New nurse OVERWHELMED

orangepink, NP · Apr 25, 2009

Hi! I'm also a new grad RN in a med surg floor. Unlike my other classmates, I specifically chose med surg because although there's a lot of workload at least it's not so critical. Plus, all the experienced RNs I've talked to recommended that I start there.

Anyway, it's been a month since I started working and yes, I do feel overwhelmed most of the times but I don't let it get to me. My concerns are #1, there's just not enough time to do everything. maybe it's just me being a new grad and that i have to learn more organizational and prioritization skills but time just flies by so fast! at the end of the day, i reevaluate what went wrong and what could i have done better but somehow, i just don't get it. so if any of you experienced RNs have tips, i'd greatly appreciate.

my 2nd concern is what else can i do to improve myself as a new grad RN? right now, i'm reviewing a list of common IV push medications.

i would greatly appreciate any tips or personal stories that way i can find ways to better myself as a RN.

cypress101010 · May 1, 2009

I graduated from nursing school at 55 and now I am in my 60's. People think I have been a nurse for at least 35 - 40 years but I am still learning all the time! Yes, I make mistakes and encounter the Spanish Inquisition at report time from nasty RN's the age of my grandchildren.

Nursing is tough and not what I expected. But we all make mistakes and you are on the right track establishing an organized plan of care. I live with a drug book, my own special report sheet for each patient with medication/treatment times listed (like you do), and readjust when things change.

Often I am tired and blame it on my age. But I am not ready to sit home and watch the soaps and Oprah either. I plan to keep on going until 70 if I can. By then I may be a charge RN!!!

Please don't give up. Nursing needs you and bedside nursing is wonderful. Good luck!

GoNightingale, BSN, RN · May 1, 2009

I don't think there is one nurse out there who did not experience everything you are experiencing at some point when commencing. DON'T BE SO HARD ON YOURSELF.....there are enough people out there that are happy to do that for you. Be gentle to yourself and know that every day you are going to get better and better. I too am a new nurse. I have been on my own for 5 months. I have grown. Today, I am not the same nurse I was 3 months ago and I wont be the same nurse i am today 3 months into the future.

I joined the Academy of Medical-Surgical Nurses and requested a mentor. She has been a pillar of support and knowledge. I recommend you join an organization of your interest and ask if they have a mentoring program. Joining an organization helps in that you grow relationships within your chapter and you grow in professionalism. I love it!

Good look my dear "leapoffaith". And keep leaping! You're doing great! :yeah:

shotzynurse · Jul 17, 2009

Thanks for taking the time to share your story. I am sorry the situation was difficult for you, but you handled it with professionalism and aplomb. The mom picked that specific time to tell her special news for a reason.... she wanted you to know her children and her husband would need an angel's eyes on them in the next few days and she trusted you with that information and that task. She must have appreciated the care you had given her and the comfort you brought her very much. Count it an honor when a patient shares such information when you are in the room - it isn't by chance.

Kudos to you for maintaining your composure for the sake of their family time. They had one opportunity to work through their situation - few precious minutes to work through their emotions. You gave them a rare gift that day. Sometimes we don't know what any particular moment will bring and what an ever-lasting gift our silence is to our patients and their families.

Hang in there and keep up the great work you are doing!

SmilesHeal101 · Jul 21, 2009

I am a new nurse myself, and last night was my first night on my own. Got first admission for the night that would not do anything for me until he got to go downstairs to smoke (psych issues). OMG, I don't know where to start. I work nights because I thought that would be a great fit for me and it wouldn't be as hard and busy as day shift. Well, it is just as busy, but in a different way. Called a Dr. and because I was so nervous forgot to ask for IV fluids and accu checks. I laugh at myself like jeesh, get it together. I want to be a great nurse, and be well-respected by my peers and docs, but when your new the light bulb just doesn't come on as bright. Real world of nursing is not like nursing school. Had a preceptor that didn't teach me anything. Orientation at my job gave one week of impacted material we are suppose to absorb, and a great 3-month on the floor orientation except that I worked with about 12 different nurses (no joke) and some were super smart, and some not so smart. So, now I am on my own trying to grasp what information I can remember. I can only make the most of these experience and do the best that I can do. When I get to a place where I am competent, good critical thinker, I am going to embrace other new nurses and take them under my wings. Remember, we are all in this together, and please don't blame anyone for something they forget or don't remember. Teach them something.

Good luck to all you new nurses. Someday we will get there, but when I don't know!!!

JVRB4 · Jul 22, 2009

I truly understand how you feel. I graduated in May 08 and started working Sept 08. I had barely finished my 8wk orientation (6wks on floor) when I gave up and quit in Dec 08. I am still not working. I am afraid to try again. I don't know if the environment and circumstances were the problem or if I was the problem. Please read my post in the First year after nursing licensure under the General section titled "Lost, Afraid and feeling like a failure...now what?"

I give you props for sticking with it. I hope everything works out for you and for everyone else just starting out. Good Luck!

shinyblackcar · Jul 24, 2009

I truly understand how you feel. I graduated in May 08 and started working Sept 08. I had barely finished my 8wk orientation (6wks on floor) when I gave up and quit in Dec 08. I am still not working. I am afraid to try again. I don't know if the environment and circumstances were the problem or if I was the problem.

