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New nurse struggles

Stress 101   (1,103 Views 7 Comments)
by tj151619 tj151619 (New Member) New Member

491 Profile Views; 8 Posts

I am in my third week of orientation as a new nurse and I cannot for the life of me understand why I went from being so eager to start this new career to dreading going in for my shifts.  I used to work as a CNA for nearly 3 years and I am finding it difficult to adjust to the change.  I know I'm intelligent enough to do the job but I am just struggling.  It's terrible that I've started searching for another job because quite frankly don't know that I can cut it as a floor nurse.  I LOVED being an aide and getting to spend more time with my patients.  But now, I am a nurse and feel like I am just not cut out for it.  I was not aware my position only allotted 4 weeks of training before you fly solo (I was under the impression from my interview that it would take 6-8 weeks).  Although my preceptor seems to think I will do just fine as well as some of the other nurses on the unit, I don't feel competent to be on my own.  I am terrified of hurting someone due to my lack of knowledge (I'm working on a specialty unit - cardiothoracic surgery).  Sure my charting looks good and I can do quick assessments, but as far as identifying patient needs or knowing when to call the physicians I am clueless.  Just the other day, I had basically been given my *** handed to me by a nurse who either intentionally or unintentionally knocked me down a peg because I wasn't aware of a certain protocol that I needed to do prior to leaving.  I stayed over willingly to fix my mistake, but by that point she was just done with me.  I didn't think it would happen so soon, but I got out to my car and just broke down.  I know I need to develop that thick skin everyone talks about, but its hard to want to go into a job where you feel alienated because you're that new nurse and everyone thinks you're incompetent.  I do not feel welcome on my unit by other nurses or even the aides.  I seldom see or hear from my unit manager.  I just don't know what to do and pray that I don't feel this way a few months from now.  Sometimes I wonder if staying an aide would have been a better choice.

Is there any advice more experienced nurses can share that may alleviate or help reassure me that this feeling will go away in time?  How do you approach your preceptor, let alone other people working on your unit for help who don't seem interested in lending you a hand.

Sorry for the sob story.  I just feel lost and uncertain about what to do moving forward.

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Daisy4RN has 20 years experience and specializes in Travel, Home Health, Med-Surg.

1 Follower; 1 Article; 987 Posts; 6,416 Profile Views

I am so sorry you are having such a hard time. Your feelings are quite normal for being in a new position. Even if you were not a new nurse it would be hard because it is a new unit, but it is especially hard because you are a new grad. Is it possible to talk to your manager and ask for more time. If not i would just stick it out and see how it goes, it will get easier with time as you gain experience and the other staff get to know you better. As far as you staying over you dont mention what the protocol was but make sure you are not being taken advantage of to do others work. If you are not sure ask the charge, "i didnt get to this/that, oncoming nurse says i need to stay over" and see what they say. One unit i worked on (as an experienced nurse) there was always one who would say that to me, "well you need to do this/that before you go", and my response was always no, nursing is 24/7. There are always those nurses that try to get you to do their work. Dont get me wrong, i never purposefully left work undone but it does happen. Talk to you manager about more time, tell her you thought you had 6-8 weeks, cant hurt to ask. Either way, dont be afraid to ask questions, those nurses might get annoyed but they should understand bc they were one also new. Hang in there, it will get better!

 

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Ruby Vee has 40 years experience as a BSN and specializes in CCU, SICU, CVSICU, Precepting & Teaching.

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On 3/14/2019 at 1:33 PM, tj151619 said:

