New Grad Nurse! Help!!

Career Columnist / Author · Aug 8, 2017

Hello!
I am a recent May graduate and started on a busy Med/Surg floor in June...
And I hate it.
I don't know if it is because I'm so overwhelmed because it is a new environment or if I just am not clicking with my preceptor. There are some nights I cry all the way home from work and some days I can't even eat because I feel a sense of dread about going to work.
Our nurse patient ratio has increased since I was hired from 6 to 7. And I just recently started taking 6 patients. It's SO overwhelming. I feel like my patient care is just a checklist. I feel like a robot nurse.. I don't have time to slow down care for and know my patients.
We have had 3 nurses quit since I've been there and I feel like it's just going to get worse with winter coming.
I started in Med/Surg because of the urge from nurses to "do my time". But my passion is psych. I really regret not starting there first.
Is there any advice y'all have to make this more bearable?
I feel like it will look HORRIBLE if just jump ship during orientation at my first nursing job, so I'm trying to tell myself to at least stick it out 6 month to a year.

I'll bet there are at least two things going on- one is a normal (but very unpleasant) response most new grads experience during the first year.

The other is unrealistic work expectations.

Only you know your breaking point- but if at all possible, try to stick it out for one year. If that seems too long, think 6 months and then reevaluate.

cle540 · Aug 14, 2017

Hi! I graduated in December and went straight to a med surg floor...I like the people I work with, and I work in a rural hospital so it's likely different from what you're experiencing. But that said, I definitely had my days where I thought I wouldn't make it. And for the first few weeks I was there charting late almost every shift, it felt humanly impossible to do all that needed to be done. It has gotten better with time, though. I now rarely find myself charting after report, I can get through 6 or 7 patients without ripping my hair out.

I definitely suggest hanging in there until at least six months and then reevaluating. There is a very difficult learning curve to overcome before you will even begin to feel comfortable, at least that was the case for me.

Whatever happens, best of luck!

BSN_TN, BSN · Aug 21, 2017

I'd get out now sounds like poor mgmt and it probably won't get any better.

caffeinatednurse, BSN, RN · Aug 28, 2017

If counting down to the 6 month mark seems too overwhelming, count down to the next pay check, and then the next. Or count down the months. If you can make it to the 6 month mark, great. A year is even better.

I didn't appreciate my med-surg experience until I was the only nurse in the building with any acute care experience. You will need this experience in psych. It's worth it to stick it out, if you can.

Shane505 · Aug 28, 2017

What city is this giving you 7 patients in Med Surg. I started as a new grad with 7 patients fresh off orientation which wasn't safe at all. I thought that's how Texas rolls with no union. I was naive and new to the profession and didn't know how much power RNs actually have in the healthcare system. RNs have the MOST POWER in the hospital I learned even without a union and I will explain.

We talked to other new grads that got hired at other branch hospitals in the city and their max was 6 patients on Med Surg. We were shocked and upset cause we had 7 patients everyday and never got a proper 30 min lunch because you can't with 7 patients. We found out we were the only hospital going up to 7. So we kept telling management 7 was too much at every meeting but they kept saying it's not in the budget to hire more RNs. Our hospital was owned by a billion dollar corporation but they can't allocate funds to hire more nurses? Oh really? We'll see how that goes with the employees that are over worked and risking their license.

So a year went by with tense relations with staff and management cause they never listened to us because "it wasn't in the budget." So one day the tipping point came when they gave a day shift nurse 8 patients and the nurse filed for safe harbor to the Texas Board of Nursing. When word got out they gave that nurse 8 patients, we had 8 nurses quit in the same month. Our manager and director had to come in and work the floor for a month cuz they couldn't find enough scab travel nurses or agency nurses to fill the empty needs. After a month of our director working the floor the CEO of the hospital had a meeting with all the RNs on our floor and asked us what we wanted to keep us working there. We all had our arms crossed and told him we can't go up to 7 patients anymore. The limit has to be 6. The CEO promised us we will never go up to 7 patients again and our nurses never take more than 6 ever since.

