Perfectionist - will I ever be able to handle bedside nursing?!

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Specializes in ED/trauma.

After finally making the decision that I wanted to start in med/surg (med/tele actually), I was very proud of that decision. I love bedside nursing and the human component that it encompasses. It's all the other stuff that gets at me though...

When I interviewed for the position with the nurse recruiter, although my manager had already unofficially decided to hire me, the nurse recruiter asked the requisite interview questions. One was, "What is one of your greatest weaknesses?" I told him that I'm a perfectionist. He chuckled, said that's not a real weakness, and said that all nurses are perfectionists to some degree. I tried to explain further, but the interview continued...

So here I am, barely 3 months as a new grad RN, barely 3 weeks on my own, and I feel overwhelmed by my fake weakness. Let me clarify a bit...

  • If the night nurse spends more than 30 minutes giving me report, I start feeling anxious. If s/he goes 15 minutes longer, the anxiety sets in. :redlight:
  • If I don't have my 0900 meds passed by 1000, I panic. (They MUST be done by 1000. There is no room for error!)
  • If I don't have my assessments completed during the med pass period, I panic a bit. :uhoh3:
  • If I'm not sitting down and charting my AM assessments by 1100, I freak. :flamesonb
  • I try to plan lunch at a time when nothing major will be occurring so my pod-mate doesn't have to worry about my patients. So I make sure all my meds are passed, no one is in pain, no procedures are scheduled (or at least no one will be taken while I'm at lunch). My pod-mate will only have to step in if something serious happens.
  • Fortunately, I have learned always to go to lunch, no matter what! One day, I was so busy that I didn't allow myself to go to lunch. My (wonderful) CNA asked how I'm supposed to take care of my patients if I'm not taking care of myself. So, now, I usually have lunch no later than 1400 and always have healthy snacks on hand if I do have to eat late.
  • Once I get back from lunch, there are usually 1300, 1400, or 1500 meds (often IVPB abx) and my reassessments. Of course, it seems like either all or none of my patients have accu-checks and pain issues -- so I'm either dealing with those all day or not all.
  • I don't know how, but (once I get back from lunch) it literally seems like the remaining 4-7 hours zoom by. I'm still convinced that nursing imposes a time warp of some sorts because, in my past office jobs, 8 hours seemed to drag on for-ev-er.
  • I try to have all my major charting (assessments, at the very least) done by 1800, so I can be totally ready for report. If I have left anything uncharted (like I&Os, documenting pain reassessments, etc.), I do it after report.

As I've just typed all that out, it seems like I have myself together pretty well. However, it's not like ANY day is EVER that organized. There are always orders that I have to double check, procedures to prepare for, meds to check on (make sure pharmacy put in the order AND sent up the meds... which they don't seem to all of the time :confused:). So all of that described above, though it seems so cut and dry, does NOT typify a normal day simply because of all the extras. And those are the things that send my silly little GAD into overdrive. I spend every free second worrying about what's going to happen next. I feel like I spend more time worrying about what I can/should/will do for my patients that I actually spend doing those things :wtosts:

All that being said... I know I've gotten better at managing my time. To my surprise, during my last shift, I didn't get my charting done until after lunch (first time since precepting), yet I somehow managed to leave earlier than I have in over a month. Yay. That doesn't help with the anxiety though! :sasq:

I know that bedside nursing is everything BUT perfect. One of our secretaries described it as "disorganized chaos." That almost knocked me over when she said that. I thought, I MUST be in the wrong place!... :barf02:

Everything is becoming more tolerable. All of my patients are safe and well-cared for. If I don't know something, I make sure to find out. I do my job very well. It's the anxiety inside that I'm not doing it perfect that eats me alive every shift, though. I've always been a perfectionist, and I don't know how to escape it!... :selfbonk:

I signed a contract with this hospital for 12 months (after precepting), so I owe them 11 months and 1 week at this point. I'm committed to sticking it out, but I'm afraid I might lose my sanity in the process. :hdvwl:

On a positive note, I have a part-time home health job lined up that should be starting in a month or so. I've heard that HH is more predictable than bedside nursing (though, of course, there are always exceptions), so I'm hoping that will provide a little more sanity to my week.

I know that was an outrageously long rant. I'm not sure if any advice can possibly help this insanity, but anyone wanna' give it a shot? :plsebeg:

TIA :rcgtku:

-- hanging by the threads of sanity :hngon:

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Specializes in ICU/ER.

I dont even know where to start but I do LOVE this line....

"I'm still convinced that nursing imposes a time warp of some sorts because, in my past office jobs, 8 hours seemed to drag on for-ev-er."

so true!!!

I could not do Med Surg nursing, I am not a perfectionist per say, in fact not even close. I do get a panicky moment if I feel like I am forgetting something I would call myself more of an ADD type. I could not keep track of all that needs done on MS. I would feel like I was giving partial care to my patients and I would hate that.

