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New RN burnt out

Stress 101   (408 Views | 7 Replies)

jennsrn has 1 years experience .

413 Profile Views; 19 Posts

I am a "recent" new grad, I graduated last May with my associate's degree in nursing and started my first RN job at a SNF. I've been unhappy there almost as long as I've been there (9 months), and it's really starting to affect my thoughts, and feelings regarding my ability to be the nurse I want to be and know I can be. It also is not helping that I am a new, unexperienced nurse in the middle of a pandemic. I didn't necessarily want to start in a SNF, because everyone says the hospital is the best place for a new grad. I was feeling a lot of pressure from my peers about "you need hospital experience, go to the hospital", but this has been a company I've been working for, for a long time (9 years), and they were willing to offer me very good money. They weren't able to offer me a position at their subacute facility which is where I wanted to go, but they transferred me to their LTC/SNF facility, so I decided to take the position because I thought it would be OK. Also, with my associate's degree in my state (NJ), it's almost impossible to land a new grad residency without having a BSN. Spots are highly competitive, unless you already have an "in" in the hospital, like as a CNA/PCT at their hospital. I did put a few applications out for just a regular med-surg position, but so far nothing, and it's really starting to eat at me! I feel as though I am not learning at my current job. I have had some experience with wound vacs, IVs, wounds, trachs, catheters, but I feel as though I am all along to figure it out - no guidance, no encouragement from my coworkers, and I just feel they look at me and see "RN", therefore I should know what to do. I am having a really hard time developing my assessment and critical thinking skills because my nurse:patient ratio is WAY too high (1:29), that I can barely think about WHAT it is I'm doing, and WHY. I have improved on my time management, that I'm proud of, but I am scared to ask questions sometimes, in fear I will look like an idiot, I question what situations warrant me to call the doctor or not to call the doctor, and whenever I have to call the doctor I get so scared because I don't want to say the wrong thing, and don't want to look like an incompetent nurse (even though the doctors are VERY nice). I am completely overwhelmed and it's not getting better. I work 3-11, and it also has made me even more upset and depressed that I barely see friends and family. I struggle with anxiety and self-confidence, something I've been aware of since before starting nursing school, but ever since starting my first job, it's been at an all-time high. I am medicated and speaking with a doctor regarding my anxiety and depression, but I am so completely burnt out and feel like I am never going to make progress as an RN and I feel like I am failing. I am so worried that by the time I get my BSN (I am in school now, and should graduate by September 2021), that no hospital will want me because I have no acute care experience and will no longer be eligible for a residency. But at the same time, I don't even know if the hospital setting is for me, and is somewhere I want to be long-term. Almost all nice outpatient jobs require acute care experience, or just nursing experience in general.

Since I do have 9 months experience now, I am in the process of looking for a job elsewhere.  I thought maybe a sub-acute/post-acute job may be a good place to start, and the setting will help with my self-confidence. I really do truly believe my problem is my job, NOT nursing. My job is very demanding, and that's also taking a toll on me. Also I tend to compare myself to others, and I hate it. My sister is an RN, with two years of experience, and I feel as though I have an expectation to live up to. I am on vacation this week, and I am still being bothered by my scheduler, asking I can work a 16 hour day in the middle of my vacation, because they have no staff. It made me so upset, that even on my vacation I can't be left alone. My family is really encouraging me look elsewhere and think it will help my mental health and happiness to get out of the toxic environment. Anyone have any advice for a new grad dealing with burnout? I think it's important to work for a facility that really supports and guides their nurses (especially new ones), and I am not receiving it at my current job. I feel as though I am just a body to get the job done. I don't even want to go into work anymore, I am feeling a great disconnect. 

 

Any advice for a overwhelmed, sad, burnt out, new RN? Thanks!

Edited by jennsrn

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barcode120x has 5 years experience as a ADN, BSN, RN and specializes in Telemetry.

