New grad residency, lots of little mistakes, beating myself up.

[FrustratedExStudent]

Hey guys,

I graduated in December and passed my NCLEX in February. Maybe because of COVID, it took until September to actually get an interview, and I didn't start my residency until last month. I've been on the floor a little over a month, about 8 shifts so far (hours were limited due to online webinars and such).

The whole time, there have been a few little mistakes every day. The last three weeks, it's been fairly smooth, but he's been giving me some independence and autonomy this week, and it might be a mistake, but whenever he's present, I feel rushed. I or my preceptor will catch them before I go through with them, so none of them actually cause a problem. However, yesterday was so bad that it made me question my career choice. I've hung maybe a half dozen IVPBs so far, but I hung an antibiotic yesterday and made a dozen stupid mistakes during the process. I kept forgetting to unlock things, forgot to flush, and tried connecting the secondary line to the proximal port because the lines were all tangled. I beat myself up about it for the rest of the night, and got a horrible night's sleep because of it.

I'm at work right now. Today, I forgot to cut a pill in half, but noticed on my own and reconciled it. I also opened the OmniCell and pulled out a controlled drug, counted it correctly, but then forgot to put an extra pill back in. I had to grab the manager to teach me how to access Medication Management so I could return it. I also got flustered when trying to manage multiple lines on my patient and was programming the wrong pump (one that was not running) until my preceptor pointed it out.

I'm starting to think I'm too incompetent to be a nurse. I can tell my preceptor is getting fed up. He stands there and stress sighs constantly when I'm working on something. He's a really laid-back, young guy, so I know if he's getting frustrated with me, it must be pretty bad.

What do I do?

[Nurse SMS, MSN, RN]

15 hours ago, FrustratedExStudent said:

Hey guys,

I graduated in December and passed my NCLEX in February. Maybe because of COVID, it took until September to actually get an interview, and I didn't start my residency until last month. I've been on the floor a little over a month, about 8 shifts so far (hours were limited due to online webinars and such).

The whole time, there have been a few little mistakes every day. The last three weeks, it's been fairly smooth, but he's been giving me some independence and autonomy this week, and it might be a mistake, but whenever he's present, I feel rushed. I or my preceptor will catch them before I go through with them, so none of them actually cause a problem. However, yesterday was so bad that it made me question my career choice. I've hung maybe a half dozen IVPBs so far, but I hung an antibiotic yesterday and made a dozen stupid mistakes during the process. I kept forgetting to unlock things, forgot to flush, and tried connecting the secondary line to the proximal port because the lines were all tangled. I beat myself up about it for the rest of the night, and got a horrible night's sleep because of it.

I'm at work right now. Today, I forgot to cut a pill in half, but noticed on my own and reconciled it. I also opened the OmniCell and pulled out a controlled drug, counted it correctly, but then forgot to put an extra pill back in. I had to grab the manager to teach me how to access Medication Management so I could return it. I also got flustered when trying to manage multiple lines on my patient and was programming the wrong pump (one that was not running) until my preceptor pointed it out.

I'm starting to think I'm too incompetent to be a nurse. I can tell my preceptor is getting fed up. He stands there and stress sighs constantly when I'm working on something. He's a really laid-back, young guy, so I know if he's getting frustrated with me, it must be pretty bad.

What do I do?

Being a new grad is super humbling and, I am going to be honest, you are doing just fine. You are right on schedule! All these little things get filed under the heading of "time management" in terms of the steps you hiccup over. IT WILL ALL COME TOGETHER IF YOU KEEP AT IT. Sooner than you think.

Most new grads get anxiety because they worry they look stupid, they worry they need too much help, they worry people are judging them, they worry they are going to make a mistake. Round and round it goes. 

The best thing you can do right now is give yourself some grace. I did ALLLLL those things you mentioned and more. Ten years in now, I survived it, got better at it and now I'm a nurse educator helping new nurses like you come to terms with their humanity ?

Its frustrating to miss all those little steps - and the frustration is what is going to anchor it in your brain until you remember most of those things automatically! You won't see how far you have come until the next new batch of new grads comes through. 

Keep your chin up. Remember to be as happy when you don't forget something as you are unhappy when you do. With a little time, you will find yourself having more shifts that don't feel frantic. I promise.