peaceweaver

100% agreed. I’ve often said to my coworkers and family that I never want to be in hospital and never want to see any of my loved ones in hospital, as I had absolutely no idea before I entered the profession how much pressure the average nurse is under, and how frequently nurses are working short-staffed with a million and one things on their minds for way too many patients. My only “good” days occur when, by some miracle, I’m down to three patients after a discharge and don’t get an admission, or (again, by some miracle), all 4-6 of my patients are one person assist. The moment I have even one total care patient who needs two or more personnel for repositioning is the moment I start having to rush to get through my day. Add two or three such patients to the workload, and the time I’m able to spend with my patients who require less assistance is cut to the bare minimum. RNs providing total care without an adequate number of CNAs may have worked back in the day when acuity wasn’t what it is at present. It barely works now, and many days my coworkers and I feel like we’ve made it through by the skin of our teeth. Our patients have so many comorbidities, complications, and complex higher-order care needs, and asking RNs to toilet, feed, wash, and ambulate patients with minimal to no help *in addition to* our mountain of other responsibilities is asking way too much. Management, who mostly nursed in the 70s-90s, are so far removed from the realities of current nursing. They tut tut and wag their fingers over increased rates of patient falls, staff injuries, sick calls, etc. and don’t listen when we explain that what we need is more bodies on the floor help to meet our patients’ basic personal care needs. We plead our case over and over again, and in return we get fancy, new, expensive safe patient handling equipment that STILL requires two or more health care workers to operate it. We shouldn’t just accept the status quo of total RN care “because that’s how we’ve always done it.” Patients are increasingly older and sicker, and that’s not changing any time soon. There are honestly times when it feels like the powers that be are just waiting for all of the baby boomers to finish passing through the system so that they don’t have to cut positions and deal with the hassle of sorting out severance pay when the census eventually goes down.

Reading this has made me realize how messed up our staffing/workload situation is in my area... ? We don’t generally have nursing assistants on our acute care med surg floors. A few floors (including my floor) have a SINGLE personal care attendant on day shift who helps between five to seven RNs. Each RN on day shift has at least four patients, or upwards of five to six patients when short staffed. On night shift, there are four to five RNs with six patients each (or seven to eight patients when short staffed). There is no personal care attendant hired for nights. This is a 24/7, 365 days a year sort of experience for me. On my floor, our patients are almost always min 2 person assist, one person assist if we’re very lucky. Independent patients are almost unheard of. Most of our patients are unable to go to the bathroom without assistance. The vast majority need help washing themselves. Some can’t feed themselves either. Some require a stand aid lift for toileting, some require a total lift to get in their chairs. If our single personal care attendant is not free when we need their help (which is almost always, since there are upwards of six other RNs who need their help), we then have to help one another with basic personal care, or have to do a heavy two person task all by ourselves — all while passing meds, taking vitals, doing assessments, monitoring blood transfusions, doing complex dressing changes, preparing patients for OR, receiving patients from OR, admitting patients from emerg, entering orders, calling physicians with updates on sick patients, performing EKGs after the EKG techs have gone home for the day, answering phone calls, dealing with family members, apologizing to patients who are yelling at us for being two minutes late with “the pill that starts with a D”, listening for bed alarms ringing to alert us that a confused patient is trying to climb out of bed, calling pharmacy to request meds that aren’t in the Pyxis, doing discharge teaching, preparing patients for transfers to other facilities, dropping everything to assist with codes/near codes, documenting, documenting, and more documenting, etc, etc, etc. I know this doesn’t help you, but holy crap, I wish I worked somewhere where it was considered ABNORMAL to not have help with patients’ ADLs and personal care needs. ? When patients are heavily dependent on health care workers for assistance with ADLs, it is NOT APPROPRIATE for management to cut corners and not staff that area with an adequate number of CNAs. RNs simply CANNOT do it all. This “doing more with less” mantra that hospital administrators and managers dump onto front line nurses makes me sick. If we don’t speak up, things will never change... It’s not safe for us, and it’s definitely not safe for our patients.

That’s the spirit. You’ve got this!

To confirm, yes, things work differently here in Canada. ? GNs are permitted to work independently with an interim license for up to three years in some provinces (though that is obviously discouraged, and most new grads write the NCLEX ASAP, usually within a few weeks or a month or two of graduating). We also, to the best of my knowledge, do not have the same kind of new nurse preceptorship that is common in the US. At the most, we have around 6 weeks of floor orientation in which we are randomly co-assigned to various nurses on our floor (usually the most-experienced, though there were times when I personally was co-assigned to a nurse with a year of experience or less, as the senior nurses had students and couldn’t take a new grad under their wing). There’s usually no consistency. It’s very much a sink-or-swim approach that’s taken here across the country. I could remember being quite envious of other posters on this site who were expressing concern about being on their own as an RN after six months of preceptorship, while I was on my own after a month and a half in an area where I’d had no prior experience as a student! Having six months of preceptorship with the same preceptor sounded like a dream! My lack of experience resulted in many a panic attack during those first few months. ? Sigh... It will get better, OP. ❤️ It’s baptism by fire, as much as we wish it wasn’t. I wanted to quit every single day, but I kept plodding forward and it all eventually came together. Don’t be afraid to tell your new co-workers what you’re feeling — they all went through the same thing, and most will admit to it. You’ll learn very quickly who to avoid, and who’s got your back. Don’t be afraid to remind anyone who ever gives you grief over anything that you’re new, and that you’re still learning. Heck, I’m still learning new stuff one year in! You can’t know it all right from the get-go, even though it feels like you’re expected to. Be kind to yourself and make time for yourself on your days off. Vent when you need to vent (venting is important!) Ultimately, you’ll get through it. ❤️ Hold on to the positive moments that remind you why you decided you wanted to be a nurse in the first place. Feel free to reach out at any time.