I have found myself a very happy home in the ICU. I have 3 patients max. I do complete care. I feel like I really know what is going on with the patients.

Have you ever considered ICU? Can you transfer and still be with in your contract?

Best of luck to you. I graduated in Dec and some days feel very sure of myself and other days feel like "who me? the nurse?"

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It seems like you already have a lot of it sorted out. Your patients are getting the care they require and you are getting your lunch...what more could you ask for?

Part of being a nurse is flying by the seat of your pants, adapting to change, rolling with the punches...etc etc. Imagine if you will, a job where the same thing happens every day. Your meds are done by 0845 exactly. Your assessments and charting are done between 0900 and 1100, no earlier no later. Lunch comes and goes, then you give the same meds for 1300. All orders are processed between 1345 and 1445....well, you get the idea. It seems like a dream right now, but after a week you'd be bored stupid and pulling your hair out. We need something to mix it up a little bit.

Being a perfectionist doesn't mean following a scheduale...it means getting everything done properly and correctly...

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Specializes in ED/trauma.
It seems like you already have a lot of it sorted out. Your patients are getting the care they require and you are getting your lunch...what more could you ask for?

Part of being a nurse is flying by the seat of your pants, adapting to change, rolling with the punches...etc etc. Imagine if you will, a job where the same thing happens every day. Your meds are done by 0845 exactly. Your assessments and charting are done between 0900 and 1100, no earlier no later. Lunch comes and goes, then you give the same meds for 1300. All orders are processed between 1345 and 1445....well, you get the idea. It seems like a dream right now, but after a week you'd be bored stupid and pulling your hair out. We need something to mix it up a little bit.

Being a perfectionist doesn't mean following a scheduale...it means getting everything done properly and correctly...

You are absolutely right... I would be bored out of my wits!

And I like your take on perfectionism better than mine. Maybe I just need more time to make it work for me...

Thanks! :icon_hug:

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Specializes in behavioral health.

have you always had such anxiety? being somewhat perfectionistic definitely makes a better nurse..but too much can hurt your health. just remember that you are not Robonurse.. i bet you are a great nurse =) better than robonurse. =)

i just know that ive had/have anxiety issues..and it is just uncomfortable.. and makes me sick after awhile. nowadays..i tend to more often get angry at others trying to sabotage my mental health rather than self-ridiculing =P although i definitely do at times.

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Specializes in ED/trauma.
I dont even know where to start but I do LOVE this line....

"I'm still convinced that nursing imposes a time warp of some sorts because, in my past office jobs, 8 hours seemed to drag on for-ev-er."

so true!!!

I could not do Med Surg nursing, I am not a perfectionist per say, in fact not even close. I do get a panicky moment if I feel like I am forgetting something I would call myself more of an ADD type. I could not keep track of all that needs done on MS. I would feel like I was giving partial care to my patients and I would hate that.

I have found myself a very happy home in the ICU. I have 3 patients max. I do complete care. I feel like I really know what is going on with the patients.

Have you ever considered ICU? Can you transfer and still be with in your contract?

Best of luck to you. I graduated in Dec and some days feel very sure of myself and other days feel like "who me? the nurse?"

While doing my ICU rotation in school (we only did 3 7-hours shifts), I thought it was kinda' sorta' neat. My biggest concern, though, was that so many patients were out of it. I really wanted to be in a place where I could communicate with my patients fully and completely. Unfortunately, on busy as heck days (like yesterday... OMG! pain meds q2h is INSANE when 4 of my 6 patients are incontient!), I don't actually get to do the things that drove me to nursing to begin with. I'm really starting to get torn :confused:

Fortunately, I have this part-time HH job lined up. Though I won't be starting for another month or so, I have high hopes for it. I love the idea of being able to spend an hour with a patient, giving them total care without having to be interrupted by doctors, orders, procedures, meds, or any other number of interruptions. I love the idea that I'll actually be able to spend time CARING for my patients -- the whole reason I even wanted to be a nurse!

As for as sticking to my contract, I have to stay in the med/surg realm. I'm currently on the med/tele/isolation unit. (Having 4 of my 6 patients being incontient AND on isolation is about as close to insane as one can get...) There is 1 surgical unit, 1 medical unit w/ cameras & sitters, and 1 onc/med/surg/overflow unit. I think I could get into one of those, but I'm not sure. I really love medical (versus surgical/post-op), but the isolation can be a nightmare (like yesterday!). I'm not sure the camera patients would be any better, though. And I have no interest in oncology.

I really want to live up to my contract, but on some days (like yesterday!) I feel at my wits end. I actuallys didn't get out of there until 2130 last night -- 2 1/2 hours past my shift ending! My patients were incredibly demanding. It was too much for a new grad. I had a new charge, and I don't think she knew that I'm new. My normal charges don't like assigning me to patients with that high acuity.

