. That's okay, everyone is from time to time.

Hope it all works out.

Obviously, this "Miss Magna Cum Laude", wouldn't have ever wanted to have an crying spell in front of her peers. I'm not exactly sure why you referred to me as that.

At any rate, it's not my intention to ever allow it to happen again. I was mortified and viewed it as extremely unprofessional.

I've been an RN for a year now, this year has been filled with many EMOTIONS. Nursing is difficult, cut yourself some slack. I remember one of my preceptor's said to me one day, "Why are you crying? Crying is a sign of weakness." OMG, that made me so angry, I said, "I'm crying because I'm angry and emotionally drained. This is not a sign of weakness but strength." Please realize that It takes time to become adjusted, It was probably 6 months or so until I felt comfortable. It does get better, remember she won't be your preceptor forever, soon you will be off and running. If you really feel you two are not a good fit, talk to your manager I'm sure she can get you a new preceptor. I'm also sure your preceptor was just joking with you. The nursing profession in general is stressful. There will be good days and bad days, get use to it, but it does easier. I'm a person that needs everything to be perfect too, you will find a balance, believe in yourself. You're doing a good job, I can sense your willingness to learn and soak it all up. Remember this is your time to learn, ask lots of questions and keep an open mind. Good luck, I will looking for your post in 6 months to see how much has changed for you. Good luck :)

Thanks! I'm ready for tomorrow. I have a plan of action for staying more organized. I know this first year is going to be rough. I'm generally tough...that's why it shocked the hell out of me when I lost it. I know myself, I'll be fine. I appreciate the words of encouragement.

Specializes in Forensic Psych.
Breaking down in tears once or twice at work when very stressed is not the end of the world people. I think the OP can and will still be fully capable of being a wonderful nurse.

Some of y'all are kind of tough. I think you must not remember how it is too me new and try to adjust to that very 1st transition to nursing.

I agree with this.

We all have different levels of sensitivity to different stimuli, and a lot of it has to do with exposure. If you're eager to please, any signs of displeasure from certain people can be disheartening.

However, like most things, the more often it happens, the higher your threshold. A "cutting edge" to a voice may phase you today, but the more you're exposed to different attitudes in your environment, the easier you'll be able to deal with it in simpler ways. There's a lot more to learn as a student/new grad than patient care.

So, don't beat yourself up over, just know that you're getting a little stronger every day :)

Personally, I find a good mental breakdown helps the soul. I always come out with much more clarity, calm and focus! I do try to have them in private, though :)

I agree with this.

We all have different levels of sensitivity to different stimuli, and a lot of it has to do with exposure. If you're eager to please, any signs of displeasure from certain people can be disheartening.

However, like most things, the more often it happens, the higher your threshold. A "cutting edge" to a voice may phase you today, but the more you're exposed to different attitudes in your environment, the easier you'll be able to deal with it in simpler ways. There's a lot more to learn as a student/new grad than patient care.

So, don't beat yourself up over, just know that you're getting a little stronger every day :)

Personally, I find a good mental breakdown helps the soul. I always come out with much more clarity, calm and focus! I do try to have them in private, though :)

I was really fighting with myself to hold it in. I agree that more you are exposed to a stimuli that upsets you, the better you learn to handle it.

Today I made some report sheets and patient sheets that I think will help me stay more organized and avoid that panicky feeling when things start to get hairy.

Specializes in Med Surg, Telemetry, BCLS.

First of all, ALL of us who have prior hospital or LTC experience somewhat feel like CNA's when doing our clinicals or preceptorship. However this is done on purpose because there are RN's who have graduated with ZERO experience and boy does it show! Some don't have even the most remote basic skills like moving a patient properly at various ages or degrees of illness.

It's good that you were excited about nursing and wanted to be independent. However it's not a good idea to do it without your floor preceptor for you even admitted that you didn't have the best clinical training.

Nursing isn't all about being "smart" or "top of your class". A lot of it is about having common sense, observation and the art of putting pieces of a medical puzzle (input from the patient, family, MD's, RN's report, clinical tests, etc) to show the whole picture of the patient.

Why are you trying to prove yourself? There's nothing to prove, really! :) You don't get points for proving yourself!

Enjoy being an RN, step back, breathe, okay breathe again, and allow your preceptor to teach you something. Remember, we have two ears and one mouth. USE your preceptor, I'm sure she's seen A LOT of things, ask her questions like: "What are three things that you wish your own preceptor would have told or taught you that you had to learn on your own?"

Or how about asking her about a skill that you can do quicker and much more easier way?

Don't try to "prove" any one. Let your skills speak for themselves. Take your time if you can. Take time to really get to know your patients, when they trust you they speak out and that's when real medicine happens. That's when you may realize the true problem of their health and can really help the docs out...

Check and double check your work. Go easy, rushing and trying to create an ego makes mistakes and can cause death...

