New grad RN

Meriwhen, ASN, BSN, MSN, RN · Jan 12, 2015

Moved to the First Year after Licensure forum to help you get more targeted responses.

It does get better, I promise :)

KelRN215, BSN, RN · Jan 12, 2015

If a patient codes, you call for help and it will come running. People who have run codes before will take over. It's only been 5 weeks. When I was a new nurse I was told it takes an average of 18 months to feel fully comfortable/confident.

Gooselady, BSN, RN · Jan 12, 2015

If your patient codes, call the code team and send someone out for the crashcart :)

If your patient chokes, call the rapid response or code team and send someone for the crashcart :)

When you are new you haven't yet realized the SIMPLICITY of your job as a nurse. It sucks, but the simplicity of prioritizing tends to come with time and lots of anxiety. You have barely started. I have completely, utterly lost count of newer nurses who describe the exact same fears and anxieties as you do.

The good news is that it will not always be like this.

It is very, very hard to kill a patient, and quite hard to hurt them if you are conscientious.

No one expects YOU to handle a code or a choking patient all on your own. This is one new nurse fear I hear a lot. "But what if my patient codes??" It's like the new nurse thinks she is on her own to deal with it. What if the patient is short of breath? Take their pulse ox. What if my patient has chest pain? Grab vitals, 0s and call the doctor or the rapid response team. You are just the nurse, not the emergency critical care crew.

The code crew are usually very enthusiastic about coming to codes, they bound in blazing with energy and push you out of the way and give you a clip board. You might even get shoved out of the room. They take over. You may give rescue breaths or compressions for a couple of minutes before they get there and take over. When you have your first code, or another nurse has one, pay attention to what happens, literally familiarize yourself with the process. Each bit of experience will 'ease' you from the inside, you'll gain familiarity and the anxiety will drain away to normal levels.

A lot of new nurse fears are wildly unrealistic and not based in actual reality. I'm big on catching my thought processes and putting them to a reality check, but not everyone finds that useful. If you can write out on paper your WORST fears, and then examine them for reality, it could help a lot.

Finally, you fear you are driving your preceptor nuts with all the questions? What kind of questions do you tend to ask? Sit back and think about it. Are you asking repetitive questions out of anxiety, like a habit? Once you get an answer, you KNOW the answer. The answer doesn't change. Next time a question comes up that you think might be 'silly', see if you can figure it out on your own. FORCE yourself to do this. This is how you gain confidence. At some point, you have to trust what you know. That's all anyone does, they aren't on the phone with God getting their answers, they are doing their best :) Just like you. Being a novice can be anxiety central for sure . . . but at some point, you have to stand up to it and take control. You'll get better at this, I promise :)

iPink, BSN, RN · Jan 12, 2015

You have to give yourself time to get there. I was about one month off orientation when I had my first code. I didn't even press the code button. Instead I screamed from the top of my lungs "HELP!" Yup, that did the trick and everyone came rushing in and pretty much took over. I worked in stepdown ICU, where codes occur at least once a week.

The learning curve will be steep at first because of the transition from being a student to being the primary nurse. Continue to write down things that are new or unfamiliar to you. Save your brainsheets about a patient's diagnoses and the labs and procedures. Cut off the patient's information and MR# and shred them then go home and review why the MD ordered these particular labs or meds, what interventions were effective, what is the big picture of the pt's diagnoses, etc. Taking the time to study at home will help you become a better nurse on the job. Also keep those brainsheets in a binder because chances are you will see those same type of diagnoses on another patient. Familiarize yourself with common meds administered on your unit. They will become second nature to you over time.

Good luck!

barankasia · Jan 12, 2015

Moved to the First Year after Licensure forum to help you get more targeted responses.
It does get better, I promise :)

You just described my exact situation right now! I am stressed out at work...don't want to make a mistake and forget smth, I feel stupid when I do and my off days are ruined because I worry and analyze every detail from work...I hope like everyone says this will change one day...I'm just not there yet and it's extremely difficult to deal with.

britpanda · Jan 13, 2015

Thank you for creating this thread. I am in a similar situation and it's good to know I'm not alone in feeling this way.

I've been off orientation just about a month now and I'm a ball of nerves the night before I go into work...so much so that I have a hard time sleeping and am therefore not feeling 100% when I go into work. I sometimes lay awake thinking of different reasons I could make to call out of work (don't worry, I don't call out...just fantasize about it). When I get to work and get stuck into my shift it tends to go ok. There have been only a couple of times I've truly felt overwhelmed and that I failed my patients (getting stuck in a patient's room hanging blood and then being two hours late giving another patient their meds is one example).

The unit I work on is really fast paced and high patient turnover. I know that my time management is what holds me back from being efficient and therefore having the best shift and giving the best care possible...and I know time management will improve with experience.

Reading all of the feedback from the veteran nurses is very helpful so thank you to everyone who continues to provide encouragement and advice to those of us transitioning into the world of nursing!

Tbajeux2010 · Jan 13, 2015

It's really good to know I'm not alone! Just the thought of being off orientation makes me SO anxious. I'm having hard time with looking at the BIGGER picture. Seeing veteran nurses know exactly what to do in the most crisis situation just blows my mind. Like how do they know what to do all the time !! I really hope my confidence builds up towards the end of orientation.

barankasia · Jan 13, 2015

Tbajeux2010 and Lucy2811 I'm there with you! I'm struggling with confidence and time management. I'm scared I'm going to make mistakes and forget/miss something...my days off are ruined because I worry about everything I did/didn't do or should've done differently... Gosh I remember thinking that nursing school was the hardest thing I've ever experienced...how I was wrong! I'm just hoping one day we will realize that we are confident and comfortable in what we do!