New Nurse Nerves

[Ruby Vee, BSN]

there is one nurse, however, who has no patience and gets mad at me. friday night we were scheduled to work together. there was no monitor clerk scheduled to watch the telemetry monitors, so the other nurse assigned herself to that job and gave me the two patients we had on the unit. things were going ok. she talked to me about being nervous and told me to just take some deep breaths, that i'm doing well with my patient care.

one of my patients who was on a vent, kept moving his legs so they would hang off the bed. i was charting. she noticed his legs off the bed and went in to put them back on the bed. then the other patient began to have audible congestion so the nurse helped suction her (oral and nasal). she wasn't bringing up a lot of secretions, so the nurse suggested i call the doctor to get some lasix ordered. i did. i gave the patient the lasix, and it was helping.

then all of a sudden, and i'm not sure what set her off, the nurse got mad and made a comment that "you have to get over your nervousness, especially at someone else's expense". i don't think she was referring to my patients expense, because they were fine. i was not neglecting them.

i got very upset over this. i hate to be this way, but i am very emotional. i tried to hide my emotions from her, but eventually i apologized for getting her upset. i said i cannot work like this and i had to talk about it (with tears in my eyes). she said she had a bad day and apologized for her actions.

i am doubting my ability as a nurse now. she said "lets start over" and we had some zucchini bread and coffee.

we talked later and i said to her that i may not be cut out for nursing. or maybe i should get out of icu and go work on the med/surg floor. she told me i will be a good nurse, i just need experience and have to get over being nervous.

she made a comment for me not to go to talk to the nurse manager. she said it would be worse for me on the med/surg floor. she said i'll learn a lot in icu. our icu is small and we don't have really super critical patients. the critical ones are shipped out to bigger hospitals.

i am seriously thinking about looking for another job. i had a couple of issues on other days when i worked with this nurse. i did talk to the supervisor who was on the first time i had an issue with her, and she told me to take deep breaths and do my best. the other nurse gets overwhelmed sometimes, but has not complained to management about me.

i know i will get over the nervousness sometime, but in the meantime i'm stressing. i don't want to take any medication either. i am trying to have a positive attitude, but lately i can't seem to handle stress.

i'm seriously thinking about getting out of nursing. please let me know if anyone has had similar experiences and how you coped with them.

thanks.

it seems that based on negative interactions -- one or a few -- with one nurse you're thinking you're not cut out to be an icu nurse. well maybe you are and maybe you aren't, but you haven't really given it enough time to know for sure.

i don't understand what it is that this other nurse did to you that was so terrible? praise your work? tell you you would learn a lot in the icu? tell you you needed to get over your nervousness? the other nurse may not be overly blessed with patience -- many of us are not. but where did you get the idea that you were only going to encounter perfect people once you got into nursing? some people are impatient, poor teachers, poor learners, poor charge nurses, poor nurses, or poor colleagues. that has nothing to do with you.

pay attention to what's in front of you. if someone gives you negative feedback, figure out -- or ask-- what you should have done differently. and then go back to work and apply what you've learned.

that other nurse told you something that you seem to have overlooked. it's not just about you. you have patients to consider, too. "not neglecting them" is not the same thing as doing a good job of taking care of them. no doubt there is something you could have done better . . . . learn from it and resolve to do better next time.

honestly? i think you're going to be a kick-@ss icu nurse. you are exactly the kind of nurse i would want to have if i were in the icu. you're the kind of nurse who isn't going to overlook something major because of the trepidation you have. now, that same trepidation is biting you in the butt because it's so stressful. but quitting and doing something different right now is not the answer. i have learned from first-hand experience that doing that will only make things worse, no matter what you end up doing. i was having very similar issues (and you remind myself of me, very much) and i bailed. huge mistake. actually, i was having very similar issues while orienting on days (i was hired for nights). it actually started to get easier but mostly i felt like an incompetent loser. i am not used to feeling that way so it was very hard on me. i truly needed to get around my ego (not that you are egotistical and i wasn't either, but i do think the ego gets in the way) and just press on, hard and steady. there will be good days and bad days. unfortunately, just a few days after changing over to nights i crashed and burned really bad. i wasn't sleeping at all, and i was still very stressed out and feeling incompetent and it was too much for me. i still regret bailing though - and i always will.

