New nurse really struggling...

Finallyat40 · May 10, 2007

Are you still working with a preceptor? If so, have you spoken with them about your concerns? Do you have a good relationship with your preceptor? It might be worth asking your preceptor to lunch on one of your days off....this way there aren't any distractions and you can have an actual conversation.....explain how you're feeling and ask for her honest assessment of how she feels you're doing. You might be surprised to hear her opinion.

I would be very concerned for you if your message had said that you were one month from being on your own and tired of being followed, felt comfortable with every assignment you were given, knew it all, yada, yada, yada....the feelings you're expressing are quite normal....It took me a good six months out of residency before I'd be able to go in and look at assignments without having a knot in my stomach. Becoming a NICU nurse is a process....I've often said that the day that I go to work and don't learn something new is the day I need to put in my notice.

Keep your chin up!

Jamie

lovemyjob · May 11, 2007

Give it a year. I promise, a year from now you will feel better about your skills. No one expects you to feel comfortable.

When I transferred to the NICU I seriously considered quitting. I was terrified of killing a baby. I was terrified to change the position of a vented kid b/c I thought he would extubate and die because I wouldnt be able to get the tape and tube off. I was terrified to lavage/bag/suction a kid, even when I knew he needed it. I would panic when I took the vent off to bag, I thought I wouldnt get the bag on fast enough and the baby would code and die. Guess what I hae learned...... The Baby Wont Die just because I lavage and suction him, and I CAN get the bag on him fas enough.

I have also learned that if I follow my gut and my assessment skills, I will have done all in my power to help those kids who get sick.

Give yourself time before you give up. If after a year youo still feel the same way, look for your niche. If NICU and adults arent your thing, that is OK. Not all nurses HAVE to be bedisde hospital nurses. You might find that you like office work, or work with research, or pre-op. You might even find tat you like floor peds. We need nurses in all different areas. You are no less of a nurse. Give yourself a chance...... and a break!!!

rnpilot · May 11, 2007

What you are feeling is pretty normal starting out in NICU. You really do need to give yourself about a year to feel comfortable. Never be afraid to ask for help or ask questions. There may be the occasional nasty person or someone having a bad day, but over all, the nurses should be very willing to help. People usually love showing off their knowledge. LOL. Also, they had to go through it to. Try not to be too hard on yourself. You can't expect to be an experienced NICU just out of orientation. Where I was trained, they did a short, second orientation a year out on the more complicated infants. It was kind of a joke for me though because working straight nights, I'd already had to learn the stuff on my own from lack of staffing. So anyway, even after a year, the hospital didn't consider one an experienced NICU nurse yet. Hope that helps you.

Humbled_Nurse · May 12, 2007

As the previous posters said what you are feeling is very normal. It took me a good year before I didn't feel like I wanted to throw up before I went to work. Those little babies can be very intimidating. I remember being afraid to take CPAP off briefly. I was convinced the baby would try to die if I took the CPAP off. I have come a long way, but it took a long time. NICU was what I knew I wanted to do so I told myself to hang in there. I hung in there for two and a half years then went to a lower stress outpatient type job for five years, but knew I would eventually go back to NICU and that's exacly what I did. I have been back in the NICU for almost two years and I am very happy!

Just hang in there! It will likely get worse before it gets better. What helped me a lot was watching the other more experienced nurses. It is amazing what you can learn just by watching.

Take care!

ldh, BSN, RN · May 13, 2007

This thread is great - I am working with a preceptor in the NICU, and I always have that "sick" feeling in my stomach before (even the night before) I go into work. I am always terrified that I will do something wrong, and I've also been having weird dreams related to my fears. I asked some of the more experienced nurses "does this nervousness go away eventually?" and all of them said to me to just give it a year. I think I've struck gold with this workplace; it is such a supportive environment. I would really love to work there - and I'm not sure if I should wait until the end of my consolidation to approach the manager about my interest in being employed there.

Anyways, good thread, it reassures those of us who are "new" that eventually one becomes relatively more comfortable with the work environment.

justjenny · May 15, 2007

Unfortunately, no pearls of wisdom. Just know that you are not alone. I agree with ALL of the above posters! Give it AT LEAST one year to start feeling okay. I started to feel comfortable after about 8 months on my own. I have decided to see how I feel after two years.

I felt terrible and alone after orientation - did not feel prepared at all. DO NOT be afraid to refuse an assignment if you do not feel safe. As a new grad, one week after orientation they tried to give me a 23 wkr on pressors, insulin, etc. I said NO WAY...they literally could have fired me on the spot and I would not have cared - I was TERRIFIED! (and angry that they would even put me in such an uncomfortable position-I caught a lot of grief for refusing)

At first I was afraid to do everything - as above poster mentioned. I would have nightmares that I slept all night and forgot to feed the baby...LOL...I would wake up in the middle of the night looking for a baby! I was afraid to turn the head of a vented kid...I still get nervous bagging a tiny kid even after one year.

