new nurses considering quiting?

uscstu4lfe · Sep 10, 2008

A previous poster here encouraged to carry around saline flushes. I don't know what this world is coming to, but at our hospital, it is a violation to carry around a flush in your pocket. It is only allowed to be carried from the med cart, in hand (like meds), directly to the patient's beside and be used promptly. We are NOT allowed to carry flushes. We are told it is considered a drug. We have a new night supervisor that looks for retarded policy violations like these and makes sure that we follow them. Do you even know how tedious it is to go back and forth for a saline flush now? Arrrggghhh....

Natkat, BSN, MSN, RN · Sep 10, 2008

I am so sorry to hear you're having a rough time. I would encourage you to hang in there. Two months isn't nearly enough time to get the hang of nursing. It takes time. I think just about everyone has this experience when first starting out. Heck, I ven went through that when I started my job, and I even had experience! It was just a different level of skill and responsibility that I wasn't prepared for. But I was patient with myself, and my boss gave me tons of encouragement. Eventually it got better and I'm so glad I didn't quit.

Hang in there. Give yourself more time. You are right on track in spite of how you feel right now. Really. I promise. Try not to be so hard on yourself. Someday you'll look back on this and wonder why you were so worried. Not to minimize your feelings though. It is stressful but you'll get there.

MILESTONE11 · Sep 10, 2008

I WANTED TO ASK IF ANYONE HAS TAKEN THE NURSE CAREER BATTERY TEST AND WHAT THEY THOUGHT??? :confused:

brissygal, BSN, RN · Sep 10, 2008

Your plight struck a chord with me.

Look on the bright side. Things will improve for you. Look at all the positive advice that has been given to you. You are a strong nurse, and will rise from this. Realise that nursing is a 24 hour job you are not expected to be a super nurse. Learn to deligate work with your LVN's and CNA's they will be your best buddies in nursing. Smile.......sing a melody in your mind.... if you are going to cry run into the stairwell or go to the bathroom, realise the patient in the bed is more frightened than you are.

I feel for you and have been in your shoes many times, I have nursed in a busy hospital in the USA and had three years under my belt then and found that I was floundering like you. I had to contend with different drug names, an imperial system that was half mixed with the metric system that I was familiar with. I survived and so will you.

Hardwork has never killed anyone! But talking to your Managers or team nurse on duty is great advice. We need people like you in Nursing - I can tell that you are a caring nurse. You can always get help in Nursing - just ask?

All the very best to you.

Chin up - you will do well and go far in your nursing career I am sure of that. :nurse:

MILESTONE11 · Sep 10, 2008

Has Anyone Taken The Nurse Career Battery Test Recently And What Did You Think Honestly??

brissygal, BSN, RN · Sep 10, 2008

Hey Milestone11,

Sorry to have cut you off. I am new at this website. Sorry I can not reflect on what you have said. As I have no clue in the world what you are refering too.

Sorry from the Aussie.

CHATSDALE · Sep 10, 2008

most people say it takes them a year to feel comfortable in their 'new nurses skin'

if you feel that this is too much for you at this point in time see if there is not another floor or a different part of nursing

you have put a lot of schooling and work into this..don't throw out the baby with the bath water

FireStarterRN, BSN, RN · Sep 10, 2008

You sound fairly normal. I agree with the poster who encouraged you to be problem oriented. Focus on the patient's diagnosis, and don't think that you are going to go down the line and do a total head to toe assessment on each patient in an orderly fashion. Nursing just doesn't work that way in real life.

Focus on the sickest patients first, and focus on their problem and or potential problems they could have. You'll get better, don't give up, you're only 2 months out of school after all.

uscstu4lfe · Sep 10, 2008

i would love to quit, but financially i can not do that. i thought nursing school was so fun! learning new things, study buddies, quizzing each other, going to labs, being nervous together, going to clinicals for about 6 hours, 1 hour lunches where we all sat together and just chatted without any worries, went to post conferece where we would snack on our snacks and we'd be spoon fed information. well, then i got a full time job. i'm busy most of the time, we're all too busy to sit down and just talk, i work for about 12-14 hours and my back hurts, i'm exhausted, and all i want to do on my days off is sleep/nap. i'm calling doctors, stressing about a declining bp without having any orders, a doctor that won't call me back because it's 2am, and so on. i think nursing work sucks ass. however, looking back, i absolutely loved nursing school.

i think i would have a better outlook if i could find a bedside job that had less hours per shift. like i said, i would love to exit nursing but where in the hell am i going to find someone willing to give me $35 an hour straight out of school with an associate's AND have the option to work all over and travel? Well, i'm probably not! I'd love to find a desk job somewhere and make 35 an hour.

mama_d, BSN, RN · Sep 10, 2008

I see that you're from St. Louis...I work in a hospital in St. Louis as well!

First off, take advantage of the fact that you feel you're on a supportive floor. And let me add on that I too think it's totally normal to be overwhelmed with as new as you are! There is a huge adjustment to be made when you first start out on your own as a nurse.

Think about the nurse that you admire the most on your floor. Assuming that they would be receptive, ask your manager if that nurse can shadow you for a day and give you advice on what you're doing right and what you could be doing better. I'm sure that there are plenty of things that don't need any fixing, and sometimes just tweaking your routine a little bit can make a big difference. Also, do as many things as you can every time you go into the room...making them use their incentive spriometer in front of you when you do their first assessment of the shift saves you the time of having to make a special trip to do so, etc.

Are you on days or nights? I think that the night shift is better for newer grads just because you don't have to do all the chart sharing, your patients are actually on the floor, and you don't have to deal with as many docs and family members. Just a thought.

