Hello everyone. Okay here it is! I am a recent grad and newly licensed registered nurse, studied for a few months and took my boards late August, thank God I passed on my first try. Fast-forward a year and half ago, during my last year of nursing school I took a part-time NA position at a reputable local hospital, but shortly after being hired, I was so disappointed at what I saw that I wanted to quit nursing completely, became profoundly depressed, truly hated being there. The lack of care, the politics, the backstabbing I've witnessed made me question my decision to become a nurse, but after countless of soul searching, seeking professional help and finding out the true cause of my depression. I am back and determine to be the best nurse that I can be. I left the previous hospital and took a nursing position after passing my boards and. Despite my previous experience, I was very optimistic and very enthusiastic to start.
SO I THOUGHT UNTIL I STARTED ORIENTATION A MONTH AGO. I honestly feel that I cannot do this, at least not in a hospital setting. As a brand new nurse, I truly feel unprepared for the fast pace and pressured orientation that is provided. I am constantly being pulled or thrown into situations that have no idea about; I started initially with two patients and every week one more patient is added. It is so overwhelming that there are times I don't even do my daily assessment because I've no time. 99% of the time I don't get anything to eat until 4:30 or 5pm. At times, we are so busy that we only take half an hour while we're being deducted one hour. I gave an IV push without my preceptor's presence, she didn't even bother to ask whether I knew the steps, just guess the needle and syringe to use. Thank God I knew that it has to be a 2-minute process. Endless paper work and MD orders, winning family members that make my head spin and unexpected deviations that can change or ruin your day. Every time I think I understand something the next day I go it seems I didn't learn a thing. My preceptor keeps on saying "hang in there honey". Frankly, I can't keep up with the constant changes. I hate the fact that I have no time to compare the MAR with the patient's main chart like we were shown in school. I feel my license which I work so hard for is at risk.
So my question to you all is, should I leave the hospital and go work for a nursing home where things are more routine and the pts are more stable. I truly feel that I don't make any difference while in the hospital. I don't even have time to speak to my patients because I've been told that I must learn to cut them short. I have been giving this a lot of thoughts should I hang around a little longer. Please understand that I love my patients and always wanted to become a nurse and am heart-broken. I've discharged several pts without assessing them. Every coworker in my unit is cutting corners. As a new grade I should be given thorough orientation I feel cheated. Is that orientation usually goes because a lot other orientees share the same concern. Please help I need guidance.:angryfire
Thanks everyone for your in depth replies. I will try to stick with it and understand I am new to this role and have so much to learn. But it so hard when one is trying her best and it feels it is not good enough. ONe day last we had a meeting with the nurse educator, the NM and my preceptor. Most of the concern my preceptor has raaised is time management she says she sees how careful and safe I am when given meds she's not worried. Honestly, I agree with her but I over check and recheck several times when it comes to meds. But she says if I check twice no need to check a third time because this method is slowing me down. When I have so much to do at times I just froze not knowing what to do first and my preceptor comes along "move it, move it". Next week when we sit down again, I will admit to my NM, Nurse educator that I am a bit overwhelmed and take it from there. Again, it is great to know that I am not alone and thanks so very much to all of you for responding and for giving me hope. I will keep you all posted.
Barlan, I hope you don't mind, I'm going to make one more observation.
Before you meet with your supers next week, make up your mind NOT to downplay yourself. I suspect you'll be plenty modest as it is. Most of us do not know how to do a realistic self-assessment.
Think like a small-business owner. If he only looked at his debts, he'd despair and close shop. You have to add up your ASSETS, as well.
You've noted some really good things about yourself: cautious, responsible, care about the patients, humble (maybe too much), willing to learn. Efficiency and Proficiency only come with time in any serious profession; lots of time.
So, I suggest go to that meeting with a sheet of paper outlining your strongpoints as well as areas for improvement. Show them you are thoughtful and rational about this.
I'm betting you'll be a great nurse down the road. :)
med surge is a great place to start, especially for people like you who likes to take one step at a time.
2) i have one preceptor and she has 18 years of experience, well respected among her peers.
one preceptor is great. with that much of experience, it's wonderful. only thing is that she may have forgotten how it feels like to be a fresh out of nursing school, so just communicate with her about how you are feeling, and what you are having trouble with. also it's good to take a time with her at end of the week to discuss about your progress, and what you need to work on with her.
3) my orientation is 10 to 12 weeks long. i am on my 4th week.
come on! you are only 4th week in! i remember feeling like 12 hours was never enough to do all the things in a day when i was at my 4th week. don't worry, you still have a long way till you are on your own. dont be afraid to ask for a help. if you are falling behind, ask your preceptor for help. or pct, or whomever is available to help you. deligation is a big task, but is also a big help and relief as well.
4) i lack time management, experience, knowledge about most meds, the different types of iv pumps, machines, cannot remember where everything is, the various paper works
out of all the things above, you can take your own time to make cheat sheet of the unit yourself (or maybe with your new co-workers). jot down what equipment you need for what procedures, write down what you need to do in each situations such as admission and discharge.(history, vaccines, labs, abx, wound/skin checks, teaching, assessment, med rec etc.) then when you are at home, you have to do your own homework. you have to study. just because you passed your nclex doesn't make you an expert nurse. you have to put your own effort into becoming a good and effecient nurse. when you do your homework(meaning you have to create a homework for yourself and work on it on your own time), then the time management will follow. you can also write down the time and what you need to do, like medications and assessments, ct, mri etc for each day when you get a report. that helps to get a glance of what your days look like, so you can do things ahead of time to not fall behind.
