New Nurse Coping Strategies?

**NICU Guy, BSN, RN** · Jun 9, 2019

You are your worst enemy. Your preceptor trusts you to enough to give you freedom, but your anxiety is consuming too much brain power, which is causing you to forget things. You are a new grad and you are expected to not know everything an experienced nurse does.

It is like learning to ride a bicycle. The training wheels are there to prevent you from falling off the bike. The training wheels allow you to concentrate on peddling without the fear of falling. Your preceptor is your training wheels. She is there to guide you and help you from falling. You must be doing something right since she is not hovering over you every minute you are with her. You are probably doing far better than you think you are.

fnlfntsy · Jun 10, 2019

You’re right about being your own worst enemy. My rotation is on 3rd shift this month and I feel like a zombie. I’ve been lying around at home unmotivated with my mind racing about work. School does not prepare you for new nurse transition lol.

JKL33 · Jun 10, 2019

Training wheels would be actually sticking pretty close with this person who is only a month into knowing how to maneuver without harming anyone in an ICU. Being somewhere else is most definitely not training wheels.

I also think it is generous to think that the most common motivation for giving a 1-month-in orientee "freedom" is related to them excelling and being trustworthy (referring to knowledge base, not ethics). We are talking about the one month mark, here. There are a variety of reasons this happens: The preceptor doesn't really like training, they have an assignment that is too large/too many other responsibilities, they think sink or swim works better than it usually does, etc., etc.

This isn't actually "training" anyone. This is letting them fumble their way through, and forcing them, by default, to come to the preceptor over and over and over repeatedly to ask for assistance.

It seems like the common scenario is that both parties actually grow weary of this rather quickly in their own way: The orientee who feels like they have to say, "I'm sorry, I'm going to need your help (againnn)..." 50 times a day immediately feels like this can't possibly be how things are supposed to go and that they should be doing "better" (after 1 month) than to have to constantly hunt someone down to ask for help. Meanwhile the preceptor getting the 50 "interruptions" is also annoyed with the person who seemingly can't do anything without help. [Well, duh!].

I do think the main problem is that no one has an assignment conducive to properly training, supporting, and mentoring a new nurse - - but the answer isn't to scurry around all the more while essentially telling the new person "You go on and work on that (while I, supernurse, do these other 30 things that you're not going to learn today, or tomorrow)." This is exactly how someone ends up with an orientation that is little more than being a set of helping hands right up until people start to get snarky about how someone isn't "progressing."

The first couple/few months are so critical. This is most definitely not the best we can do. [Insert obligatory acknowledgment that every once in a while someone will actually thrive with their "freedom"].

JKL33 · Jun 10, 2019

@fnlfntsywhat kind of feedback are you getting?

This is a major adjustment. If you are getting good/decent vibes from people along with some sort of encouragement or positive feedback, you are probably doing better than what you feel inside. Plus now you're adjusting to a different shift.

Have you had an opportunity to sit down and talk with manager/educator/preceptor about your progress thus far?

fnlfntsy · Jun 24, 2019

I just asked my preceptor where she thought I was with training and she told me I’m doing really good. However, I’ve found that I’m having trouble moving forward and recently hit a wall. I’ve already had several “real” ICU patients which made me realize that the unit is not a good fit for me at this time. Unfortunately, I will be talking with my manager and informing her about my awareness to this matter. I’m hoping she will be able to suggest a more entry level floor that will better fit my needs. I feel like I’ve failed myself and my department.

Forest2 · Jun 24, 2019

On 6/10/2019 at 4:57 PM, JKL33 said:
Training wheels would be actually sticking pretty close with this person who is only a month into knowing how to maneuver without harming anyone in an ICU. Being somewhere else is most definitely not training wheels.
I also think it is generous to think that the most common motivation for giving a 1-month-in orientee "freedom" is related to them excelling and being trustworthy (referring to knowledge base, not ethics). We are talking about the one month mark, here. There are a variety of reasons this happens: The preceptor doesn't really like training, they have an assignment that is too large/too many other responsibilities, they think sink or swim works better than it usually does, etc., etc.
This isn't actually "training" anyone. This is letting them fumble their way through, and forcing them, by default, to come to the preceptor over and over and over repeatedly to ask for assistance.
It seems like the common scenario is that both parties actually grow weary of this rather quickly in their own way: The orientee who feels like they have to say, "I'm sorry, I'm going to need your help (againnn)..." 50 times a day immediately feels like this can't possibly be how things are supposed to go and that they should be doing "better" (after 1 month) than to have to constantly hunt someone down to ask for help. Meanwhile the preceptor getting the 50 "interruptions" is also annoyed with the person who seemingly can't do anything without help. [Well, duh!].
I do think the main problem is that no one has an assignment conducive to properly training, supporting, and mentoring a new nurse - - but the answer isn't to scurry around all the more while essentially telling the new person "You go on and work on that (while I, supernurse, do these other 30 things that you're not going to learn today, or tomorrow)." This is exactly how someone ends up with an orientation that is little more than being a set of helping hands right up until people start to get snarky about how someone isn't "progressing."
The first couple/few months are so critical. This is most definitely not the best we can do. [Insert obligatory acknowledgment that every once in a while someone will actually thrive with their "freedom"].

