New RN on the verge of a breakdown.... Help!!

Brea LPN · May 24, 2011

Just keep at it. Your feelings are normal. I remember thinking that i made the wrong career choice when I was training.

Five&Two Will Do · May 24, 2011

Ok so I am a brand new RN and am working in a fairly large hospital. I started out on a telemetry floor and found it to be a bit too much for me during my residency, so I asked to switch floors. Now I am on an ortho/neuro floor working nights just getting ready to finish my residency and I am soooooooooooooooooo stressed and overwhelmed with everything. I feel like I know nothing and that I am going to forget something and hurt a patient : ( Is this a normal feeling? Is hospital nursing not the right fit for me. I feel like I picked the wrong career and I should love working in the hospital. Please help! I needs some words of encouragement.

Sounds like you are right where you are supposed to be. I felt the same way in my first year of nursing and then again when I started in the ICU. Just follow the rules of med administration. Ask your preceptor questions and have her/him verify your assessment findings. I did these things to help myself gain confidence. When you get a bit of confidence you will start to feel better. It also helps to find a systematic approach to your day. This will help you to remember things and become more efficient so you do not always have to feel like you are behind. When you leave work, leave it there. Unwind in whatever way suits you the best and let it go. You will be fine just hang on a little bit longer and you will see it come around!:)

sameyjaney · May 24, 2011

I am a new nurse too. My preceptor was very open with me about having very similar feelings when she first began her career. She said after a year she finally stopped getting nauseous before her shifts. I have talked with many others who felt the same way. They said they really didn't feel like nurses until about 3-4 years into their career. I find this very encouraging whenever I start to doubt myself and my capabilities or when I make a mistake or come close to making a mistake. Hang in there! I'm right there with you and so are many others!

FunRun · May 24, 2011

This is completely normal, when you are feeling overwhelmed just stop and take a deep breathe, if you are worried about hurting someone you should be able to stop for a minute and eye ball them and make sure everything is in place- VS are stable, they are comfortable and there are no acute concerns. It is very easy to get overwhelmed (esp. with "tasky" things) and as a new nurse myself (it will be two years in Sept) I have learned it is so vital to express your feelings to your preceptor and the senior staff you are working with- they will have excellent feedback and should give you support. If you weren't stressed and concerned about hurting someone I would worry- the most important thing you can do is keep your patients safe so when things start to feel overwhelming just ask yourself "are my patients safe? Are they in any harm right now" if the answer is no then just relax and prioritize and do the best you can :-) Never be afraid to speak up and ask for help, you are not alone!

bluerose001 · May 24, 2011

I'm a new nurse myself. I've been working on the floor for 2 wks now by myself (fresh from orientation) and feel so anxious going to work. handling 5 patients still overwhelms me. time management, still a BIG challenge for me. i feel depressed since in my flr the rn-pt ratio is 1:6. it depresses me that i still can't handle 6. i've been a good student but it seems school prep was not enough to give me such confidence. doubting myself if i'm on the right career as well.

Five&Two Will Do · May 24, 2011

I'm a new nurse myself. I've been working on the floor for 2 wks now by myself (fresh from orientation) and feel so anxious going to work. handling 5 patients still overwhelms me. time management, still a BIG challenge for me. i feel depressed since in my flr the rn-pt ratio is 1:6. it depresses me that i still can't handle 6. i've been a good student but it seems school prep was not enough to give me such confidence. doubting myself if i'm on the right career as well.

School is not enough to prepare us for the floor. When I graduated I was on a floor where the ratio was like yours. I remember thinking in clinical how would I ever care for 2 let alone 6. It comes with time, and in my opinion, a systematic approach to your day. Get a good routine, but be willing to deal with whatever comes up. Things come up, codes, falls, etc. but then get back onto your routine. Write things down so you do not forget to followup like PRN effectiveness and such. It helps and sooner or later you will be feeling fine.:)

kelleann · Jul 9, 2011

I just went searching this forum for the same thoughts and concerns. I feel as an RN who's new to hospital nursing (worked in a clinic 2 years out of school), that every single thing I do is new, takes a lot of time, and "a lot of time" is not a luxury we have on the floor. So my days feel so task-oriented that I feel I'm missing the whole "critical thinking" aspect of care. I am blessed to have the most fantastic, supportive group of co-workers (haven't experienced a single 'nurses eating their young' incident). I am just so afraid I'm going to miss something though. It's good to see from seasoned nurses that this is "normal" and also good to know that you start feeling more in your skin after about a year.

Mia_2011 · Jul 9, 2011

I am a new RN as well and i recently got a position on a rehabilitation unit. I usually work nights 10p-6a, but I worked 2-10 a few days ago. Oh my, I was so overwhelmed! I felt like I was glued to my cart, and the two nurses that were working along side me were just chit chatting away and didn't look half as busy as I was.

I normally have pretty decent time management skills, but after that one shift it made me feel like I still have A LOT to learn, and work on. I'm pretty sure my feelings are normal. It to me, was a different world. The nurse I usually work along side is SO HELPFUL! She is a seasoned RN who made it very clear she was there to help me along my new journey. One of the very first things she said to me our first night on the floor together was "If there is anything, and i mean anything you feel uncomfortable doing, or just want a second pair of eyes with you, let me know!" It felt like a load was taken off my shoulders.

