Nightmares, hate going to work 99% of the time

[Certifiable, BSN, RN]

Hi,

I'm two months into my first job as an RN on a highly specialized unit. The patient to nurse ratio is fairly low due to the complexity of the work (mornings - 3 or 4, evenings 4 or 5, nights 6 patients). All shifts are 8 hours. The low ration was one reason why I wanted to work there - i couldn't imagine working a night shift and being in charge of 12 patients - that's just insane.

I rarely get a night of uninterrupted sleep. My dreams vary from real patients, med mistakes and once I even invented a fictitious patient in my dream. I don't feel rested and as soon as I turn off the lights, thoughts about the day that was flick on in my head just like the flick of the light switch.

I had orientation for a month alongside my instructor. I always felt very threatened by her (no idea why... maybe it was her knowledge? she was kinda intense) and that didn't help my confidence whenever I had her.

To the credit of the staff, they're really supportive and encouraging (99%... there is that odd duck).

I HATE morning shifts! They cause me unbelievable stress - once I couldn't eat what I brought because I was stressing out so badly about keeping my patients on schedule. (we deal with a lot of drugs given through PICC lines). I always pray that when we get the lab results at 8am that I don't have to order PC/FFP/PLT/SDP... that always makes me super nervous. (worse than when i'm giving chemotherapy- which can happen during any shift). The doctors are changing the orders often in the morning which is really hard when suddenly you have to give another 3 different IV meds that don't go together, that the TPN needs to be stopped because of it - basically anything that screws with the already crazy med schedule i've drafted.

I like the evening shift the best, because it's a little more relaxed, there's more patient interaction and the staff are also a bit less stressed.

I realise the best way for me to learn is to do morning shifts- because that's where and when everything happens... but the stress, oh my god, I can't take it. I wake at 5:15am, get home at 16:30 and am exhausted.... and of course I dont' sleep well after that, I can't stop going over what I did wrong etc'

The head nurse keeps telling me that "the staff really like me", i can't be sure if he's being nice and honest or this is being said to me in a condescending manner.

I have yet to cry, I process things really slowly, i regard myself as a meta-thinker (when it comes to my own emotions) and I don't discuss my innermost fears with anyone- who else could relate??? The nurses on my ward dismiss my anxiety as "first year nurse syndrome" and that it happens to everyone. That doesn't help me deal with the problem.

My family have commented that I seem really on edge and cranky and tense - but at work i'm all smiles (that's just the way I roll, I smile a lot, even if i'm not happy).

The more experienced nurses tell me that when the ward door closes, that my mind should close too about the workday- like a cork. leave my day in the hospital and not bring it home with me. Yeah, that didn't work.

Because of the nature of my shiftwork, I don't see my close friends as often as I'd like and I'm feeling kinda down about it. I've stopped working out because I can't find the motivation even though i've signed up for a 10k (already missed another 10k because of bad scheduling).

If you'd describe my current self to my nursing student self 6 months ago i'd probably say: all new grads are stressed, you need to do things that make you a happy, see friends, work out, speak to the nurse manager.... all things easier said than done.

HELP!

[sourapril]

I think a lot of us newbies feel the same way. Not sure what good advices I can give you except persevere. I do try to go to the gym several times a week. Even if I only do it on weekends it still makes a huge difference in my mood. Take a mini vacation. Get a massage. Soak in the hot tub. Maybe tell your manager how you feel. (Maybe that is not a good idea depends on your manager) I do think things will get better with time. Good luck.

[Nurse SMS, MSN, RN]

I know you know this already but yeah, that is all pretty typical for where you are at. The description of your environment frankly sounds great. You are supported. That is huge.

Get some melatonin or some other sleep aid you would be comfortable with. Talk to your doctor about your anxiety and sleep troubles. You would be amazed how big a different just getting good, quality sleep will make in your ability to manage your thought process. And then just hang in there. Keep learning. It DOES get better. Seriously. For me it was the 9 month point when I realized I was coming along and I stopped being quite so anxious. Seeing the latest new cohort of new grads coming along behind me helped me recognize how far I had come.