Long-time browser around these parts, first-time poster — your situation resonated with me so much I just had to make an account to respond. ? While everyone is different, I feel like I know almost exactly where you’re coming from and what you’re going through at the moment. I’ve been working as an RN for about a year now, and like you, I started nursing school at an older than average age and was in my early 30s when I graduated. I can tell you that the first few months on the job were pretty miserable. I felt like nothing in nursing school had prepared me for the realities of floor nursing, and I felt like a complete failure who didn’t belong there. There were days when I came home feeling utterly stunned by just how hectic and overwhelming the previous twelve hours had been, and would curl up on the couch and cry until it was time to go to bed. It got to the point where I was even having crippling panic attacks after/before work, and occasionally crying in the bathroom during work. On top of it all, I was worried I’d never fit in on the unit (I’m also fairly shy and quiet), and was also dealing with passive-aggressive bullying from a small number of VERY burned out nurses on my floor who were dealing with their own issues and had clearly forgotten about what it’s like to be a new grad with lots of questions. The younger new grads seemed to be having an easier time of things (something that was not true at all, as I found out after the fact when we all had a much-needed venting session together), and I worried that my more senior coworkers felt I didn’t measure up to them. I thought about quitting almost every single day. It got better, though. It took several months, but it got better. Here are some of the things I did that helped me with the transition (hopefully they will help you, too): 1. Visiting forums like this one, realizing that other new grads were going through the same thing, and reading seasoned nurses’ reflections on how hard they also found it when they first started. It made me feel much less alone, and like much less of an impostor (impostor syndrome is a common thing in high stress professions: look into to it if you haven’t heard about it before). You’re already here looking for advice and support, so that’s an excellent start. ❤️ 2. Identifying kind, helpful, supportive coworkers and letting them know what I was going through. This can be hard in the first few weeks when you’re settling into the unit and learning more about the people you’re working with, but these individuals will soon become apparent to you one way or another. It’s very rare that a unit will be SO toxic that there’s no one to turn to for help and support. 3. Reminding myself of the good things that happened on a shift, and holding on to those moments when I felt overwhelmed. I still do that to this day. Just recently, I had an absolutely terrible day at work, thanks to being slammed with WAY more transfers and admissions than usual just before change of shift. I felt miserable when I got home, and sobbed almost as hard as I did in my very early days as a new grad. What pulled me through it, though, was recalling a moment earlier in the shift when I’d managed to somehow find five minutes to simply speak to one of my very scared, elderly patients and help her calm down a little before surgery. She squeezed my hand through her tears before she went down to OR, thanked me for comforting her, and said “I couldn’t have asked for a better nurse.” Hold on to those positive interactions you have with your patients. Most patients DO appreciate and recognize what you’re doing for them. However crappy and incompetent you personally feel, know that your patients and their families generally think the world of you and that you’re making a difference for them. 4. Actively seeking out opportunities to learn more about skills/procedures I was less familiar with. I found that when I graduated, there were certain skills commonly in use on my floor that I’d only read about or, at the most, practiced on plastic learning lab mannequins during school. If I discovered during report that one of my coworkers had to do a skill/procedure that I had limited experience with, I asked if they wouldn’t mind letting me observe/assist. That way, when I had a patient who needed the same thing done, I didn’t feel quite as completely at sea. Technical proficiency with skills comes with time and lots of practice — no one expects you to be an expert from day one. And as another poster above said, some things will ALWAYS be tricky. 5. Making time for myself on my days off, getting lots of exercise, and speaking to my doctor when I needed to the most. It was very tempting during those first few weeks/months to wallow in all the negative emotions I was feeling, but I knew it was getting me nowhere. Going for long walks, spending time with loved ones, etc. really helped me to recharge between shifts. Also, speaking to my family doctor helped a lot when the panic attacks became unbearable. I haven’t had a panic attack in months since I took the proper steps to get it treated. Ultimately, hang in there. You’re not alone in this. The transition from student to novice nurse is very difficult, and in addition to the usual stress that goes with that transition, you have the added strain of dealing with grief over the loss of a parent. Nursing is hard, mentally/physically exhausting work, and no one understands this more than your fellow nurses. As cliched as it is, always remember that you need to take care of yourself before you can take care of others. Remember, too, that you’re doing valuable work that makes a difference in people’s lives — even on those days when you feel like garbage. You matter, and the work that you do matters. And it will get better. You just need to give yourself time.