New Nurse, terrible shift

allnurses Guide · Jun 26, 2019

First, when your brain starts to overwhelm you, take a moment for a few deep breaths. Everything functions better with enough oxygen.

Next, have your brain sheet ready for report. Fill it out as report is given. Know which things you NEED to know and which things you can get easily enough from the chart (ie: noncritical labs etc). As far as being judged, extend the nurse giving you report some grace. He or she may be very willing to help you if you give them the chance to do so. Your patients deserve you to ask the questions you need to know and not one single nurse out there is self-taught. We all were helped up by other nurses. All of us. You will not be an exception, so let them help you.

Skills will get better with time. Yeah, it is humbling for a while. It will improve faster than you think and some things may never be completely easy (ie: putting foleys in very obese women).

Stop comparing your personality to the other new nurses and telling yourself stories about them. Admit that you have no idea - because you don't. Ask yourself what you know to be true and don't believe everything your brain thinks. Be friendly, be kind, extend the grace you would like to receive. You are not less than them nor more than them. Patients need all kinds of nurses and one person's boisterous personality may be too much where your softer, kind reserve may be just right and vice versa. Tell your past and your insecurities to hush. They had nothing to do with you getting through nursing school and they don't get a vote or a voice now.

The first six months is really hard. Then more new grads arrive and you start to see how far you have come. The next six months then get a bit easier and the next year after that feels more solid.

Bad shifts come. I have learned its cyclical, so every time you have a bad shift, breathe deep and know the next shift is almost guaranteed to be better.

Hang in there. Reach out for help and find a good mentor.

allnurses Guide · Jun 26, 2019

Also....

I am very sorry about the anniversary of your mother's death. I was actively grieving as a new grad as well and the anxiety of being a new grad RN combined with acute grief can be crippling. Your mother would be proud of you. Give yourself permission to NOT work on important anniversaries if that helps you make space for your grief. Recognize your sorrow will occasionally (or even often for a while) tinge everything with a darkened hue. I am so sorry for your loss. Please feel free to reach out to me if I can offer you support in any capacity.

peaceweaver · Jun 26, 2019

Long-time browser around these parts, first-time poster — your situation resonated with me so much I just had to make an account to respond. ?

While everyone is different, I feel like I know almost exactly where you’re coming from and what you’re going through at the moment. I’ve been working as an RN for about a year now, and like you, I started nursing school at an older than average age and was in my early 30s when I graduated.

I can tell you that the first few months on the job were pretty miserable. I felt like nothing in nursing school had prepared me for the realities of floor nursing, and I felt like a complete failure who didn’t belong there. There were days when I came home feeling utterly stunned by just how hectic and overwhelming the previous twelve hours had been, and would curl up on the couch and cry until it was time to go to bed. It got to the point where I was even having crippling panic attacks after/before work, and occasionally crying in the bathroom during work. On top of it all, I was worried I’d never fit in on the unit (I’m also fairly shy and quiet), and was also dealing with passive-aggressive bullying from a small number of VERY burned out nurses on my floor who were dealing with their own issues and had clearly forgotten about what it’s like to be a new grad with lots of questions. The younger new grads seemed to be having an easier time of things (something that was not true at all, as I found out after the fact when we all had a much-needed venting session together), and I worried that my more senior coworkers felt I didn’t measure up to them. I thought about quitting almost every single day.

It got better, though. It took several months, but it got better. Here are some of the things I did that helped me with the transition (hopefully they will help you, too):

1. Visiting forums like this one, realizing that other new grads were going through the same thing, and reading seasoned nurses’ reflections on how hard they also found it when they first started. It made me feel much less alone, and like much less of an impostor (impostor syndrome is a common thing in high stress professions: look into to it if you haven’t heard about it before). You’re already here looking for advice and support, so that’s an excellent start. ❤️

2. Identifying kind, helpful, supportive coworkers and letting them know what I was going through. This can be hard in the first few weeks when you’re settling into the unit and learning more about the people you’re working with, but these individuals will soon become apparent to you one way or another. It’s very rare that a unit will be SO toxic that there’s no one to turn to for help and support.

