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Wondering how JustKaren2 is doing now. I felt the same way she did when I was hired at a small hospital last December. I took my refresher course in October of 2008. I'm still a nervous wreck! Let me know how you are doing.

Thanks for the response sallyrnrrt. I was originally hired for the ER, but didn't feel that I could handle the fast pace. That is why I transferred to ICU. Everyone told me it would get better, but I felt that I should have had more med/surg experience before working in the ER. When I float, I still have to ask questions, and everyone is very nice. I know it takes a while to gain confidence in this field. Sometimes I think I'm just too hard on myself. I get nervous and forget things! The nurses I work with tell me that they know I know what I'm doing, I just get too nervous and overwhelmed at times. I pray every night that things will get better. I just have to take one day at a time. :heartbeat

I returned to nursing after many years and I am really having a difficult time with my confidence. I graduated in 1996, worked part time in homecare (1 patient) from 1998 to 2002, and I am now working in the ICU of a small hospital. I took an RN Refresher Course in 2008. I started working in the hospital in December of 2009, trained on med/surg, ICU, ER from December 2009 through May 2010, and I am now on my own in ICU. I keep getting floated to either the med/surg floor, or ER because we don't have enough patients in ICU to warrant having 2 nurses, so I'm not getting the experience I need to become confident. I was just wondering how you all made out returning to the field after being off for a long time. Any advice will be appreciated!

Thanks for the feedback. Two very different perspectives. I was told by the other nurses on the unit that the nurse I referred to in my post has two sides to her. None of them want to work with her. She does her best to do as little as possible and criticizes the other nurses all the time. Two nurses quit because of her. I won't let that influence me though. I will not let this incident prevent me from learning as much as I can. I will just be more cautious on how I approach her with questions. I don't want her to blow up at me again. Ruby, you ask what she did. She just all of a sudden got mad and was nasty to me. I truly don't even know what provoked her. I probably over-reacted, because I am an over-achiever and want to do the best I can. And I absolutely hate conflict. However, we worked it out, and it's water over the dam. I'm working with her again this Friday. I'm going to "suck it up and deal". I realize some people don't have a lot of patience, but in this profession, I think that seasoned nurses who are teaching new nurses should be nurturing and encouraging. Nurses should not "eat their young". However, in the real world that happens all too often. I welcome constructive criticizm, but there is no need to get nasty. I realize that I have to get over being overly sensitive. That is one of my weaknesses. As for asking the supervisor not to schedule me with her, everyone has the same request . Being low man on the totem pole, I have no choice. I will not go to the supervisor about any of this. It's my problem. I'll deal. Thanks for the advice.

Well, I need more advice from you all. There ended up being an opening in the ICU, so that is where I have been working since the 3rd week of May. They gave me two weeks of orientation (I had 5 weeks of orientation in ICU prior to going to the ED). I have been on my own for two months now. They do not schedule me by myself. There is always a seasoned nurse scheduled with me. I still am very nervous. The nurses I work with are totally understanding about my nervousness and help me all the time. There is one nurse, however, who has no patience and gets mad at me. Friday night we were scheduled to work together. There was no monitor clerk scheduled to watch the telemetry monitors, so the other nurse assigned herself to that job and gave me the two patients we had on the unit. Things were going ok. She talked to me about being nervous and told me to just take some deep breaths, that I'm doing well with my patient care. One of my patients who was on a vent, kept moving his legs so they would hang off the bed. I was charting. She noticed his legs off the bed and went in to put them back on the bed. Then the other patient began to have audible congestion so the nurse helped suction her (oral and nasal). She wasn't bringing up a lot of secretions, so the nurse suggested I call the doctor to get some Lasix ordered. I did. I gave the patient the Lasix, and it was helping. Then all of a sudden, and I'm not sure what set her off, the nurse got mad and made a comment that "you have to get over your nervousness, especially at someone else's expense". I don't think she was referring to my patients expense, because they were fine. I was not neglecting them. I got very upset over this. I hate to be this way, but I am very emotional. I tried to hide my emotions from her, but eventually I apologized for getting her upset. I said I cannot work like this and I had to talk about it (with tears in my eyes). She said she had a bad day and apologized for her actions. I am doubting my ability as a nurse now. She said "lets start over" and we had some zucchini bread and coffee. We talked later and I said to her that I may not be cut out for nursing. Or maybe I should get out of ICU and go work on the med/surg floor. She told me I will be a good nurse, I just need experience and have to get over being nervous. She made a comment for me not to go to talk to the nurse manager. She said it would be worse for me on the med/surg floor. She said I'll learn a lot in ICU. Our ICU is small and we don't have really super critical patients. The critical ones are shipped out to bigger hospitals. I am seriously thinking about looking for another job. I had a couple of issues on other days when I worked with this nurse. I did talk to the supervisor who was on the first time I had an issue with her, and she told me to take deep breaths and do my best. The other nurse gets overwhelmed sometimes, but has not complained to management about me. I know I will get over the nervousness sometime, but in the meantime I'm stressing. I don't want to take any medication either. I am trying to have a positive attitude, but lately I can't seem to handle stress. I'm seriously thinking about getting out of nursing. Please let me know if anyone has had similar experiences and how you coped with them. Thanks.

Sounds like you found your niche! Best of luck to you!

