New Nurse Stress

[Tay56]

Hey. I've been working as a new nurse for about a month now. When I interviewed, I was nervous but I interviewed at the hospital of which I thought was one of the bests in Las Vegas. I got the job, probably because I had preceptored at similar floors of that same hospital a few months ago and was well known.

It's scary, honestly. I slowly took on one, two, and then three patients. I am currently at three. I am dealing with similar frustrations that the rest of the new nurses are taking. At first I was terrified. Luckily everyone on the unit was friendly, willing to help, and my preceptor helped me slowly accommodates to what is going on. Now she's letting me loose on my own with three patients and said that I'm ready to take it on by myself. She'll still stand by to help if I need it.

I failed horribly the first day on my own though. I had to ask for help. I mean, I'm glad she believes I have potential. She told me that when she started, she was a mess for the first year. I feel like I'm a complete mess and I'm doing so many things wrong. I make notes and I forget what to chart. Plus even though I know how to prioritize I don't follow it because the patients want certain things that they don't exactly need (extra milk, coffee, etc).

I know I'm probably beating myself up a lot more. I go home and I am full of anxiety of what I did wrong or what I missed. For example, taking medication out from the Pixis but not all of them show up so I have to go back and forth from that. I know I can master it over time, I just wish I can master it now.

This is probably a long rant, but it helps me reduce my anxiety and allows me to have some input about other fellow new graduates and to know I'm not the only one. I talked with some of my other classmates but they seem to be doing well. My friends say they adore night shift and take on more patients than I do. I kind of feel like I'm being left behind.

Plus when a situation comes up and I'm asked information about my patient that I had the past two days, I SHOULD know it, but I get nervous and scared. I look like I didn't know anything about anyone I was taking care of. That's embarrassing. I'm worried that the other nurses will think less of me, and I question if I actually know the information I think I know about the patients I take on.

For example, a patient who was in complete pain (despite PCA+Fentyl patch after surgery), kept crying and complaining of pain (but kept falling asleep when no one was in the room talking with her). I looked through her charts but the (very friendly and very nice) charge nurse asked me to call the on call anesthesiologist. When talking to him I got flustered and wrote down the medications he wanted, but had to check her kidney functions, which were high. She didn't have a kidney doctor as far as I know.

I just wish I knew everything so I know what to say. The patient got her pain medication (Nerve Block), which helped for a bit (still went back up to a 10/10 later that day…not sure what else we can do for her without ODing her), and not be so nervous about talking to other healthcare professions. I sometimes think back about what I did wrong or caught myself and think about how I can improve that. It's nerve wrecking and my anxiety is horribly high.

I think I understand why most new grad nurses drop off before a year. The stress and fear gets to be a lot. Especially when you're beating yourself up the most and everyone else is treating you as kindly as possible. I'm lucky in that regard; that the staffing is one of the best. L Any tips to help me relax and to help me be more proficient as a new grad nurse? Much help is needed!

PS. I've heard rumors that some new grads take Xanax for their first couple of years to settle themselves for work. What do you guys think of that?

[ChutneyFries, BSN, RN]

I just got hired and i hope i can relax on the job. I have the same fears. I try to positively talk myself out of getting crazy though. Remember what you are there and that you want to be the best nurse. Meditation helps. Good luck!!!!

[LadyFree28, BSN, LPN, RN]

One of the pearls that have gotten me through my first years as a LPN that I have been going through as a RN and in a new specialty is being open to criticism and recognizing and embracing the fact that I DON'T know everything and will continue to have moments when I won't-and that is OK!

I've also had used a small booklet to write down pearls that I learned over the years; it helps that once in a while I do over them; I also use a critical thinking book to refresh my way of thinking; I love Pat Benner's "Novice to Expert" and believe that one can move successfully in the profession by understating and applying this theory by understand their own situation and how it applies to the theory itself.

My take on becoming a proficient nurse is following the three C's: competency, consistency and confidence; if you follow policy and best practices competently and consistently, one will have the confidence to practice proficiently; and that takes practice!

Understanding and practicing with a questioning attitude and applying what's learned to another day is a very good way to reduce stress and survive and thrive in this business.