Newbie needs empowerment!

HouTx, BSN, MSN, EdD · Apr 1, 2011

[Warning, personal rant] I don't know what the heck nursing schools are doing to turn out new grads that are so terrified of losing their licenses!! They need to get a grip and stop scaring their students to death. Ahhh that feels better.

Oh hon, You're barely keeping your nose above water -- you need a new manager who can provide you with professional waterwings and floaties. Seriously. But although it may seem like it, even the best manager is not capable of reading minds. Managers have very intense & busy jobs - and very little patience for dealing with what looks like a big hot mess of emotional crisis.

I would advise you to do some self-exploration & reflection to figure out just what exactly is it that you need? Try to separate that free-floating anxiety into actual 'things'. Why are you having difficulty with charting? Compare what you're doing to your colleagues' documentation. Are you trying to document too much? Are you waiting until the end of the shift & trying to do it then? Are you having difficulty remembering what to chart where? When you go into panic mode & feel like you're drowning, try to figure out exactly what pushed you over the edge. THEN - go to your manager with a list of specific things that will help you. If that isn't successful, work with your preceptor or an experienced colleague whom you admire.

For most of us, anxiety is most strongly associated with lack of confidence. Think about this for a sec.. imagine you're driving down a busy freeway doing 60+. If you aren't familiar with the exits and interchanges, it can pretty hair-raising. But if it is a familiar road, it's much easier because you know what's ahead and exactly what you need to do and when you need to do it.

Use your nursing skills on yourself... problem analysis, intervention, evaluation... rinse & repeat.

NurseVN · Apr 1, 2011

I'm a new grad myself (5 weeks in orientation, still have 7 weeks to go) on a cardiac step down unit. I'm sorry your coworkers have not been so professional but I agree with previous poster. I made it clear since the beginning that I do not gossip and I do not participate in any. I'm friendly and helpful to EVERYONE, including MDs, RNs, CNAs, housekeepers, etc. I prepare a fruit tray mysef for everyone once a while and people like it. The next thing I know other people start taking turns bringing healthy snacks. But I am also firm that I want to learn and do things correctly. I have 2 preceptors and they both appreciate the way I approach. I thank them for every opportunity but I also show them that I am competent. I advise you to start watching how other RNs plan their day. How about a cheat sheet? Know the drugs you give. Practice charting on a "healthy" person, like yourself- from head to toe. It does get better. If you give pain meds, assess 30 mins or so later to see if they help. Try to group a few things when you enter a patient's room. For example, I tell my CNA that I like to do morning vitals myself so I can introduce myself, plan the shift with my patient (ambulate x times/day, any pain med routine they have, etc.), assess the patients, give meds (I need to check BP and HR before anyways because I'm on a cardiac floor). I chart my meds when I give them. I have 3 patients and work AM so I would finish all that by around 9 AM. I like to pain medicate my patients early so they do not get cranky later. Then I take a 15 min break for breakfast, come back and check on pts. Then I chart my head-to-toe assessment. By around 10 when the MDs and residents coming in, then new orders and stuff. Care plan, education, and other chartings will be done periodically throughout the day. My narrative notes are usually brief, and I finish them before 1800. In my mind, my day ends at 1800. I & O's and chartings and everything else will be anticipated to get done by 1800. This way if anything unusual happens, I still have an hour to deal with. This system has been working for me and I have not leave the floor later than 1930, even when I have 3 discharges and 3 admissions. My preceptors are always there to observe, double check my charting, answer my questions, and assist me when necessary. I usually have 1 discharge and 1 admission. If I know that patient is being discharged, all their chartings and requires paperwork will be done earlier so I do not feel rushed. I hope this helps a little. Every floor and every situation is different but do not let other people stress you out. Also, if you are unsure, do not be afraid to ask. Not because you will lose your license (it's hard to lose your license) but because it is fair and best for you and your patients.

Hope11 · Apr 9, 2011

I'm a new grad myself (5 weeks in orientation, still have 7 weeks to go) on a cardiac step down unit. I'm sorry your coworkers have not been so professional but I agree with previous poster. I made it clear since the beginning that I do not gossip and I do not participate in any. I'm friendly and helpful to EVERYONE, including MDs, RNs, CNAs, housekeepers, etc. I prepare a fruit tray mysef for everyone once a while and people like it. The next thing I know other people start taking turns bringing healthy snacks. But I am also firm that I want to learn and do things correctly. I have 2 preceptors and they both appreciate the way I approach. I thank them for every opportunity but I also show them that I am competent. I advise you to start watching how other RNs plan their day. How about a cheat sheet? Know the drugs you give. Practice charting on a "healthy" person, like yourself- from head to toe. It does get better. If you give pain meds, assess 30 mins or so later to see if they help. Try to group a few things when you enter a patient's room. For example, I tell my CNA that I like to do morning vitals myself so I can introduce myself, plan the shift with my patient (ambulate x times/day, any pain med routine they have, etc.), assess the patients, give meds (I need to check BP and HR before anyways because I'm on a cardiac floor). I chart my meds when I give them. I have 3 patients and work AM so I would finish all that by around 9 AM. I like to pain medicate my patients early so they do not get cranky later. Then I take a 15 min break for breakfast, come back and check on pts. Then I chart my head-to-toe assessment. By around 10 when the MDs and residents coming in, then new orders and stuff. Care plan, education, and other chartings will be done periodically throughout the day. My narrative notes are usually brief, and I finish them before 1800. In my mind, my day ends at 1800. I & O's and chartings and everything else will be anticipated to get done by 1800. This way if anything unusual happens, I still have an hour to deal with. This system has been working for me and I have not leave the floor later than 1930, even when I have 3 discharges and 3 admissions. My preceptors are always there to observe, double check my charting, answer my questions, and assist me when necessary. I usually have 1 discharge and 1 admission. If I know that patient is being discharged, all their chartings and requires paperwork will be done earlier so I do not feel rushed. I hope this helps a little. Every floor and every situation is different but do not let other people stress you out. Also, if you are unsure, do not be afraid to ask. Not because you will lose your license (it's hard to lose your license) but because it is fair and best for you and your patients.

Hi NurseVN

I am a relatively new allnurse.com user and I just applied to WMMC Summer Versant program. Was hoping you could PM me for some guidance. I don't think they let me PM you b/c i havent made 15 posts yet..

I'd appreciate any help you could give! Hope things are still going well over there

NurseVN · Apr 9, 2011

I sent you a PM. Hope it helps. Best of luck to you. Let me know here if you have any questions and I will either respond here or PM you again. I know how hard it is to land the first RN position so I'm glad to help :-)