New Grad - Surg floor blues - needs encouragement

[workingmom76]

I have had a terrible orientation to my surgical floor and feel like it has affected my self confidence.

I had a coach who was having personal struggles and so I was only with her for a week and then obtained a new coach who I believe hated me from the get-go. She humiliated me over mistakes I made by talking to me at the nurse's station about them in front of everyone. She talked with fellow nurses about my mistakes and at times I truly believe she did not want me to succeed. She in fact, had only been a nurse for a year and had graduated in the class before me.

I have struggled with making too many mistakes. My floor manager and assistant manager are very concerned. I feel like my confidence was fragile to begin with and then my coach made sure there was nothing left of it. I have been doing the bery best that I can at work but it seems I continue to make mistakes.

At one point my coach laid into me in the privacy of our conference room while I was finishing some orientation paperwork. I ended up in tears and I'm sure because of how my coach gossips...it got back to management. We were both pulled into the floor managers office and I was told at the time by my manager that she thought I was super anxious because of how I was being treated and it was contributing to my mistakes. My coach just bawled and said she was having personal issues. My manager decided we would both have to work it out. I continued to be oriented by her but things were never the same. I always felt tense and on heightened alert and scared to death to make any mistakes. I felt she had already destroyed my reputation by talking negatively about me to other nurses. I am on my own now and nevertheless, I continue to make mistakes. I can honestly say I am doing my absolute best.

I am having to take antidepressants again....I had stopped them several months ago. I am starting to have panic attacks - and I've never had these in my life before. There are so many details I am leaving out here to avoid writing a novel, but the bottom line is I have no confidence and I feel like my future on this floor has been severely damaged.

On top of that...I am struggling at home in my marriage, financially (my husband lost his job last year) and with major depression. Recently a mistake was made where radiology left equipment underneath a surgical patient. The patient arrived to our floor and it was not discovered by day shift. It was finally discovered late in my night shift. We failed this patient. Nonetheless...on top of my many mistakes already made, this one tipped the scale. I had failed to make sure my CNA and myself had been turning this patient Q2. This is obviously a huge ordeal on our floor. I feel horrible. I know that on this particular night I felt severly overwhelmed. I can not stop feeling horrible and my confidence has been stripped to nothing. I realize we all are going to make mistakes but I can't seem to get through a day where I leave work feeling good. I leave in dread wondering if the next shift will report more that I did wrong. I know that I try to cover my bases and re check my work. I wish I had someone I could trust on this floor but I don't feel like I can trust anyone. How can I get back on track? I obviously have issues with attention to detail and organization. Can anyone help?

I recently went to HR and talked with someone who directed me back to my floor manager. She was very helpful and said she would give the manager a heads up and lay some groundwork for my discussion with her. I'm dreading this conversation but I need to figure out some solutions here. Any advice on this?

[SnowShoeRN]

I'm so sorry. A lot of that sounds painfully familiar to me. It's SO hard to get started. And the old maxim of "nurses eat their young" is sometimes still so evident in some hospitals. I actually quit my 2nd job out of nursing school because the women I worked with were so gossipy and catty. It got to the point where the cliques interfered with patient care. It was disgusting. It's called lateral violence and it doesn't get the attention it deserves. Is there anyway you can talk to any of them. It's terribly daunting to address someone who has hurt you, but sometimes it's worth it.

I know you're having trouble right now in terms of your confidence, but did you feel confident in your abilities before all this happened? Sometimes, for me, it helps me to find a quiet place and just think about everything I'm doing RIGHT. Try to remember that unless you're in a code or someone really is about to crash you can generally take some extra time to triple check your meds, think things through another time, and just generally go a little slower to MAKE SURE you're where you want to be in terms of your practice before you do something. I remember that when I started as a new-grad there was a woman on our floor who just didn't hear you when she was pulling meds or reviewing a tricky order. She'd smile and calmly say "I'm tuning you out." No idea how she did it, but I always admired it. Staying a little late is sort of inevitable your first year out of school. But if it means that you grow confidence and patient safety increases, so be it.

Sometimes too, one's anxiety can make other people anxious. Obviously don't lie about your abilities or put patients at risk, but trying to remember that "Hey! You passed your boards! You're a nurse! You know this!" can help bolster your spirits. As long as someone's safety isn't at stake, "faking it til you make it" can help your confidence. Maybe try to get involved in committees or educational programs. When I've made mistakes I've tried to show that I really DO want to learn from them and subsequently immersed myself in risk-reduction programs at the hospital. Stuff like that. It shows your manager that you're owning up to what you did do wrong and that you have a real commitment to improving.

Can you see a therapist? Does your hospital have some kind of employee assistance program?

I hope things get better for you soon. Try to remember it's just a job and that if things get really really bad, you can always try to transfer or go to a different facility in a year's (or less) time. Best of luck to you.

[workingmom76]

Thank you so much for your advice. I agree that staying late may just have to be what happens if it means patient safety. I also agree about my anxiety making other people anxious or even perhaps making myself a target. I am doing my best to keep this to myself and use self calming or soothing techniques or just fake it if I have to.

We do have an employee assistance program with counseling and I intend to make an appointment. I have started on anti-depressant medication and hopefully will feel the effects in a few weeks. I'm also going to be going back to the day shift here in a few weeks and I'm thinking the sleep pattern will help my moods also.

It always helps to have a nurse who has been through it and who has more experience tell you that you can get through it. If only there were more kind nurses out there who supported new nurses, it would be so different. Thank you for your thoughtful reply. :)

[SnowShoeRN]

Aww. :) You're welcome. Hang in there and keep us posted.

[tencat]

Rough start for you and I'm so sorry! But look at the bigger picture: the facility sounds like it has FAR bigger issues that have nothing to do with you. Leaving radiology equipment under a patient for TWO shifts??? That was NOT totally your mistake, in fact YOU are the one who corrected it. It took SEVERAL folks to make that mistake, so don't let them tell you it's all on you. And giving you a preceptor who only has a year of experience???? So not helpful to anyone, especially if she is having her own issues and is not really a good fit to be a preceptor. A year's worth of experience is not enough for most people to be fully competent in their jobs, much less trying to teach someone else about it. If at all possible, I would be looking for a MUCH better place to work. Cover yourself, because you will be the one they will try to blame for anything that happens on the floor.

You graduated from nursing school, which is NOT easy. You passed the NCLEX, which is NOT easy. You have it in you to be a good nurse. You need a lot more support than you are getting right now, and you deserve a far better environment to work in. You have to try to build back your confidence and learn from your mistakes. We all make mistakes.

One thing that helped me organize was prioritizing. For example, let's say patients need 2000 scheduled meds, one patient has a dressing change due, another needs a PRN pain med. My priority would be to get the med pass done, give the PRN med during this time, then deal with the dressing change. And you have to realize that you are NOT going to make everyone happy. And that's okeedokee.