i am a new grad rn who started work recently. i was going ok at first, i really enjoyed it, and felt a sense of accomplishment that i was making a difference to peoples lives. but recently it all seems to be falling apart, i feel that i am going backwards and getting more incompetent by the day. there are moments where i feel totally utterly and completely lost and i really just don't know where to begin....and once the panic sets in, i fall to pieces.......after that it is all i can do just to make it to the end of the shift. i really don't care about what i'm doing, i just want it to be over.....i start with one pt, and eventually find something i don't know how to do, one of the meds, a dressing, or whatever, so i just leave that pt for the moment and move on to something i can do for the next person, until of course the same situation arises in the next person, and i just move on the next and so on..... eventually the only things i have left to do in my shift are things i don't know how to do, and i panic, and the shift gets worse and worse and worse as i go.
i'm not usually a tearful person, but would find myself in tears during each shift, even over the slightest things. it was an awful week this week, i couldn't sleep, couldn't eat, i was just so stressed and i hated it....there were so many times during the shift where i just feel like walking out the door and never coming back.. the worst bit is i get so focused on the "things" i have to do, i almost forget about my "patients." the only way i make it to the end of the shift is by telling myself that i will resign tomorrow and never have to come back here.
i have called in sick 3 times in 3 weeks (once i didn't even call, just didn't show up) because i just couldn't bring myself to go to work. i feel so sorry for my patients. i really don't know what i'm doing. they ask me questions and i haven't got a clue how to answer. and when i get home i start to remember all the little things i forgot to do, or should have done.....all the other new grads are doing so well, and there really are no excuses anymore for my inability to be a good nurse.
the other staff are so nice to me, and this stresses me out even more. even when i do stupid things they just tell me its ok. but its not ok!! i should know better. they think i am a good nurse (or so they told me)....and really i am not! i am terrified they will find this out eventually...i know it shouldn't matter so much what others think, but it really does......they have such high expectations of me, and have spent so much of their time trying to help me, and i don't want to disappoint them. they all help me so much. they help too much, i should be able to do things on my own, but don't seem to be able to get through the shift without an enormous amount of help from the other nurses. i even had a student rn working with me this week who was 10 times better at the job than i was. i couldn't have got through the shift without her help. this is very wrong as i was supposed to be the one teaching and helping her, not the other way around. i really don't know how i even still have a job. people keep saying that i'm a good nurse, that i just need more confidence, etc.......i don't understand how they can say this after they see how hopeless i am and all the stupid things i do??????? i really have started to hate the job, or at least i hate that i am no good at it.
i wish i could go back to my old job as a nurses aide. at least i knew what i was doing and i enjoyed it, and at least i felt i was giving competent care to my patients. people told me all along i'd never make a good rn and i really should have listened. i suppose i just didn't want to face the fact that i really am not cut out for nursing, and i still don't want to face it or else i would just resign and get it over with. you probably cant tell from this post, but i really do love nursing. i really don't want to give up, is there anything i can do? any hope i will get better at this job? or should i quit while i'm ahead?
i precept new grads on a daily basis, in addition to remembering the new nurse experience all too well.
i want you to try approaching this job as a learning experience. not "i'm bad" or "i'm good," but "i'm learning." please stop critiquing your work; that's your preceptor's job. if you're hearing that you're doing ok, go out on a limb and believe it.
when you find something you don't know how to do, please write it down under the heading, "my learning list for today." you'll come up with about 10 things every shift you work, i guarantee.
and i, an experienced nurse, will come up with at least two! i'm still making a learning list in my head, and my coworkers help me with mine, and i help them with theirs.
this is why you must stop beating yourself up for not knowing it all. you can't. none of us can. there are too many things to know, and as soon as you learn them, something new comes along--a new device, a new procedure, a new policy.
your stumbling block is that you think you can know it all--or at least a really large part of it--and it's much too soon for you as a new grad to be able to handle yourself without help.
please understand two things:
1.it's ok to ask for help--experienced nurses do it all the time.
