New Grad Nursling Struggles

[Starbin7]

Hello allnurses! I came here looking for answers, none of which I could find in any thread, so I created an account so that I could ask. I am a new grad nurse in a float pool, so I am training on different floors each shift I train on. So my training schedule has been 32 hrs/week; four weeks of day shift on one med surg floor, two weeks evening shift on a different med surg/oncology floor, one week night shift on a med surg/tele or med surg/ortho floor, then the last week being one shift in geriatric psych, one shift in the ED, and two random shifts. So eight weeks of orientation total.

I finished my four weeks of days, and wrapped up my two weeks of evenings. I was asking for my night shift schedule, and they kept saying "Tomorrow we'll have it. Tomorrow." Then I got called in on my day off where they told me no one fits in a cookie cutter, but I wasn't meeting their expectations of where I should be at 6 weeks of orientation, that my time management needed a lot of work, that I needed to ask for help, etc.

Time Management: I know it's a huge to-do for task oriented new grads. I was told document in the patient's room unless they talk your ear off, if so then document at the nurse's station. I followed this advice. I felt like I was at the nurse's station more often due to pages from physicians, PT/OT wanting reports, pharmacy/OR/labs calling with questions and results, a whole other slew of possibilities, and ultimately the talkative patients. My evening shift preceptor (who has been a nurse on the same floor for 30+ years) wants me to have all my documentation done by 1800. 1800!! I'm doing my very best but some shifts it is just not feasible (esp for a new grad who has been on the floor for 6 whopping weeks) to document until later in the shift when assessments/med passes/drug seeking pts have calmed down some.

Asking for help: Sometimes when my preceptors would ask if I wanted them to hang this antibiotic or that bag of 0.9 NS, if I was almost done in whatever room I was in I would ask them to hold off and explain it was so I could practice time management and handling my own pt assignment, because that's what I thought the whole point was. Some preceptors would get pissy and go hang it anyways if I didn't come out of the room in the next 2 minutes (non time sensitive drugs), some would let me do it. Apparently they all went to the nurse educator saying that I refused their help when offered, so I got reamed for not accepting help. I explained that I had misunderstood and thought that the point was that in a few week's time I would be handling these patients with not a lot of help. I was told that there always seems to be that one nurse drowning in her assignment and she needs to be able to ask for help if she's falling behind. So since then, I have said yes to any piece of help that is offered, even if I am on time with my shift.

So with all of this, I was told I was not on target and had to stay on for another week of evening shifts, which I just finished 2 out of 4 for the week. I was going to ask for another week of orientation anyways because 1) I felt like 8 weeks was not nearly enough time, and 2) I was not ready to handle a full assignment on day shift, they had increased me 1 pt per week on days so I was only on 4 pts when I wrapped up days. I understand the evenings is a good place to practice esp with discharges and admissions, but I feel like now I can't ask for that extra week of orientation on day shift.

Here comes the part I really want to pretend has nothing to do with anything, but I have ADD/high functioning anxiety as well, diagnosed very late in life (sophomore year of nursing school, didn't have the structured home life that disguised my ADD and was drowning). I take a low dose of long acting adderall and I feel that it does help me at work, but the anxiety can be pretty bad; I tried celexa about two years ago and I was so zombie-like I took myself off it.

My ultimate dream is to become a maternity nurse and maybe one day a certified nurse midwife once I get my experience. I know this experience is very valuable, and I am being very receptive to criticism (as much as it sucks to hear) and applying it to my actions and thoughts throughout my shifts, but I still feel like I'm not good enough. My preceptors keep reassuring me that I'm a great nurse but then they go and tell the nurse educator about all of these things behind my back, and I wish that they would just tell me to my face at least before they go to her. I am SO EXHAUSTED when I get home that I go to bed around 1-2am, sleep through my alarms like a rock, then wake up at 1pm just to go through it all again. Half the time I'm DREAMING about nursing so I feel like I just pulled a double, then have to go back in again!

So I guess my question is, are there ADD/anxiety nurses out there who can tell me how to get through my nursling year without crying 2-3x/week? And if it's all worth it in the end?

Also, how do you help your boyfriend who works an 8am-4pm job understand why I didn't clean xyz before I went to work? I've tried explaining how exhausted I am 24/7 and he thinks because I only work 32 hrs/week I can be tired but "not that bad."

I am so sorry for how long that was, but wow it felt good to get off my chest!

