New Graduate Blues

Green Tea, RN · Aug 12, 2017

It sounds paradoxical, but I find not aiming to be a better (or good) nurse is beneficial to deal with the stress caused by working as a nurse. I'm not saying to steal narcotics or to put patient in danger.

After all, the ideal nursing role taught at nursing schools is non existent in the real setting. In the real world, working as a nurse is like being on a sinking boat. Patients/family members can be drug seeker/needy/abusive, nurses may have to work with lazy nurse aids, upper management may care only about money... The list goes on and on. What I have learned from actual bedside nursing is the importance of knowing and accepting the limitations. Like, even if giving a certain care looks beneficial (or evidence based practice) to nurses eyes, the patient may not seeking such a care from the beginning.

Redhead,RN, BSN · Aug 13, 2017

I agree with Green Tea. The nursing role is glorified in school and on tv, but bedside nursing really does suck most of the time. It's very hard and you will always be underappreciated. With that being said, you can find the little moments in it that give you joy and purpose, and stay in it for that, or you can leave the bedside because you realize it's not worth it. It's a personal choice and choosing not to work bedside is ok! I got out for my own sanity and have never looked back. I work case management and I love my patients and going to work every day. But it took me 10 years of misery to get here. Sad that I let myself suffer so long...life really is short.

Ruby Vee, BSN · Aug 13, 2017

It sounds paradoxical, but I find not aiming to be a better (or good) nurse is beneficial to deal with the stress caused by working as a nurse. I'm not saying to steal narcotics or to put patient in danger.
After all, the ideal nursing role taught at nursing schools is non existent in the real setting. In the real world, working as a nurse is like being on a sinking boat. Patients/family members can be drug seeker/needy/abusive, nurses may have to work with lazy nurse aids, upper management may care only about money... The list goes on and on. What I have learned from actual bedside nursing is the importance of knowing and accepting the limitations. Like, even if giving a certain care looks beneficial (or evidence based practice) to nurses eyes, the patient may not seeking such a care from the beginning.

Why does everyone think they are (or have to be) "an awesome nurse." Even folks who are writing in to the forum telling us they've made multiple med errors and cannot get along with their co-workers will also tell us that they're "awesome nurses," their patients get "great care" and that they know in their hearts the problems they're having are all someone else's fault. If everyone is "an awesome nurse," then there's no such thing because EVERY nurse is superlative. That's just nuts.

No one can be an "awesome nurse" until they're at least competent, and it takes about two years to become competent. The first year of working as a nurse is miserable for most of us. You find out very quickly that what you were taught in nursing school has very little relationship to how things actually are. The work is hard, the responsibility is crushing and one's colleagues are one's colleagues, not one's family. Most of us cried on the way to work or cried all the way home or cried in the bathroom AT work -- or all of the above. We felt incompetent (which we WERE), stupid, disorganized and sloppy in our thinking and in our "skills." We were that, too. We were also too overwhelmed with our new jobs to get out of bed on our days off some of those days, we were exhausted all the time and we SURE we had chosen the wrong career. (Some of us did, but not most of us.)

Aim for being an average nurse -- that's aiming pretty high for a new grad. Don't beat yourself up because you're not superlative. Superlatively good is unattainable for a new grad and superlatively BAD is undesirable.

Redhead,RN, BSN · Aug 15, 2017

Aim for being an average nurse -- that's aiming pretty high for a new grad. Don't beat yourself up because you're not superlative. Superlatively good is unattainable for a new grad and superlatively BAD is undesirable.

I don't agree at all. Do you want to be cared for by an "average" nurse? Or your child, relative? Nope. We all want the best. If you can't aim at being the best, and work hard to get there, you shouldn't be caring for patients...no room for average.

Ruby Vee, BSN · Aug 15, 2017

Aim for being an average nurse -- that's aiming pretty high for a new grad. Don't beat yourself up because you're not superlative. Superlatively good is unattainable for a new grad and superlatively BAD is undesirable.

I don't agree at all. Do you want to be cared for by an "average" nurse? Or your child, relative? Nope. We all want the best. If you can't aim at being the best, and work hard to get there, you shouldn't be caring for patients...no room for average.

I'd rather be cared for by an average nurse than the worst. Or by someone who is so convinced that they are the best, there is no room for admission that they might make (or might have made) a mistake. Aiming for "the best" puts undue and unreasonable pressure on new nurses. We cannot all be the best -- law of averages states that some are better than others -- and it's unrealistic to expect that someone who hasn't been a nurse for more than two years will be the best. It takes two years to just become competent. Aim for that as a new grad. Once they're competent, they can aim for being the best nurse that they can be. And that might not be the best nurse ever . . . law of averages in effect again.

chacha82, ADN, BSN · Aug 15, 2017

Welcome! So happy to have you. Focus on being a strong new grad, which is a completely different animal than being an awesome nurse. A strong new grad:

1) Does not call out frequently

2) Seeks out opportunities to practice skills and get checked off on competencies on the unit (Your preceptor should be checking, but also check your paperwork yourself. If you are in need of a skill, let your preceptor know during your orientation talks).

3) Is flexible and courteous. If someone snips at you, try not to take it personally and keep it moving. It doesn't mean they don't like you, or they are "eating their young." Nursing makes all of us frazzled and even the most polite people can get overwhelmed.

4. If you're feeling caught up with your work, ask someone else how you can help.

5. Pitch in to turn patients or assist with an admission. This is especially appreciated in the ICU, where I am sure you have seen that people often work together on patients.

6. Look ahead in your work. If you have a 1900 med, this should be given before you go off shift. Check to make sure your meds are given and scanned so the oncoming nurse is not wondering if something was given or not.

7. Go through your report sheets and focus on giving a concise, complete report. I don't like rambling, all - over the place reports and don't know anyone who does.

8. A strong new grad will strive to not leave large tasks undone for the next shift. There is even less reason for this if you are working with a preceptor - they should help you identify what the priorities are. So, the chest tube canister should be changed, the dressing should be changed, new tube feeds hung, etc.

9. If you work overnight and do pre-procedure check offs, make sure these are done. Stressful coming on and having several patients going for procedure, only to realize the night nurse didn't do the check-offs.

allnurses Guide · Aug 25, 2017

I would add to focus at first on time management. The critical thinking will come. Get the routine stuff down pat first.