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New Grad RN Med-Surg: Is this right for me?

Stress 101   (153 Views 2 Comments)
by nursejo nursejo (New) New Nurse Student

172 Profile Views; 3 Posts

Hi everyone, I’m hoping to utilize this forum as a safe space to express my doubts and anxiety as a new nurse on a Med-Surg floor. Any advice, words of encouragement, tough love, ...anything, I welcome it all! I’m blessed to have a great support system otherwise but I’m really eager to hear input from unbiased, like-minded strangers online 😉 

I graduated Aug 2018 with my BSN-RN. Worked as an HHA during nursing school. My first RN job was in Nursing Informatics, basically helped a hospital organization transition from paper charting to EHR. I worked there for about 6 months. I missed the clinical aspects of nursing and so I worked for a plasma donation clinic for about 4 months and the job itself was very menial and easy, but management was extremely unprofessional and it did not meet the work-life balance that I wanted. 

I challenged myself to go into bedside nursing, especially since I went back for my MSN and I know that I need experience in acute care. In nursing school, as much as I loved acute care, my heart flourished in Public Health. However, I felt such immense pressure to get experience in a hospital setting and I battled with the SoCal nursing market for about 2 months this summer until I finally got hired with the help of my school’s career fair. 

I am now four weeks into my 8 week orientation on a Med-Surg floor. The day before an upcoming shift, I have anxiety attacks throughout the day. I isolate myself, watching the clock and counting down the hours that I have to clock in for work the next day. I get nothing done, I’m paralyzed by my anxiety, and it’s starting to affect my health. My blood pressure shot up to the high 130’s SBP, I’m starting to have rapid weight gain from poor coping strategies, and my overall demeanor and appearance is reflective of the cognitive dissonance that’s happening in my mind.

When I’m at work, I have a work flow sheet that maps the hours during my shift as a checklist, a brain for each patient, and an amazing preceptor who is firm, organized, and the kind of nurse that I want to be one day. I have a workflow schedule to keep me on track for the day. I’m never short of resources (access to people, policies, etc.). At work, I’m able to compose myself well enough but it’s starting to take a toll on my mental and physical health at the end of the day.

I had my first shift with 4 patients this week and I felt like everyone needed something from me every second of every minute of that 12 hour shift. Between the doctors, my patients, my bladder, the call alarms, my CNA’s, my preceptor...my mind is constantly racing as fast my poor heart. I’m terrified of hurting someone, I’m terrified of jeopardizing my license, and I’m terrified of disappointing myself, my preceptor, my educator, and my director. 

I feel incredibly overwhelmed and I’m starting to doubt my capabilities as a nurse. Maybe my strength as a nurse lies in another field of nursing? Yet, there are many people, including my educator, who constantly reminds to stop being so hard on myself—to be patient with myself. But I don’t know, am I being too overzealous with the expectations that I set up for myself or am I actually incompetent and I should be performing at a higher standard than what I’m doing? 

I feel like I’m too slow for this unit. I’m always playing catch up with my charting, I feel like I don’t even really know my patients because I’m so limited in time and attention due being such a task-oriented unit. I need to take my time because I want to be safe, I want to open my eMAR in the med room even if I just checked their chart outside, I want to carefully set up their IV pump because I just want to be sure it’s set up properly, but it’s just go-go-go on that unit and my preceptor makes sure that I operate with the idea that I’m on rollerskates and that at anytime, my patients can quickly deteriorate. 

I find myself looking at job opportunities in public health and clinic positions, and I feel so guilty because I remember how badly I sought out this position when I was unemployed. People are also saying that night shift is different, “less resources; but half the work and double the pay.” In all honestly, I want to serve marginalized communities...families with limited resources, to educate, to screen, to prevent disease and illness, to do health fairs, to study diseases and how to mitigate/treat, to develop policies, to give medical aid to people who are limited in access and courage to seek medical aid.

I’m just so full of doubt and guilt. The anxiety is wearing me out. I don’t know if this is where I’m supposed to be. I don’t want anyone to get hurt because of my incompetence. Things are moving too fast. I feel like if I express these feelings, that I’m not cut out for bedside, at my next evaluation, that I’ll be less of a nurse in their eyes, and in mine. 

I come to work 20 minutes early to check my charts, I feel like I’m trying new avenues to be a better nurse each shift and I just end up feeling defeated regardless. 