I felt somewhat isolated during the 2-10 shift I worked, both nurses looked at me like "what is she doing here" and only spoke to me when they absolutely had to. My only advice right now is to find someone you feel safe asking questions to and who is willing to help you when you are feeling unsure of yourself.

VURN2010 · Jul 11, 2011

I was in your shoes about 9 months ago...now I'm just about at one year in Ortho/Surg and it's a world of a difference.

Some things I have learned though:

1. take your time in report

Another RN on our floor made up a report sheet (optional of course, some ppl just jot notes on worksheets) but it helps me to make sure all boxes are checked...including space for vital signs and possible more frequent I&Os. It's helped me stay organized tremendously.

It's organized by system so that also helps to get a picture.

There's also a spot for D/C plan, Consults, Tests etc. so you know what to expect.

2. If you don't do walking report, take a minute to pop in and introduce yourself to patients or at least eyeball them.

It might also be helpful to let them know you are IN report still and that you'll be back in a bit to assess them (I try to give myself till closer to 745-8) so unless something is urgent I like to SET LIMITS so I don't get a 100 requests to "get washed up" or other items 1- our cnas could help with or 2- that could wait. I find most people are understanding knowing you'll be back soon.

3. take time after report to update things

i try to make notes for our rounds (issues that have come up), take note of labs (by 745 ours are usually posted from 0600). It's also nice to note low/high values so you know what to ask about or expect...low Hgb means I'll check for T&S and prep for giving blood at some point--keeping an eye out for K orders for low k...etc.

also key, i see what meds i need to give & who needs to go first. i'm a nut about checking bp right before bp meds--so i know that's going to be extra time. I'll also grab my antibiotics and see who's gonna be due for pain meds to save some trips on our big/spaced out floor.

I try to organize my patients in order of when they'll be seen. I've eyeballed them and sometimes i'll grab their bedside chart, take note of vitals and note that they were resting or if i assessed pain or if they had any requests.

4. personally i like to make lists & bring my report sheet in to assess the patient. I try to be quick, but assess those systems & make notes of anything else I might need before I leave the room...do my systems assessment, give some meds (usually i'll get a couple pts that'll kinda just have multivitamins, iron etc. that i can just give right away).

I'll try to at least document that I saw them. I might doc their assessment if it's long/complicated

5. Try to have uninterrupted med giving and uninterrupted charting. It is SO hard, but I try to delegate as much as possible while in assessment/charting mode. It might also be a good idea to partner with your tech/cna so they know how you roll. I also try to bait them to let them know I'll be more helpful later when the majority of my meds/charting is out of the way.

6. Get started on your I&Os early. I also alert patients that I'm a crazy about I&Os so regardless if anyone else was ok with bathroom privs etc. I wanna know what they drank & peed. It helps to partner.

7. It just takes time. The important thing is to communicate your limits with Charge Nurses, your preceptor and CNA. You aren't magically born with the ability to be the organized/knowledgeable RN...it'll happen for you soon!

8. Keep asking questions and just take your time with important things. I try to ALWAYS pay attention to high alert things--narcs, glucose items, vitals, bp meds etc. Mistakes DO happen (I've had one actual med error and a near miss), but the important thing is to be careful, take your time and learn from your mistakes and others. It helps to ask what mistakes have happened to others (if they are forthcoming) so you can learn what NOT to do (like taking a verbal order for a heparin drip...don't do it.)

9. Ortho is harder than it looks. I'm sure many disciplines could claim this, but it really is. Everything takes a lot longer and people need a lot more help. Most Nurses don't get (however many patients your load is) ours is 5 (flex to 6) NON ambulatory heavy partial-complete care patients. Give yourself credit.

If you don't love it after a couple more months and even as your experience grows: maybe it IS time to think about something else.

That being said: do you like the health system? Are people in the hospital in general friendly and seem happy in their jobs? Do you experience a lot of conflict RESOLUTION where you are? Do you like the benefits of the job & does it seem to offer reasonable compensation & good opportunities? If you answered YES to many of these questions you might consider switching floors. If you answered NO maybe it's time to talk to people who work elsewhere to see if there's better opportunities elsewhere. No health system is perfect, but there are definitely some that have a lot more positives than negatives--or that might be a better fit for you.

Good Luck. I hope I offered at least a little helpful advice from my experiences.

It gets better! Promise!

kelleann · Jul 23, 2011

I am wondering how you are feeling now that it's a few months later. I'm where you are, started in April. I've been a nurse for 2 years but worked in a medical clinic and just entered the hospital environment in April (Telemetry). I think that when we're new, we are learning the culture (hospital), new routines, where things are, learning to organize and supposed to be critically thinking all at the same time. This can only come with time. I find these forums so helpful to "normalize" all of these things. I find that I'm having more "great" days less "I don't know if I can do this" days. I'm hoping you are finding this too.

tishluvnc · Jul 23, 2011

wow, i'm not a nurse but i have to say that they all are right. If you have made it out of school then you have the ability to perform well, if not you wouldn't have gotten this far. I know some one who got her ADN and worked at our local hospital and every time I seen her she only complaine about how work was horrible and the hospital med/surg floor was terrible. She almost gave up during nursing school but she didn't. Well she left the hospital with her 2 year experience and now is happy for this moment working at a clinic. I think with every career it takes time to creat that professional you want to be. You'll get it. Don't give up.