New RN floundering on HDU

[LoneRN]

I got my first job in the high dependency unit. I have never done anything but med-surg as a student but I wanted to try this to get some extra clinical/assessment skills.

It was my first shift today. I was not left alone but felt so unprepared. I was a bag of nerves, did not sleep properly. I struggled to do a blood sugar. I can usually do this blindfolded but today even speaking to a patient was difficult. I used to have long, friendly chats with patients as a student.

I was also asked to do a GCS for the first time. I could not decide what boxes my patients fell into eg, is that flexion, weakness etc??? I asked the nurses what they think but they would not tell me. They are really nice and all - but they were just watching while I floundered and telling me that it was taking a long time. I just had to tell them that I still don't know how to record my findings? So they told me to keep assessing until I knew. This went on for about 30 minutes and the patient is having this hourly. This patient did not speak English, and had deteriorated overnight. I'm so embarrassed, I think I would need to see this done for 5+ different patients before I felt like I could do it properly. I was getting really confused looking at the giant bedside chart, mixed up with my findings and started to have a panic attack.

I felt sick when the consultants/doctors came around...there was about 15 of them. I could barely talk and remember what is going on with the patients. Even simple things like are they eating or not. But I get confused when I see the NG and I'm not sure on the spot whether they have had a swallowing assessment as I only got report 30 minutes before and I just did not know. There is a BLOCK IN MY BRAIN where I can not think what to do next, or what is even going on.

I am so embarrassed about my poor performance today. I did learn one new skill though (tracheal suctioning)... but I am never going to be able to manage 3 HDU patients on my own when just one is so taxing.

Even the students on the ward are far outshining me! I think they are looking at me and think I'm stupid

[Jules A, MSN]

I know this is easier said than done but try to relax and cut yourself some slack. It was your very first shift! I promise it will get easier. Don't worry about what students are thinking because as I recall I was always so stressed out as a student that I wouldn't have noticed whether you were a shining star or a stooge. :)