New Grad on Medical Floor Need Advice and Support

Published

I'm a licensed rn in CA and have my bsn. I just started in a new grad program on a very busy medical/oncology floor. I'm not chemo certified so I'm not doing any real oncology work besides PCAs and such my preceptor does all the chemo meds but for the most part I have all medical pts. I have a total of 4 pts per shift and am still on my "one on one" with my preceptor. I'm on week 7 and I absolutely hating it. The thing is that I literally am running my whole "12" hour shift (more like 14 since I have to be there at 615,and usually dont leave till 8). I have one main preceptor who I dread and am with her twice a week and with someone else the other day. I have one good day out of 5 usually and am always crying once I get home. The work conditions are great and the team is very supportive since the floor I am on is specifically for new grad training. Its a 40 week long program then we apply within the same hospital system but for a different floor. The first 20 weeks are days and the second 20 are nights. I go on my own starting in three weeks when we go to three new grads per preceptor a shift. What can I do to help me critically think better?? My preceptor says she only sees me doing task after task instead of looking at the bigger picture (shes 18 years in and never gives positive praise EVER). My other preceptor I feel like I can actually talk to and told her how I need that positive praise for encouragement and she is awesome at it. She helps me recognize learning moments and is very good at demonstrating skills with me. I guess I'm just looking for advice and words of wisdom. I have a great brain sheet and we also have a great system of kardexes that gives all the important info on a pt but I have a hard time putting into words what my "plan" for the shift is. I'm like deer in headlights when asked but feel like when I am left alone I do fairly well. HELP!!!!! How would you verbalize your plan if asked? How do you organize your day? Any and all advice welcomed. I'm basically regretting going into nursing but this will be what I do until my student loans are paid off. I literally have so much anxiety the night before a shift I wake up every 20-30 mins and am holding back tears the whole drive to work. I really need to make it through these 40 weeks because any RN job requires a year of experience and some even more. I am finding that I am just hating bedside nursing but find I will doing this for awhile even after the 40 week program because jobs are SCARCE! Thanks in advance for any tips and advice. I should add that I have a baby so it is also hard leaving her as days I work I literally do not see her awake as she is sleeping when I leave in the am and just goes to bed before I get home. It freaking sucks so much.

Up Vote Up Vote ×

Anyone??

Up Vote Up Vote ×

I'm a licensed rn in CA and have my bsn. I just started in a new grad program on a very busy medical/oncology floor. I'm not chemo certified so I'm not doing any real oncology work besides PCAs and such my preceptor does all the chemo meds but for the most part I have all medical pts. I have a total of 4 pts per shift and am still on my "one on one" with my preceptor. I'm on week 7 and I absolutely hating it. The thing is that I literally am running my whole "12" hour shift (more like 14 since I have to be there at 615,and usually dont leave till 8). I have one main preceptor who I dread and am with her twice a week and with someone else the other day. I have one good day out of 5 usually and am always crying once I get home. The work conditions are great and the team is very supportive since the floor I am on is specifically for new grad training. Its a 40 week long program then we apply within the same hospital system but for a different floor. The first 20 weeks are days and the second 20 are nights. I go on my own starting in three weeks when we go to three new grads per preceptor a shift. What can I do to help me critically think better?? My preceptor says she only sees me doing task after task instead of looking at the bigger picture (shes 18 years in and never gives positive praise EVER). My other preceptor I feel like I can actually talk to and told her how I need that positive praise for encouragement and she is awesome at it. She helps me recognize learning moments and is very good at demonstrating skills with me. I guess I'm just looking for advice and words of wisdom. I have a great brain sheet and we also have a great system of kardexes that gives all the important info on a pt but I have a hard time putting into words what my "plan" for the shift is. I'm like deer in headlights when asked but feel like when I am left alone I do fairly well. HELP!!!!! How would you verbalize your plan if asked? How do you organize your day? Any and all advice welcomed. I'm basically regretting going into nursing but this will be what I do until my student loans are paid off. I literally have so much anxiety the night before a shift I wake up every 20-30 mins and am holding back tears the whole drive to work. I really need to make it through these 40 weeks because any RN job requires a year of experience and some even more. I am finding that I am just hating bedside nursing but find I will doing this for awhile even after the 40 week program because jobs are SCARCE! Thanks in advance for any tips and advice. I should add that I have a baby so it is also hard leaving her as days I work I literally do not see her awake as she is sleeping when I leave in the am and just goes to bed before I get home. It freaking sucks so much.

