New grad- job stress/depression

WestCoastSunRN, MSN, CNS · Oct 19, 2020

First, if you are using your real name on AN, you need to change it.

Secondly, nursing is a very difficult gig, such that we are not really prepared for it upon graduation. Night shift is really difficult on the body if you are not built for it (most are not), so you need to really implement healthy strategies for doing the best you can until you can get a day shift position.

You need to take a deep breath and talk to your charge nurse if you feel the assignments are not fair. Really, you should be doing that before going to unit management about it.

I doubt you are "burnt out". I think you are dealing with the reality of the job with this particular patient population. And it is tough, for sure. That said, there are supportive and non-supportive nursing environments and we cannot tell by your post where yours is on the continuum. But regardless, inpatient nursing is HARD. The first 1-2 years of professional nursing is HARD. These are facts. What you are hearing from co-workers is that, yes, the job is difficult and you won't feel confident in it for awhile.

I am many years in. I do not know, on any given day, what awaits me when I get to work. I have been kicked, spat on, punched, groped, grabbed, cursed at, and even had a patient try to strangle me with IV tubing, once. I do not think to myself, "Gee, I'm super experienced so I shouldn't have to deal with this crap, anymore". I have cried in the bathroom, and prayed all the way into work on many, many occasions. I have cried in the shower when I get home. I know what you are talking about, and I would still choose this profession over again - for all the reasons and probably more, than what made you go into it in the first place. So if it is a pep talk you need, there it is. If you have a toxic work environment, (for real) that is different, but what you described sounds like a "day-in-the-life" typical experience of not only a new nurse, but thousands of nurses everywhere.

JKL33 · Oct 19, 2020

It's impossible to say whether you're overreacting without being there to understand the situation.

So...random thoughts:

1 hour ago, nurseMR2020 said:

I do not get any support from my manager. I talk to her about my stress and I am told to exercise and take melatonin.

Based on years of observation, I don't think the managers are the best ones to hear about your stress. It may not really be their fault, it's just that their loyalties/interests are divided at best and this seems to affect how they react to hearing about the stress. Some react exceedingly negatively almost as if it's a personal insult to hear of a staff member's stress or dissatisfaction. The chances that they will believe or choose to imply that this is a personal problem (with you) is ~fairly high. For these reasons I believe it's best to be cautious and judicious with the sharing of anything that could remotely be considered a complaint or personal struggle.

1 hour ago, nurseMR2020 said:

patients with complicated medications and devices I have never worked with before.

This is okay and will improve your knowledge base. Just be chill and work through it by consulting your resources. If your CN believes that you can handle these patients, involve him/her as one of your resources and involve them in double-checking your work. You can document having done so: When you administer complicated meds make a note that says "double-checked by [M. Chargenurse, RN]." After they have double-checked, thank them and let them know you will document that they double-checked with you. All of this is not strictly necessary, but it goes a long way toward having them actually pay attention and help instead of assigning difficult patients to new RNs and then rendering the least assistance humanly possible. There is nothing wrong with you being exposed to these learning experiences, even if difficult, as long as someone is actually willing to help you--for your sake AND the sake of patients.

In many of the difficulties you encounter during the shift, stop for just a second and think what you can do that is calm and proactive rather than panicked and reactive. If you have a question, what resources can you consult? Then go consult them. If it's a flailing/agitated patient, assess your patient and consider possible interventions. If you don't have what you need to help your patient, contact the admitting service. If you don't know what might help, consult your resources (charge nurse, etc.).

2 hours ago, nurseMR2020 said:

When I think about going into work, I have chest pains.

2 hours ago, nurseMR2020 said:

this job is nothing that I thought it would be.

2 hours ago, nurseMR2020 said:

All I hear from my coworkers is that not having at least 2-3 years in the hospital will keep me from being a good nurse.

2 hours ago, nurseMR2020 said:

I am not passionate about the place I'm in and I have cried in the bathroom at work so many nights

2 hours ago, nurseMR2020 said:

missing the urgent care

As for some of the rest of this, I am in no way meaning to minimize the difficulties of the first 1-3 years of nursing, but in a way it sounds like you are having a little bit of a good old-fashioned freak-out. If that's the case be encouraged that a good portion of this will get better. Some of it won't get better but you will become more capable at handling it.