I just read your other post because this sounded so much like my situation. I graduated in August 08, started working in May 09, and left my job 2 and a half months later because the stress was simply not worth it. I, too, cried every night before work, working myself up to a full blown panic attack. I had started in an ICU and couldn't possibly know till I was in the middle of it that it WASN'T FOR ME AT ALL. I think you know that the environment and circumstances were the problem-- NOT YOU. YOU CAN DO THIS. I am in the same boat as you, looking for a job now and not sure who will hire me with only 2.5 months "experience" under my belt. Right now, I can only hope that I get a job, and after that I can only hope that whatever job I get is a better match for me and that I don't give up on nursing altogether. Anyway, my thoughts are with you. :redbeathe

PostOpPrincess, BSN, RN · Jul 26, 2009

*HUGS*....Believe it or not, you will survive this.

roxie144 · Oct 20, 2009

After reading these posts I don't feel so alone. I graduated in May 09 and started working in the ICU about 5 weeks ago. I just started night shift and have about 5 more weeks of orientation left. I don't think there has been a day where I don't feel completly overwhelmed and clueless. The patients I've been taking care of are a mess. I'm not even used to dealing with numerous IV's going and here I am with two patients titrating multiple drips on each and if that's not enough we ended up intubating one of them. The hours that I've spent there have been chaos and my preceptor is constanly saying I'm sorry, I feel like I didn't teach you anthing because things are moving so fast. I recently went to my educator and told her I just don't feel ready and she agreed to switch me to MCU. I'm just feeling totally inadequate and that I made the wrong decision in my career, what if this isn't for me. The other issue for me is watching all these people die, being in the ICU and going to codes with the I-team nurse is leaving me with a heavy heart. I'm not sure if it's because the people are so young or if it's because I recently lost my father-in-law or a combination but it sucks. I too like so many of new grads find myself coming home in tears and dreading my next shift. I'm just putting hope in the comments made by so many of you that it does get easier

dieterj · Oct 20, 2009

I too am overwhelmed and having some similar experiences. You can see from these posts you are not alone. I am trying to "tough it out" but often self-doubt and anxiety make me wonder if I'll make it through this first year. I wrote the following to try to calm my nerves before my shift.I hope it helps:

Prayer of an R.N. (Rookie Nurse)

Lord, I am a Rookie Nurse. As your servant, I begin this shift with the desire to do your work and care for my patients' needs in body, mind, and spirit.

Be with me today. Inspire my thinking and guide my hands; help me to set priorities and respond to competing demands in ways that will be of maximum benefit to my patients.

Give me humility and openness; allow me to learn from each person I come in contact with. Help me communicate your love and acceptance; let me embrace all of your needy souls with equanimity.

When I am overwhelmed and discouraged, lift me up and refocus my energies onto my patients. Steer me away from the pettiness, personalities, and politics that can distract me from your work.

I pray that more experienced colleagues, doctors and nurses, will remember the early days of their own careers and be generous with their knowledge and gentle with their criticism.

And when my rookie days are (finally) over, help me to maintain the ideals that led me to the noble profession of nursing as I endeavor to do your will.

Take care. Hugs from a fellow rookie. JD

shotzynurse · Oct 21, 2009

thanks for sharing that prayer. after the last few days, i really needed it.

i am so saddened by the lack of support for fellow nurses (particularly newly graduated/younger/less experienced) and the disintegrating sense of teamwork in our hospital, particularly in the critical care units. it is so disheartening. i often wish i had chosen to go to work for a teaching hospital because of situations like these. i see the young devoured before their love for the profession can be fully nurtured, and the truly talented die on the vine for want of knowledge, leadership, acknowledgement and career development. it's difficult to watch so many struggle for lack of a mentor, a gentle word, a nudge in the right direction....

i see the experienced - full of the wisdom of the craft, brimming with knowledge, and the hope and future of the nurse of tomorrow, now, seething with resentment, broken in body and spirit, barely hanging on to retirement, trodden down, weary in the fight and thwarted on every side by management, politics, and the almighty insurance company. it seems more and more is expected to be accomplished in less time with less staff for less money.

i supposed the worst of it is that our hands have been tied as to what, when and how we can provide for the patient. they are the ones who suffer, the ones who are short-sheeted by the bureaucracy and politics of the situation. i hate going home knowing we can't get it all done. all these outside forces have taken the best of what we had and spread them so thin, they exist only as a vapor - a shadow of what they used to be able to do, accomplish, provide - for our patients, our peers, our community, and the newcomers to the profession.

when, oh, when did the tail begin to wag the dog?

just know - experienced ones - your knowledge and wisdom can be perpetuated for generations if you share a hint, a tip, a tidbit --- there are new nurses who need your knowledge, your help, your encouragement. otherwise, your legacy dies with you, and that is so sad, because you have touched so many in your life.

newbies, the experienced nurses who you think hold you in disdain are mostly just tired. help bathe their patients. do their i/os. make a pact - a trade. i'll help you do your___ if you'll share the secrets of your success in nursing - or please show me how to titrate ___. or how do you get ___ done so quickly. it takes me so long, and you do it so well.

maybe, just maybe, the gap can be bridged, one barter at a time, one bath at a time, one story at a time....

(i hope so. i am counting on it in my own situation.) :redpinkhe

nurselt_1317 · Feb 18, 2010

I worked as a nurse on a busy med-surg floor for two years and I definitely felt this way, but it DOES get better. As time goes on, you learn from each experience you have. You learn how to do things differently the next time, how to prioritize your time better, how to be more efficient at each thing you do. Find a few more experienced nurses that are great teachers and go to them with your questions! And don't be afraid to ask questions! If another nurse has an interesting patient with something you haven't seen or done before, ask them to show you!

Also, the biggest thing that helped me was staying organized. If I was disorganized, everything seemed chaotic.

Make your own sheet to fill in with patient info and use it on each shift you work. Have all the pertinent info you need in front of you before calling the doctor. Take the opportunity to talk to and learn from other disciplines, i.e. dietician, physical therapy, etc.

Also, stay caught up on your charting as much as you can. It is so much less stressful when your charting is updated throughout the day, as opposed to finally sitting down to chart at the end of the shift (sometimes this is inevitable, but it's always better when you don't have to do that!)