TL;DR = I'm a new grad with ADD/anxiety trying to get through my measly 8 (now 9) week orientation without feeling hopeless or my boyfriend getting mad because I'm sleeping too much. Please send help!

[Been there,done that, ASN, RN]

That is the most outrageous orientation I have ever heard of. I cannot imagine any new grad has been successful at this.

Sounds like an attempt by clueless administration to develop an in house staffing pool. Be proactive, tell your manager you need to placed on one unit.

Your boyfriend is supposed to be your loving, supportive life partner. It is not up to him to tell you how tired you can be. You are going through a difficult process right now, period. If he wants something cleaned, he can clean it himself, you are not a maid. Sounds like a control freak you would be better off without.

Best of luck, take charge of your life.

[LovingLife123]

6 weeks of rotating units??? Not a good idea for a new grad. You need stability and need a unit to be your home.

To be honest, 6 weeks is way too short for this and I feel your preceptors are wanting way too much. You do need to learn to ask for help but people don't need to act like that.

Your boyfriend is going to need to "get it". Nursing is physically and mentally exhausting. But that is between you guys. My husband truly does a lot of the stuff around the house. And has for years. If I have a few days off in a row I try to make up for it, but I need my rest too.

[HouTx, BSN, MSN, EdD]

Have you discussed any of this with your PCP? Based on personal experiences, sometimes we automatically assume that problems are due to a particular issue - such as ADD - but there may very well be something else going on. At one point in my life I was very shocked to discover I was severely anemic - I thought I was just tired because of inadequate sleep. Just sayin'.

Please take the time to sit down with your educator and get more specific information about the goals and expectations that you must meet.... including timelines. Don't settle for generalities. Ask him/her about the specific measurable (objective) criteria that will be used to evaluate your performance. Get this in writing. If you have identified any skill/knowledge gaps, ask about self-development opportunities and resources to address them. You are entitled to this.

[NewGurl, ADN]

Is there anyway you could look at another field of nursing? I also have problems focusing and can not deal with 100 things at once. My mind just doesn't work like that! I moved to surgery and had one pt and their problems to deal with. For me it was a really good fit. Just keep in mind you don't have to only do floor nursing as a new grad. That is the beauty of nursing, there are so many different places to explore. Good luck!!

[aeris99]

I don't have too many words of wisdom for you. But I did want to let you know that I share your feelings. I'm in a similar situation and having to evaluate whether I need to consider moving to a different unit or out of the hospital setting all together.

I'm a new grad too. I've been at my job for 5 months, off orientation for 1. Up until this point I have found ways to work around my brains lovely wiring. But it's just not cutting it now.

My only advice to you is what I plan to do myself. Take a little while to digest the feedback I have received, evaluate my ability to improve to the goals set and make a back up in case I find that I can not preform to the standards which have been set.

Also for what it's worth, float pool is not where I would want to be starting out fresh after graduation. I'm struggling despite being on one unit. I can't imagine trying to get my feet under me while bouncing from unit to unit.

[anchorRN, BSN, MSN, RN, APRN]

Working in a float pool as a new grad is a horrible idea!!! I've been a nurse for 13 years and floating to a different unit still makes my anxiety level sky high because I'm not as confident in myself as I am in my home unit around coworkers I know and trust. Look for a job on a unit where you arent working somewhere new every night. With your mental health issues this is not a good situation!

[kalycat, BSN, RN]

I agree with the other posters. A new grad starting in float pool is challenging enough, but it sounds like you have a very short orientation period as well. New grads on my unit are on orientation for 13 weeks, with the option to extend as needed.

I dont really know what to say about the anxiety piece. Floating is something that I enjoy now that I am a more experienced nurse... but in the beginning I found it somewhat nerve wracking. However, I'm not a particularly anxious person and feel pretty comfortable as long as I can access my resources for new scenarios that may arise. Try to be as organized as possible and communicate effectively with your preceptor... that's all I can really recommend there. Line out your shift in writing or use a good brain sheet. There are several different styles posted on AN; just search "nurse brain".

Is there a possibility of taking a budgeted position on one of the med-surg units? An internal transfer?

[TriciaJ, RN]

Yup. What they said. A home unit and a tuned-in or kicked-out boyfriend. We're rooting for you.

[Libby1987]

One shift in the ED for a new grad so they can pull you down there when needed? What in the world?!