My routine for my shifts is as follows, in case it might help:

1. Get report. Check monitor to ensure rhythm is what I was told it was. Check chart to make sure that orders from the last 24 hrs were noted and see if any need following up on. Make sure any timed labs were drawn that needed to be and see which ones need to be drawn at odd times on my shift.

2. Quickly check MARs to make sure those pesky 1800 meds were all given...if they weren't, I can give them right away. Also check to see what patients are getting cardiac/BP meds with their 2100 pass...those go into a pile so that I can check on vitals before giving them.

3. Check on each patient and do assessment; check all armbands and make sure they have all they are supposed to have; cut off outdated blood bands. While in room, I check to make sure dirty linens are picked up; labels are on I&O, charge, and rounds sheets on door; urinal/BSC/hat is emptied; gloves are stocked; heplocks flushed; how much IVF is left and make sure tubing is not outdated; how much O2 patient is on; turn and/or potty if needed; check any dressings/wounds; pitcher is filled (unless fluid restricted); check for signage on door if warranted; collect dirty trays. Before I leave the room, I am sure to ask if the patient needs anything, if they think they will need a sleeper that night, and if they have any concerns about their care they need to address. I also let them know at this point if they're NPO after MN, verify that they are aware of any tests going on over next 24 hours, and if they have labs/EKG due in am. I then tell them "I'll be passing my meds after I finish assessing all of my patients, I'll likely be back in in about an hour. If you think of anything you need before then, just call on your light." For some reason, them knowing when I'll be back in helps cut down on call light usage. Lather, rinse, repeat for next in line.

4. By now, the techs are about done getting vitals. Hopefully they are all fairly stable, or can be easily addressed. I make sure that my techs are up to date on what they need to know, run my strips, and sit down to look over care plan/kardex and update as needed. This is also when I call docs if patient vitals need to be addressed or if the patient indicated they want a sleeper and there's none ordered, if the pressures aren't under good control and I feel I may need a PRN for it throughout the night, or if I want to suggest Lantus for a patient, etc.

5. Around 2100, I start my routine hs med pass. I make sure to tell the patients what I'm giving them and what it's for, so if they have any questions I can address it. You won't believe what you can catch this way..."Oh, I forgot to tell my doctor that the last time I had a sulfa drug my throat swelled shut"...."Um, I only take 6.25 of Coreg at home...I just split the 12.5 pills in half" and ended up it was misrecorded on admit papers....you get the idea. This is also when I make sure my diabetics have their snacks, assuming that the one touches are done already.

6. By now it's about 2200, and I can sit down and do charting around the call lights. Take advantage of every patient interaction you have for education and evaluation. Just got Mrs. Jones up to the commode? Slap some barrier cream on her butt when she's done and you've done skin breakdown prevention. This is also the time to remind the techs who I have that needs to be turned and to let me know if they need help doing so. This is also when I check to make sure that I have all the piggybacks I'll need for the shift and order any supplies for the patient that I need to as far as ostomy/wound/breakdown prevention etc. And check MARs.

7. Now that it's about 2330, time to do it all over again. And again at 0330.

8. Starting at 0500 (it seems like whether you work days or nights the crap hits the fan at either 0500 or 1700...anyone else feel this way?) I make sure my area is picked up, pull up 0600 meds, verify that my paperwork is done, and then pass meds. I also let my patients know that I'll be going off shift soon and want to make sure that everything is taken care of before the next shift arrives. Refill pitchers if needed, double check hats/BSC/urinals, do a final turn or potty, etc.

9. I like to start checking my lab results by 0550 so I can start calling docs with them if needed at 0600. Gives me time to get orders and often even give that extra dose of KCl or draw that type and cross before I go. I've learned that if you take the extra few minutes to do those kinds of things for the next shift, they'll be more willing to return the favor.

I also chart very thoroughly for my 2000 assessment, then just enter a brief narrative to accompany the checkmark charting for subsequent assessments, assuming that the patient stays stable.

Once you find your groove, you'll be fine. It just takes a while to get a system worked out that works for you. Ask for help if you need it, ask for advice when you need it, utilize your resources. If you start out well organized at the beginning of the shift, it makes a world of difference. Also, no matter how long you've been doing this, you won't always have organized shifts or get out on time or get everything done on time. The mere recognition of that fact can take alot of stress off of you.

Sorry it was so long, but I hope it might have helped you out some.

Virgo_RN, BSN, RN · Sep 10, 2008

The first year is very difficult. There is nothing like nursing to make a person feel so inadequate and stupid. What you are going through is so normal. My advice; identify your resources and use them. Never, EVER be afraid to ask questions.

RN1982 · Sep 10, 2008

Hello all,
I graduated nursing school in May. I passed boards and have been a practicing RN for 2 and 1/2 months.The floor I am on is very supportive and encouraging for new nurse learing(well,most people).The floor is really fast paced, a little to fast for me.i can't keep up! I dont know if im coming or going and I feel like the patients are suffering from my lack of knowledge. For as long as I can remember, I have always gotten not so good reviews about my performace. Which leaves my confidence down.Actually, I have never been that confident.I have not had a chance to build it up. So, I do not know if I should quit or stay.I dread going to work so much that the night before I dont get any sleep, Im stressed the whole time I am there, and i cry when I get home.I dont know if I should go to another floor or stick it out with this one.What to do all nurses?Thanks for your help.

Your username sums up the first year for just about every new nurse. It sucks but before you think about quitting, take a deep breath. I felt the same way you do when I graduated from school and got my license about 3 years ago. I cried every night when I went home for three months.

The first year was extremely trying especially when I started working on the same floor that I had been an aide on. The nurses were nitpicky and the aides felt that I shouldn't be asking for assistance because I was an aide and apparently I could do everything on my own. It does get better. Give yourself a chance. Like another poster said, you are in the pre-school of your nursing experience. You will feel differently in a few months, I swear.