New nurse and feeling so discouraged

**NickiLaughs, ADN, BSN, RN** · Oct 16, 2016

Everyone has those shifts. Everyone needs help sometimes. And if the oncoming nurse complains chances are she's one that is always going to complain even if you do everything.

GE90 · Oct 16, 2016

one thing i've learned after working as a grad for almost 9months is that...if someone is deliberately giving you a hard time or trying to embarrass you, **** them.

Libby1987 · Oct 16, 2016

If you can, try to think of these shifts as layering on experieence. Truthfully, if they were all smooth this early on in your nursing career, you would be stuck in your growth. It's jus tnot remotely realistic for you to not feel completely over faced. Every nurse you admire has had to grapple through tremendous challenge. Every shift you make it through, you are adding to your skill set and building wisdom.

NotMyProblem MSN, ASN, BSN, MSN, LPN, RN · Oct 16, 2016

Skip ahead 5 years down the line: 5 years and knowledge of many tasks and the skills to perform those with utter proficiently. Yet you still have 2 or 3 admits arriving just minutes apart. Something is NOT going to get done. Sometimes, the one right admit will have so much going on with the patient that it will feel like 3 admits, and something is NOT going to get done. Factor in your other patients and it is a freaking nightmare. The oncoming nurse WILL have to do it.

One day, you WILL be that oncoming nurse. That's life as a nurse. Do what you can, pass on what you couldn't get to, clock out, go home, and forget about it.

These other nurses know this already. But the more they can intimidate you into staying over and doing until it's all done, the less they'll have to do; and they'll turn right around and leave you a mess to clean up when you come on, and not think anything about it. Here is when your skin begins to thicken.

As for the subq injection, rotate those sites. If every nurse goes for the "same spot", the patient may suffer tissue damage. If administering insulin injections, try to use areas that the patient doesn't use at home for this very reason. Explain that you're giving his or her chosen areas 'a breather' and saving those sites for when he or she returns home. But also teach the importance of rotating injection sites.

This is a 24-hour-a-day job. There is a reason for another nurse to relieve you after you set hours has ended: you cannot do all that needs to be done by yourself...none of us can.

KHT · Oct 16, 2016

Thank you ... I think I have to work on accepting that and better understanding the process of becoming the nurse I want to be. I'm not one who likes to ask for help (although I enjoy helping others) and I am my biggest critic. It's reassuring to know that everyone has had to go through this ... and for every oncoming nurse who likes to give me a hard time for one reason or another, I have to think about the ones who have been supportive and have been willing to guide me. Thank you everyone for your feedback ... I'm always so appreciative and grateful for this forum!

Cowboyardee · Oct 16, 2016

I agree pretty much with what bsnbedone wrote.

Also, you ask if there will ever come a point where you get everything done. Well, not really. You get faster and more efficient as you gain experience, but youre still only one person. Instead, you mainly get better at prioritizing correctly and confidently, and at recognizing those emergency situations where you need to call for reinforcements to get the critical tasks completed. When you prioitize correctly, sometimes some things won't get done, and that's fine.

Workitinurfava, BSN, RN · Oct 17, 2016

Nurse bullies always try to make your shift miserable.

NightNerd, MSN, RN · Oct 17, 2016

I have been having a similar weekend at work. One coworker has been awesome and helping me get stuff in place, things I will now be more equipped to handle on my own next time. One has been less than helpful and offering "constructive criticism" at less than ideal moments. It feels totally awful, but we are just having some growing pains. We've got to be novices before we can be experts. :)

nutella, MSN, RN · Oct 17, 2016

I am sorry you are having a rough time!

It is very normal as a new graduate nurse to have problems with managing an assignment especially when you get an admit. It takes probably around 6 months off orientation until you have somewhat of a handle on it and after a year you should feel better. It takes solid 2 years after you graduate until you are comfortable in all regards meaning you are able to handle the assignment, you are respected by your co-workers, and you have seen the most common things on your floor.

