New Nurse on a stepdown unit! Extreme lack of confidence! What to do?

Ruby Vee, BSN · Nov 3, 2017

Hello All,
I want to thank you all for taking the time to read this and address my concerns if you will. Actually, I just started this new job on a step down unit at a hospital and its got me really anxious, nervous, and all I can do this think about quitting because I feel like this is unhealthy. I have read numerous articles on this site where almost everyone who is new in nursing has gone through this phase and somehow have come to the other side as stronger nurses. I just want some pep talk and good vibes.
Before this job I have had no other hospital experience except clinicals and capstones which now I feel like were nothing compared to what I am going through now that I am an official RN- rightfully so because with the title comes great and many responsibilities. I just feel so nervous and anxious that I am responsible for 4 to 5 patients and I must know exactly what to do at the right time and be quick and fast otherwise I will allow harm to come to my patients. I really hate having this feeling because I know right now being new at this I am totally inadequate. I am always worried i will make a mistake! My time management really sucks so I always am running around trying to get things done. Most nurses at my work tell me I'll be fine. I am not sure what they see in me that makes them I will be fine. They tell me I am a safe nurse but how am i safe if i dont know what to do in an emergent situation except maybe freeze? the stff I work with is really supportive but I always feel like due to my lack of confidence I can same questions for reassurance and at some point it might be annoying. I just want this time to pass quickly and not be so nervous wreck when its time to go to work specially after having a bad day- that is when i feel like quitting the most. I question why I even did this. I know everyone goes through this and I am also just payng my dues to get experience but any advice, pep talk, wisdom, suggestions.. anything is welcome. How did you get through this time?

Everyone goes through this; you're just paying your dues to get experience. I got through my first year because I had a husband to support and not succeeding was simply not an option. I didn't have any hospital experience other than my clinical, either. It was rough. But the only way to GET through it is to GO through it.

Of course you're inadequate! You're a brand new nurse. It takes approximately two years to become competent.

The new grad who terrifies me is the new grad who is confident and convinced that they're competent. Those are the new grads who are going to go ahead and do something stupid without asking someone. Those are the ones I don't trust out of my sight. Those are the ones I'm always checking up on as a charge nurse and as a preceptor, those are the ones I'm hovering over.

Your colleagues who say you're fine, that you're a safe nurse are seeing your very real, legitimate fear of making a mistake. That fear is what keeps you from making a big mistake! That fear is what makes you double check and triple check (thereby impeding your time management) and that fear is the little voice inside your head that tells you if you have to pull 10 vials of digoxin to give the ordered dose, the ordered dose might not be correct. I would MUCH rather have a scared new grad than a confident one.

Without knowing you, your work or your colleagues, I'm pretty sure that they're right. You're going to be fine. But it's going to take about a year. I really, truly wish you luck with this and I hope you keep in touch and let us know how you're doing.

nursej22, MSN, RN · Nov 3, 2017

I wholeheartedly agree with Ruby Vee. Have you tried to reflect on the things that you are doing well at, or have shown progress? Surely there must be some things that you are proficient on now, that you weren't before starting this job. Your EMR, learning new meds, clinical assessment, etc.

I used to tell my nursing students, did you feel completely confident the first time you drove a car? No, it took a lot of practice, remembering how to shift, look in your mirrors, watch the road, regulate your speed, foot on gas, clutch, or brake, steer the car, not to mention what to do if you lost control of the vehicle. Nursing is like that, you learn the basics, you practice, you reflect, and you build on your foundation.

Responding to emergent situations is similar. No one expects you to run a code solo. And one of the first steps is get some help! And once the issue is resolved, debrief with an experienced clinician to see what went well, and what would you do different.