now about that nurse. she sounds like a b*tthead. she sounds a little unpredictable and not a good source of support. i'm really happy to hear most of the other nurses are supportive and kind. that's huge.

you could always talk to your supervisor and request that she not schedule you with that nurse because of "personality conflicts". you sound like a very easy-going, rational person. you do not sound like a trouble-maker. i think it would be totally reasonable to make that request.

i hope you stick with it. i really, really believe you are and will be a great nurse.

i still don't understand what that other nurse did that makes her a butthead.

i'm sorry that you bailed on your job and even sorrier that you regret it, but requesting not to work with a certain nurse because of "personality conflicts" isn't going to help at all. it's just going to make you difficult for the supervisor. more than likely, she's going to side with the nurse she's worked with for a long time over the newbie. and you might just talk yourself out of a job, a learning experience, or a colleague who will be a great mentor if you can overlook her impatience or whatever other personality flaws i'm missing.

i'm not sure where you two have gotten the idea that you should only have to work with people you like, or who like you, or are nice to you. there are as many personalities as there are people in the work place. if you want to learn and grow, to advance or even to remain employed, you're going to have to learn to work with them without running to the supervisor every time you feel as if you've been "picked on." figure out what the other nurse is trying to tell you, and focus on the message, not the delivery. it could be she can teach you a lot. even if not, you're still going to have to work with her. suck it up and deal.

as for who is going to be a stellar icu nurse and who isn't -- i don't think we can tell from posts on the internet. perbd may or may not turn out to be an excellent nurse. i hope she does.

[perbd]

Thanks for the feedback. Two very different perspectives.

I was told by the other nurses on the unit that the nurse I referred to in my post has two sides to her. None of them want to work with her. She does her best to do as little as possible and criticizes the other nurses all the time. Two nurses quit because of her. I won't let that influence me though.

I will not let this incident prevent me from learning as much as I can. I will just be more cautious on how I approach her with questions. I don't want her to blow up at me again. Ruby, you ask what she did. She just all of a sudden got mad and was nasty to me. I truly don't even know what provoked her. I probably over-reacted, because I am an over-achiever and want to do the best I can. And I absolutely hate conflict. However, we worked it out, and it's water over the dam.

I'm working with her again this Friday. I'm going to "suck it up and deal". I realize some people don't have a lot of patience, but in this profession, I think that seasoned nurses who are teaching new nurses should be nurturing and encouraging. Nurses should not "eat their young". However, in the real world that happens all too often.

I welcome constructive criticizm, but there is no need to get nasty.

I realize that I have to get over being overly sensitive. That is one of my weaknesses.

As for asking the supervisor not to schedule me with her, everyone has the same request . Being low man on the totem pole, I have no choice. I will not go to the supervisor about any of this. It's my problem. I'll deal.

Thanks for the advice.

[Ruby Vee, BSN]

i will not let this incident prevent me from learning as much as i can. i will just be more cautious on how i approach her with questions. i don't want her to blow up at me again. ruby, you ask what she did. she just all of a sudden got mad and was nasty to me. i truly don't even know what provoked her. i probably over-reacted, because i am an over-achiever and want to do the best i can. and i absolutely hate conflict. however, we worked it out, and it's water over the dam.

i'm working with her again this friday. i'm going to "suck it up and deal". i realize some people don't have a lot of patience, but in this profession, i think that seasoned nurses who are teaching new nurses should be nurturing and encouraging. nurses should not "eat their young". however, in the real world that happens all too often.

i'm glad you're not going to let this incident hold you back from learning as much as possible. and it's absolutely good that you were able to work things out and let it go -- water over the dam is a good way to look at it. i don't know either of you and i wasn't there during the incident, but i will propose to you that "all of a sudden getting mad and being nasty" rarely occurs in a vacuum. that's not to say it's your fault in any way, but it may have been something you did -- or didn't do. maybe you suck on your pencil when you think, you aren't even aware of it, and it drives her absolutely crazy and she's told herself she's never going to mention it to you but she's really busy and stressed tonight and she has a migraine coming on and as you approached her you were sucking on your pencil and it just drove her right over the edge. maybe your voice is just like her aunt mable's and it's like fingernails on chalkboard to her. maybe you wear pink scrubs all the time and she has a pink phobia. (don't laugh -- it could happen!) maybe she expects you to preface every question with "your majesty, might i have a moment?"

