New grad nurse in hospital and feel like I won't make it through orientation.

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So I'm a second career nurse (never worked in health care before - in school I was working in former my career through school). I graduated in December, passed the boards in February and applied to every job possible. I was lucky enough to be accepted into a new grad residency program at a well known hospital out of state (and moved by myself over 600 miles from home). I was told the program would be a 12 week orientation with a preceptor, as part of the two year residency committment. Well I've worked about 4 weeks on busy med/sug floor with the same preceptor (so far I've worked 15 - 12 hour shifts), and I'm due to change preceptors soon). The problem is I feel like I'm drowning already. My clinical skills are week, and I'm pretty sure my preceptor thinks I'm stupid (as well as the other younger nurses on the floor). I'm full of anxiety all day long, and feelings of shame, and doubt. I cry almost daily, and feel like I will never get the hang of everything. I'm supposed to be taking care of 4 patients on my own now, but I'm still at 2, and still being told I'm too slow and my time management is not where it should be. Again, everything is completely new to me, and I thought the program would be more of a transitional period from school to RN (with more one-on-one assistance.) But I'm finding the expectations to be much greater and faster than I anticipated. Not to mention the fact that I'm really supposed to be on my own at 8 weeks, not at 12 weeks which is what I expected (and really feel I need more like 6 months). My NM said she wants me to be at the expected 4-5 patient level in about 2 weeks. All of this is completely overwhelming me and I feel like I won't be able to make it.I know people say the first year is the hardest and just push on through, but I feel sick to my stomach that I'm going to have a major screw up, due to rushing around or forget something pertinent. I'm wondering if it's worth it for me to continue in the program -considering the amount of stress and anxiety I'm experiencing (it just feels so wrong to me). And I don't want to work in an environment like this. I feel like I made a huge mistake in going into nursing. I don't like the responsibility of caring for people so sick when I feel so incompetent. And I know my preceptor and other younger nurses on the floor think I'm stupid. (I wish I could do PT - but the schooling takes so much longer and at my age I can't do that). With no acute care experience, where can I go to work as a nurse? I just don't want the pressure that I'm feeling..Any thoughts/advice to a struggling, extremely stressed and anxious second career nurse?

Thanks GrnTea...very encouraging words..you're helping me see the light at the end of the tunnel..Thank you..!

Try to remember what it was like when you learned to drive. The year before getting your learner's permit was the loooonnnnngggggessstttt year of your LIFE. Then you sat in the classes and couldn't wait to get behind the wheel.

And it was harder than it looked when you were watching your mom drive you around. All those things to remember! All those things to observe! You couldn't have the radio on because it decreased your concentration just enough to make you even more nervous. You ground the gears, and the tires squealed when you jammed on the brakes parking in the lot. When your mom, riding shotgun, yelled, "Stop!" when you didn't see the guy in front of you didn't have functioning brake lights, she scared the bejaysus out of you and made you mad at the same time.

When the big State Police guy took you out for your driver's test, you were shaking in your boots. But you know what? You passed. You couldn't believe it, couldn't believe you had that thing in your wallet, because still when your mom handed you the keys it was scary. The first time -- and the second, and the fifth-- you drove the interstate into the city by yourself you thought you were gonna die. But you didn't. It got better.

And now.... flash forward mumblemumble years. You buckle up and back down the driveway, drive with three kids yakking in the back seat, listening to Terri Gross on NPR, aware of every damn fool on the road, and you haven't had a problem with parallel parking since the Reagan administration. While drinking your morning iced coffee. And planning your grocery list. And you remember to get gas.

See?

You can do this. You're just ... new.

:-D I'm a new grad and this of allllllll the posts on allnurses and from my colleagues, has helped me the most. I kinda got a slight chuckle from it lol. I have been feeling the same way as the OP since day 1 on the floor. Great preceptor & everyone on the floor has been beyond supportive, helpful & encouraging. My confidence just isn't there. Although, each day I gain just a tad bit more confidence in SOME area compared to the shift before.

Thank you OP for this threat and Grntea for that post that put everything into perspective!

