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New RN

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I'm a new RN. I know I've had some emails with some of yall back and forth about this but I just needed to make a good venting thread.

I feel so incompetent. Right now, my preceptor catches all my mistakes. But when I'm on my own ... no one will be there to catch them.. that's what scares me. Mistakes mostly like I forgot to add a morning med and saw it overdue later after med pass. Mistakes with charting. Setting the wrong rate on an IV pump. Being nervous (which is now diminishing). I've had 3 days on the floor and I don't feel my old self outside work. Last night I went home and kept wondering about if I forgot anything. I just wish someone could grab me ... shake me ... and tell me this is OK this is normal (my mistakes). I do see improvements. At the beginning it'd be 10 and I'd be passing meds. Then 930 and passing meds. Last time I finished med pass at 0845. I want to come home and learn to disconnect and not ponder if I forgot something.

Congratulations, and welcome to nursing. You've just described every new RN's first year!:)

I used to swear I heard IV pumps beeping at home. Honest. Starts to bore right through your brain.... :D

I also used to dream about having a patient assignment and not being able to FIND the patients (wandering through rooms, to procedure areas and back, still can't find them, missed med passes, STILL can't find them). And then, of course, were the dreams in which I didn't even know I HAD a patient assigned to me until the end of the shift! (oh, wait, that did happen in reality....but it was a sneaky charge nurse trying to cover the fact that she assigned NO NURSE to a patient for a whole shift...ouch).

Yep, welcome to nursing!

workinmomRN2012, BSN

Has 9 years experience.

Are you in a hospital or SNF. How many patients do you typically have per shift?

It is normal! All new grads feel that way, myself included.

Is the hospital you are at a good one? Do you trust your preceptor?

If so, just keep telling yourself that they are not going to leave you alone until you are safe! They have done this before, they know how to train new nurses, and they know when you have improved to the point you are safe to be left alone with patients.

Where I work, one of my classmates is on another floor and there is another new nurse on the unit right next to mine. We have formed an informal new nurse coalition and meet after work once a week just to vent. It is SUCH a help to know that the others feel exactly the way I do. It really is a sanity saver. You might want to try something like that where you work, you would be surprised at how much it really helps!

It is normal! All new grads feel that way, myself included.

Is the hospital you are at a good one? Do you trust your preceptor?

If so, just keep telling yourself that they are not going to leave you alone until you are safe! They have done this before, they know how to train new nurses, and they know when you have improved to the point you are safe to be left alone with patients.

Where I work, one of my classmates is on another floor and there is another new nurse on the unit right next to mine. We have formed an informal new nurse coalition and meet after work once a week just to vent. It is SUCH a help to know that the others feel exactly the way I do. It really is a sanity saver. You might want to try something like that where you work, you would be surprised at how much it really helps!

Great hospital. Great teaching hospital/university. Preceptor is always there to help, and is real and honest about what I did good and where I must improve. Yeah, that sounds like a good idea!

I know I need to work on my confidence. My preceptor and I both agree that I don't give myself enough credit. I guess there's a spectrum the more nervous nurse that doesn't give him or herself credit and then on the other extreme there's the overly confident dangerous new grad that doesn't acknowledge their weaknesses.

I need more confidence in myself.

Congratulations, and welcome to nursing. You've just described every new RN's first year!:)

I used to swear I heard IV pumps beeping at home. Honest. Starts to bore right through your brain.... :D

I also used to dream about having a patient assignment and not being able to FIND the patients (wandering through rooms, to procedure areas and back, still can't find them, missed med passes, STILL can't find them). And then, of course, were the dreams in which I didn't even know I HAD a patient assigned to me until the end of the shift! (oh, wait, that did happen in reality....but it was a sneaky charge nurse trying to cover the fact that she assigned NO NURSE to a patient for a whole shift...ouch).

Yep, welcome to nursing!

Oh gosh! O=

Nooooo way!?

Yeah I had dreams about me working. That's gotta stop! I think I'm getting a fan and some nice music to fall asleep to. Maybe some tea or a cup of wine for those nights hehe.

I think it is much safer for patients to not be over confident.

I feel exactly the same way you do, but from everything I hear and read, it is normal to feel this way. Those who don't are probably never going to be safe.

THELIVINGWORST, ASN, RN

Specializes in Public Health. Has 4 years experience.

At the sixth month mark and newer grads are asking me for help and people are asking when I'm going to start charging the floor. Ummm no. I am Jon Snow, I know nothing.

It gets better everyday. When I finished orienting, I knew I could do it bc I have the resources to succeed. If you have the support and you ask good questions and learn from your mistakes, you will do GREAT!

Thanks everyone it's also that I'm realizing how easy a med error can be made. The bright side is I'm catching it. Example? About to give insulin and right before I give it.... I check the orders ... guess what? The 1630 novolog had beeen d/c and the sliding adjusted. Needles to say I wasted 9 units ... what a difference that would have made. 0.0 AHHHHHHH and I caught it ... YES but I still feel like wow ... wow... wow.. really?

