Please Help! I'm 3 months in and feeling like a horrible nurse

christvs, DNP, RN, NP · Jun 28, 2007

I have been working for 3 months on med-surg. Every day I leave work I question myself about everything...did I chart that med? did I document everything? did I remove the IV on my pt that was discharged? The IV question is the one keeping me up tonight. I feel like I am a terrible nurse. My anxiety level has been sky high ever since I started. I keep asking myself if I did the right thing going into nursing, and lately I'm not so sure. My family and friends seem like their getting fed up with me stressing all the time, but I can't stop. I feel like I'm going to break soon, any advice is greatly apppreciated!

I've been an RN for 2 years now and I remember feeling that way too-it's perfectly normal to question yourself at the beginning. It shows you care and are very conscientious. :) I would try charting whatever you do right after you do it, to eliminate questioning yourself afterwards. I also write notes to myself on my nursing kardexes and then check things off once I complete them. I know you will become more confident of yourself over time. :)

Curious1alwys, BSN, RN · Jun 28, 2007

Three months in and you feel like your head will pop off with all the things you have to keep track of? You're right on schedule.
Seriously, you're living through the retooling process that the brain needs to convert from theory to application. It isn't pretty, and it isn't fun, but it's absolutely necessary to leave the relative cocoon of academia and emerge into the real world.
Here are some tips:
Design or acquire a really good cheat sheet. Take note of items you repeatedly have to write in and incorporate those into a better sheet.
Leave room for notes. Revise and revamp as often as necessary.
Begin each shift by taking the necessary time to get a thorough report. An extra ten minutes up front can mean the difference between feeling capable and feeling like you're spinning out of control. Check your MARs. Check for, and sign off on, new orders. Look up labs and other diagnostic test results. Make a note of those not yet completed so you know to look them up again later. Jot down anything that you will need to remember. D/C times. Med parameters like v/s. Special requests. Phone calls you need to make. Anything and everything that you need to recall at some point.
Cross items off as they are completed, but do it in such a way that you can still read them and remember what was done.
Chart as you go. It's a horrendous experience to leave charting till the end of the shift and then try to reconstruct the last eight or twelve hours in one sitting.
As you fly through your day, keep adding to your cheat sheet, even as you are crossing items off. It's so annoying to get to the supply room and have to wrack your brain for what So-and-so in Rm 3612 asked you to bring.
Keep a spiral notebook, as someone mentioned and write down questions and problems you encounter. Look these up after you're done working or during a quiet spell, if you ever get one.
At the end of your shift, go over your cheat sheet to make sure every item is crossed off or otherwise accounted for. Use your cheat sheet give report. Develop a pattern for giving report so that you don't leave important things out or jump all over the place and give the oncoming nurse whiplash.
Go over your MARs one last time to make sure you signed out everything or signed that something wasn't given. If you're supposed to write in v/s or other parameters, make sure those are done as well.
There's a reason why we think of things on the way home. That's usually the first chance we've had to be still, and that's when those pesky things bubble to the surface. Take five minutes to sit and just be quiet before you leave, and you might be able to save yourself a panicky phone call.
Before you leave or just after you arrive home, take that spiral notebook, and write at least one good thing that happened to you on that shift. A mistake caught before you did it. A new trick you learned from a more experienced nurse. A compliment paid by a coworker or a patient. A skill you did well for the first time. This is what you refer back to when you've had a lousy day and you are certain you were meant to be a litter collector on the highway of life.
This will get better. One day, you'll be halfway through your shift when you realize that you forgot to panic. And then you'll smile and think you might be able to do this job after all.
P.S. Please remember these days and these feelings for that glorious time a few years down the road when you're precepting some poor newbie who is terrified out of her shoes. Give her the same encouragement that you need now and she'll be forever grateful.

Wow, what an awesome post! So encouraging. As a fellow freaked out new grad, I feel your pain OP. And as a poor newbie, I THANK YOU Miranda. I am forever grateful!