3. Reminding myself of the good things that happened on a shift, and holding on to those moments when I felt overwhelmed. I still do that to this day. Just recently, I had an absolutely terrible day at work, thanks to being slammed with WAY more transfers and admissions than usual just before change of shift. I felt miserable when I got home, and sobbed almost as hard as I did in my very early days as a new grad. What pulled me through it, though, was recalling a moment earlier in the shift when I’d managed to somehow find five minutes to simply speak to one of my very scared, elderly patients and help her calm down a little before surgery. She squeezed my hand through her tears before she went down to OR, thanked me for comforting her, and said “I couldn’t have asked for a better nurse.” Hold on to those positive interactions you have with your patients. Most patients DO appreciate and recognize what you’re doing for them. However crappy and incompetent you personally feel, know that your patients and their families generally think the world of you and that you’re making a difference for them.

4. Actively seeking out opportunities to learn more about skills/procedures I was less familiar with. I found that when I graduated, there were certain skills commonly in use on my floor that I’d only read about or, at the most, practiced on plastic learning lab mannequins during school. If I discovered during report that one of my coworkers had to do a skill/procedure that I had limited experience with, I asked if they wouldn’t mind letting me observe/assist. That way, when I had a patient who needed the same thing done, I didn’t feel quite as completely at sea. Technical proficiency with skills comes with time and lots of practice — no one expects you to be an expert from day one. And as another poster above said, some things will ALWAYS be tricky.

5. Making time for myself on my days off, getting lots of exercise, and speaking to my doctor when I needed to the most. It was very tempting during those first few weeks/months to wallow in all the negative emotions I was feeling, but I knew it was getting me nowhere. Going for long walks, spending time with loved ones, etc. really helped me to recharge between shifts. Also, speaking to my family doctor helped a lot when the panic attacks became unbearable. I haven’t had a panic attack in months since I took the proper steps to get it treated.

Ultimately, hang in there. You’re not alone in this. The transition from student to novice nurse is very difficult, and in addition to the usual stress that goes with that transition, you have the added strain of dealing with grief over the loss of a parent. Nursing is hard, mentally/physically exhausting work, and no one understands this more than your fellow nurses. As cliched as it is, always remember that you need to take care of yourself before you can take care of others. Remember, too, that you’re doing valuable work that makes a difference in people’s lives — even on those days when you feel like garbage. You matter, and the work that you do matters. And it will get better. You just need to give yourself time.

Golden_RN, MSN · Jun 26, 2019

I was shy and timid as a new RN. This was a turn-off to some coworkers, and certainly to some nursing instructors. My assertiveness was something I had to work on over the years. As a new grad I felt exactly like you. I had to find a unit in which I felt comfortable (it was not my first RN job!) and make a concentrated effort to go outside my comfort zone, like approaching people that intimidated me, offering to precept (after I got thru that first year!), and later on, teaching. I still am working on my assertiveness 20+ years later.

On the positive side, being shy/quiet may mean that you are a good listener - so important in nursing. Give yourself some grace to get through this very tough 1st year. ALL new grads feel overwhelmed and have a ton to learn, even if they act outgoing or appear confident.

Monkey Nurse, ASN, RN · Jun 26, 2019

The more confident you are the more you will be able to put your shyness behind. You might have to imagine you're an actress pretending to be outgoing. I am also shy and reserved but I came out of my shell little by little because I began to feel more confident in my skills.

Being a new nurse is totally unnerving. I still feel clueless at times and am changing jobs and will soon feel clueless again. I promise it'll get better.

I'm sorry you are suffering such an acute loss. I'm sure its hard to venture out into this new career and new era in your life with someone so important missing from it. You have a family of nurses here that are happy to listen.

ascty87 · Jun 26, 2019

Thank you all so much. I have waited to be a nurse for so long (I always wanted to become one, but went a different career path first) and I have looked up to all nurses, so sometimes I get down on myself about my obvious lack of nursing experience. I feel much more positive today, and will take all of your wonderful advice and support in, I truly appreciate it. Thank you all!!

allnurses Guide · Jun 26, 2019

I was 41 when I graduated from nursing school. You are right on time. lol

Being a new nurse is extremely humbling. Do your best to accept gracefully your learning curve. You will only be new for a little while. Hang in there. I am glad today is better.

peaceweaver · Jun 26, 2019

That’s the spirit. You’ve got this!

Workitinurfava, BSN, RN · Jun 26, 2019

Problem is your panicking before the report. You know more than you think. First focus on what you did and what needs to be done. If you can't remember everything just talk on those two thinks mostly. The history is important but it can be looked up. As time goes on add everything together.

