New grad sinking fast

Nurses New Nurse

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Hi,

im a new grad nurse and am in terrible need in of some advice. Please any advice is welcome!

I just started orienting on my floor 2 nights ago. & I have to say I am already bombing it. My first night was ok but the second night I was orienting on a PCU & that's where things went bad.

To get to the down and dirty I was an absolute mess. I slowed my preceptor down considerably. Like to the point that I think she may be missing some things because of me. I charted on one patient and managed to miss key components on that. & it's not from not knowing about the pt. It's mostly because idk how to work the darn charting system. In clinicals they had Cerner system which was SUPER easy to use. This hospital uses meditech & I'm struggling tryna figure where everything is.

On top of that, I feel like my hand has to be pretty much held. I don't think I'm making the transition from nursing student well. I've made med calculation errors ( I always review with my preceptor tho), messed up on looking up what meds should be given at a certain time, but the point is I miss key things. I can't look thru 6 pt orders on a chart that I barely know as fast as I should yet. Therefore since i don't have time to look thru everything, I barely know what's going on.

I just feel like I'm too slow of a learner & perhaps acute care isn't for me. I mean I couldn't even put the yankauer to the suction on correctly, I'm struggling with how to use the pumps, how to run the meds, how to set up tube feedings. just all the simple stuff a nurse should know. Today my preceptor told me I wouldn't be getting not even ONE pt to myself. Mind you its my first week but I can't even progress to one pt. Most ppl at least make it to 3. I wouldn't be surprised if they fired me in this week.

my preceptor is pretty nice. But you know how gossip is, especially in a hospital. & I feel like I'm just following her everywhere & ppl are looking at me like "why are you following her every footstep".

even the patients can tell I'm new, which is bad. Has anyone else been in this situation? Should I request to go to a slower unit ( this floor is known to be the hardest floor in the hospital), or should I just try to work somewhere else entirely? I want to be good at this and work in a hospital! but I really starting to understand if ain't meant for ya , it ain't meant for ya.

You are struggling because your nerves are getting the best of you (been there). It's a process, you will get there.

Print out your post and tuck it away. Read it again in 6 months, I bet you will be amazed at how far you have come (you will most likely get a good chuckle as well). Hang in there!

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Specializes in Urgent Care, Oncology.

Did you receive any orientation on the equipment? During my new grad residency during the week of computer training we also had half days where we went over the hospital-specific equipment. We were also shown the policy and procedure for that hospital. I was glad they did that because I did not end up working at the hospital where I did my preceptorship during nursing school because it was over an hour away. Both hospitals had different equipment, different charting (like you stated), and different policies and procedures. If you haven't had this, I'd suggest asking about this. Also get in contact with your unit's nurse educator as he/she will be a great resource.

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Specializes in LTC, Rehab.

"Has anyone else been in this situation?". Yeah. Probably the majority of us.

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Specializes in Med surge/ tele.

Thanks for the advice and support! I just felt down because all my other classmates and friends were handling at least one pt by themselves within 3 days of orientation while I'm not even doing that... it just hurts because I want to do this and be good at it. There's even an objective for orientee's stating that we should be able to handle one pt load at the end of 1 week. & i don't want the pt to suffer because they can't have their primary nurse's full attention. & I guess to clarify on my statement about "is anyone in this situation?"

i ask because I often feel like I have to be shown how to work the pumps and some things more than once. & that's why I'm worried about my pace being to slow.

& we did go over the pump and charting system in orientation but i couldn't remember everything.

I just also felt like there's a lot I haven't even seen & wondering did everyone else get to do these things in clinicals. In my clinical experience I did a tube feeding change probably once. So I couldn't exactly remember how the machines worked. & I'm just scared after reading some posts that once they see I'm struggling they will have this preconceived notion about me. & already count me out. Like I said my preceptor is fine but I know she's been talking bout me because I have her so behind. That's why I'm questioning this.

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Specializes in Med surge/ tele.