Thanks HouTx...I'm definitely working with my preceptor on ways to prioritize my care and handle what needs to be done first (and I agree...I never take morning break or sit around chatting with other more experienced nurses chattting...just kind of wonder how they have the time to do that..My concern is what if I can't meet the expectations of the program of taking on 4-5 pts..at 8 weeks time(which is only really 2 weeks away) when I'm currently just barely making 3 pts..Any one hear of new grads being terminated for not being able to meet expectations of the orientation program? I'm finding it hard to go from one patient in clincials during school, to 4-5 pts. in real life (all within about 7-8 weeks time of orientation)\? I feel like I'm the ony new grad struggling to do this..and think I might get fired..uggh..is it worth all the stress? Or maybe I'm not cut out for fast paced med surg unit? Thanks all...

Thanks HouTx...I'm definitely working with my preceptor on ways to prioritize my care and handle what needs to be done first (and I agree...I never take morning break or sit around chatting with other more experienced nurses chattting...just kind of wonder how they have the time to do that..My concern is what if I can't meet the expectations of the program of taking on 4-5 pts..at 8 weeks time(which is only really 2 weeks away) when I'm currently just barely making 3 pts..Any one hear of new grads being terminated for not being able to meet expectations of the orientation program? I'm finding it hard to go from one patient in clincials during school, to 4-5 pts. in real life (all within about 7-8 weeks time of orientation)\? I feel like I'm the ony new grad struggling to do this..and think I might get fired..uggh..is it worth all the stress? Or maybe I'm not cut out for fast paced med surg unit? Thanks all...

See above. You're just new. your preceptor and manager has seen this all before and can name this tune in three notes. They know how much (or how little) clinical time your college gave you. They hired you anyway, didn't they? Why do you suppose they did that? Because they thought you could be brought along? Yep. You are certainly not the only new grad in these shoes. Have a little pity on your manager :) but thank her for hiring you anyway. You could even ask her why she did that...the answer might surprise you. :) Good luck!

Specializes in Going to Peds!.

My first year was awful. I had serious documentation problems, serious time management problems. At times, I even had poor prioritization skills. I felt like I was in the office at least once a week. (I wasn't, but I was in there a LOT.) If you had judged me by my first year, you would have said, she'll never make it.

My point is that your first year is gonna be tough. It'll be even tougher if your program didn't provide you with a lot of clinical experiences.

I am a new nurse too, in a new grad residency program. I am now 6 months in and there are still nights when things are crazy and I feel like I am just treading water. I am lucky in that most times when I am working 2 or more shifts in a row I get the same patient assignments, which helps with familiarity of history and the ability to detect status changes with a frame of reference. Even with the same patients, however, there are still nights when I have to address a new issue and the flow of the evening changes and I am back to treading water. All of the skills you need to succeed (prioritization, etc.) can only be gained with work experience. Keep working and learning new things. Try not to stress about anyone's expectations of you and just focus on working on your weaker areas through practice. You gotta crawl before you can walk :)

Specializes in public health.
Thanks HouTx...I'm definitely working with my preceptor on ways to prioritize my care and handle what needs to be done first (and I agree...I never take morning break or sit around chatting with other more experienced nurses chattting...just kind of wonder how they have the time to do that..My concern is what if I can't meet the expectations of the program of taking on 4-5 pts..at 8 weeks time(which is only really 2 weeks away) when I'm currently just barely making 3 pts..Any one hear of new grads being terminated for not being able to meet expectations of the orientation program? I'm finding it hard to go from one patient in clincials during school, to 4-5 pts. in real life (all within about 7-8 weeks time of orientation)\? I feel like I'm the ony new grad struggling to do this..and think I might get fired..uggh..is it worth all the stress? Or maybe I'm not cut out for fast paced med surg unit? Thanks all...

Did you take care of 4 patients by yourself during any if your clinicals? I had to do that in med surg 2. It was tough but I managed. I remember when I first started clinical, I was like you, wondering how do people have the time to chat? But sometimes taking a break is very important. I always made sure I went somewhere else to eat lunch so I wouldn't be interrupted. Everything takes time and practice. Don't be too rash on yourself and always take breaks. Good luck.

