Nurse-without-a-clue

[perfectbluebuildings, BSN, RN]

Hey you all,

I have had a bad few days at work and want your advice. I'd thought things were getting better and I was knowing more what I was doing, but that's slipping away.

First off, I have trouble giving report. I feel like I know what's going with my patients just fine to care for them, up till time for report when I'm staring at that care plan, going through it, and realizing that if I didn't KNOW something about a certain patient some things on the plan wouldn't make sense. I seem to go on and on, especially when I feel bad that I didn't do something or missed something.

I feel like I am the nurse without a clue- someone asks me about labs, or about something that always seems I have no clue. I have noticed people who've gotten report from me often before, leave me for last to get report from, so that they won't be stuck there forever while they still have other patients to get report on.

I guess what I am looking for, are some ways to stay really organized during the shift and to keep up with things during the shift even when you don't quite have the time to- and also, how to be more concise in giving report and stop rambling when I'm nervous. I don't know if you can help me, but any and all suggestions are very appreciated!!! It's gotten to the point that I just dread giving report because I KNOW there will be something I forgot during the shift that I don't realize till then, and will get the "look" and "That's okay!" from the oncoming nurse that means it's really NOT okay. I offer to do something about it often, like make a phone call or whatever, and they say "No don't worry about it."

And the when to know about calling the doctor- my charge nurse was upset that I didn't call about a pt on a 50% venti-mask, and I guess it is a matter of policy, that I didn't know about. The doctor too, was very very nice about it but could tell that he wished he would have known the situation earlier in the night.

And a mom who was supposed to be feeding her li'l one every 3-5 hours, and I thought she had been and get to checking the I&O's while writing my pt notes and find that he's had hardly anything after 11. I had gotten in report that she'd been woken up through the day to feed him, but she stayed up so late and it seemed that she had fed him several times that I'd seen, but maybe he hadn't eaten much those times. And early in the shift, I got orders to leave his IV out because he'd been eating so well. So at that point, I went in and he's very hungry, I feed him 4 ounces and wake Mom up to try and give him more. He still seems hydrated: fontanel flat and not sunken, good turgor, moist mucous membranes.

I am just frustrated and feel like there are things I'm not picking up on, that I should be. I've been a nurse since June now. But I feel like I don't have any nursing common sense at all yet. Where does that come from and how can I get some? :)

Any insight you may have would be wonderful. I am feeling more overwhelmed every day. It's not the staffing; I have great staffing and wonderful people to work with. It's just me. But I am ready to call off this whole nursing thing; don't think I was meant for it, but I am trying to get advice first on how to get better before I just give up. I don't want to give up. Thank you.