New Nurse, Too Slow

[Shrizeal]

Hello all, This is my first post, but long time lurker. Reading many of the posts have made me feel better immensly, and I want to thank everyone who posts and responds on this forum. I am posting because I feel that maybe someone can help me figure me out a little better or at least have any pointers, tips, anxiety relief. Just talking about it makes me feel better to be honest. My essential problem is..TIME MANAGEMENT. My educators keep saying that it'll come with time and they all say I'm doing great and I'm fantastic and heard good things about me from the nurses. One actually said that i was the "star pupil". But I still can't help but feel that I'm not good enough and now recently i fear that they'll let me go. (Most likely just my own paranoia).

I graduated in May, found a job by Novermber-ish on a Med/Surg/Tele Unit. I am in my 8th week of orientation now and just got switched to the evening shift in which I was hired for but still on orientation.

Throughout my orientation my preceptors have all said that I'm slow when giving out medications and my assessments but usually can get most of the work done with not so much help. I now started my evening shift with a new preceptor and she also says I'm slow, but this time too slow. She's very knowledgeable and is a very good nurse. When it comes to meds for me, I think I'm a little too careful. I check medications 3-4 times (as i look for the med, when i get the med, after dispensing it into the cup and again right before going to the patient). I understand that being careful is good, but it seems like I'm being too careful as per my preceptor. It's funny because my clinical professor in school actually took me to the side and asked me if I had OCD because id check my meds several times. I really just don't want to make an error. I've caught myself almost making errors a few times and my checks have saved me from making that error.

Currently I have 6 patients. I do their med, assessments and check orders some of the time. But it seems like i'm never doing enough. When giving report to the next shift the nurse is always filling in a gap that i missed or didn't follow up on.

Essentially my issue is time management I believe. To work on time management takes experience according to the educators. My preceptor that precepting me on the day shift says i was doing well, I just get faster and I would be a good nurse. Now I have a new preceptor (just finished my 3rd shift with her) which says I'm far too slow and need to get faster, quicker.

Another issue that seems to come up is following up on things. I think this is a true problem of mine that I need to work on. What I've been doing is that I'll write it down and I'll keep checking back to that its followed up. It has been effective, I just need to get better at it.

I think I'm too focused on the medication administration aspect I think. I won't have a med in my cart and i'll just dwell on that. What i should be doing is flag it, and come back to it when i get the chance unless its a stat or a drug that's very important, and continue on. But sometimes i'll just dwell on that. Or if i need a a drug thats in the med room i'll just dwell on that rather than taking my cart all the way back to the station and getting it and then going back. (can't leave the med cart by itself =) ). When I do meds i'm stressed and pretty damn anxious to be honest. I know the meds, i know the 5 rights, i check my patient Identifiers and everything. I clocked my self at almost taking me 10-20 mins to do one patient medication from start to finish (reading the med book then to sign the meds given)..

If anyone can provide assistance, words of wisdom, or anything in general; please feel free to reply!!! =) Thanks for letting me vent and typing this out. Perhaps tomorrow in the morning I can give a better post, because I just got out of a shift and I didn't do well at all =(. I keep kicking myself for it too. And it feels like my Preceptor is too (I think i'm just being a sensitive sally about it).

I think I'm going to talk to one of the educators tomorrow about it, so i can just vent to her a little bit and let her know how I've been feeling and everything.

I just hope i keep this job!!!!!! is it often that orientees are let go?

[slave_diverRN]

Perhaps you are little OCD, and it sounds like your biggest challenge is passing meds.

Even in the "NCLEX hopsital" where there is unlimited time and resources, there's no need to check a med more than 3 times.

Wiith time, you'll get faster at this peice as you become more familar with the meds. By this, I don't mean just knowing what the drug is and what its prescribed for, I mean which pills you can open easily....which ones you pull out the scissors for...(prilosec has the most evil packaging!), which ones you just stuff in your pocket all together (stuff like Miralax). You'll develop your own routine...where the longest part of the med pass is waiting on that patient who wants to take them .....one....pill......at......a......time....zzzz.

Best of luck to you, and STOP STRESSING.

[nurseprnRN, BSN, RN]

listen to them. they think you're good, and they've seen enough new hires to be able to come to an informed opinion. if you want to see what they'll tell someone who isn't cutting it, check out the thread on "new grad, bad report in orientation."

cut down the med checks to three-- multiply that times all the meds and all the patients and you'll find you have a lot more time to use more productively. you'll start feeling better. and there's nothing like feeling better to make you feel better.

[Shrizeal]

Thanks a lot Slave diveRN. I have to agree haha, I've been running into situations patients don't want to take the meds or they take a longggggg time taking them, or G-Tubes or NGT (the worst, got to make sure the meds are crushed to powder) haha.

You're right too Grntea, they're the ones who train everyone they've seen plenty of new grads and new hires to see the potential in me and everything.

I saw the Nurse Educators again for my weekly review. They said again I'm doing well, and I let them know how I was feeling and everything. They said the way I feel is a typical New graduate haha. They said to relax, and to take it easy. They said New grads tend to think too much of themselves to quickly. I definitely see myself doing that. I noticed that I expect myself to operate as a fully fledged RN like my preceptor who has been a nurse for 5 years. The educators said that, I shouldn't be doing that and should just concentrate practicing safely and effectively the rest comes with experience and practice.

Thanks a lot so far. Made me feel a lot better.