I am in my third week of orientation as a new nurse and I cannot for the life of me understand why I went from being so eager to start this new career to dreading going in for my shifts.  I used to work as a CNA for nearly 3 years and I am finding it difficult to adjust to the change.  I know I'm intelligent enough to do the job but I am just struggling.  It's terrible that I've started searching for another job because quite frankly don't know that I can cut it as a floor nurse.  I LOVED being an aide and getting to spend more time with my patients.  But now, I am a nurse and feel like I am just not cut out for it.  I was not aware my position only allotted 4 weeks of training before you fly solo (I was under the impression from my interview that it would take 6-8 weeks).  Although my preceptor seems to think I will do just fine as well as some of the other nurses on the unit, I don't feel competent to be on my own.  I am terrified of hurting someone due to my lack of knowledge (I'm working on a specialty unit - cardiothoracic surgery).  Sure my charting looks good and I can do quick assessments, but as far as identifying patient needs or knowing when to call the physicians I am clueless.  Just the other day, I had basically been given my *** handed to me by a nurse who either intentionally or unintentionally knocked me down a peg because I wasn't aware of a certain protocol that I needed to do prior to leaving.  I stayed over willingly to fix my mistake, but by that point she was just done with me.  I didn't think it would happen so soon, but I got out to my car and just broke down.  I know I need to develop that thick skin everyone talks about, but its hard to want to go into a job where you feel alienated because you're that new nurse and everyone thinks you're incompetent.  I do not feel welcome on my unit by other nurses or even the aides.  I seldom see or hear from my unit manager.  I just don't know what to do and pray that I don't feel this way a few months from now.  Sometimes I wonder if staying an aide would have been a better choice.

Is there any advice more experienced nurses can share that may alleviate or help reassure me that this feeling will go away in time?  How do you approach your preceptor, let alone other people working on your unit for help who don't seem interested in lending you a hand.

Sorry for the sob story.  I just feel lost and uncertain about what to do moving forward.

Sounds to me like what we used to call "reality shock."  I went through it as a new nurse, and so did everyone else I know -- except those diploma grads who had a whole lot more clinical than the rest of us.  

It takes about a year to feel comfortable in a new job, especially a first job. Somewhere around that one year mark, things just seem to "click."  You know what to do, and if you don't you know where to find out.  The other nurses seem so much nicer because you're comfortable enough in your job to take the few seconds out of your day to ask them about their weekend, or their kid's latest softball game or whatever they're interested in.  

Looking for another job before you've mastered this one is foolish.  Stay in this job, learn all you can, and a year from now decide whether you still think you're not cut out for it.

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This is a major life transition and, as already mentioned, basically the picture of what they used to call reality shock, or navigating the gap between what you imagined/what you were taught, and actual reality.

A few comments:

On 3/14/2019 at 2:33 PM, tj151619 said:

Although my preceptor seems to think I will do just fine as well as some of the other nurses on the unit, I don't feel competent to be on my own.  I am terrified of hurting someone due to my lack of knowledge (I'm working on a specialty unit - cardiothoracic surgery). 

Generally speaking, being cognizant and even worried about this (but hopefully not truly terrified/incapacitated) is going to work in your favor, as well as the favor of every patient you touch for the rest of your career. Acknowledging a normal/expected knowledge deficit is part of being a safe learner, IMVHO. So I hereby proclaim that you are safe to continue learning. 😉

 

On 3/14/2019 at 2:33 PM, tj151619 said:

Sure my charting looks good and I can do quick assessments, but as far as identifying patient needs or knowing when to call the physicians I am clueless. 

Two pluses in your favor! You know the basics of assessing patients and are able to chart effectively.  It is perfectly fine and normal that you are still learning to integrate the next step of making a nursing dx, or (for a less scary description) recognizing a problem and beginning to formulate a plan for how to handle it.

 

On 3/14/2019 at 2:33 PM, tj151619 said:

Just the other day, I had basically been given my *** handed to me by a nurse who either intentionally or unintentionally knocked me down a peg because I wasn't aware of a certain protocol that I needed to do prior to leaving.  I stayed over willingly to fix my mistake, but by that point she was just done with me. 

Okay, yes, that is hard. Try to take reasonable correction in stride and try not to take others' reactions personally (their reactions are on them). Try to stay calm as you gain perspective about these things. Pretty soon (actually pretty quickly) you are going to learn who is reasonable and trying to help you, who is passionate about good patient care and is sometimes a little intense based on that, who has a poor self esteem and looks for opportunities to skewer other nurses in order to feel better about him/herself, and who is simply selfish, self-centered and mean.

I won't even begin to pretend this is easy, but if you will first think of these as learning opportunities rather than first thinking of them as "being knocked down" or being injured in some way, you will be on a much faster and smoother track. Get a little mantra going for yourself, "stay calm...what can I learn here..."