2. it's ok that you do not know everything right away.
different students come from different levels of education, training, and experience. please don't compare yourself to them. you know some things that they don't, they know some things that you don't. this is why nurses collaborate with each other, both in real life on the job, and here.
i also would like you to make a list of things you can work on improving. instead of saying, "oh, i'm a horrible nurse, i should've given mrs. x's solumedrol before i hung up the vanco that takes two hours to run!!" (true story, by the way), try saying to yourself, "ok, i want to improve, so next time i'll do my iv pushes before i hang up the iv infusions to make sure the patient gets all their meds before the shift ends."
what i'm really getting at is this concept:
focus on improvement, not on judgment.
because if truth be told, we all sucked as new nurses.
focus on getting your inner voice involved in more positive self-talk. say something like, "i will be successful at this. they want me to succeed."
because we--your nurse coworkers and colleagues--really do!
pm me if you need to talk more, and please keep us updated.
wow. bravo !!! :balloons: excellent post, angie !
well, you said it all, so now i have nothing left to add... except one thing:
Being a new nurse is a stressful experience. You are not alone on how you feel. When i read your post there seems to be an underlying depression symptoms going on along with the stress. Also your feelings of insecurities can sabatoge you. Believe me i know because the same has happen to me. You need to do some soul searching and figure out if you are working in the right nursing environment for you. I had to admit to myself my first new grad job was not the right choice. Once i found the right nursing area, i was 100% more comfortable & happy with my job. If is the right place, go to your supervisor, talk about how difficult all is. Keep a list of what you are having a hard time with. It is okay, your new!! May do wonders to go talk with a professional about your insecurities, not sleeping, and crying. You may be suffering from depression on top of the stress of new job. Number one is talk about what is happening to you with others. Don't isolate. Please PM me anytime. I really relate to what you are going through.
DO NOT QUIT. Just as encouragement for you, your post was encouraging and educational for me. I am a new LPN student who hopes to go on to RN. I have no medical experience, so I am taking a CNA course next quarter (which starts in 2 weeks) so that I can get some work experience as I progress through school.
What you shared gave me a realistic view of what's ahead of me and I REALLY THANK YOU for taking the time to give such an in-depth statement of your experience.
You really are too hard on yourself. I tend to have the same characteristics as you reveal. It may turn out that you prefer a different type of Nursing. There are SO MANY OPTIONS. But in the meantime, please look at this as a learning experience. At this early stage in your career, do not compare yourself to others. You mentioned that people told you that you would not be a good RN. I NEVER listen to Negative people. Although I am a student nurse, I am an older and experienced person, so trust me - BELIEVE everthing that was said in the posts preceding me. Again - DON'T GIVE UP - Your experiences are going to make you a GREAT nurse with much to offer to your patients and co-workers and student nurses like me.
I can completely relate to your story. Please don't give up on nursing. You chose this profession because....I'm sure you had a reason. It couldn't have been the money, b/c I haven't met a nurse yet, that had a limo,and lives like J.Lo....so, I'm guessing it was the people and that you wanted to make a difference. Don't give up on that. Live is hard. New jobs are hard. Nursing can be he!!....but, the rewards make it worth it....I know, I'm sounding like the johnson&johnson commercial, but it's true....for some of us. But you have to really want it. Know that you really won't be satisfied with any other career. I HATED, did I stress that enough, HATED, my first nursing job....it started out good, but declined fast....sound familiar? I didn't realize until recently (2.5 years after the fact) that this is normal....the first part is called the honeymoon phase, everything is great...wonderful...perfect. You're working, saving lives, and they are paying you....couldn't get much better. but then reality sets in...for me it was being left IN CHARGE of 25, yes, 25 rehab patients....I had been off orientation for 1.5 weeks....didn't even have my actual license, was working on a temp. anyway, I have had 1 other moment that I thought, I might consider truck driving, or welding, or ANYTHING but nursing. But after a good cry , I realize that I would not be happy doing anything less than this. Maybe you could try another area...another great thing about this line of work...there are always oppertunities...I wanted peds, but there weren't any openings...everyone told me that I needed 1 year of adult experience, med/surge....I did it for 10 months....hated all 10 months, but now I work at a childrens hospital....LOVE IT... :) :wink2: LOVE IT!!!!!!! just hang in there, change places, situations, change something to make life/work/everything better...but don't ever, never ever, give up on a dream...a career of working with people, making a difference. If you give up on that, what else is there? I know there is no way I could work another job. ever. don't settle for anything less than what you deserve. You deserve to be happy, enjoy your job.....so find one that you enjoy....find one that you love...smile, cuz life's too short not to....... :)
Where is your preceptor? Where is your manager? It sounds like you have been tossed into your assignments alone and without assigned supervision.
