New Grad RN Feeling so OVERWHELMED

[justudentnurse1]

Hi,

I just started orientation about 2 weeks ago and have completed 6 shifts. I am so overwhelmed. I went to a school in a smaller town where the hospital doesn't have quite the acuity of patients I am working with now. We rarely saw Central Lines, gave blood or anything like that. My preceptor is super nice however I feel so clueless and feel like I know nothing from what I learned from school. She actually asked me on my 2nd shift if I had done any clinicals in the hospital, which made me feel even worse because I had just been asking a lot of questions about the central lines. She has only been a nurse for 3 years and I feel like everything I learned from my teachers in school, other nurses and my preceptor during school is completely different then what she teaches me. The equipment we used during clinicals was way different as well, so I keep feeling like an idiot when she teaches me something that I have already done, however with different equipment. I hate to make excuses for myself so instead and I just stand and listen, looking like I know nothing.

I constantly question myself with her because of her watching over my shoulder I truly feel like I'm making a mistake or doing something wrong the entire time. She just makes it feel like there is only 1 way to do anything and any other way is wrong. For instance the other day we were hanging blood together. In the old hospital I did clinicals in, the hospital always had a blood warmer for patient comfort. So I asked my preceptor if we ever do that on the floor I am working on. She looked at me and goes no we would never use a warmer unless the pt was hypothermic or it was maybe a newborn. So I just kind of said oh okay and went on with the day. But any question I ask seems to go that way.

I feel like I am not a dumb person and I do know things, I did well in school and passed my NCLEX with 75 ?s however, I'm just feeling so overwhelmed and have zero confidence since starting as an RN. Will it ever get better? I really enjoy the patients and enjoy nursing I just am feeling so stressed out. I really like my preceptor as a person, she is just really overwhelming me. Theres so much to learn from school to working as an RN.

[missmollie, ADN, BSN, RN]

Nursing school gives teaches you the basics of nursing. Now you're learning nursing through your facility, and it should be more specialized based on the unit you're on. You are not alone. Everyone feels overwhelmed when they're new on the job.

I'm a new nurse six weeks into orientation. The best advice I have is to set goals for yourself so you can improve, and to listen to your preceptor. Start with small goals that you can control on things you know you need improvement on. At the end of your shift, ask your preceptor what goals she believes you should accomplish on the next shift, and ask her what you could have done better during this shift. Knowing your weaknesses can only help you succeed. Obtaining your goals can help to improve confidence.

It's okay to ask questions, but always thank them for the answer, even if it's not what you think it should be. Congrats on your new job, and best of luck! Eventually, we'll be like our preceptors and feel comfortable in the job. :)

[icuRNmaggie, BSN, RN]

The fluid warmer has specific indications such as rewarming a hypothermic patient, preventing hypothermia with the massive transfusion protocol and to prevent clotting during administration of blood in patients with cold agglutin antibodies.

A blood warmer would never be routinely used for patient comfort in any facility that I have worked in.

[CFLA.RN]

It will get better! My clinicals were in a very small rural hospital, I was definitely proficient at administering PO lasix for CHF exacerbation and IV abx for pneumonia...but seriously, nothing else. I didn't give my first suppository until I had been working on the floor as an RN. My first position was on a Transplant floor which was completely different than anything I had seen in clinicals. I was always so nervous when my preceptor was with me but I found that I was more comfortable with my skills once she had left me alone with the patient because I no longer had the pressure of someone watching my every move. My preceptor was nice enough but not very helpful. At the beginning of the shift I reminded the other nurses that I was new and really wanting to help with all procedures to get proficient...they were very accommodating in including me on different things - from central line care to dressing changes to foley changes - so that I learned different techniques from each nurse and was able to become confident in myself. It takes time to find your place as a nurse. I worked on a great floor with physicians that were so helpful and kind and nurses that really worked to help each other so my experience probably wasn't typical - but even then it took a good 3-4 months to really feel like I was doing my job well.

[SierraBravo]

The reality of the matter is that there is often a big gap between school and working as a nurse. Hence why orientation is so important, as well as getting connected with a really great preceptor. We've all been there right at the beginning, feeling so overwhelmed, and questioning ourselves. But it does get better. Your confidence will build with each shift.