 

On 3/14/2019 at 2:33 PM, tj151619 said:

I know I need to develop that thick skin everyone talks about, but its hard to want to go into a job where you feel alienated because you're that new nurse and everyone thinks you're incompetent. 

Yes. That is hard. Know that a very good number of us would never refer to or think of this as "incompetence." I mean this kindly: Don't project your (normal) concerns onto others and then let that cause you to feel alienated by "everyone else." There are outliers who are unkind. Don't let them dictate your life. Assume good until you have a real reason not to.

 

On 3/14/2019 at 2:33 PM, tj151619 said:

I seldom see or hear from my unit manager. 

This person might be happy to touch base with you if you ask. In addition, do you have an educator or person in similar role who can kind of synthesize feedback for you/with you? Give you some reassurance? Talk with you about how your orientation is progressing?

**

Your post seems to be written by someone who can and will make it. So I say "hang in there."

👍🏽

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I hear you. I am in a similar situation on a unit where I had worked for 2 years prior to becoming an RN. I have anxiety, which has been under control for a number of years, but is rearing its ugly head almost daily when I have to go to work. My manager told me that having so many new people is stressing out the charge nurses. I totally understand that, but feel even more isolated because I feel like I can't show any discomfort or ask for help because I am a pain. 

I also feel like the experienced nurses on the unit think I am stupid because I don't know the things that they do in terms of charting/hand-off/bed alarms... This then makes me feel even more anxious... 

The whole experience has felt very undermining. I am already thinking about getting off the floor and moving into a different environment because I feel so inadequate. Every day I feel like I am going to do something that is going to hurt a patient and then find out afterwards that what I did was the most obvious thing in the world and it was my incompetence that killed them.

I am 6 months in and feeling more and more anxious.

Did others have this same experience?

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Jenna specializes in Care giver.

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On 3/14/2019 at 11:33 AM, tj151619 said:

I am in my third week of orientation as a new nurse and I cannot for the life of me understand why I went from being so eager to start this new career to dreading going in for my shifts.  I used to work as a CNA for nearly 3 years and I am finding it difficult to adjust to the change.  I know I'm intelligent enough to do the job but I am just struggling.  It's terrible that I've started searching for another job because quite frankly don't know that I can cut it as a floor nurse.  I LOVED being an aide and getting to spend more time with my patients.  But now, I am a nurse and feel like I am just not cut out for it.  I was not aware my position only allotted 4 weeks of training before you fly solo (I was under the impression from my interview that it would take 6-8 weeks).  Although my preceptor seems to think I will do just fine as well as some of the other nurses on the unit, I don't feel competent to be on my own.  I am terrified of hurting someone due to my lack of knowledge (I'm working on a specialty unit - cardiothoracic surgery).  Sure my charting looks good and I can do quick assessments, but as far as identifying patient needs or knowing when to call the physicians I am clueless.  Just the other day, I had basically been given my *** handed to me by a nurse who either intentionally or unintentionally knocked me down a peg because I wasn't aware of a certain protocol that I needed to do prior to leaving.  I stayed over willingly to fix my mistake, but by that point she was just done with me.  I didn't think it would happen so soon, but I got out to my car and just broke down.  I know I need to develop that thick skin everyone talks about, but its hard to want to go into a job where you feel alienated because you're that new nurse and everyone thinks you're incompetent.  I do not feel welcome on my unit by other nurses or even the aides.  I seldom see or hear from my unit manager.  I just don't know what to do and pray that I don't feel this way a few months from now.  Sometimes I wonder if staying an aide would have been a better choice.

Is there any advice more experienced nurses can share that may alleviate or help reassure me that this feeling will go away in time?  How do you approach your preceptor, let alone other people working on your unit for help who don't seem interested in lending you a hand.

Sorry for the sob story.  I just feel lost and uncertain about what to do moving forward.

Be confident and don’t let anyone make you feel less than or dull you’re sparkle you are amazing and an angel a gift! Be confident all else will come shine they with you’re confidence! 

On 3/18/2019 at 11:18 AM, JKL33 said:

This is a major life transition and, as already mentioned, basically the picture of what they used to call reality shock, or navigating the gap between what you imagined/what you were taught, and actual reality.

