New RN on busy med-surg/oncology floor

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Hello all! I graduated this past December and feel extremely blessed to have found a job. I did an externship my last semester of nursing school and my manager was kind enough to find a spot for me when I graduated. I have just finished a 12 week orientation with a preceptor and am now on my own. I realize I was extremely blessed to have that long by reading other's posts, so I'm not complaining about that. I'll be honest and say I'm terrified most of the time. I'm sick to my stomach even when I'm not at work. My worst fear is missing something important. It's not even really a fear for myself or my license, but for my patients. It would be absolutely devastating to me if it caused harm to someone else.

I know that by working on this extremely busy floor (we have 6 patients each) it has been the best learning environment. And I have learned so much. But when I look at certain situations, I would have never known certain things without my preceptor's guidance. My lack of experience scares the heck out of me. I know logically that most new nurses make it and do well, but it's still scary. I'm behind most of the time and can't seem to figure out how to get myself into my own routine. I'm hoping that will come with more time on my own. If I don't know, I have no problem asking. I'm not stupid, I know where to look if I don't know. It's just the constant stress of "not knowing" plus being behind all the time. My preceptors have told me that I've got it, that I'm the best one they've had in a long while. And while I appreciate their vote of confidence, I myself do not feel confident at all. One thing I never do is show my stress to my patients because in doing so I know they would lose confidence in me and that would just make it worse. I act confident even though I'm not. I am able to get through stressful situations without falling apart. I don't fall apart until I'm off the floor. I can honestly say I've cried on the way home more than once. I love my patients and I love nursing. I honestly feel like it's what I was put on this Earth to do and Lord knows I've sacrificed and worked my butt off to get here, but working at Starbucks has become more and more appealing lately. :rolleyes:

I guess I'm wanting to know that others out there have felt or do feel like I do at the moment, that I'm not alone. That this too shall pass. I guess I'm looking for reassurance that eventually I will become comfortable with the patient load and be able to handle things more efficiently. I guess more than anything this was a way to vent. No one else but another nurse could ever understand any of this. Thanks for listening.

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Specializes in Hospital Education Coordinator.

Most, if not all, nurses have felt this way. Remember learning about the honeymoon phase ending and leading to ego bruising? Well, that is where you are. Once you get comfortable with your new identity and duties you will be fine, but that could take up to a year. Meanwhile, ask for help and advice from more seasoned nurses. How do they stay organized? How do they prioritize? I had a grid I carried for 1-2 years before I finally learned how to remember what I needed without prompts. It took that long because my brain was full of other stuff. Once some things got to be rote, I had room in the grey matter for memorization. It will come. Congrats on your new job

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Specializes in med/surg/onc.

Your first year is definitely the most difficult! I remember feeling the same way...

My best advice, try to arrive at work at least 30 minutes before the start of your shift to get your assignment and look up patient information. This way, as soon as report is done, you will be ready to hit the floor. Also, try to find a good worksheet that keeps you well organized but is simple (PM me if you want mine). Just try to go with the flow and realize that sometimes you just can't accomplish anything. Also, learn to delegate! This is a big problem for new nurses.

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I have been an RN on a medsurg floor for nearly 2 years and can honestly say, I know how you feel. I reassure you that it gets better and easier with time.

Best advice I can give you is to stay calm and realize that you CAN do this. Even if you're feeling overwhelmed, remind yourself that everything will get done. If you need to stay over, then so be it...you are new and they will understand. Another bit of advice is to try to help co-workers as often as you can. I have found ppl are less likely to become frustrated with your questions and more willing to help you... if you help them. This goes for your secretaries, LPNs, and aides. I know you feel overwhelmed and busy with your own patient load let alone having the time to help someone else but I'm talking about helping with small things... taking off an order if the secretary is overwhelmed, getting vital signs on another nurse's new admission, helping an aide change your incontinent patient, etc etc.

You are not alone and it will get better with time.

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I wanted to tell you that I had these exact same feelings as a new pediatric med/surg nurse. My first year or two was really rough. I couldn't sleep some nights before my shift...I lost 10lbs...I got reflux!!! I was in bad shape! These things were just symptoms of my constant feeling of not feeling in control. I now have been a RN for 7 years and somedays I feel GREAT, and other days I feel like I came straight out of school! There are resources on your floor that can help. Once you get to know the other RN's you should all be able to bounce things off of each other. You should find time to look up whatever you need to before you start your assessments. The confidence you gain over the years will get there. You are correct that if you question what you are doing then don't hesitate to call the charge nurse or a nurse you trust just to ask if you are on the right track. I NEVER did anything I was uncomfortable with unless I asked first....even if it could be annoying to some nurses. Trust me...when I read your post I just completely felt like I could relate. Good luck! Trust your instincts!

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Thank you so much for your posts. It helps to know that you all have felt that way. I've decided that it is what it is and I just have to work through it. There are days I'm terribly behind, well then I'm behind. There is nothing I can do except work through it and get it done. I can't quit so I just have to be behind. As long as my patients are being tended to and are safe, then I'm not going to worry about it. I'm starting to realize that even the most seasoned nurses get behind and have bad days. Every day I work, I get a little bit faster and feel a little better about things I've already learned. There is so much I don't know and it's stressful, but I'm learning every day. The next time I have that situation I'll know what to do. I probably drive some crazy asking stuff all day long, but oh well, it's the only way I'm going to learn and be safe. Anyway, thanks again for the advice. I appreciate it.

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Specializes in ABMT.

One thing that really helped me when I was having those out-of-control too-many-things-to-do moments was to stop and take two minutes to make a little list on a post-it note of the things I had to do. It helped me prioritize, it helped me figure out what I could do quickly and what would take more time, and I felt a little sense of accomplishment and relief as I physically crossed things off the list.

Congratulations on getting a job. You have a very positive, grit-your-teeth, get it done attitude. That's admirable. You will get the hang of this. Six years out of school and med surg still has me spinning in circles some days. Best of luck.

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