New grad nurse, feeling like I am barely hanging on!

Do-over, ASN, RN · Jan 14, 2014

Time.

I don't think "struggling with the easier patients" is much to worry about right now. You are new.

It took me about a year to feel OK and 18 months to feel somewhat competent - and that was starting out on a step-down/tele floor. I've been in ICU less than a year, but I credit my previous floor experience for the level of comfort I have now (and I know I still have TONS to learn re: critical care).

Ruby Vee, BSN · Jan 14, 2014

Please don’t take this the wrong way, but I am totally feeling overwhelmed and just need some advice. I am grateful and incredibly lucky to begin my nursing career as a new grad in a critical care unit. That being said, I am so overwhelmed! I am now 5 weeks off orientation, and many nights I want to leave work and just cry. I often feel like I am not sure where I went for the last four years, but I can definitely say real nursing is not like nursing school. I know everyone says that, but you really need to be in the field to grasp this concept.
This new anxiety (swear I am having PVC’s!), makes me feel incompetent as a new nurse. I am well supported and I am so thankful for that, but I really would just like to feel that comfort level that I can actually do this job and become a fantastic nurse. I love so many parts of this job, but often feel like I am on the edge and my boss is going to call me in the office and tell me that I am not cut out for this job! Honestly, I feel that if I am struggling with the “easier” ICU patients, how the heck am I going to take on heavier assignments.
I look for feedback from my colleagues and don’t take offense to constructive criticism. I am also open to different suggestions about time management and nursing care. I try to get feedback from the oncoming nurse on how she/he felt I left the patient and what I could have done differently. This is a second career for me, one that I have wanted to do since I was 19. I really can’t believe that I am asking this, but how do I gain more confidence in myself and when will I feel like I can just breathe.
The best way I can put it is that when I get to work a switch gets turned on, and I feel like the energizer bunny on steroids. Does this mean I am not cut out to be a nurse on this type of unit??

Overwhelmed is what you're SUPPOSED to be feeling when you're a new grad only five weeks off of orientation. If you weren't feeling that way, I'd be very concerned about whether or not you should be a nurse in the first place, much less on that sort of unit. You say you want to leave work and just cry -- you don't say that you ARE leaving work and just crying. So that makes you ever so much better off than I was 35 years ago when I was in your shoes! I cried all the way to work and all the way home with astonishing regularity. Sometimes I had to hide in the employee bathroom and cry during my shift as well.

Anxiety and feeling incompetent is not only normal, it's expected. Honestly, have you not heard how miserable the first year of nursing can be? Believe it! It's miserable! Being a "fantastic nurse" is too much pressure to put on yourself right now. Strive for mediocrity; it will be the best you can do for at least a year. Mediocre is competent - that's a great achievement for a brand new nurse.

Your boss may call you into her office and talk to you about how you forgot to change this dressing, hang that antibiotic or sign this pre-op checklist. That's normal, too. She calls you into her office to tell you when you've screwed up because she knows you're going to screw up, and she wants you to know exactly where you've screwed up so you don't do that again. Don't worry. She knows your going to screw up somewhere else next time. And that's OK because, repeat after me, "You are a brand new nurse."

You'll feel as if you can just breathe in about a year, if you're right on schedule. Confidence will come in fits and starts. One day, something will just "click" and you'll start feeling competent more often than you feel incompetent. And that's when you can start taking on the heavier assignments. Right now you have SO much to learn.

monkey2008 · Jan 16, 2014

I'm coming up on my one year anniversary as a nurse and six months on my own in MSICU. Last night I had my first nimbexed patient and my other patient decided to have an MI! I was overwhelmed and on the verge of tears the entire shift. I felt like I had no clue what to do, I didn't understand the big picture for my patients and I had no time to think. But you know what? I survived, my patients survived, and I left them in better shape than when I got them. sometimes, that is the only thing you can do.

Do you know what I learned? Teamwork is vital to anyone's success. I honestly had an amazing rt and resident last night. Together, we made things better.

the unknown is stressful, but once you have real life experience with a patient, the next time will be a little bit easier. I understand your frustration, but trust me, you will get there. If you told me 2 weeks ago I would have the assignment I did last night, I would have laughed and said I wasn't ready. But when you are thrown into unfamiliar waters, you learn to swim.

The very fact you have these feelings makes me confident you are going to be a successful and amazing nurse. Never stop questioning, never stop growing and never stop learning. Best of luck!!

Beachhiker · Jan 17, 2014

Please don't take this the wrong way, but I am totally feeling overwhelmed and just need some advice. I am grateful and incredibly lucky to begin my nursing career as a new grad in a critical care unit. That being said, I am so overwhelmed! I am now 5 weeks off orientation, and many nights I want to leave work and just cry. I often feel like I am not sure where I went for the last four years, but I can definitely say real nursing is not like nursing school. I know everyone says that, but you really need to be in the field to grasp this concept.
This new anxiety (swear I am having PVC's!), makes me feel incompetent as a new nurse. I am well supported and I am so thankful for that, but I really would just like to feel that comfort level that I can actually do this job and become a fantastic nurse. I love so many parts of this job, but often feel like I am on the edge and my boss is going to call me in the office and tell me that I am not cut out for this job! Honestly, I feel that if I am struggling with the "easier" ICU patients, how the heck am I going to take on heavier assignments.
I look for feedback from my colleagues and don't take offense to constructive criticism. I am also open to different suggestions about time management and nursing care. I try to get feedback from the oncoming nurse on how she/he felt I left the patient and what I could have done differently. This is a second career for me, one that I have wanted to do since I was 19. I really can't believe that I am asking this, but how do I gain more confidence in myself and when will I feel like I can just breathe.
The best way I can put it is that when I get to work a switch gets turned on, and I feel like the energizer bunny on steroids. Does this mean I am not cut out to be a nurse on this type of unit??

What you're feeling is absolutely normal. In fact, I'd be more worried if you don't feel overwhelmed or concern at all. Just like anything new it can be scary, but don't worry as time passes by you'll become more confident and learn. Take every opportunity as a learning experience. Don't be afraid to as questions, it is not a sign of weakness, it is expected out of a novice nurse aka new grad. I've been doing this for almost 12 years now and we still ask for each other's opinions. Use your co-workers as a resource and don't be afraid to talk to physicians because you're all working towards the same goal, which is to provide the best care for your patient. There will be a time when patients, family members and physicians will give you an earful. Just remain calm and maintain professionalism while standing up for yourself at the same time. There will be a time where you will make a mistake. Own up to it, don't try to hide it.

Know your scope of practice and policies because they're there for a reason, especially in the intensive care unit where you fill find that the nurses have more autonomy compared to nurses on other units, (meaning you're allowed to do more compared to let's say a med-surg floor.)

Good luck with you're new career.

Dial9first · Sep 7, 2015

You stated "I am lucky to begin my nursing career in a critical care unit". Then, you do not feel comfortable being in the unit. What is wrong with working in a less critical area until you get your assessment, skills, and critical thinking process down? Am I missing something? Post after Post of new grads believing they do not need to work on a Medical-Surgical floor. Unless you have a mother, friend, or relative working in the unit, you should not be there. You are setting yourself up for failure.