Thanks so much for your response. I do feel somewhat better. I'm just afraid I'm going to be the one fire after or before orientation is over because I'm doing so bad. We have an orientee objective where they expect us to be able to handle one pt load in a week and I'm just really worried because within my first week I haven't even progressed to handling one pt load. So by week two I will basically still be working on trying to handle one pt load. And thank you for the advice about having a check list. That will help to organize me. I think I need to work on talking with my preceptor more as well. The pace is fast & I am not as quick so I like to have a minute to get situated. Which to my preceptor's credit she did do but I just take to long. I think maybe I should just suggest focusing on one person. At times I feel like I am trying to focus on everyone at once which would be me gettin ahead of myself. & I did improve on charting a little. But as far as imputting the pump settings, and how to work the medicines I feel like I'm not making a fast enough improvement on that due to the fact that I have to be shown how to set the pump multiple times. I even had a another nurse to come in a room and look after our pt because I somehow missed the pt in distress while charting. & when suctioning her I didn't even have the yankuer hooked up correctly to the suction. It's like I get so nervous & do stupid stuff without thinking which is dangerous. That's why I'm wondering is this level of screw ups is normal?

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Specializes in NICU.

Darling ,at least they did not put you in charge!!!

You are new ,that is how new people feel,you will learn,stop listening to those that tell you it is the hardest floor,you can have a miserable day on an "easy floor "too.

The panic will subside and you will find your wings and fly like a butterfly.

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"all my other classmates and friends were handling at least one pt by themselves within 3 days of orientation while I'm not even doing that."

No, not all your classmates . Have you discussed your feelings with any of them?

" it just hurts" Nurses don't get to hurt. Nurses get tough. You can do this.

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Specializes in Med surge/ tele.
You sound just like a new grad. Welcome to being a new grad. You'll mess up. You'll forget things in the charting system. You'll slow your preceptor down. You'll have your hand held. Don't take that personally. You're supposed to. You'll forget how to hang something or what settings to turn the pump to. You'll be unsure of what meds you can give, how to give it, and ask countless questions that any other nurse should know. My preceptor told me "better safe than sorry". Question everything and anything, don't feel stupid. If she had a question and I couldn't answer it (like, what a med we spent two seconds on in school was for or how it would help a particular patient) she went over it with me. I was lucky to have a wonderful preceptor and when she wasn't on those who filled in were equally as great. I hope you do as well. My Educational Outcomes Director was constantly on me asking me how things were going with my preceptor. Now, that wasn't to say there weren't some days where I stepped on my preceptor's toes or made her eye twitch. Of course I did. There's a fair amount of "I want you to develop your own methods and ways of doing things, while at the same time, doing exactly as I show you and tell you". And I understood this. My screw up isn't just my screw up, it's hers too. My first week was pretty much shadowing and learning the system (we have Cerner), that next week I had two of our 4/5 patients. No one ever said to me "wow, you've been here two days, you can't handle your own patient load yet". If I felt like the patient was giving me a strange look all I said was "Hi I am Miss.Leo, I'm new to (facility name) and orienting with (preceptor name) today."

The third week I was doing all the charting and most of the care, as well as (trying to) give report (she'd had way more time to look through the chart and even pin down doctors for questions than I did and would help out), though my Preceptor was over my shoulder the entire way and she still made sure to be right there when I gave meds. Some days were seriously hard. I was expected to hit the ground running and get right to it, sometimes without a full picture of the patient. Some days I went home and my mind was blank because I wasn't even sure what I accomplished that day. It wasn't until Week 5 that she was letting me go my own and then following up afterwards.

By the time she said goodbye to me and passed me onto my night shift preceptor, I could hold down a full patient load, had no issues with charting, was skilled in tracking down doctors to ask questions (it was important to the floor that new grads felt comfortable paging, calling or talking to doctors, especially if they were gonna be night shift), and managed report easily.