You might feel better and do better with a more formal, more supervised, internship-like transition from student to independent practitioner. Look for a more structured program for new grads. Talk to your manager and see if your hospital has such a program. Look at other hospitals in your area.
But stop torturing yourself and cheating your patients. This road will lead you to despair. Don't deny yourself a good shot at a wonderfully satisfying profession. You've put in the study, now find the best transition to patient care for you. Don't delay.
Being a new nurse can really suck sometimes. You are so overwhelmed, but I guarantee you this, through all your frustrations you are already learning new things. If you do something and then kick yourself because maybe you could have saved time doing it in a more timely manner, you've learned something.
I remember having problems answering simple questions from patients and the RN charge nurse going in to talk to them for me. At least you have a good support system, because the nurse I worked with would talk about me like a dog. I felt exactly like you did. Totally stressed. But my resolve to be a nurse outweighed all the negative feelings and emotions and I was like a sponge, soaking up information every day.
If you stick it with it, one day everything will just sort of 'click'. Sure, you'll still be learning new things all the time and be dealing with new situations, etc., but you will have the confidence to deal with it based on what you are going through now.
Be patient--Rome wasn't built in a day. Careers are not made overnight. Take one day at a time and before you know it, six months will have passed, then twelve, etc, etc............:) Would be interesting to hear from you then and see how it's going!!
I graduated May 2003 and started on a unit in July 2003 -- passed my boards and just didn't fit in with the unit. I stayed 6.5 months with unsupportive, backstabbing coworkers who couldn't care less that I was new, scared, and stressed. I worked as a tech for a long time before my RN at the same hospital, so I thought it would be an easy transition...was I wrong!
You have supportive co-workers. Use them. They are your best resource and you will learn from them. Every day, for the rest of your career, you will learn something.
I transferred to an ED at a different hospital after my first six horrendous months as an RN. The ED is the only place I want to work. I still get stressed, and even after 7 months here, I find myself going to experienced RN's all the time and getting the help I can.
You know what? It's better for my patients. It's better for me. I don't know a whole lot about cardiac drugs and when I have a patient in rapid A-Fib and I'm giving cardizem, I want either a more experienced nurse with me or the resident doc, if I can't get to the attending.
Have I made mistakes? You bet I have. I had to admit that I made a huge med error to the physician with a critically ill patient because I was rushed and didn't read the label correctly.
I've also had astounding successes -- I kept a ruptured AAA alive until the OR came to get her -- she made it thru surgery. I have learned, as Tweety said so eloquently, to be gentle with myself.
Beating up on yourself is doing no one any favors. You will learn, you will be confident, but you must learn to ask for help. And take it. Then you won't feel incompetent, you won't feel like you can't do anything.
Every single nurse on this board, working, has been faced with situations they did not know how to handle. Just work thru your day, ask for help with that weird dressing change or IV stick, and you'll get thru it. You will learn and in time you won't feel so incompetent anymore. Do get help with the things you need; have another nurse walk you thru what you don't know or aren't comfortable with and soon it's all good for you.
you start to come across situations that you have been in before and remember what you are supposed to do, and then one day it will "click".
and when that happens, it is the coolest feeling in the world!
i hope you are listening to your on-line support group. you are soooooo not alone! i was the same was (minus the supportive staff, as most can attest to). i would wake up for work and count down the hours until it was over.
when you find your niche (and it may take a while), you will know it. and when you start to answer the questions your pt. asks you (honestly and correctly) you're not gonna believe you ever felt the way you do now.
and don't think if you cant handle this job, that you can't handle something else. everyone has their thing. some people prefer one or two unstable pts. vs. 10 or 12 med surg pts., others won't go near a vented pt (even if it's their only pt.).
Thankyou to everyone who took time to respond to my post. I really appreciate all of the encouragement and advice. It is unbelievably kind of you all. Thankyou for sharing your stories with me, it makes me feel less alone. Your replies have been very encouraging. Thankyou :) After two days off work, and reading through all the advice, i now feel ready to go back to work tomorrow morning and make the most of it.
