New grad

[Alexisrachelle]

Hi all! I could really use some advice. I am a new grad nurse and have been off orientation for about 6 weeks. I work days and I'm getting 6+ patients at least once a week. I'm really struggling to do all of my tasks and I leave work defeated and feeling like I really shouldn't be a nurse anymore. My unit is an ortho/ Neuro with medical overflow. Am I just a bad nurse or is this too much for a new grad? With 5 patients 90% of the time I can get all of my tasks done and I'm able to care for my patients the way I'd like. But when I'm given more I feel like I'm drowning. I know being a new grad is hard but I just feel deep down it shouldn't be this bad. I've told coworkers and my supervisor I'm struggling and they all respond with yeah it's hard to be a new grad. When we get 6+ patients it seems like we are all in the weeds. Most of my cnas are wonderful but I always seem to get stuck with the ones that hate me and the job so I have no help. I just don't know if it's me or the patient load. 

[barcode120x, RN, NP]

It's going to be a mixture of you (being a new nurse) as well as the patient load. I'm going to assume that you are working in a state with non-mandated RN-to-patient ratios. Unfortunately, this is part of nursing. None of us ever want that one (or two, three, etc) extra patient(s) but it is what it is. Being a new grad is definitely the hardest part to get through because you're still trying to figure out how to micromanage your patients, tasks, and your time. Maybe some of these tips can help you:

Cluster your care: Try to do everything you have to do for one patient all in one or two stops to the room. For example, let's say you are about to start your first rounds and it's 8am-9am. Get those meds (assuming it's allowed by your facility and your training), grab a cup of water, bring your stethoscope, throw some flushes and alcohol swabs in your pocket, grab the blood sugar machine, bring IV date stickers and IV tubing (if it needs to be changed). The less time you have to keep going in and out of rooms, the more time that can be spent doing another task, seeing another patient, or even charting. Also, the less time you can spend in a patient's room unnecessarily, the more time that time can be spent elsewhere.

Triage your patients and tasks: Assess to see what patients or tasks can be done quickly while the others can wait. I generally built the habit of taking care of the "quickest" patient first before moving to the next. But also know that if you have a patient(s) that requires a lot of work, maybe that one needs to be taken care of first before seeing the rest of your patients. 

Ask for help: Don't be afraid to ask for help! Your coworkers and unit should know that you are new so don't be shy. Unfortunately, every nursing unit has it's own culture, good or bad. Hopefully yours is good enough where help is offered, and if it is, take the offer. Of course you don't want to be asking for help for every single thing, but do ask for help if you are really drowning and/or a delay in care of the patient requires that additional help right away from another nurse. 

Remember, charting can always be done at the end of the shift. No one wants to be stuck at work after they clock out or rack up overtime due to charting. It's frowned upon, yes, but a delay in patient care because you are trying to catch up on charting can be worse. Hope these tips help.