New graduate: I don't feel competent enough :(

[tmjwe3]

Hello everyone,

I just graduated this year and started my very first job last month. The job offered me 8 orientation days and I requested 2 more where I was assigned my own clients because there was a lack of nurses. Now I am on the floor and I feel fearful going into work. I am trying my best to time manage but I can't help but feel incompetent or lack the proper time management skills.

My floor is a med-surg floor consisted of primarily elderly patients. All these patients are pretty much total care and incontinent. We lack staff so its difficult to find people to call upon. There are no CNAs or extra help. I must wash all of the clients in the morning and set up trays for breakfast, lunch, dinner, feed, give medications, transcribe my medications, check my orders, clean all of my clients, get them out of bed and put them back in, run to the lab, take my pts down to xray/US. Half of the charting is paper, half is computer. I gets so overwhelming and it scares me. It is a 5-1 ratio in the morning and 7-1 at night.

The nurses of the floor look at me like they're annoyed. For ex. I accidentally took my break late because I got caught up changing my clients bed due to soiling his sheets and the nurse came and told me I can't do that and that next time I won't get a break. I got really upset. Also during TOA I was all over the place during my first couple of shifts and the nurse walked away and was like "omg are you kidding me". Or I took a IV bag into the room and the nurse is like " you need to look into the room first, theres already another one there. Do you even look before you go in?". Or I asked help for a boost and the nurse says " ok you need to start putting them in trendelenburg and get them to push themselves up. It'll save you time and us". Or " ok what you'r'e doing is wrong, I would do this. But do what you want to do".

Now when i go into work i get anxiety. I understand how the body works but its all the technicalities and other tasks that are not giving me enough time to actually assess what is going on and utilize my nursing knowledge. I don't' know how to prioritize enough to feel competent and accomplished. By the end my body aches, I don't sit, I'm running everywhere and its not enough. When I leave work I do not feel accomplished at all.

[RegularNurse]

You are new and this is part of the transition. You sound competent to me. You aren't going to hurt anyone, so stop worrying about that.

Look for a different job because the facility you work for is overworking nurses and you will get burnt out. A single employee cannot change a company's broken culture.

[Purple_roses]

I would look for another job. Reading through your post actually made me angry. You're doing the job of at least three people right now.

[pmabraham, BSN, RN]

Ditto on the previous posters. Add 8 days of orientation isn't enough for a new grad. RN's where I work typically get 6 to 8 weeks of orientation (not including one week of system orientation). In terms of your feelings, they are very normal; even after my several weeks of orientation (I started 2/6 of this year), I still don't feel competent and I'm still learning how to manage my time. Like the others, I recommend looking for a different job.

[cleback]

Your coworkers sound like real peaches.

Telling you to boost on your own? If you keep doing that, you will end up with a back injury.

Sounds like a pretty bad work environment, honestly.

[DarkDiva]

8 days sounds more like SNF orientation, not a medsurg floor; to be fair 8 days isn't enough for a new grad in most bedside nursing. I agree with the others, you need to start looking around for another job. But be picky, you don't want to end up in the same situation you are now. Also, you get guaranteed breaks?!

[Here.I.Stand, BSN, RN]

That is ridiculous. Yes you do get a break, no you shouldn't boost by yourself. Plus, 8 shifts is completely inadequate for a new grad in med surg!! I got five shifts in SNF, was an experienced RN, and still had lots of questions.

[jen.lu]

I agree on all previous posts, 8 days is not a sufficient amount of time for a new-grad nurse in any setting to feel at all competent and it is most likely management's way to fix staffing issues by taking you off orientation. Of course, I agree with trying to find a better position elsewhere; however, I also understand if that isn't a practical answer as a new grad nurse.

What I recommend is: 1) have a de-brief with yourself after your shifts. Find out what went well, and what went wrong, and how can you improve on that the next day. 2) Befriend a fellow nurse, maybe the next newest nurse on the floor. They've been there, done that, and they have obviously gotten through it so maybe they can give you some pointers. 3) Reflect why you went into nursing, and the exhaustion will get better. Some days when I'm burnt out and tired after a terrible day at work, I try to tell myself the reasons why I got into nursing and that not all days will be this way-- that this one bad day does not define who you are as a nurse, or a person.

Good luck love, you'll get through this. !