Off orientation--scared

Ruby Vee, BSN · Aug 20, 2016

I am a new grad working ltac. Just finished my orientation last week. This week I will be "on my own." I am terrified. Everyone says I was "doing great" and that I am ready to be on my own. I just feel like there are so many scenarios that could come up that I haven't seen yet. Even on my last two shifts of orientation there were things that came up that I didn't know how to deal with. My main preceptor was great. Very supportive. The house supervisors have told me that I am not ever alone, they will be there to support me. It just seems so scary.
The goal was to get me up to 6 patients by the end of orientation. I only got up to five, because of the acuity of the types of patients I had been assigned (most recently 5 patients, 4 had trachs, 3 had vents, 2 were getting tpn, 3 on tube feeding, all with piccs/mid lines and all with multiple iv abx). Logically I know I am probably ready, but emotionally I am definitely not ready. I have four shifts in a row starting tomorrow night. I guess it will be sink or swim. Any well wishes or positive thoughts sent my way will be greatly appreciated!

The first year of nursing is the hardest. Read the "First Year After Licensure" forum. EVERYONE is scared except those new grads who think they know everything, and those new grads scare ME. If you weren't scared, I'd be worried about YOU. Clearly you are someone who knows how much you don't know. That's appropriate.

Use your resources. Those nursing supervisors offered their help; take them up on it. Know where your policy and procedures are located, how to look up unfamiliar drugs and who to call when you have a question.

It takes about a year to become comfortable as a nurse and then perhaps another year to become competent. The first year is scary, but the only way to GET through it is to GO through it. We've all been through it.

Best wishes -- I hope you sail through your first week!

Shagce1 · Aug 22, 2016

Thank you for your kind words of encouragement. I got through the past 4 nights on my own. It was hectic and busy but I did it and stayed afloat. I didn't hesitate to ask questions when I had them, and no one really seemed to mind when I did need to ask. We were even short a cna for the past two nights and was able to not only manage my nursing duties but did all of the cna duties as well.

Ruby Vee, BSN · Aug 22, 2016

Sounds like you're off to a great start!

Shagce1 · Sep 29, 2016

Here it is six weeks later and I am still struggling. I just can't seem to stop myself from being so hard on myself. I had a good week and thought things were starting to fall into place. And then the last shift I worked all heck broke loose. I couldn't keep up. I know it has only been three months since I started, but I am starting to lose faith in my abilities. I have had 5 days off and I just can't stop thinking about how awful it was and how scared I am to go back. The depression that so many speak of on these boards is so real. I work third shift and my schedule is a bit unpredictable. On a night, off a night on a night. Then maybe on two nights. I think my body needs a little more consistency. I have a meeting set up with my manager on Monday to hopefully make my schedule a little better. Hoping that helps.

To anyone else out there feeling similar know that you are not alone.

I know this would probably be better off in the first year after licensure forum if anyone wants to move it.

Ruby Vee, BSN · Sep 29, 2016

Here it is six weeks later and I am still struggling. I just can't seem to stop myself from being so hard on myself. I had a good week and thought things were starting to fall into place. And then the last shift I worked all heck broke loose. I couldn't keep up. I know it has only been three months since I started, but I am starting to lose faith in my abilities. I have had 5 days off and I just can't stop thinking about how awful it was and how scared I am to go back. The depression that so many speak of on these boards is so real. I work third shift and my schedule is a bit unpredictable. On a night, off a night on a night. Then maybe on two nights. I think my body needs a little more consistency. I have a meeting set up with my manager on Monday to hopefully make my schedule a little better. Hoping that helps.
To anyone else out there feeling similar know that you are not alone.
I know this would probably be better off in the first year after licensure forum if anyone wants to move it.

Of course you're still struggling. It usually takes about a year to feel comfortable in your job and perhaps two years to become competent. You can't help but struggle now -- you haven't had enough time for the difficult transition from student to nurse. It is far too soon to lose faith in yourself. You're going through a rough transition, and the only way to GET through it is to GO through it!

Shagce1 · Sep 30, 2016

Thanks ruby vee. I know that I have to go through it. And everyone does. I just want it to be over. I do need some tough love. Someone to snap me out of it and tell me to "suck it up buttercup." I assume every new nurse feels very similar, but it still feels so lonely. Each shift I have something new comes up, but last night I decided to take the attitude of 'next time I'll know what to do.'

Thanks for for the support :)

Shagce1 · Oct 30, 2016

In case anyone has been following my story. Thought I'd post an update. I have been working as a nurse for about 4 1/2 months now. Off orientation for about 10weeks. All of a sudden, last week it dawned on me that i was starting to get it. I am learning better prioritization and time management. I had two different patients recently who needed blood at the same time and my coworkers were complimentary about how well I handled (their words) "an unfair assignment". I have been the blood queen lately. Another patient who was to receive blood I was the one who caught a mislabeling of the blood product and refused to give it until it was straightened out. Even though the nurse who was checking the blood with me thought it would be fine.

Things are coming together. Anyone out there feeling anxious, lost, depressed-- it's normal. When they say it gets better after 6 months to a year, I am finally starting to believe it. Hang in there all of you new grads. Learn as much as you can and ask as many questions as you need to be a safe practicing nurse. We can all do this. One day at a time!

Ruby Vee, BSN · Oct 30, 2016

In case anyone has been following my story. Thought I'd post an update. I have been working as a nurse for about 4 1/2 months now. Off orientation for about 10weeks. All of a sudden, last week it dawned on me that i was starting to get it. I am learning better prioritization and time management. I had two different patients recently who needed blood at the same time and my coworkers were complimentary about how well I handled (their words) "an unfair assignment". I have been the blood queen lately. Another patient who was to receive blood I was the one who caught a mislabeling of the blood product and refused to give it until it was straightened out. Even though the nurse who was checking the blood with me thought it would be fine.
Things are coming together. Anyone out there feeling anxious, lost, depressed-- it's normal. When they say it gets better after 6 months to a year, I am finally starting to believe it. Hang in there all of you new grads. Learn as much as you can and ask as many questions as you need to be a safe practicing nurse. We can all do this. One day at a time!

I'm so glad you're getting it. Congratulations, and never stop learning!

Here.I.Stand, BSN, RN · Oct 31, 2016

It sounds like you're doing great! LTAC is by far the most difficult specialty I have worked in, in terms of workload, family dynamics, and in many cases in terms of complexity.

Sweet charm, ASN, RN · Sep 12, 2017

any more updates?

MrNurse(x2), ADN · Sep 26, 2017

I started LTAC after 28 years in acute care. I had 4 nights orientation and a good to go. I switched to day shift after 30 years of nights without any orientation. Thankfully my manager was accommodating and I constantly reminded them I don't know what I don't know, but it is a bigger learning curve than I thought. You will do fine, you seem to have the maturity necessary to ask for help, the first sign of a good nurse.