New Grad, 8 patients. HELP!

Specialties Med-Surg


I feel terrible posting this because I realize how lucky I am to have a med-surg job as a new nurse...but I'm just looking for coping advice...

I am one week away from being off orientation (orientation is 6 weeks) and I am already freaking out! I knew Med-Surg would be terribly challenging, but I never knew it would be like this. It is standard to get 8 patients on my floor (I work days). 8 patients to me feels terribly unsafe. When you factor things like critical labs, hanging blood, starting new IV's, patients crashing, rude doctors, demanding families, etc.....8 patients is just too much! I am terrified I am going to miss something important and risk losing my license because I am just so overwhelmed with everything that's going on.

Maybe it was naive of me, but I thought I'd be able to have more interaction with the patients. The whole reason I decided to become a nurse (once again, maybe this was naive) was because I thrive off of patient interaction. I like feeling like I make a difference and in med-surg I barely have time to spend 10 seconds with one patient before running into the next room. I am feeling so discouraged and am questioning if med-surg or even hospital nursing is for me.

Becoming a nurse has been a huge dream of mine for YEARS and I feel lousy for questioning myself already. I am just wondering how people do this. Is 8 patients on a super busy unit do-able?

Specializes in Trauma Surgical ICU.

It is do-able..yes. It is right, no but you will get better, faster and more efficient. You will get better at time management, delegation and dealing with families more effective. The first 6 months will be the worst time, it will be a huge learning curve for you. You will make mistakes, you will miss things BUT every mistake is a lesson learned and next time, you won't forget :) When in trouble, ask for help, not sure what to do, ask. I promise, you will get better and if after a few months, you feel this is not safe; find a new job with a lesser ratio.

My first 3 months were hell, by 6 months I was getting pretty good at keeping it together and by a year I had a real understanding of what I was doing and how to manage it all. This takes time, don't be too hard on yourself.

Also nothing wrong with asking for more orientation time if you feel you are not ready to deal on your own, but just keep in mind, your NM may not feel the same way.

Specializes in Med/Surg,Cardiac.

IMO, nights is better for new nurses. I find nights to be more manageable usually. It gets busy but there seems to be more support. 8 patients is too many and sounds overwhelming. See about nights maybe? Good luck! Sounds like at the least you'll learn a lot.

A lot depends on the acuity of your patients and if you are doing primary care or if you have techs and how many techs you have. I've been a nurse for two years. I started nights on med surg. I've only had a max of 7 patients at one time and that is a lot. I agree with eatmysoxRN, see about transferring to nights and ask for some additional orientation time. I was on my own for a while and was feeling so stressed and overwhelmed that I hated my job. I asked my NM for additional orientation time with a specific nurse whom I felt provide good care and seemed to have good time management skills. After 3 additional days with this nurse I felt more settled and less stressed. If you don't take some type of action now, you will end up hating your job and having to take blood pressure medication!

Specializes in Certified Med/Surg tele, and other stuff.

Ok, I posted this once and it disappeared. Weird..

Anyway, 8 pts is a lot...period! That's even a tough load for an established RN!

I echo the others. Ask for more time or move to nights. If you can't do either, then cut yourself some slack on how much you can accomplish during a shift. You will pick up speed, but 8 pt's is still a lot.

I worked for a facility that would give us 6 minimum and it burned me out. Now I work for a facility that is max 5, and it's so much more doable.

Thank you so much for the replies everyone!

I actually asked my nurse manager if I could switch to nights but unfortunately there currently aren't any night positions available. She did say she would let me know if something opens up, so fingers crossed something opens soon. I am afraid I am going to burn out real fast on days, which is unfortunate because I have wanted to be a nurse for sooo long.

Sometimes I regret accepting this position knowing the patient staff ratio was so high, but I was so desperate for a job as a new grad. Ehh, I'm just going to try and stay positive and hope something on nights opens up soon!

8 on days is a lot, but like others have said you will start to be faster and more efficient, hang in there you will get the hang of it, I felt the same way, got sick every day before work, but you will get through it!

I know thisis along time but did you stuck it out? I myself is on orientation and ANSI the going to work.

Specializes in Cath lab, acute, community.

You WILL get better! I felt overwhelmed when I was a new grad starting out. I really loved it when the other nurses helped me! It's normal to feel overwhelmed, but you have to remember you are still a newbie who needs to develop skills in time management, and become quicker at everything, and learn the short cuts. You WILL learn that. I would literally have days where I would cry in my car on the way home because I was so exhausted, I felt like I was doing badly, and I was so overwhelmed the thought of another shift was just to much. If you have a good manager, perhaps speak to them to see if you can get "lighter patients" for a month or so when allocation occurs.

Specializes in LTC, Agency, HHC.

Whatever you do, don't quit to go to LTC.....28-30 there!!

But, don't be so hard on yourself! Hang in there. I started as a new grad LPN in LTC. Took me a month to get comfortable. You gotta give yourself some time!

Specializes in Telemetry.

I'm a new grad in orientation as well. I'm on a med/tele floor. Our normal ratio is 5 or 6 to 1. Beyond that the charge nurse will take patients. I'm very fortunate to work with very supportive nurses and an awesome NM. I also work with a new nurse that is only 4 months out of orientation and another that is at 1 year. It gives me hope to look at them and have an idea of where I'll be in that amount of time. I'm

still terrified. Just know you aren't alone and it will get better. We worked too hard to get here.

8 is too many for days. Maybe switch to nights.

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