It all comes with time. As long as you are improving... you're doing fine. So you're first few shifts or even your first two weeks felt like a disaster. Are you repeating the same mistakes or did you learn from them? If you're struggling, let your preceptor know exactly what you are struggling with. "I'm not too familiar with this charting system, can you double check to make sure I've covered everything". Make a check off list for charting if you need to. Carry a clip board with notes of things you need reminders of. Mine had IV times, pump settings, important extension numbers, charting reminders, whatever I needed.

So, in short... take a breath. You're doing just fine.

Thank you for the advice! I feel somewhat better now. I just felt down because I just feel like this level of screwing up is not normal for a new grad. I feel like I miss a lot of vital things. There was even one point in the night where another nurse had to help with our pt while my preceptor was off the floor. She was in distress & I had somehow missed it while charting. She had been vomiting a lot & needed suctioning to. I couldn't even hook up the yankaur correctly. It wasnt working properly so I had hook it up to the vacuum directly because she needed help right then. Silly mistakes such as these is why I think I should rethink things. I am improving with charting but I have to ask on multiple occasions how to set the pump, run the meds or set up a feeding tube change. & the other new grads don't appear to struggle like I do. They're practically on their own while I'm hand holding

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Specializes in ED, Cardiac-step down, tele, med surg.

I would try to just roll with it and learn as much as you can and ask as many questions as you feel are necessary for you to learn. It doesn't matter how you look, what matters is that you keep your patients safe. Rushing won't help you. You need to know how to do things, why and when and in what order. Your preceptor is there to help develop you into a safe independent RN capable of safe patient care. You won't know how to do everything and there will be lots of things you don't know but you should know how to get the answers you need. Knowing where to find information is also important. Emergency procedures, where important equipment is kept, who to ask if you don't know something, are all important. Keep a notebook and write things down so you aren't asking the same question over and over. Everyone started where you are now and there's no shame in that. The shame would be in not asking for help and pretending you know things that you don't or rushing to get things done and overlooking safety. Good luck and try to remember again that we were all in the boat you're in when we first began.

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Specializes in Critical Care; Cardiac; Professional Development.

I think one of the hardest parts of being a new grad nurse is the giant heaping helping of humility that smacks you in the face. You are a new grad. You know next to nothing. You aren't unusual in this and nobody experienced in nursing would reasonably expect otherwise. Now is when your real education begins.

Try to stop freaking out. This will be hard for the next year to two years. The sooner you wrap your head around that and settle in, the less difficult it will be. Hang in there.

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Specializes in Critical Care; Cardiac; Professional Development.
Thank you for the advice! I feel somewhat better now. I just felt down because I just feel like this level of screwing up is not normal for a new grad. I feel like I miss a lot of vital things. There was even one point in the night where another nurse had to help with our pt while my preceptor was off the floor. She was in distress & I had somehow missed it while charting. She had been vomiting a lot & needed suctioning to. I couldn't even hook up the yankaur correctly. It wasnt working properly so I had hook it up to the vacuum directly because she needed help right then. Silly mistakes such as these is why I think I should rethink things. I am improving with charting but I have to ask on multiple occasions how to set the pump, run the meds or set up a feeding tube change. & the other new grads don't appear to struggle like I do. They're practically on their own while I'm hand holding

Try to realize that a lack of experience and training is not a "mistake". It is a lack of experience and training. To be honest, I think you are a little wound up in not wanting to look stupid. Its okay. We were all there. ALL OF US. Ask questions. Ask for help. Focus on learning time management. There is no way you ever should be alone with an unstable patient that is vomiting and needing suction at this point, so don't question that another nurse stepped in. You aren't qualified to handle that on your own yet. It is okay. You will get there.

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Sister, take a deep breath! We all have gone thru those feelings. Try to give yourself a break. The 'learning' actually starts when we hit the floor. Be honest, and request another Nurse show you the ropes. We as Nurses training other Nurses sometimes forget...realizing you want to make sure you do their machines and procedures correctly, is an admirable trait. Believing you know 'all', will result in a not so good outcome. I would rather someone ask...then do, without understanding. Hang tight!

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