When I started on my own after three weeks of orientation on med/surg, I was so nervous about being on my own! But I actually noticed that I liked it a lot better! No one breathing down your neck telling you to do it this way or that way. No more trying to impress my preceptor. Although the first few weeks were a struggle of me running back and forth about forgetting flushes or luer locks.. I learned from the struggles and set my own pace. I have gotten better since. If you are nervous about IV rates, have another RN double check with u until u feel more comfortable. Good luck!

HouTx, BSN, MSN, EdD

Specializes in Critical Care, Education. Has 35 years experience.

We all make mistakes - the important thing is to learn from them. Stop and think about WHY you made the error & then take the necessary actions to avoid doing the same thing in the future. From your description, it sounds as though you have been focusing on speed rather than accuracy of med administration. It's far better to make sure that you always follow the '5 rights' each and every time. This needs to become ingrained, automatic behavior for you so that you are not tempted to deviate by taking shortcuts.

In my organization, I am frequently involved in root cause analysis after clinical errors.... The most frequent factors in medication errors is distraction &/or rushing to avoid 'getting behind'. Just a momentary lapse in concentration can have awful consequences and devastating impact upon a nurse's career.

When you're feeling anxious because you're pressed for time, it is even more important to stop and take a breath so you can focus on the task at hand. We encourage our staff to do this while washing their hands prior to engaging with the patient..... just take some deep breaths and 'center' yourself for 30 seconds so you can be fully present with that patient. Try it, it really helps. In the long run, it is much more efficient than having to double back with a do-over because you forgot something or need to correct an error.

You've got this. You're on your way to becoming a great nurse.

Cheyenne RN,BSHS

Specializes in Med Surg, ICU, Infection, Home Health, and LTC. Has 35 years experience.

It is so refreshing to see a new nurse who does not think they "know it all." They are the ones that scare me because they will eventually make a mistake, as we all do, and their pride will try to convince them to hide it hoping no one will know if there isn't any "real" harm done. I have seen it happen and it can be frightening as a preceptor too. There is so much to know and medicine is ever changing and growing daily with new meds, new discoveries, and new procedures. No one can know it all because they is still so much no one knows. It has yet to be discovered. Please continue to ask questions, seek validation, and realize that with experience the fear will become balanced and turn into assurance and confidence.

DatMurse

Specializes in Hematology/Oncology. Has 3 years experience.

1. How do you miss meds? Do you have a EMR system that has you scan things and lets you know if you need meds?

2. Can you see orders on your EMR? such as IV Rate?

3. Even if the med is overdue is it an time important med?

I dont know, I have missed meds and I look at the EMR and it tells me if I missed something. I dont know how people can set the IV rate wrong if its posted as an order in the computer.

I am using McKesson and this EMR system is a POS compared to EPIC and I feel that everything is there.

1. How do you miss meds? Do you have a EMR system that has you scan things and lets you know if you need meds?

2. Can you see orders on your EMR? such as IV Rate?

3. Even if the med is overdue is it an time important med?

I dont know, I have missed meds and I look at the EMR and it tells me if I missed something. I dont know how people can set the IV rate wrong if its posted as an order in the computer.

I am using McKesson and this EMR system is a POS compared to EPIC and I feel that everything is there.

I didn't miss the meds per se. I realized I missed putting them in my cup/bag because either the MAR said "overdue med" or my preceptor told me to look at the MAR because it said overdue med. I think I made it sound like I was skipping meds and missing complete doses. Noooo 0:

I input the information wrong because I'm still a bit confused by the pumps and I'm just now getting the hang of these pumps.

No not time sensitive. I didn't miss any doses. I just happened to realize later thanks to the MAR or coming across it myself or my preceptor.

It is so refreshing to see a new nurse who does not think they "know it all." They are the ones that scare me because they will eventually make a mistake, as we all do, and their pride will try to convince them to hide it hoping no one will know if there isn't any "real" harm done. I have seen it happen and it can be frightening as a preceptor too. There is so much to know and medicine is ever changing and growing daily with new meds, new discoveries, and new procedures. No one can know it all because they is still so much no one knows. It has yet to be discovered. Please continue to ask questions, seek validation, and realize that with experience the fear will become balanced and turn into assurance and confidence.

Thank you so much. I appreciate all the support.

Studentofhealing-YAY that you caught it! In most hospitals, insulin orders need to be checked by 2 nurses, so you would have likely been protected, but what an awesome feeling to catch it yourself!

It is my opinion that ALL new grads feel this way and we are ALL gonna be ok!

Studentofhealing-YAY that you caught it! In most hospitals, insulin orders need to be checked by 2 nurses, so you would have likely been protected, but what an awesome feeling to catch it yourself!

It is my opinion that ALL new grads feel this way and we are ALL gonna be ok!

You're right! I did catch it. I need to give myself credit. positive vibes: Now I will always continue to check my orders right before giving meds. Wanna know how long it took to me to check the MAR? 10 to 15 seconds. 10 to 15 to check the order. So about half a minute can prevent an error. I need to remind myself of the could have been med error. Half a minute can make the difference.

::: positive vibes:::: positive vibes: =)

& yes! We have to cosign too for insulin.