That is sooo right. As a newbie, you end up helping out and not getting to learn because the nurses do not have the time to teach you. That was how my last orientation was, terrible. Then they wonder what is wrong with me. It's not me, it's you. I don't know what I don't know. So don't expect me or any other new person to.

Forest2 · Jun 24, 2019

1 hour ago, fnlfntsy said:
I just asked my preceptor where she thought I was with training and she told me I’m doing really good. However, I’ve found that I’m having trouble moving forward and recently hit a wall. I’ve already had several “real” ICU patients which made me realize that the unit is not a good fit for me at this time. Unfortunately, I will be talking with my manager and informing her about my awareness to this matter. I’m hoping she will be able to suggest a more entry level floor that will better fit my needs. I feel like I’ve failed myself and my department.

No you didn't fail them, they failed you.

NICUismylife, ADN, BSN, RN · Jun 25, 2019

As a brand-new RN in the ICU, your preceptor should 100% be glued to your hip. She should be watching your every move, giving you tips, guiding your care, asking you what types of experiences you feel you need more of. She should be asking you questions about your patients that make you critically think, and help you develop the RN mentality of constant assessing and what you should be looking for, red flags, etc.

I agree with Forest, you haven't failed, you just haven't been given a proper orientation! Is your preceptor willing to be more hands on with you? Advocate for yourself, express your needs.

fnlfntsy · Jun 25, 2019

Thank you everyone for your support. It means a lot to me.

Jenna · Sep 11, 2019

On 6/9/2019 at 2:03 AM, fnlfntsy said:
Hi everyone,
New to the forum and I’m looking for advice on how to handle new nurse anxiety from other nurses. I recently accepted a position as an ICU nurse at a large hospital. I have no previous health care experience (2nd career) and I find myself second guessing my new career choice. I’ve been in my role for a month and my anxiety is overwhelming. My preceptor gives me a lot of freedom with patient care and is not attached to my hip. I ask questions and clarify anything I’m not certain about, but I just don’t seem to get it or I forget it the next time around. On my days off, I can’t stop thinking about how terrified I am about being a nurse.
I read about others telling new nurses it takes time. I’m just wondering what can I do now to help get me through these unnerving feelings? Any advice would be much appreciated.
Thanks!

I believe encouraging each other building each other up is key in a positive healthy working environment to have healthy successful nurses!

Forest2 · Sep 14, 2019

On 6/10/2019 at 4:57 PM, JKL33 said:
Training wheels would be actually sticking pretty close with this person who is only a month into knowing how to maneuver without harming anyone in an ICU. Being somewhere else is most definitely not training wheels.
I also think it is generous to think that the most common motivation for giving a 1-month-in orientee "freedom" is related to them excelling and being trustworthy (referring to knowledge base, not ethics). We are talking about the one month mark, here. There are a variety of reasons this happens: The preceptor doesn't really like training, they have an assignment that is too large/too many other responsibilities, they think sink or swim works better than it usually does, etc., etc.
This isn't actually "training" anyone. This is letting them fumble their way through, and forcing them, by default, to come to the preceptor over and over and over repeatedly to ask for assistance.
It seems like the common scenario is that both parties actually grow weary of this rather quickly in their own way: The orientee who feels like they have to say, "I'm sorry, I'm going to need your help (againnn)..." 50 times a day immediately feels like this can't possibly be how things are supposed to go and that they should be doing "better" (after 1 month) than to have to constantly hunt someone down to ask for help. Meanwhile the preceptor getting the 50 "interruptions" is also annoyed with the person who seemingly can't do anything without help. [Well, duh!].
I do think the main problem is that no one has an assignment conducive to properly training, supporting, and mentoring a new nurse - - but the answer isn't to scurry around all the more while essentially telling the new person "You go on and work on that (while I, supernurse, do these other 30 things that you're not going to learn today, or tomorrow)." This is exactly how someone ends up with an orientation that is little more than being a set of helping hands right up until people start to get snarky about how someone isn't "progressing."
The first couple/few months are so critical. This is most definitely not the best we can do. [Insert obligatory acknowledgment that every once in a while someone will actually thrive with their "freedom"].

I see this more often than not. The preceptor is working and generally does not have a lot of extra time.