You see it's the RNs that keep the lights on in the hospital and keep the shareholders fat. 1 night inpatient stay in a hospital on a general floor is at least $4k a night. If just 2 nurses don't show up to work that's tens of thousands even hundreds of thousands of dollars in lost revenue in empty beds especially if there was a scheduled surgery. Everytime a RN calls in sick and they can't find a replacement that is tens of thousands of dollars in lost revenue for the hospital. That is why agency nurses get paid well. You fill in and save the hospital tens of thousands of dollars in lost revenue.

So whenever your work conditions are not safe and management is not listening to staff remember as RNs you hold all the cards in the hospital. Even without a union if you all talk and band together if management still refuses to listen and meet your demands have enough of you threaten to quit in 2 weeks and management or administration will negotiate with you. RNs keep the lights on in the hospital not doctors remember that!

NWeems · Aug 29, 2017

That is exactly what I'm doing! I count down 3 twelves at a time. I tell myself if I can make it through the week only x amount of weeks left.

I know the experience will only make me better. I just hate the overwhelming sense of dread I feel the day before I start my shifts for the week.

Gary Mendoza · Aug 29, 2017

I think you could have gone into Psych without 'doing your time'. I'm an ER nurse of 10+ years now and I've heard lots of nurses say new grads should never jump straight into a specialty because they need to 'learn the basics'. I personally think you can learn your basics anywhere. Do you think the ER let me go without knowing what I was doing? Of course not, and the psych hospital wouldn't either. I say start putting in for psych positions and do what you want rather than suffer through something you don't like.

Happy trails...

tokmom, BSN, RN · Sep 4, 2017

Every department is its own specialty. That wasn't aimed at you, OP, but that comment drives me nuts.

If you can stick it out for 6 months just to get the background. Even psych pts get sick suddenly.

After your six months then leave.

Having 7 pts is crazy. We max at 5.

NurseLAE, BSN, RN · Sep 5, 2017

i know how you feel. i just started in med surg because i couldn't land a job in postpartum or L&D. i believe med surg will give me the experience i need to move on! im hoping the time flies by and my preceptor continues to be a great help !! we can do this !!

caffeinatednurse, BSN, RN · Sep 8, 2017

That is exactly what I'm doing! I count down 3 twelves at a time. I tell myself if I can make it through the week only x amount of weeks left.
I know the experience will only make me better. I just hate the overwhelming sense of dread I feel the day before I start my shifts for the week.

You know, I'm nearly 2 years out, and I still count my days down until the next paycheck. It sounds awful, but I know many, many nurses who are just pushing through their current job so that they can one day have another job. You do what you have to do to survive.

That feeling of dread will go away in about a year. Certain things that you didn't think would ever become routine, will become routine. You'll occasionally have a moment of anxiety about something before you remember that you reported off to a perfectly competent nurse who will catch your mistakes, if you made any. You'll even learn to forgive yourself for the mistakes you do make.

shakeela1027 · Oct 18, 2017

Understandable. I, too, face the same anxiety. I finally got a job in telemetry, in order to do my time so I can work as an OR or PACU nurse. I tried to apply to multiple new grad OR/PACU positions and nothing turned up. Coincidentally one of my first jobs was psych and I was a psych nurse for 1 year. The anxiety does wane but personally I think psych is easier depending on what type of hospital you were in. In my facility, all the RN were charge nurses so we didnt pass any meds or provide any medical care. But it did put me at a disadvantage because in many ways if evaluated by skill only I am very much a new nurse. So when I finally got the offer to work as a telemetry I jumped at the offer, only problem is I know I am going to hate it. My personality is introverted and I find being around people draining. Once I start my orientation in November, I hope I manage to make through a year. My only advise is to do it and stick with it for a year because if you become a psych RN, charge RN, nurse manager or a nursing supervisor, those skills come in handy when a random patient with medical issues is going through some type of medical issues. You'll know what to do. I think in psych only encountered two patients with possible acute medical issues that require medical attention and this is being a psych nurse for a year. Do what you can and try to think positive. That's what I tell myself and I havent started my job yet. :'(