it also could have been that the other nurse didn't get nasty, but you sensed her anger and you interpreted what she said as being nasty even when she didn't mean it that way. some people are very direct in their communication, and people who aren't direct often see them as being "mean" when they're just being factual or matter-of-fact. maybe in the light of her culture, you were nasty to her. or maybe she really was nasty, but you see it could have been just a simple miscommunication with no insult intended.

a lot of people seem to think that seasoned nurses teaching new nurses should be nurturing and encouraging. most -- not all -- of those people are new nurses. many -- not all -- seasoned nurses expect themselves to be friendly, calm, patient and able to explain things in a logical manner. "nurturing" is in the eye of the beholder as is "encouraging." what i might see as encouraging critical thinking and developing logic, you might see as "being mean and making me do it myself instead of just explaining it to me." what i might see as being helpful of your learning, you might see as breathing down your neck and not trusting you to get it right. it's all in the perception.

it's easy enough to offend somebody without meaning to and without even realizing you've done it. it's easy to offend someone and recognize you've offended them but have no real clue what you did wrong. it's easy, especially when you're new and hypersensitive to misinterpret something meant kindly as something meant to hurt or humiliate you.

i don't think seasoned nurses owe it to newbies to be "nurturing." we do owe it to you to help you develop your knowledge base, skill set, critical thinking skills and to teach you to function in the culture of your particular job.

[rierie]

I was you 14 years ago. And if I say so myself you are going to be a fabulous nurse! I was trying to talk myself out of nursing for the first 4 years of my career and one night a young man with a major GI bleed rolled over and looked at me while I was giving him enemas until clear and he asked, "Do you enjoy your job?" ---Now I had to think about it in that moment but I chuckled and said "Yes I do." Since that I haven't looked back.

I remember having diarrhea on the way into work every shift for some years. I gained alot of weight and worried or cried myself to sleep many nights. That is what makes you a good nurse. You have feelings, you can FEEL when something is wrong. You can't teach that instinct. I used to wear my heart on my sleeve but I am so confident in my skills and being an advocate for my patients that you have to really prove me wrong these days. I used to be scared to talk to doctors or superiors but now I feel like an equal. In fact I now teach clinical for nursing students and it has been what I needed to show myself how far I have come. You will not be perfect...but you will be great! Learn from those that take the time to show you and when you are confident pass those skills to someone new. Those that make you feel bad are just tactless. Saying something rudely and creating a hostile work environment is good for no one. I would rather be liked by my colleages and treat everyone well. Keep up the hard work!

[Vtachy1]

I'm very thankful that I have had good nurses train me. I have had some bad ones but I'm thankful that Ruby isn't a coworker of mine~!!!! Yikes!!! I have been a nurse for 20 years worked ICU for 10 and met a lot of hateful nurses. It made me a nervous wreck. I know that I was excellent in ICU but I could not handle the hateful couple of nurses, one in particular. So after 10 years I left that place and have been extremely happy and content. I'm not sure why ICU attracts people like that nurse that worked with you. But I worked with her evil twin or clone!

I'm still a nervous nellie but there's no excuse for someone to snap like that. To me, she sounds like a psycho -Nth degree jerk, and I totally disagree with the previous poster that thinks what she did was perfectly acceptable.

I've had numerous awards from the ICU I worked at, and I have a scrapbook of all the letters to our local newspaper commending me on the excellent care I gave. But it was killing me, the way this other nurse was. I could not handle it anymore so I left and found a wonderful job with great co-workers that build each other up and are sensitive and constructively criticize each other.

[rcd9229]

perbd,

Whatever you do, don't quit the ICU. I wish you hadn't quit the ER either but either way. You are my mirror image right now. I am interning at a large trauma 1 ICU. I've had 2 years of med surg experience and 2 years outpatient surgery. All of my preceptors are giving me tons of "good jobs" but I usually leave feeling like a ball of nerves. It's the nerves eating me alive, not the job. You sound a bit like me, and what I keep getting from everyone one is-I need more self confidence and I'm a little timid. But the timidness comes from being unsure. And I too got pretty emotional knowing I was coming to the end of my internship and felt so incompetant. And apparently, we are gonna be unsure for at least a year. So what we have to do is find some way to bump that confidence, or "fake it until you feel it". There are a couple of nurses who have been a bit similiar to me but I am not sure that the nurse you are speaking of was really trying to be nasty. You said she had suggested that you call the doctor. She may have been trying to push you to start being more proactive. One preceptor told me to go ask the doctor for something. The resident looked at me I realized later, and gave me minimal orders because I was rather minimal in my presentation. My preceptor went on and flat out told the attending "this is this and we need to do something about it." He looked at her, and asked, well what do you think would be good out of these.