568 Posts; 10,583 Profile Views

The obvious choice is to look elsewhere, but unfortunately you can never know if another facility/position will treat you well. I personally think it's not worth working at place that you dislike and/or is not good for your mental health and if I were me, I would leave. Then again, I don't know how financially stable you are, if 9 months of experience is enough to go somewhere else, etc. There's a lot of factors you will need to consider if/when you leave. But remember, there's no guarantee your 2nd, 3rd, or even 4th job will be better, worse, or neither. You'll come across crappy patients, crappy docs, crappy nurses, crappy management, crappy workplace, crappy everything. You're bound to come across at least one of those but unfortunately, that's the nature of nursing.

It's hard for me to say "you'll get used to it," because sometimes that is the truth to nursing and it is hard to get away from it all. But, there are some things you will get used to. Just like you, I was terrified to have to call the doc for anything because of similar reasons you had mentioned about asking the wrong question, giving the wrong answer, etc. Over time I got used to and now, I just call the doc with whatever I need with no hard feelings on either end. My first 6 months were the most anxious months I've ever lived because of nursing. I would sit in my car after work for 20-30 min thinking if I forgot something. I would lose sleep because I would think about what potential sick patients I might get and what I would have to deal with.

Find good coping strategies and stress relieving hobbies. Weightlifting really helped me through my first year as a new grad; although I didn't nearly have it as tough as you. I found solace with the new grads that started with me. We all hung out and talked about our days. It really helped to talk to others that were dealing with similar anxiety issues. Good luck and focus on your health!

Edited by barcode120x

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14 Followers; 4,219 Posts; 32,803 Profile Views

Sorry you are feeling bad. Start with giving yourself some credit for surviving these 9 months. You undoubtedly have learned a lot more than you realize.

One thing that complicates everything is this idea about acute care. Yes, in acute care there is more support; if nothing else there are just more people around (peers) who can be consulted throughout the day.

It isn't a bad idea to keep putting out feelers for other jobs, but I agree with the previous poster that there are no guarantees about finding a better environment. Hospitals have their own expectations and they aren't especially pleasant about getting done exactly what they want done. They're no different than any other big business.

Some small part of this is internal discomfort and you should continue taking steps to conquer that. For example:

16 hours ago, jennsrn said:

I am scared to ask questions sometimes, in fear I will look like an idiot

You fear that someone else might think you're an idiot or mock you in some way or find your questions ridiculous. Well, realistically it's unlikely that you're surrounded by people who are far and away more intelligent than you are. They probably know some things you don't, especially if they have been there longer than you and/or been a nurse longer, but they learned what they know the same way that you're going to learn what you need to know. They aren't a different breed that is just inherently better and smarter than you.

Ask away and be pleasant about it. Tip: If you are pleasantly assertive (using good posture, eye contact, friendly face, etc.) they will be WAY less likely to find something to pick at. Unfortunately those who look like easy targets are often targeted. If you give off the vibe that there's something wrong with asking questions (by displaying reluctance, insecurity, shame, etc), then others might just follow suit and treat it as if there actually is something wrong with it. Work on what you are displaying/projecting; make sure it is confidence, pleasant assertiveness. Don't be ashamed.

16 hours ago, jennsrn said:

I question what situations warrant me to call the doctor or not to call the doctor, and whenever I have to call the doctor I get so scared because I don't want to say the wrong thing, and don't want to look like an incompetent nurse (even though the doctors are VERY nice)

Ask yourself what's the worst that can happen. This helps keep your own anxieties in check. What's the worst that can happen when calling a doctor? Realistically it won't be much worse than having to hear snide comments or being yelled at. While this isn't pleasant (and isn't appropriate), it's a big whoop-dee-doo overall. Who cares. When others act inappropriately it doesn't say anything about YOU. It says something about them.

If you are concerned about a patient or need something for a patient, get your thoughts together (write down a concise summary if that helps you), have recent vital signs on hand, and have access to the chart. Present your case in a professional tone, and use common courtesies. That's all there is to it. If someone doesn't like that, it's their problem.