This is so long, I don’t know where I was going with it. But thanks for reading this if you made it this far. My last two weeks of preceptorship will be nights...I’m hoping it gets better. I’m terrified of getting a full patient load next week. 
 

Please send help.

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12 Followers; 3,689 Posts; 27,502 Profile Views

Hello @nursejo,

 

7 hours ago, nursejo said:

I am now four weeks into my 8 week orientation on a Med-Surg floor. The day before an upcoming shift, I have anxiety attacks throughout the day. I isolate myself, watching the clock and counting down the hours that I have to clock in for work the next day. I get nothing done, I’m paralyzed by my anxiety, and it’s starting to affect my health. My blood pressure shot up to the high 130’s SBP, I’m starting to have rapid weight gain from poor coping strategies, and my overall demeanor and appearance is reflective of the cognitive dissonance that’s happening in my mind.

Speak to your PCP about this. It might be a mistake to associate your anxiety strictly with this job; this may be more of an exacerbation of chronic anxiety, uncertainty, indecisiveness, etc. 

It seems like people should seek to mitigate what they can (optimize underlying issues) before trying to make important life decisions and before deciding that one is this or that. Meaning, it might be best to optimize any physical or mental health concerns before deciding what you are or aren't cut out for over the long haul. If you don't, you may decide that you aren't cut out for med-surg and subsequently that you aren't cut out for the next 5 things you try either (or that they aren't right for some reason). Don't make the mistake of blaming your discomfort on t, then u, then v, then w, x, y and z. Address the heart of the matter and then see where things stand.

Plus you don't need to suffer this way.

 

7 hours ago, nursejo said:

I have a work flow sheet that maps the hours during my shift as a checklist, a brain for each patient, and an amazing preceptor who is firm, organized, and the kind of nurse that I want to be one day. I have a workflow schedule to keep me on track for the day. I’m never short of resources (access to people, policies, etc.).

These are all very good things that aren't as easy to come by as one might think. Especially the level-headed preceptor and the resources.

 

7 hours ago, nursejo said:

I feel like I’m too slow for this unit. I’m always playing catch up with my charting, I feel like I don’t even really know my patients because I’m so limited in time and attention due being such a task-oriented unit.

 

What you can't see is that many new grads feel this very way. And many people in new situations do too, even if somewhat experienced. Nurses' time is severely limited in almost all acute care bedside positions, and some other areas as well; LTC is notorious for lack of time and resources.

 

8 hours ago, nursejo said:

I’m terrified of hurting someone, I’m terrified of jeopardizing my license, and I’m terrified of disappointing myself, my preceptor, my educator, and my director. 

 

So you have the makings necessary for becoming an excellent nurse, if you can harness your conscientious nature for productive use. 🙂

 

8 hours ago, nursejo said:

I’m just so full of doubt and guilt. The anxiety is wearing me out. I don’t know if this is where I’m supposed to be. I don’t want anyone to get hurt because of my incompetence.

 

A little doubt is normal. Almost any guilt, is not. You haven't described one thing worth feeling guilty about. Acute care nurses are not in control of the situation that leaves us with less time with patients than we would like; that is almost solely the result of the actions, decisions and motivations of others. You don't have enough perspective/experience to see that there isn't a single thing in nursing/patient care that should make you personally feel guilty right now. The question is, can you get to a place where you are doing your best, learning, helping people, and not trying to take responsibility for things out of your control.

 

8 hours ago, nursejo said:

In all honestly, I want to serve marginalized communities...families with limited resources, to educate, to screen, to prevent disease and illness, to do health fairs, to study diseases and how to mitigate/treat, to develop policies, to give medical aid to people who are limited in access and courage to seek medical aid.

It's possible that your best bet is to get some solid m/s experience to lay the foundation for a position out in the community where you will be independently assessing needs and recommending plans for how to meet them...without a ton of others' expertise and resources immediately at hand.

Unless you have been notified through meetings, concerned conversations, improvement plans, etc., that you need to step it up, then you are doing fine with your orientation. [I realize you don't feel fine, I'm not trying to say that]. Maybe it would help you to take 5-10 minutes to low-key let your preceptor know the basics of how you are feeling and ask whether you are pretty much on target. I suspect you will get some reassurance. Your brain chemistry may not allow you to feel reassured, and that is why I recommend meeting with your PCP ASAP.

This doesn't sound like it's bound for failure to me, but you must take some positive steps in your own best interest, for your own long-term well-being.

👍🏽💮

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