please help am going mad

mother/babyRN, RN · Nov 3, 2003

Milly, {{{}}...It just takes time...Sometimes I will line out a piece of plain paper and square it off, marking Iv, Pt Pt room Treatments Meds and their times, etc with boxes that I can check off or fill out during report and throughout the shift...Take some deep breaths..When you make the sheet, copy a blank one so you won't have to keep making one up.....Just hang in there. It will come.....{{{}}}

nekhismom · Nov 3, 2003

I am so sorry that you are feeling this way. Maybe someone in the new graduate forum can give you some ideas on this one? I am in my last semester of school, and we each take a nurse's assignment. What I do is get a cardex report on all the patients (we have a page that will print a mini-cardex and put all the patients in my assignment on the same page). I turn it over and make notes throughout the day as needed. One student is responsible for all the meds for all the patients, so we don't have to worry about meds, but I still miss little things throughout the day. Don't beat yourself up, because you will get it in time. Good luck!

:kiss :kiss

sanakruz, ADN · Nov 3, 2003

Originally posted by milly
hi all,

not only that i have no one in the world to talk to about it and get some peice of mind to stop feeling sick to the stomach because i have missed something, is there any forum or group that you can go to to de breif and relect positively.

HEY HEY HEY NOW!
Youve come to the right place!:kiss

mother/babyRN, RN · Nov 3, 2003

How do you feel about "talking" to us????We are here for you....Just ask....PM any of us ( if I may speak for you all) or just let us know how you are doing...NO one knows EVERYTHING right away.....

neechee · Nov 3, 2003

:kiss

Milly,

You are suffering from shock. There are several things that cause your brain to go into this type of shock. Reality of the work, being overwhelmed with tasks, lack of experience, fear, self esteem issues, etc.

There are several things you can do to get help.

1. Did you get good enough orientation?

2. Talk with your Nurse Manager about what is going on.

3. Ask for help...guidance. Don't wait until evaluation time and then get a bad eval.

4. Learn from peers. Ask how they do things.

5. Be open mined.

6. What is the patient to nurse ratio?

7. Get to work on time. Plan your work day. etc

Be proactive in resolving. Attack the problem. If you are leaving too much behind and there are medication errors occurring, you will find yourself in a discipline situation .

Good Luck:)

chad75 · Nov 3, 2003

i am going out of my mind i really am at this present moment, i am a newly qualified nurse and i am having a real hard time getting my prioritising and time management right. i seem to keep making little mistakes and things get left.

Advice: Mentor a proffesional nurse. There never seems to be enough time to take care of everyone but if you triage and work effciently ONE PATIENT AT A TIME it will get done. I find myself overwhelmed at times but I take a deep breath, maybe even get a cup of coffee and take a five minute break to gather my thoughts and form a game plan. I have been doing this five years and consider myself quite effcient and I still need to ask for help occasionally. I do occasionally forget something (releasing the roller clamp on the iv piggy back anyone?) I learn from it and move on, we are human.

not only that i have no one in the world to talk to about it and get some peice of mind to stop feeling sick to the stomach because i have missed something, is there any forum or group that you can go to to de breif and relect positively

Peers are a good source for venting, so is your charge/NM etc. they have been there too and I'm sure can empathise if they aren't bitter old battle axes. As far as feeling sick to your stomach because you might have missed something etc. I suggest you really try and decompress, I have learned that work stays at work I don't think about work once I step out of my car and walk in to my house. I say to myself on the drive home I know I am a competent nurse if by chance I missed something the hospital has my home/cell number if they have any questions then I LET IT GO.

askater11 · Nov 3, 2003

Don't feel alone at all. I've been a R.N. for 8 year's and some day's with the a hectic day--I feel disorganized.

1) Take your breaks.

2) Remember to slow down--when things are getting hectic--take a breath slow down.

3) A) Make a to do list. Mine is at the bottom of my report sheet. It doesn't include things that are done on everyone (like A.M. meds(unless somethings at a unroutine time) or assessments)

B) What I do for Assessments and Routine Meds--say after I THINK I'm done passing all the 10 A.M. Rx's--I go through ALL the meds sheets check one by one to make sure ALL Rx.'s were given. I do the same for assessments.

4) On my report sheet I put a "M" and "A" when I'm done giving meds I slash the "M" (or you could put the time)--When I'm done with the assessments I slash the "A" next to the patients name.