Up Vote Up Vote ×
Specializes in Med-Surg, Emergency, CEN.

Hi! First of all, take a second and breathe.

Take a huge slow breath down to the bottom of your toes and let it out very slowly.

Got it? Ok, now I'd like to point out that you will absolutely be task oriented at first. You're still learning the skills and the time management techniques needed for a full patient load in a serious specialty. This is 100% normal. Believe it or not you are still in a school mind set, and you are going to feel like being 5 seconds late for a blood glucose is reason for being fired. It's not.

Second, it is absolutely normal to be that exhausted at the end of the day. It sucks, but that's the reality of nursing today. It will get less as you find your groove, but you will pretty much always be tired. Exercise trainers tell the average person to wear a pedometer and try to aim for 10,000 steps in a day. When I wore mine, I never got less that 15,000 without even trying. (Wear a darn good pair of professional marathon running sneakers with high impact insoles... It helps to feel a little less exhausted and sore.)

Third, there's nothing more stressful than learning how to be a nurse. High acuities, high census, multiple diagnoses, toxic coworkers, extreme red tape and required detailed documentation all add up to one heck of a giant ball of nerves. If you don't find a way to let it out, your body will find it's own way to do it. Crying and sleeplessness are a few examples. Yoga, kickboxing, motorcycles, knitting... Find a way to de-stress.

Finally, I want to say that IT GETS BETTER!!! That's why there is a whole forum for first year nurses! Because it is so normal to feel crazy that there are books, forums, and support for just this situation. Hang in there, and you'll get past this too. Pretty soon you will be helping other first year nurses through their crying jags and night terrors too.

Up Vote Up Vote ×
Specializes in SICU, trauma, neuro.

Deep breath. Critical thinking will come. I remember a nurse-educator (org development educator, not a nursing school instructor) once saying that new RNs often provide task-oriented care for the first year or two; after that they expect to see more goal oriented care. Seven weeks in, of course you're still learning how to see the big picture. Especially given how complex medical pt's can be. I found it helpful to consider WHY all those tasks need to be done. If you're not sure, ask. Your one preceptor may love that you're asking, if she's concerned about you just doing task after task and not seeing the big picture. You'd be showing that you want to learn to see the big picture. Will you have a different preceptor on nights? FWIW, in my experience most preceptors want to help new nurses grow, more like your second one. Keep focused on this experience, ask questions, seek out opportunities to learn where you can. You'll get the hang of it!

Up Vote Up Vote ×
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

duplicate threads merged as per the Terms of Service.

((HUGS)) it really takes a year to feel like maybe you aren't a complete failure....it does get better.((HUGS))

Up Vote Up Vote ×

Any more advice? How do you prioritize your day?

Up Vote Up Vote ×

I usually go in and write down who needs accuchecks (CNAs can't do it where I work), who's on peg tubes and who's going off the floor. I then go to the most "critical patient" then assess, etc etc. I am a new grad too (licensed in Oct in PA). I feel more and more comfortable each day.

The hard part is staying focused when people try talking to you when you are preparing meds. I find that hiding in the patients rooms while getting things together helps. :)

HTH

Up Vote Up Vote ×

Med surg nursing is MISERABLE! I am looking for some help too... I have been a nurse for about 6 months now, 4 months on this hell-recreated med surg/tele floor. I feel like I work in a zoo and the patients are the animals. Everyone is so needy and it seems like the patients are getting worse every week. I HATE med surg nursing. When I was in school I excelled at everything and loved it. I couldn't WAIT to be a nurse. Now nursing is beating me down to the point where I am in bed for 2 days after working 2 shifts in a row. I can't live like this. Help! :(

I really want to work in the OR where you can see patients for a short while and keep it moving. I don't think my personality fits med surg, I don't want to build relationships with people and families, I want to do my job and do it WELL, and keep chugging along. I know I am gaining awesome skills each shift I work on this unit, but I really want to know what can I do to set myself up for an OR position.

Is it too soon to transfer after 9 months? How can I make the transition? How can I sell myself? What can I put on my resume to translate med surg into "i will be an excellent OR nurse". Help me pretty please so I can remove myself from this med surg hell!!

Up Vote Up Vote ×

Agree that med surg nursing is not for me. I enjoy outpatient work or something else. I just hate the craziness of it all and the constant running from here to there my whole shift. It's awful :(

Up Vote Up Vote ×
+ Join the Discussion