Summary: You're getting by. Go ahead and feel a little more confident that you can handle things. Nothing wrong with continuing to look for other employment possibilities, but in the meantime keep moving forward with your confidence and overall patient management.

Best wishes~

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speedynurse is a RN, EMT-P and specializes in ER.

110 Posts; 442 Profile Views

It is good that you recognize you need a change. That is the first step. One thing I recommend is make sure you have a very good resume and cover letter to sell yourself as a future employee. I agree that jobs are somewhat hard to come by right now in the midst of a pandemic, but don't let that stop you from trying. I started in the ER and am still in that environment, so can attest that acute care is very tough. However, the difference is that IF you have a supportive team (and some acute care is supportive and some is not), then that can make the craziness a little less crazy.

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Can your sister get you hired at her facility?  You should be able to land a hospital interview as long as you include that you are enrolled in a bachelors program.  Ask for an informational interview with talent acquisition/ HR.  Tell them that you are great at your job but would like to work with higher acuities and more experience RNs.  Ask them how best to get onboard.  Dress like you are interviewing and have all of your supporting documents with you.  Show them you are ready.

Edited by Queen Tiye

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jennsrn has 1 years experience.

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On 6/5/2020 at 10:15 PM, Queen Tiye said:

Can your sister get you hired at her facility?  You should be able to land a hospital interview as long as you include that you are enrolled in a bachelors program.  Ask for an informational interview with talent acquisition/ HR.  Tell them that you are great at your job but would like to work with higher acuities and more experience RNs.  Ask them how best to get onboard.  Dress like you are interviewing and have all of your supporting documents with you.  Show them you are ready.

I applied at the facility... management there is terrible I'm finding. No call back, no interview. I figure it's because they don't want me working in the same building as my sister even though I was told that's not a legitimate reason not to hire someone. Which is unfortunate because I really think I'd benefit well in a strict subacute setting, where it's similar to a hospital setting, but not as extreme. I'm going back and forth on the hospital setting. I'm not sure if I'll like it, but I can't imagine not TRYING, even if it's only a couple years to get some med/surg experience. My problem is I worry too much about what others say and think. I don't want people looking down on me because I have no hospital experience, or desire to work in a hospital. My overall goal is to find a nice job outpatient, I do have interests in forensics and case management. I did apply to some hospitals in my area, so hopefully I get a call back. In the mean time I'm trying to stick out my current job until the 1 year mark, and look for other sub-acute jobs with better hours. 

Thanks for your input and advice!!

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jennsrn has 1 years experience.

19 Posts; 413 Profile Views

On 6/4/2020 at 1:45 PM, JKL33 said:

Sorry you are feeling bad. Start with giving yourself some credit for surviving these 9 months. You undoubtedly have learned a lot more than you realize.

One thing that complicates everything is this idea about acute care. Yes, in acute care there is more support; if nothing else there are just more people around (peers) who can be consulted throughout the day.

It isn't a bad idea to keep putting out feelers for other jobs, but I agree with the previous poster that there are no guarantees about finding a better environment. Hospitals have their own expectations and they aren't especially pleasant about getting done exactly what they want done. They're no different than any other big business.

Some small part of this is internal discomfort and you should continue taking steps to conquer that. For example:

You fear that someone else might think you're an idiot or mock you in some way or find your questions ridiculous. Well, realistically it's unlikely that you're surrounded by people who are far and away more intelligent than you are. They probably know some things you don't, especially if they have been there longer than you and/or been a nurse longer, but they learned what they know the same way that you're going to learn what you need to know. They aren't a different breed that is just inherently better and smarter than you.

Ask away and be pleasant about it. Tip: If you are pleasantly assertive (using good posture, eye contact, friendly face, etc.) they will be WAY less likely to find something to pick at. Unfortunately those who look like easy targets are often targeted. If you give off the vibe that there's something wrong with asking questions (by displaying reluctance, insecurity, shame, etc), then others might just follow suit and treat it as if there actually is something wrong with it. Work on what you are displaying/projecting; make sure it is confidence, pleasant assertiveness. Don't be ashamed.