---At the end of the shift I have "OP" I & O's and "o" for double checking signed off orders and to make sure all the orders I've signed I've Implemented them in the patients care.

---I know it sounds like a lot of extra work--but I love doing it--at the end of a outrageously busy day I see all my tasks are slashed off--I leave work feeling like I DID everything. For example, yesterday I was leaving and I passed one of my patient's rooms I thought oh no I didn't give my patient's 1800 R.X.'s...I looked down at my report sheet--saw a "M" slashed and knew right away YEP I did give him his RX'.

5) 10 things can be going on at one time. Handle each task one at a time. Don't try doing 2 things at one time.

---yesterday at work two senior nurses were talking about "blocking out people" They said, "at time's they have to block out things." (eg answering a ringing phone) We are only human...and more mistakes are likely to happen if we're trying to do two tasks at once. Take a second finish what you're doing...if there is an urgent matter going on--jot fast on your to do list so you don't forget what you were doing.

6) Sometimes you have to say "NO" or "certainly but right now this is going on...once that's finished I'll do what you're asking me to do"

E-mail me any time if you want to vent or just chat!!!

Yesterday at work--a fellow nurse vented to me how hard being a new grad was. She discussed how people treated her...she asked me how other colleagues treated me over the past 8 years. She brought up other things but she told me, "after talking to you I feel a lot better."

pepperbark · Nov 3, 2003

I was the same way when I first started nursing. You have to get organized. When taking report prioitize, placing things that must be done in columns, high light them or write them in red ink on your report sheet like med times, xrays, mri, labs, and always follow up with these things. When the doctor comes in he will be wanting results.

It helps to have a special place on the report sheet for things like diet, o2, allergies, etc... and don't try to do everything all at once. Prioritize tasks as well.

Hope this helps

bellehill, RN · Nov 3, 2003

Every nurse feels overwhelmed from time to time. Chad75 gave some good advice that I find helps also; sit down and have a cup of coffee/soda/water, whatever. Use this time to relax and catch some quiet time.

Don't be afraid to ask for help. Some hospitals have a mentorship program for new grads, check to see if yours does or if there is someone you can talk who can help you prioritize.

There are two shifts at hospitals, don't drive yourself crazy getting everything done...I don't mean a stat order or something written at the beginning of your shift. I am talking about the UA order written 30 minutes before shift change or whatever. The next shift is there to help you, sometimes it is impossible to do everything.

Keep smiling and laugh every now and then, this is supposed to be fun and rewarding.

:chuckle

megjrn · Nov 4, 2003

Milly:

Are you working with a preceptor? If not, your facility should be providing preceptors to all new nurses. If your facility has simply put you with other nurses to orient you to your particular unit, you are being cheated out of having a specially-trained nurse who has been through a preceptor class to work with you during your 3 month employment probation period. If your facility does not provide preceptors, then go to work at a facility which does provide them. Being a brand new nurse is stressful and scarey. In my 15 years as a nurse, I still have not forgotten that "tight stomache" feeling of being new, fearful of making mistakes, and feeling scrutinized by the experienced staff members. Unfortunately, some seasoned nurses are not always welcoming and nurturing to new grads. In the meantime, invent your own system to help you remember things--make a check-off sheet for your med passes, charting, paperwork requirement, v/s, I & O'S, etc., for example. Do not leave until you have actually checked everything off. Also, you you may want to consider the type of unit you're on: perhaps it is too fast-paced and demanding for a new grad. With the nursing shortage, a lot of facilities will just stick a nurse anywhere there is a vacancy without considering that nurse's experience and needs, and leave him/her to sink or swim. Do not accept being "thrown to the wolves," if that is the case. BTW, they often do that to experienced nurses, too...There is no shame in transfering to a unit of lower acuity, or even going to another facility where the acuity is lower. The main thing now is, you want to develop your skills and your confidence. You don't want to over challange yourself in the beginning. I'm telling you all of this because usually the feelings you're experiencing are a reult of the environment in which you work, not from being incompetent as a new nurse. You're new, you can't be expected to know anymore than you learned in school at this point. Good luck to you.

nursemary9, BSN, RN · Nov 4, 2003

Hi Milly,

I am a Nurse for 37 yrs. I work full-time. IT TAKES TIME TO

GET IT TOGETHER!! This is NOT something that happens

quickly.It takes time to learn organizational skills and to learn to prioritize. Go easier on yourself.It will come with time.