A few comments:

Generally speaking, being cognizant and even worried about this (but hopefully not truly terrified/incapacitated) is going to work in your favor, as well as the favor of every patient you touch for the rest of your career. Acknowledging a normal/expected knowledge deficit is part of being a safe learner, IMVHO. So I hereby proclaim that you are safe to continue learning. 😉

 

Two pluses in your favor! You know the basics of assessing patients and are able to chart effectively.  It is perfectly fine and normal that you are still learning to integrate the next step of making a nursing dx, or (for a less scary description) recognizing a problem and beginning to formulate a plan for how to handle it.

 

Okay, yes, that is hard. Try to take reasonable correction in stride and try not to take others' reactions personally (their reactions are on them). Try to stay calm as you gain perspective about these things. Pretty soon (actually pretty quickly) you are going to learn who is reasonable and trying to help you, who is passionate about good patient care and is sometimes a little intense based on that, who has a poor self esteem and looks for opportunities to skewer other nurses in order to feel better about him/herself, and who is simply selfish, self-centered and mean.

I won't even begin to pretend this is easy, but if you will first think of these as learning opportunities rather than first thinking of them as "being knocked down" or being injured in some way, you will be on a much faster and smoother track. Get a little mantra going for yourself, "stay calm...what can I learn here..."

 

Yes. That is hard. Know that a very good number of us would never refer to or think of this as "incompetence." I mean this kindly: Don't project your (normal) concerns onto others and then let that cause you to feel alienated by "everyone else." There are outliers who are unkind. Don't let them dictate your life. Assume good until you have a real reason not to.

 

This person might be happy to touch base with you if you ask. In addition, do you have an educator or person in similar role who can kind of synthesize feedback for you/with you? Give you some reassurance? Talk with you about how your orientation is progressing?

**

Your post seems to be written by someone who can and will make it. So I say "hang in there."

👍🏽

The biggest thing I’m seeing is all nurses need to lift each other up and in school and on the job build each other’s confidence !!! 

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laflaca has 5 years experience as a BSN, RN.

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Everyone feels like this at first!  EVERYONE.  Even you, even people who look more confident, even people who got all A's in nursing school.  I did too. 

A lot of what you need is pattern recognition.  Think of something complicated that you already know how to do, like driving a car.  I recently was in the car with my niece, who's just learning.  There are a million situations that freak her out.....Merging.  Driving up a steep, curvy hill.  Passing.  Entering traffic circles.  Changing lanes at highway speed.  Most of her attention is taken up just by going forward and keeping the car in a lane, so she has to think really hard and get a lot of patient coaching to do anything additional.

But if you've driven for a while, you usually do this stuff with confidence, right?  It's not because you're smarter than my niece - it's because of experience.  You've learned to recognize a situation and, without thinking about it, take a bunch of steps almost unconsciously.  You notice people ahead braking, you put on the brakes and check the traffic behind you without thinking.  You're looking over your shoulder before you even see the "merge" sign.  You're turning left from a small street onto a busy street - you know that if you can't find a gap to safely turn, you can always turn right and go around the block. 

It's similar with nursing.  A lot of our work is not rocket science, frankly - it's experience.  Your brainpower is working hard now to just do assessments, give meds safely, basically stay between the white lines.  After a while, that stuff is integrated - you're not reciting a list to yourself, you just know it - which frees up some brainpower to work on the next layer of knowledge.

Being on a specialty unit is GOOD in many ways.  Soon you'll see that there are certain procedures/patient types that repeat themselves.  You're not dealing with everything under the sun like you would in the ED - it's a defined group of procedures, specific pathophys issues, a particular list of protocols and meds, a certain group of surgeons.  You will start seeing them over and over.  You'll see some codes and participate in responses, over and over. 

If you stick around to get the experience, pay attention and do your best, and tolerate the distress of feeling like an idiot for a while....it gets better.  It really does.  But you're going to feel worried and dumb for a while, there's just no way around it. 

Deep breaths, write down what you learned and what you need to look up after every shift, and be kind to yourself.  You can do it 🙂


 

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