I will add my perspective to your problem. I will echo what others have said....give yourself a little break! We all have moments of feeling inadequate. After all, we have a very important job, and life and death can be an issue, but it usually is not. I have been a nurse 31 years. I have taught college classes, worked ICU/ER, dialysis, PACU and home health. I have taught ACLS, CPR, been a preceptor, charge nurse, house supervisor, infection control nurse, risk manager and travel nurse. I have worked at community hospitals, and regional medical centers. I have worked with the doctor who literally wrote the book on "the heart". (J. Willis Hurst). I have delivered babies in the parking lot, been involved with hundreds of codes, evacuated patients during a hospital fire, ridden on ambulances before there were EMT's or paramedics. I have helped ease the pain of childbirth and ease the pain of death, and you know what? With all the things I have done and seen, there are times I feel overwhelmed, inadequate and afraid that if people really knew me, they would realize just how scared I really was.
I recently started a travel assignment in the busiest ER I have ever been in, and was just feeling totally inadequate and stupid. I was keepig up but left feeling completely drained at the end of the shift. My husband put it all in perspective for me. He said, " how many patients do you have in one shift that, if you never did a thing for them, they would die?" I had to admit, very few, but it helped me think through things. I have always been somewhat of an "over achiever", but I had to realize that, I do NOT have to have everything done for the patient before the doctor ever sees them. I do not have to have the chart in perfect order every minute of the day, just when I finish it and turn it in. I do not have to stop doing one task, just to jump when a family member asks for a blanket. I must continually prioritize, complete one project and move on to another, then another. That does not mean I am not still busy, but it helped change my thinking. So, don't look outside yourself for your accolades. Look inside. Don't be so critical of yourself, and do what you can in the time you have. That is why we have different shifts.
Read nursing magazines, but don't try to learn everything all at once. Many things come with time and experience. Seeing something one time has a much greater impact than reading it a dozen times. Seek out new experiences, but don't be afraid to ask questions. Ask your co workers, your resource staff or the doctors. Don't be afraid to call the pharmacy if you have a med question, call x-ray if you aren't sure about a prep, call the lab if you can't remember what color tube that drug level goes in. Call respiratory therapy if you have a question about a nebulizer treatment. Call anyone you need to to get the answers you don't have. I believe Albert Einstein was quoted as saying, "Don't memorize anything you can look up.". You can't know it all and you can't do it all, but you can still make a difference. Hang in there. You sound like you are doing just fine.
Maybe nursing isn't for you Skye. Do you have other interests? Other options? Don't get locked into something that you hate for the rest of your life. I was glad to go into Anesthesia or I probably would have left the profession a long time ago. Give it a little time but if the passion ain't there don't try to make nursing something that it simply may not be for you.
I can completely relate to your story. Please don't give up on nursing. You chose this profession because....I'm sure you had a reason. It couldn't have been the money, b/c I haven't met a nurse yet, that had a limo,and lives like J.Lo....so, I'm guessing it was the people and that you wanted to make a difference. Don't give up on that. Live is hard. New jobs are hard. Nursing can be he!!....but, the rewards make it worth it....I know, I'm sounding like the johnson&johnson commercial, but it's true....for some of us. But you have to really want it. Know that you really won't be satisfied with any other career. I HATED, did I stress that enough, HATED, my first nursing job....it started out good, but declined fast....sound familiar? I didn't realize until recently (2.5 years after the fact) that this is normal....the first part is called the honeymoon phase, everything is great...wonderful...perfect. You're working, saving lives, and they are paying you....couldn't get much better. but then reality sets in...for me it was being left IN CHARGE of 25, yes, 25 rehab patients....I had been off orientation for 1.5 weeks....didn't even have my actual license, was working on a temp. anyway, I have had 1 other moment that I thought, I might consider truck driving, or welding, or ANYTHING but nursing. But after a good cry 
:wink2: LOVE IT!!!!!!! just hang in there, change places, situations, change something to make life/work/everything better...but don't ever, never ever, give up on a dream...a career of working with people, making a difference. If you give up on that, what else is there? I know there is no way I could work another job. ever. don't settle for anything less than what you deserve. You deserve to be happy, enjoy your job.....so find one that you enjoy....find one that you love...smile, cuz life's too short not to....... :)
jnette, ASN, EMT-I
4,388 Posts
wow. bravo !!! :balloons: excellent post, angie !
well, you said it all, so now i have nothing left to add... except one thing:
skye... you're normal.
(((((((huge hugs))))))))