New nurse, constant misery

[thatnursedude]

Hi guys! Sorry to post another topic about an unhappy newly graduated nurse, but I just wanted other people's opinions.

Before I graduated, I took a job at a hospital about 50 miles from my home town, on an orthopedic and trauma floor. Having an interest in ortho already, I was excited, and I was excited to move and be on my own. I was told that my schedule was going to be 3 weeks of day shift then 3 weeks on night shift, and constantly flipping back and forth.

Once I passed my boards I moved away from my family to be closer to work. Once my floor orientation started my manager told me it would not be the minimum 8 weeks planned, but shorter since the unit was so short staffed. My orientation ended up being on 5 weeks. All my friends from school had a minimum of 16 weeks orientation or more depending on their unit. Obviously I don't think 5 weeks is enough orientation for any nurse who just graduated school, and I voiced my concerns to my manager but she didn't care since she needed me as a number on the floor. So after my 5 weeks of orientation I was thrown on my own to manage 6 patients (the usual load for nurses on the unit). The unit itself is very outdated, and looks like the last time it was very updated was in the 80's. The pumps, and computers and various other technologies on the unit are also outdated (one nurse told me that the hospital hasn't gotten new pumps since they started working there in the early 90s). After flipping between nights and days, I have determined that I LOVE working nights. The nurses there are more helpful, answer questions (I'm always asking questions since I am new, and had a short orientation) without judgment, nicer, and I enjoy their overall company and feel like a 'family'.

I'll break off here to talk about the average patient on the unit. We usually get gun shot wounds, car crashes, falls, crush injuries, etc. I would say that 8/10 of our patients can not move so the nurses and aides are very busy with constant total care. Since the hospital is a big hospital, the acuity of the patients is equivalent to what some ICU in smaller hospitals would see. The nurses (especially on day shift) work closely with social work since patients have a trauma.

Recently my manager told me that I would not be working any night shifts and would be all days during the summer since that is the "trauma season" and I was needed on days more. I was very upset with this since I love being on nights, and day shifts are so overwhelming to me. I did apply for a full time night position on the unit, and was the only one to do so, so I thought I would get the job but my manager has not gotten back with me. My manager has also been controlling my schedule instead of allowing me to self schedule, and she never gives me more than 2 days off in a row. I've had to work weekends that are not my assigned weekend, and I just think I'm taking too much responsibility for a new nurse.

I feel like since I always take on 6 patients that are such a heavy workload, and the usual 'drug seeking' that patients can do, I've become hardened. I got into nursing to be a positive influence for my patients, and make a difference, but now all I care about is getting everything done in a timely manner. The few times I've gone home my family has even voiced concerns. They say how tired and sad I always look, and I find myself snapping at them over the littlest things.

I dread going into work everyday, especially when I am on day shift. I cry after every shift on the car ride home, and there have been times I've cried at work. One time I had a panic attack at work because PACU sent me patient that needed to be in the ICU but had no open rooms, and I didn't have the skills to do all that was needed for them (luckily some other nurses helped out a lot). I can't really sleep before work because I keep thinking how miserable the next shift is going to be.

I'm also having a rough time because I don't have a support system down here. My family and friends from school are 50 miles away, and I never thought I'd miss them all this much (since this is my first time on my own). I'm not making 'out of work' connections with my coworkers, and never have the energy to go out and do anything on my own for fun.

I know that the first year of nurse is hard, and all new nurses hate it, but is it normal to hate everything this much? Sorry to rant and vent so much, I'd just love to hear everyone's opinions.

Thanks so much!

[Ruby Vee, BSN]

Honestly, this just sounds like what we used to call "reality shock." The first year of nursing is miserable, and it is common to hate your job, hate your life, hate your patients, hate your schedule . . .

You had five weeks of orientation which is a good bit more than many nurses. It wasn't enough for you so you spoke up, and your manager told you she needed you in the numbers. Evidently your manager and preceptor thought you were doing well enough to be on your own. The first time you're off orientation and have your own patients is a terrifying experience, even if you were SURE you were ready to fly on your own. Not to make light of it, but suck it up and do it. The only way to get competent and confident is to be challenged. It generally takes about a year until something "clicks" and you realize that you're feeling confident more than you're NOT feeling confident. And about two years to be truly competent. Don't make any moves to different jobs until you are both confident AND competent.

Your manager may want you on days more so that you get more support from senior staff, so you're exposed to teaching rounds, so that you get more interaction with the MDs and can ask them questions about why they prefer to do things this way rather than that way, or because she has determined that the skill mix on nights is unbalanced and someone more senior needs to be there instead of you. Many managers won't put a new grad on permanent nights until they've determined that the new grad is able to function independently and is growing in skill set.

Crying before work, after work, and at work is a first year of nursing thing -- it's common. Things get so much better when you've had a little experience, grown into your job and feel a bit more comfortable. To get through this miserable part, you have to GO through it. Good luck.

[JKL33]

A lot of truth in the PP's reply - think about the specific factors discussed above and see what you can apply. Specifically the parts about how your feelings are not unusual and will likely improve with time, and how you really don't get to choose your shift and there may be very valid reasons why you are being placed on the day shift for now. You may actually find that things improve for you personally without having to flip back and forth for the summer!!

That said,

Once my floor orientation started my manager told me it would not be the minimum 8 weeks planned, but shorter since the unit was so short staffed.

This should simply never be a reason to end an orientation. This place had their own established standard time-frame for orienting a new nurse and they cut it short by nearly 1/3 due to poor staffing. Unacceptable. This is why new grads leave first jobs, and rightfully so. It would be one thing if she'd been able to truthfully say, "Nursedude, you are doing very well and your coworkers and I are impressed with how you have come up to speed. How would you feel about coming off orientation?" Instead, she essentially said that, although she knowingly took on a new grad, she does not intend to honor previous statements about the orientation period, and does not intend to concern herself with the kind of needs that are specific to new grads.

thatnursedude, I'm sorry you are faced with this. It is certainly not the best this profession can offer - but what will you choose to do about it? Continue to strive for excellence, both in skills and attitude. If it were me I'd probably see what the summer brings. It is indeed trauma season, so look forward to the knowledge you will gain. Show your day-shift co-workers that you are serious about working hard and serious about continuing to learn. Put your very best foot forward with them in all interactions. Get rest and find regular time for personal relaxation and enjoyment, knowing that if you work hard with a good attitude, it's likely that "this too shall pass". Re-evaluate at the end of summer. Chin up, you can do it.

Come back and let us know how it's going

Blessings ~