Ask yourself what's the worst that can happen. This helps keep your own anxieties in check. What's the worst that can happen when calling a doctor? Realistically it won't be much worse than having to hear snide comments or being yelled at. While this isn't pleasant (and isn't appropriate), it's a big whoop-dee-doo overall. Who cares. When others act inappropriately it doesn't say anything about YOU. It says something about them.

If you are concerned about a patient or need something for a patient, get your thoughts together (write down a concise summary if that helps you), have recent vital signs on hand, and have access to the chart. Present your case in a professional tone, and use common courtesies. That's all there is to it. If someone doesn't like that, it's their problem.

Summary: You're getting by. Go ahead and feel a little more confident that you can handle things. Nothing wrong with continuing to look for other employment possibilities, but in the meantime keep moving forward with your confidence and overall patient management.

Best wishes~

Thank you!! I really needed to hear that. I am trying to work on the whole self-confidence issue, especially when speaking with doctors, NPs, etc. I just feel because I am so new, I'll say something stupid or look incompetent. But then I tell myself I rather look stupid than risk a patient's health and/or life, and my license. But I realize I won't be the nurse I aspire to be in month's time. The only thing I can do is keep looking for employment elsewhere, and in the meantime make the best of my current situation. Go into work with a positive attitude, ask questions, and also be open to learning. I think part of my issue is that I started in a SNF that had no "new grad residency", so I was kind of just given a short one month orientation and told to figure it out, so not feeling supported and comfortable in my current environment hasn't helped my anxiety, fear, and incompetency. I have made it 9 months so far though, and I'm sure I have made progress, and I need to give myself at least a little more credit! 

Thanks for your advice and help!!

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jennsrn has 1 years experience.

19 Posts; 413 Profile Views

On 6/4/2020 at 1:06 PM, barcode120x said:

The obvious choice is to look elsewhere, but unfortunately you can never know if another facility/position will treat you well. I personally think it's not worth working at place that you dislike and/or is not good for your mental health and if I were me, I would leave. Then again, I don't know how financially stable you are, if 9 months of experience is enough to go somewhere else, etc. There's a lot of factors you will need to consider if/when you leave. But remember, there's no guarantee your 2nd, 3rd, or even 4th job will be better, worse, or neither. You'll come across crappy patients, crappy docs, crappy nurses, crappy management, crappy workplace, crappy everything. You're bound to come across at least one of those but unfortunately, that's the nature of nursing.

It's hard for me to say "you'll get used to it," because sometimes that is the truth to nursing and it is hard to get away from it all. But, there are some things you will get used to. Just like you, I was terrified to have to call the doc for anything because of similar reasons you had mentioned about asking the wrong question, giving the wrong answer, etc. Over time I got used to and now, I just call the doc with whatever I need with no hard feelings on either end. My first 6 months were the most anxious months I've ever lived because of nursing. I would sit in my car after work for 20-30 min thinking if I forgot something. I would lose sleep because I would think about what potential sick patients I might get and what I would have to deal with.

Find good coping strategies and stress relieving hobbies. Weightlifting really helped me through my first year as a new grad; although I didn't nearly have it as tough as you. I found solace with the new grads that started with me. We all hung out and talked about our days. It really helped to talk to others that were dealing with similar anxiety issues. Good luck and focus on your health!

This is another fear of mine. Leaving my current job to go to another job that's just as bad. It's hard making that decision, because I can be just as miserable at my next job. I also think part of the problem is that I started in a facility that has no new nurses. No new grad residency, no other nurses I can express concerns with, and talk about my feelings with. I was given a very short orientation time and felt I was not properly trained on certain things, which I also think hasn't helped my self-esteem and confidence in my abilities. Management never checks up on me, asks how I am, never gives me feedback on what I'm doing good, bad, or what needs improvement, and it bothers me. Unfortunately there are many companies out there that have corrupt and unorganized management. 

 

Thanks for your advice!

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