And then there are always nights to consider...

Anyway, thanks for your ideas :icon_hug:

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Specializes in ED/trauma.
have you always had such anxiety? being somewhat perfectionistic definitely makes a better nurse..but too much can hurt your health. just remember that you are not Robonurse.. i bet you are a great nurse =) better than robonurse. =)

i just know that ive had/have anxiety issues..and it is just uncomfortable.. and makes me sick after awhile. nowadays..i tend to more often get angry at others trying to sabotage my mental health rather than self-ridiculing =P although i definitely do at times.

I've always had such anxiety, yes, but was only "diagnosed" with it a couple years ago. (I think being aware of it makes it worse!)

Some days (like yesterday!), I'm painfully aware that I'm not Robonurse. It's sooo frustrating to spend the whole day giving pain meds and cleaning up incontinent patients and then have a doctor ask me why I didn't do a dressing change. Because I didn't have time is not a valid answer...

My anxiety makes me sick also. I suffered from tension headaches for years! Only after I started taking anxiolytics did I find out that it was the anxiety that was causing my headaches. Sometimes my GAD crosses into a full blown panic attack with nausea and the whole nine yards. I had to call in sick one day while precepting. It was so bad that even my meds didn't help :crying2:

Yesterday, I spent most of the day being irritated at my patients -- actually just 3 in particular. I realize that I can't change obesity and incontience, but both really complicate a day's work... I know some statements are interpreted as offensive, and this one is not intended to be at all. It is a simple reality that cleaning an obese patient (esp. when s/he is incontient) is far more challenging than cleaning an average sized patient -- esp. when they can't move as much (either are unable to or choose not to) and when you need at least 1 person to assist you. Just in case I haven't made it abundantly clear (ad nauseum...), yesterday was my day from heck!

So... I actually would have liked being RoboNurse yesterday! :stone

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Specializes in IMC, ICU, Telemetry.

I'd caution you about spreading yourself too thin and taking on another job, even though it sounds like HH will be more to your liking. Given the stress and anxiety of your MS job, you need to take full advantage of your time off to recuperate. If it's absolutely not possible to exit the MS position because of the contract, be sure to take extra care of yourself. I think the time spent in a 2nd job might add to your anxiety, especially the first few weeks when you're learning the new job.

It's not usual for a new grad to go into HH, they typically want 1-2yrs experience - that they would hire a new grad 3 mos out and only 3 wks flying solo - big red flag.

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Specializes in ED/trauma.
I'd caution you about spreading yourself too thin and taking on another job, even though it sounds like HH will be more to your liking. Given the stress and anxiety of your MS job, you need to take full advantage of your time off to recuperate. If it's absolutely not possible to exit the MS position because of the contract, be sure to take extra care of yourself. I think the time spent in a 2nd job might add to your anxiety, especially the first few weeks when you're learning the new job.

I've thought about that too, but I need the money and think it would be worse for me to work OT at my current job, as I imagine I'd burn out immediately if I worked even 1 extra shift per week. With the HH job, I only have to work 4-6 hrs/wk to start with the option of going full time in the future.

It's not usual for a new grad to go into HH, they typically want 1-2yrs experience - that they would hire a new grad 3 mos out and only 3 wks flying solo - big red flag.

I had heard the same thing. I actually got a referral from a very good friend who knows me very well. I was explaining to her my concerns about burning out, so she referred me to a friend of hers. This company wants to remain small. The DON actually is quite young and feels the same way about hospital nursing as I do. I told her that I love nursing but feel like I'm not as able to "care" for my patients as I had always dreamed. She said she'd felt the same way, which is how she ended up in HH. I asked her about hiring a new grad, and she said she actually liked the idea of setting me up with a mentor to train me fully (again, with the prospect of working for them full-time in the future). (Her willingness to hire me was also based on this outstanding referral she was given.) Normally, I would have thought "red flag" too, but her explanations made it more reasonable.

Thanks for your input!

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Specializes in Adult Acute Care Medicine.

  • "Fortunately, I have learned always to go to lunch, no matter what! "

I just wanted to congratulate you on this! Keep taking care of yourself! :nuke:

As a new nurse, I still have difficulty with this. About a month ago I vowed never to go another shift without eating...but it happened tonight..I was SO busy and still not sure what I could have done differently....

Anyhow keep up your routine of making sure you do your own "self care" ...It sounds like you are very contientious and give excellent pt care.

I hope things continue to get easier.:redbeathe

-Jessica

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Specializes in ICU.

........

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Specializes in cardiac rehab, medical/tele, psychiatric.

I could have written that! I was the same for about 6 months..then I realized that my anxiety was getting in the way, so I would stop and take a breath and remind myself that if I was running behind, my med pass (or whatever) would get done, and lo and behold, by the end of the day, everything was done.

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