New grads always run behind in documenting because you are still not organized enough, still have to look up things between, have to ask and prioritize in a way that it throws you back. It is important to sit down between and document in the computer. If you are discharging and admitting nobody should expect you to complete the admission if the patient shows up right before change of shift - but you have to settle the patient and make sure the pat is safe.

Staying one hour longer is not good - avoid getting out late because you will regret it and will start to hate going to work.

For patients who do not speak English you need to get the interpreter for everything to ensure communication. Nobody gets the interpreter for minor stuff but for everything else. I recommend you get organized with having the language line number or ipad - whatever you guys use right on your cheat sheet so when you go in you can call right away. If you make it a habit it will be normal and you won't lose much time.

The other thing is to have material handy for patients who do not speak English - some languages are difficult to get an interpreter or the patient is very hard of hearing - pictograms are great - the patient can point to something and also there are sheets with the most important phrases translated both languages and the patient can point to it. If you have an EHR your system might actually have some of those downloaded.

You can usually find and print out teaching sheets for the most common languages through your EHR or find them somewhere else. Always ask if the patient is able to read though because literacy in some cultures is low or the language is primarily spoken but not read. If that is the case make sure that for all big things like discharge teaching and so on family is also present.

Here comes the special tip for patients who are deaf and whose first language is American Sign Language:

There is video interpretation available and most hospitals are set up with it. In addition, if you have a matter that is of significance or legally like health care proxy forms, consent for surgery, discharge teaching you should get an ASL interpreter and a Certified Deaf Interpreter (CDI) to ensure proper understanding. A regular ASL interpreter might not be able to translate everything is a way that it makes sense as you can not translate word for word - it has to make sense within the culture. A CDI is an interpreter who is deaf or whose first language is ASL and it is a 3 way communication. If you need a CDI it has to be booked - social work can usually help with that. Most nurses do not need a CDI in their day to day work but it does happen once in a while. You do not want to sign a health care proxy form with somebody who is deaf unless the CDI is also present. Reading English does not replace that because it is not always clear how much content is understood. Wong-Baker is the only acceptable pain scale.

Avoid using your colleagues to translate for you because they do not want to get called all the time for that, just get comfortable with the language options that your facility has and think ahead. If your patient gets D/C at 2 pm book the in house interpreter in the morning and tell everybody that the paperwork needs to be done by ...time by the physician so you can do your paperwork and be ready for the interpreter.

As for your colleagues --- there is not much compassion for new grads. Most other nurses do not like to work after a new grad because they are afraid that they get stuck with too many tasks that are left over or loose ends. You will find that some people are always giving other people a hard time with report and some are more laid back. Just make sure that all the critical things are done and the patient is in ok shape. Also, it helps to be extra apologetic for a while and just say that you did everything you could manage, you are still new but working hard on getting everything done. If you find that you are always overwhelmed talk to the charge nurse to review your assignments - if everybody else is having a slow day but you are running like crazy perhaps you got all the heavy patients, the ones who are high maintenance, or the ones that need more time due to language barrier. Most charge nurses seem to be interested in evening assignments out but once in a while there is somebody who will favor some nurses over others and you may end up with an unbalanced assignment.

All of us have days where we go home and are "done" - even after 20 years that happens at times. That is a normal part of nursing too because it is a high stress job no matter where you work, emotionally charged, and the pressure is intense. It does get better though....

nurse813 · Oct 17, 2016

It's all part of "growing pains"... we have all been there. Just remember - every expert was once a beginner! The tough days make you stronger and often teach you more than the "easy" or normal days. All great nurses have ben through the ringer a few times, and that's what has help mold them into the great nurses they are now in my opinion! Stay positive! :)

SmilingBluEyes · Oct 17, 2016

I am so sorry you are going through this. It's a combination of being new and having an absolutely crappy shift. It will get better. You received a lot of stellar advice, so I won't expound on it. I just wish you the best.