Rob27, BSN, RN · Jun 27, 2019

Do not worry about the other nurses "outgoingness and confidence." The best nurses I have ever seen are shy, quiet, and ask lots of (good) questions. If you don't know it, then that's OK, you can find out. The most dangerous thing in the world is to *think* that you know it, and proceed as such. I see these "outgoing" nurses like this come, and I cannot wait for them to leave because they annoy the hell out of me, and make newer nurses afraid to ask questions.

Nurse8988 · Jun 28, 2019

Hi there! First off, I want to commend you for pursuing your dreams and for the major achievement of becoming a nurse! I'd like to say that it is totally normal to have an off night. It is a reminder that you are human. I can identify with feeling uncomfortable socially and being shy. Also I've been in situations in report where I feel judged and uncomfortable as a result. Lastly, I've also had a rough night. The key is identifying your weaknesses and formulating a plan on improving them. As far as feeling shy, I'm not the expert in this to say that you will no longer feel shy but can say that once you develop a rapport with the staff and continue in your nursing practice, you will feel more comfortable with who you work with, feel comfortable with your practice, and you may not feel as stunned by the shyness as time goes on. As far as report goes, I recommend you have a system as to how you give report. For me, I make sure I get a good report, have all concerns addressed on report(don't be shy to kindly ask for clarification of things that don't make sense in report), and add on to report sheet as I go during the shift of occurrences that way when report comes I have a basis of report from what I received from previous shift and already have things added on as I went throughout shift so I feel confident during report that I won't miss anything. Either way, formulate a system and stick to it. IF you do miss things in report, remember this is all new to you. So be easy on yourself. Make sure you are working on improving but also don't be so hard on yourself. Each day is a new day so breathe and remember that the new day is another opportunity for you to grow and NAIL it! Confidence plays a big part in everything. I know you may not feel confident right now, but in my experience I find that the brain is a funny thing in that it believes whatever feedback you tell it. I say that to say that in this case speak kindly of yourself and eradicate negative self talk; that goes for internal and external. Each time you do it, catch yourself and replace it with something kind. Over time you will stop speaking negatively of yourself. Also tell yourself internally that you are a good nurse, that you have studied hard and can do this. Again, your brain believes what you tell it. It all has to do with brain circuitry and rewiring of it. SO, when you are giving report or even getting it and the nurse may be giving you the evil judgy report look, speak kind to yourself, remind yourself that you can do this, hold your head up, and shoulders back and conduct yourself as a professional. Or if you're in any other situation that you don't feel confident in you have to still carry yourself confidently so that you believe it and that others will believe in you(patients, families, and coworkers). HOWEVER, although you are to carry yourself confidently, NEVER do any nursing actions that you are UNSURE OF. ALWAYS consult with a resource(whether it be human resource or the policy, lexicomp etc) before doing something you are unsure of. You can hurt a patient otherwise. Better to be behind on meds, charting, etc than do things that you are unsure of. It will protect patients and your license that you have worked very hard for. I also recommend being humble and receptive. Watch other nurses who you feel have a good handle of the floor(may even be nurses who started with you and that's okay) and maybe even ask them for pointers or just observe for things that they are doing that you can incorporate. You can learn things from EVERYONE be it the patients, their families, CNAS, etc. Be receptive and humble. As far as the younger nurses who come off as more confident, that's okay. I've noticed that the younger ones have experienced less in life and are therefore less intimidated by social situations and other things. Similar to how for example younger kids may be so quick to do things like cart wheels and can make friends easily in the playground but adults are more self aware and are more cautious in doing those things. So same concept here and that's ok. However, as being older than them you most likely bring other things to the table that they have yet to master. The beauty in this is that okay, the younger ones may be more confident but that's great. Good for them! You can learn from that. They key is to be the best that you can be. If you identify your weakness and formulate a plan to improve, day by day you will be better and in months to a year you will be you 2.0. As time goes by you may still have very busy nights but will be able to handle it(as you will know where everything is, what the policies are etc) and will look back and say "Look how far I've come!". I'm so rooting for you and wish you all the best. Feel free to PM me if you have any other issues that you are having difficulty working through. We've all been there although there will be people who pretend they haven't(so don't let them intimidate you..which is a topic for another post lol).