That doctor looked at her, a girl probably ten years my junior, and gave her the respect of an equal because she was standing up for her patient, and was not unreasonable, and that nurse was completely confident that she was doing a good thing.

I want to be that nurse. I'm not stupid, I care for my patients, and have had nothing but good reviews from my peers and other physicians prior, and nothing but support here. I refuse to quit what I want to do. Because as stressed out as I am, I want to do this. I want to be just like that nurse and the dozens others I have seen in the past few weeks. Because I need to do it, to prove something to myself. And you need to for the same. Because you sound like you care, and you want to do it. Anything you do in nursing is gonna be hard, I guarentee. But if you let this defeat you, it's gonna follow you around from place to place and just drag that confidence down.

You sound like you have support from most of your peers, that doctor? he didn't turn around and tell you to quit nursing or quit er and get out, he saw that you needed a boost and he pushed you towards it. And left you to make a decision. He coulda just agreed that you sucked and walked out. But he didn't. That says something to me. And that nurse that was nasty to you, she told you basically the same thing, stick it out. Many ICU nurses seem to be on the blunt side, many seem a bit cold to me but I really am starting to think its just my perception. Because I am so sensitive. And you've got a lot of nurses here telling you the same thing, nerves are just something you have to work past.

I've seen some really good nurses make some serious mistakes. It happens. But you do your best. I've seen some new doctors just as nervous as me and you here lately.

I got on here looking for some advice for my own nerves, because I too was thinking of just giving up because I can't seem to conquer them simply because my confidence is so low right now. But I guess in reading this, and the advice given to you, I'm gonna keep chugging along and just keep trying to fight the nerves until I make it through. I really hope you do too because I kinda feel like I need you to as well. To know that there is someone out there just as nervous as me. Because its not fair to us or the patients to give up just because its hard. I would much rather have a nurse like you that may be a little slow and knows it, than one who has no doubts and hurts a patient. So do me a favor and stick it out with me eh? :)

Besides, ICUs are famous for swarming to help each other out.

[Brea LPN]

I might not be the person to come to for a pep talk. Maybe what I'm going to say will help you, but maybe it won't.

You are NOT ALONE. Those nerves are part of the package. I don't know anyone who didn't experience those feelings at the beginning. Some nurses have it worse than others when it comes to nervousness - I, for one, became physically ill before work.

What helped me was routine. As long as I carried out my pre and post work routines, I felt a little better because those things I could control.

It could be as simple as using a certain type of pen during report. (I don't know if ER nurses write during report; I've never worked or even shadowed in an ER). I always use my special pen, and it makes me feel better. I used to make my bed before I left for work and have my pajamas sitting out on my bed. That way I could look forward to those warm pajamas and my comfy, freshly made bed! Then I changed up and looked forward to my microwavable miniature Weight Watchers pizzas and watching Dr. Oz. Just thinking about those pizzas got me through some tough shifts! Now I have a nice car and look forward to driving it to and from work. The smell of the leather gets me through.

Maybe you could incorporate some uplifting music on your drive to work...or watching a funny TV show as you get dressed and ready! Putting your mind at ease before work can help a great deal. And I think a big chunk of our nerves as nurses comes from the unexpected and knowing we can't control everything that happens during our shifts. That's why routines are so helpful, because even if we can't control what patients' bodies do, we CAN control what socks we wear and the book we read right before going to sleep after a long shift.

The bad news? If you're an anxious person by nature (like I am), the nerves may never go away completely; but...even I (queen of nervous Nellies) have learned to adapt.

You can do it. If I can, you can, too!

Awesome post! I'm naturally an anxious person. I fear not knowing what is going to occur during my shift, I think the pjs thing is a good idea. I'm going to try that tomorrow. :) I like having things to look forward to.