When it comes to sleep, it can be very hard to wind down. Create a routine for reviewing your day (10-20 min or whatever works for you but not too long) and then after that move on and don't let yourself ruminate. Allow yourself to rest knowing that losing sleep is not going to change anything and many of the things new nurses worry about after the shift are small potatoes (as far as their own actions...) - and if it's about something someone else did, well ?, forget that altogether and just go to sleep. If it's worth thinking about, you can think about it when you wake up.

Hang in there.

Nunya, BSN · Oct 20, 2020

I would start by keeping track of the times you get patients in restraints/attacking staff vs times other nurses get these kinds of patients. If there's two on the floor at once and you get them both that's a problem. If you get these patients 50% of the time and some nurses never do, that's a problem. I think getting patients with complicated meds/devices will only do you good in the long run, but you shouldn't get those kinds of patients in addition to the first, unless there's no way around it due to census, patient room location etc. When other nurses notice that you seem to be getting the hardest patients and they say something to you about it there's definitely a problem in my opinion. That being said, you might be getting the harder patients because you're new, and they feel you need the experience, but you shouldn't be overburdened with the hard patients. Start keeping track and if there's a pattern you need to decide if you want to talk to the charge/supervisor or suck it up or leave. Working nights and not sleeping makes it worse. Have you thought about seeing your doctor and getting something to help you sleep? I've used Benadryl, though there are problems with dependence with any sleep med, but short term it might help. If you do use something try it out first on days off so you see how you feel with it. I've found melatonin to be useless. And I found when working nights, even though I LOVE to work nights, that I feel better if I stay on a night schedule as much as possible on days off. So if I worked Monday night and am off Tuesday and Wednesday I might stay up for a few hours longer Tuesday and do some stuff, or I might try to get up a little earlier to get stuff done, but I get enough sleep that I can still stay up most of the night even though I'm off. It does sometimes make for a more lonely existence because you're up at night but it worked. And I was still awake to do things in the evening with friends, though nowadays that's not as much of a problem because of Covid (depending on where you live). And there's nothing wrong with sleeping all day! If you need to sleep you need to sleep. But even people who work regular day hours and have sleeping problems are told to keep to the same schedule all the time, even on weekends, and I think this is doubly important when you work nights.

Good luck, it's tough to be a new nurse AND to work nights. But you got through nursing school and you can get through this.

simonedbv · Oct 24, 2020

I think you might want to think about transferring to another unit (dialysis, ortho, psych, cath/stress lab) that could possibly be less overwhelming. Your feelings are valid and from what you describe you are extremely stressed. You need to take care of yourself. It also sounds like the culture on your floor kind of sucks (management at least). You should be able to transfer within the hospital at 6 months.

If you can't transfer and have 6 months under your belt I bet you could find a better fit in another setting (dialysis clinic, home health, state or county LTC environment). You can be honest at the interview and tell them you have concerns about staffing/safety and the work culture on your floor. They will know what you're talking about.

Just some things to think about. Not everyone is cut out for acute care. You very well might be....I'm just putting that out there. It's OK if you're not. You decide.

speedynurse, ADN, BSN, RN, EMT-P · Oct 24, 2020

1. It may be a compliment that you are getting hard assignments. I know I often had the most difficult assignments in the ED because I was told that I was “a good critical care nurse”.....which is fine....until it isn’t and you have had enough.

2. Night shift is really hard. Many do well on it....many don’t. I did nights for years and generally did OK until I hit a wall and my body and brain were just done. Second go around, I lasted a matter of months on night shift and not years before I realized I couldn’t do it anymore.

3. I don’t think you are overreacting although some of what you feel may because of the lack of support or lack of sleep or being a newer nurse. I do recommend *trying* to stay a year. At the same time, keep looking out for lower stress jobs to take a break when you need it. There ARE much less stressful nursing jobs believe it or not. But you do have to look for them. Try OR, pre-op, PACU, etc. Sometimes I miss the ED.....but in all reality, I don’t miss it that much once I realized how I could have a NORMAL life.

nurseMR2020 · Mar 1, 2021

Hello again, and thank you all for your advice and taking the time to reply to me. It is so appreciated. I thought I would let you know I accepted a job with OR at a hospital near me. I start March 15th!! My job situation got even worse and I definitely knew I needed to leave. I can't wait to start OR. I got some floor experience in and I *almost* made it a year LOL. Thank you all again!!