Sourapril..No - I had one patient in clincals....only had patients one time in my maternity rotation, so going from one patient in clinicals to four during orientation (within about 4 weeks time, after about 6 months of graduating from school) is very difficult for me)..that's where I'm finding the difficulty...My preceptor is there for me (now that I have a new one), but the expectations of the program are that I will be able to handle 4-5 pts. on my own by week 8 (which is about next week)...I just find it all so overwhelming. giving 8 and 9 am meds to 4 different pts., some who need insulin w/bkfst.,. I just don't feel confident enough to rush pulling and giving meds all within about an hour and a half time to 4 different people. I don't know how it's possible to assess pts, give meds, document all by 11 am...and deal with unexpected pain/nausea/bathroom/other emergencies that arise. So overwhelmed. Just wonder if I should pursue another type of nursing, as I'm not good under all this pressure. And certainly don't feel qualified to do it on my own. thanks for your advice.

I'm sure they've seen it before, but I feel that my clinical experience never came into the conversation during my interview, so I'm not sure they would have hired me if they new how unprepared I am. (And I didn't know myself how unprepared I was until I started working)...There are so many things I'm seeing in the hospital that I NEVER encountered in clinicals. It's a very high paced, difficult medicine unit where there are a lot of very sick people (trach's, amputations, PCA's - etc. - all of which I never encountered in school). I feel like a fraud for getting into the program, as I feel so clueless most of the day, though I did well in school and passed the boards easily..I just wish I'd had more clinical experience and less classroom work...Not sure what to do. Sometimes I'd rather be a waitress than a nurse. I don't mind working hard, but the stress is overwhelming, and the responsibility is almost too much to bear...

Specializes in public health.

Hospital is not for me. I love med surg only because its high patient turnover rate and diversity of diseases. I am applying for public health jobs because I think it gives you more autonomy and variety. Don't give up your job just yet. Things will get better. Try to stay in your position for at least a year before you switch.

I'm sure they've seen it before, but I feel that my clinical experience never came into the conversation during my interview, so I'm not sure they would have hired me if they new how unprepared I am. (And I didn't know myself how unprepared I was until I started working)...There are so many things I'm seeing in the hospital that I NEVER encountered in clinicals. It's a very high paced, difficult medicine unit where there are a lot of very sick people (trach's, amputations, PCA's - etc. - all of which I never encountered in school). I feel like a fraud for getting into the program, as I feel so clueless most of the day, though I did well in school and passed the boards easily..I just wish I'd had more clinical experience and less classroom work...Not sure what to do. Sometimes I'd rather be a waitress than a nurse. I don't mind working hard, but the stress is overwhelming, and the responsibility is almost too much to bear...

Again... they knew that when they hired you. Really. They didn't have to ask what you saw in school because no matter what it was, they knew it wasn't as if you had seen/done all you're doing now. They didn't expect that. You are not a fraud. They know that. Give it some time. If they are keeping you, being nice to you, and noticing when you learn something, you're fine.

So did you ask them why they hired you yet? :)

I'm sure they've seen it before but I feel that my clinical experience never came into the conversation during my interview, so I'm not sure they would have hired me if they new how unprepared I am. (And I didn't know myself how unprepared I was until I started working)...There are so many things I'm seeing in the hospital that I NEVER encountered in clinicals. It's a very high paced, difficult medicine unit where there are a lot of very sick people (trach's, amputations, PCA's - etc. - all of which I never encountered in school). I feel like a fraud for getting into the program, as I feel so clueless most of the day, though I did well in school and passed the boards easily..I just wish I'd had more clinical experience and less classroom work...Not sure what to do. Sometimes I'd rather be a waitress than a nurse. I don't mind working hard, but the stress is overwhelming, and the responsibility is almost too much to bear...[/quote']

Ohhhh my goodness!! I felt the same way today...make that everyday! Like, 'How in the world did I pass the NCLEX?'. I feel as if I don't know a thing and I can't "put the pieces together" (critical think). Will it ever get better? You hear/read that it'll get better but you feel as if no one is doing/has done as bad as you are, as an orientee. Sometimes, I feel like maybe I'm a fraud, too. I'm surrounded by orientees that had clinical or worked as techs at this hospital. I come from a smaller nursing program and completed my clinicals at smaller hospitals (with less advanced pt care, illnesses, injuries, & equipment). I hate to compare myself to others but they started the same day that I did, but make it look super easy.

I don't mean to thread jack but it feels a tinsy-bit better to know that I'm not the only person in the world that feels this way!! ***hugs***

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