Also, I too have not really found a "friend" or anyone that I can really talk to at work. Sure, most people are nice and there is lots of "small talk" (ie: is it going to be nice out tomorrow?) but I feel like no one really knows me...that too will get better with time (I hope)

If there are things happening on the unit - make sure to be a part of it. Whether it is a bedside procedure or a baby shower for a co-worker...the more engaged you are, the better.

Good luck and keep us posted!

Jenny

rellco40 · May 15, 2007

Don't feel alone. Most nurses will not admit to you that they felt the same way or worse! I did feel like a dummy with a lot of knowledge in my head and no safe way to question how i could apply it. You will find someone you can trust to ask questions and bounce ideas off of. Do NOT give up! ! !

Remember the reasons you chose Nursing and find a way to re-inspire yourself. That is easier said than done. I had to do the same........

BittyBabyGrower, MSN, RN · May 15, 2007

Hang in there. You still have a month left and you will grow in that time.

We give our new people the same assignments we would take, but our new people have a resource person and the charge nurse to fall on for 3 months after orientation (that means that the resource person is in the room or near her) and to guide them thru those kids. I would hope most units do the same. Nothing like throwing someone to the wolves with a slab of meat on their neck!

But, if you truly do NOT feel this is for you and you are really, really uncomfortable, you may want to consider changing jobs. I don't say this to me mean, but only as someone who is a preceptor. I hate to see people stay only to decide that maybe they should have left. Not only are they miserable, but it isn't good for anyone. Do you have a nurse educator or nurse specialist you can talk to?

LilPeanut, MSN, RN, NP · May 18, 2007

IMO, I think there's a difference between being nervous, scared and unsure of your new position and some of what is being described here. I'm in orientation and I can get myself worked up and nervous and on edge as all heck, but I never actually dread going to work.

Yesterday I had a terrible day, near miss on a med error, media and a very touchy 500g baby, getting behind and just whatever could go wrong, did, in my mind. But, I'll have that same assignment (hopefully) on saturday, pick myself up, and try and do better. I keep reminding myself I'm in orientation for a reason - I'm not going to be perfect, that's why I have a preceptor watching over me, as I learn what I need to learn.

It's usually when we have a big jump in acuity of the patients I've been caring for (ie, stable NCPAP to stable-ish vent, or stable-ish vent to not-so-stable vent) that I feel so terrible the first day. The second time, I try and correct the things I didn't like about the previous time, and just improve. I still am not perfect (unfortunately) but I still love it and look forward every day to going back and getting better.

So, maybe you need to adjust your expectations for yourself, or maybe it's not the right place for you, no one can know that except for you.

ldh, BSN, RN · May 18, 2007

IMO, I think there's a difference between being nervous, scared and unsure of your new position and some of what is being described here. I'm in orientation and I can get myself worked up and nervous and on edge as all heck, but I never actually dread going to work.

I totally agree with lilpeanut. I too am nervous and scared but I do look forward to going to work - it's just that everything is so new, and plus this is my second career, so it's just going to take some "adjustment".

justjenny · May 19, 2007

I totally agree with lilpeanut. I too am nervous and scared but I do look forward to going to work - it's just that everything is so new, and plus this is my second career, so it's just going to take some "adjustment".

Definately a difference between being scared and loving what you do. I cannot imagine myself doing anything else, but there are some days.....we've all had them......when I wouldn't mind working at Dunkin' Donuts or something! LOL!

NICU is an entirely different world in nursing, IMO. There is the fear when you are new (no matter where you work) and then there are the issues and fear of dealing with such a tiny, vulnerable population.

I will never forget the other morning...peds surgery came in to check on a post-op kid...over 3 kg, healing nicely, getting ready to go home (so treating him like a "normal newborn" at this point) the surgeons were scared to death to touch him!!! I had to help them with pj's and diapers, etc. and made the comment like "You guys cut him open and operated on him, but you are scared to touch him" and they said "YEAH!" :uhoh3:

We also have an RN transfer from the ER and he voiced the same opinion...a newborn baby comes in to the ER and even though they know what to do...they are afraid to touch it!

Really only time and practice are going to help. It is nice sometimes to bounce something off of an experienced RN - just to make sure you are on the right path with your care.

Also, don't be afraid to ask for help if/when your baby is getting really sick. IMO, while it is a great learning experience to have a baby who is "crumping" at the same time, what that baby REALLY NEEDS is someone who can get things done quickly and without further stressing the baby...I'm sure not everyone agrees with this but the baby is ultimately MORE important than your learning....proficiency comes in time, it does not happen overnight.

Jenny