5) i recently passed my boards and have been working as rn for a 6 weeks
you are still brandnew! give yourself a break! you are on the right track. everyone learns at different pace. and in the fact that you are feeling overwhelmed, it shows that you want to be better, and don't forget that feeling. just don't let that feeling take over you. use that feeling to grow.
6) one of my strength is that i have good interaction with the patients and family, a team player, someone who is willing work hard and learn.
my weaknesses are i am getting intimidated very easily, terrified of making mistakes, very slow at everything, whether is passing meds, triple check meds before and after drug administration, mortified someone will die on my watch because i don’t understand what i am doing."
your strength is wonderful. because you have quality that you can't be learned. you can't teach someone to have a good personality, you can't teach someone to be willing to work hard and learn or to be a team player. and you are. that is a quality. you are already ahead by having that. your weakness does need to be worked on, because many times pts and pt's family are going through tough times and they may take things out on you. you have to be confident of what you do and what you say. they can be intimidating just because they ask you questions, and you want to be able to interact with them with confidence and not confrontational manner. (even though sometime you may have to stand up for yourself!) and also, don't be afraid of death. when time comes, pt will die. you just have to be able to handle it, such as knowing your cpr, knowing when to call rrt(rapid response team), knowing when to call code etc. since you are working on the med surg floor, it's not your responsibility to run the code. icu team will take care of that for you. but give a good report. and that's one of the reason why you can not skip your assessment time. it's okay to fall behind on documentation, but as least write it down on your cheat sheet. again, do not skip your assessment time. what if you come in at 0700 and get a report, you dont' do your assessment, your pt crashes and dies at 0715, you don't go in to give your meds for your pt until 1100 and you find the pt dead. how are you going to explain that? you have to be able to take responsibility for what happens to your pt during your shift. so, take your time to do assessment every morning.
7) i feel comfortable with my preceptor, i share a lot of my concern with her and she usually replies welcome to the real world of nursing. i don’t trust my nurse manager as most of them are backstabbers who mostly look at for management.
that's good, you should be able to do that not only during your orientation, but throughout your career. and you are right about not trusting your nm...
you are doing good by doing "safe than sorry practice."
For one it's great that you care this deeply about doing a good job. I've trained nurses to the NICU and trust me it's always the ones that don't worry that scare me.
I will make one suggestion since you said you need to "cut-corners" NEVER do this when it comes to your assessments. That's the one thing that covers your a**.
Your pace will pick up as you get to learn the meds you see pretty routinely and you discover your own flow. All those things take time. Trust me 98% of us went through the first year waking up at 3am saying _ God did I do this or that. It take 8months-1year to feel comfortable with the responsability that comes with the title.
Specializes in Community Health, Med-Surg, Home Health.
Every new grad nurse experiences this, I am sure. Textbook verses real world usually = to post traumatic stress syndrome (I'm exaggerating) until you get more acclimated. Usually, the first year is the worse. However, if you are the sort of person that really knows yourself, you can assess at least 6-9 months down the road whether or now med-surg/floor nursing is for you. If they aren't giving you a hard time, try to stay there a year, so that you can add this to your resume.
If LTC did not dump as many as 60+ patients on LPNs, I would have loved to have started there in order to gain the basic skills of dressings, medication administration, g-tubes, etc... earlier in my career. I had to gain the courage to get up there, so I started doing per diem on med-surg to bite that bullet while I had the energy and fortitude to face that demon. It wasn't as bad as I though, but believe me, I was still afraid! I work in a clinic at a hospita for my main/regular job, but do go to the floors to gain experience at the bedside. Can't speak for everywhere, but for LPNs in my hospital, our responsibilities are more skill based (not to say that critical thinking is not needed-that is not true). I believe that working on the floor for at least a year for an RN, especially a BSN would probably open more doors and also having experience dealing with crashing patients is beneficial to improving your assessment skills and gaining confidence. Give yourself a bit of time...if they are not harassing you, give yourself a break.
Barlan
6 Posts
Thanks everyone for your in depth replies. I will try to stick with it and understand I am new to this role and have so much to learn. But it so hard when one is trying her best and it feels it is not good enough. ONe day last we had a meeting with the nurse educator, the NM and my preceptor. Most of the concern my preceptor has raaised is time management she says she sees how careful and safe I am when given meds she's not worried. Honestly, I agree with her but I over check and recheck several times when it comes to meds. But she says if I check twice no need to check a third time because this method is slowing me down. When I have so much to do at times I just froze not knowing what to do first and my preceptor comes along "move it, move it". Next week when we sit down again, I will admit to my NM, Nurse educator that I am a bit overwhelmed and take it from there. Again, it is great to know that I am not alone and thanks so very much to all of you for responding and for giving me hope. I will keep you all posted.
Barlan