NOT saying you're trying to create an ego but it's the path you're choosing without realizing it. (((HUGS)))

I'm glad the preceptor is checking the spelling and the work you all do in charting. There's been plenty of times an MD or RN wrote something and it didn't make sense and/or the spelling was off by 2 letters and it almost caused miscommunications about medicines or care we were about to give. That's dangerous!

LAUGH about it! You're so focused on "proving" yourself that you don't realize this person probably wants to help you. Step back and LAUGH about the error, thank her for finding the issue, correct it, then go back to work. Thankfully she found it to let you know so the doc doesn't see it first or the NM.

My suggestion is to enjoy nursing, breathe, take your time when you can, thank people who notice your mistakes (you want them on your side to save your butt from errors) and LAUGH often! Life is short! :)

Specializes in Med Surg, Telemetry, BCLS.

Crying is NORMAL! It's okay, I'm sure there is not one person who's been a NEW RN, CNA, etc that hasn't had a "crying spell". I'd rather you cry then to lash out in anger.

Who cares! You cried, so what. Life is short. Move onward, there is so much to life for you to enjoy. :)

We all still think you're a great person. (((HUGS)))

Laugh about it next time and move on. Don't focus on this for so long. Most have forgotten about it.

If people remember, make fun of yourself, then move on and laugh with them on another issue.

Life is too short. Hospital work on a med surg tele floor is too hard for little things like this to boggle you down.

Forgettaboutit - as they say. :)

Specializes in Cardiac.

I actually just started working on a busy med-surg/telemetry floor this past May as well! I can completely see where you're coming from and I don't think there is anything wrong with showing emotions. Just because you cry does not say anything about the strength you have. We're human, and this is a stressful job..not to mention we're still new at everything. I would just try to push on and remember that the first few months ARE the hardest and you'll get through it. Especially with the preceptor part, you'll only be with her for a short amount of time, and even though she is there to teach you, there are soo many other resources for you to go to (other nurse, charger nurse, etc.) Maybe your preceptor doesn't realize that she upset you by her comments? Some preceptor-new nurses aren't a good mix; we have a few at my new job but they just do their best!

Goodluck! :)

Its tough out there and some people love to play on that.I have been a nurse for 17 yrs. and I have also had my moments..Never forget what you are there for...Remember and I know its hard but you cant be all things to all people..Try to slow it down..

Good LORD you people are MEAN and CRUEL! It's people like YOU that give nurses a bad name. SHAME ON YOU!!! AWFUL, simply HORRIBLE ADVICE!!!

I started off on a medsurg/tele floor and was there for a year. I PROMISE you when I tell you that it will get better. I had many of those moments my first 3 months and then I was relieved to be off orientation because that meant I could get into my routine and not follow my preceptor's. Around 6 months you will get the swing of things (that's if you're really determined, focused, and willing to take on the hardships), then I guarantee it. I get the "nit-picking" scenario. Your preceptor shouldn't do that every time; however, you do need to watch your spelling because I have written "No injury occurred during this ****" when I meant to write "shift". That's where amending your notes comes in handy, so I would pull her aside if it really gets to you and tell her you appreciate her noticing your grammatical errors but to please keep it between you two. My preceptor and I eventually got into it one day. She would reprimand people in front of doctors, nurses, supervisors, and patient's family members. She did that to me one day when I was having a bad day and I told her "Med room. Now." and started to yell at her (and, shamefully, cuss at her) because I wasn't taking that. I regret doing that since it was unprofessional, so you need to realize what your limits are before you go that far. She never did that to anyone again because I brought to her attention she was the most disliked person on our floor (this is true) and her unprofessional behavior to chastise others in front of fellow professionals was what made her so hated as well as disrespected. It wasn't a proud moment in my career, but it happened, so don't do that. You'll be OK. You're new and people will eventually forget it if you show them what you're capable of. Good luck.

"Your focus is on the wrong area. It is not up to you to evaluate where you preceptor has been or is coming from.

She sounds like Mother Teresa compared to my first preceptor.

This is your time to learn and grow.. not take charge of your orientation.

You heard a "cutting edge to her tone''? Trust me, if you don't like HER tone of voice.. wait until a doctor, supervisor ,or family member starts snacking on you. When the missing documentation was discussed... how did it escalate to "needling'? Seems like all you needed to say was.. "I didn't get to it yet, .. thank you for pointed that out"..etc.

Breaking down in tears is not acceptable, you are not dealing with the stress of orientation. I hope you have an Employee Assistance Program.. and get counseling. Otherwise.. I really don't think you can succeed."

YOU HAVE GOT TO BE KIDDING ME WITH THIS CRAP!!!!! WHAT THE HECK KIND OF ADVICE IS THAT? CERTAINLY NOT HELPFUL!! YOU'RE THE ONE THAT NEEDS COUNSELING!!!!! YOU NEED TO GET OFF YOUR HIGH HORSE AND GET YOURSELF SOME SERIOUSLY ACCURATE PERSPECTIVE....YOUR COMMENT MADE ME PHYSICALLY ILL....

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