Hi, Thanks for the responses! I talked to my Nurse Manager and explained my concerns about working in the ED. She was very understanding and asked me where I would prefer to work. I told her the ICU would be my first choice, but I'd be willing to work on the med/surg floor if there were no openings in ICU. There were no openings in ICU at first, so I was scheduled to start on the med/surg floor. The week before I was to leave the ED and start on med/surg, there was a change in the schedule. The nurse who bid on the job in the ICU changed her mind and went back up to the Med/surg floor. I am now in my second week in the ICU. I love it. It can be intense. We had a code the last night I worked and I had to do chest compressions for the first time. It was sad because the gentleman didn't make it. I will be off orientation next week. I'm nervous about that, but my preceptors are telling me that I will do fine. I will never be alone. There will always be a more experienced nurse with me. I can go back on orientation if I don't feel comfortable. They will also send me to a critical care course. It was weird, but I was feeling more comfortable in the ER the last week I was there. I think it was because I knew I was leaving. They may float me down there when we have no patients in the ICU. I think I can handle that. Anyway, I am happy now. I love the nurses I work with and feel much more comfortable taking care of one or two patients at a time. I have time to review their charts, labs, history etc. and can get to know the patients and their families. I no longer dread going to work. PABrn, let me know how you make out. I think it is very difficult for a new nurse to handle the chaos in the ED. Good luck! :)

Thank you for the great advice CFitzRN , but I talked to my nurse manager and told her I don't feel ready to work in the ER at this time. I have been feeling so stressed out just thinking about going to work. In fact, tonight I feel like vomiting thinking about what my day will bring tomorrow. I don't think I can go on feeling this way for two more months. I'll be working 3 more days in the ER and will do my best, but I feel like a fish out of water. When I got to work on Saturday, the preceptor I was with told me to take my own patients and that he and another RN would be available to help me if needed. I acutally did ok on my own. I was slow though. Of course, I did not take any urgent or emergent patients. I still forget to ask certain questions during my assessments and have to go back and ask, but some of the seasoned nurses told me they still do that too. I will be going back to the med/surg floor starting 5/19. The nurse manager on the med/surg floor told my manager they would be glad to have me back there. They will orient me for a couple more weeks on the night shift, then I should be on my own. Unless I don't feel ready for it. They will give me more orientation if I need it. I know I will learn a lot in the ER, but my gut tells me I'm not ready for that pace yet. Especially since I'll be working the night shift and there are only two nurses staffed from 11 pm to 7 am. All of the nurses in the ER support my decision. Most of them think that an RN should have at least one year of med/surg or ICU experience before working in the ER. I will learn a lot on the med/surg floor. They told me they will float me to train in ICU on slow nights on the med/surg floor. I think I made the right decision. I am just a bundle of nerves in the ER. I felt more comfortable when I was orienting on the med/surg floor and ICU. Maybe once I have gained more experience and feel more confident, I'll return to the ER.

Well, I am now going in to my 6th week in the ER. I work three 12 hour shifts per week. I thought it was getting better, but now I'm not so sure. I know it is expected to have good days and bad days. I had a couple of good days, but more are bad. I feel so inept. My nerves are still getting the better of me. I was trying to put a non-rebreather mask on a pt who just had a seizure, and dropped the mask right in front of the doctor. Then I fumbled for the tubing. He made a comment that we have to be quick here. I felt like such an incompetent fool. On his way out, the doctor said goodbye and I made a comment that I may not come back. I said I am so afraid I might hurt someone. His comment to me was that he comes into work everyday feeling that way. We talked for a few minutes and he said "Do you mind if I give you some advice?" I said please do. He said that it would probably be good for me to spend a year in the ICU where the pace is not so fast, but the patients are critical. Then come to the ER. I was hired for the ER, but to be honest, I liked the ICU much better. I spent 5 weeks there, and the last two days I was on my own (preceptor was there, but let me fly). I felt confident. I recently had a tragedy in my life (a close relative died, probably suicide). I know that this is having a huge impact on me right now. I try to put it out of my mind, but it's very hard. I'm going to a support group meeting this week. Hopefully that will help me. My question to you is this. How long should I stay in the ER before I make a decision as to whether or not it is my niche? One of the night shift nurses told me to give it 3 months (which is the entire length of my orientation). I dread going to work now. I don't want to feel that way. The people are terrific, they make work fun. But my lack of confidence is getting the better of me.

I am very fond of the "Nursing Made Incredibly Easy" books. I refer to the Pathophysiology one and the Fluid and Electrolyte one frequently. I also refer to my medication book. When I was in nursing school, I studied with 5 or 6 other students in a study group (we are all still good friends). We studied for every test together at each other's homes. We would review everything that would be on the tests. We also would make up questions and then go over them together. To study for the boards we used the NYCLEX review books. Good luck!

Hi AB normalRN. I too am new to nursing although not a new grad. I forgot what I learned as well. You have an advantage over me because you just graduated, I graduated 14 years ago. You probably will feel stupid and incompetent at first. I sure do. I have been working in a hospital since December. I spent 2 months on med/surg floor, 5 weeks in ICU, and now I am in the ED, the department for which I was hired. I have been there two weeks. I am still very nervous. I make mistakes, but I learn from them. I ask questions, and sometimes feel they are the dumbest questions, but I don't care. It's better to ask than to do something wrong. All you can do is your best! You will be fine. Good luck!

This thread is just what I needed to read. I'm in my 3rd week of orientation in the ED after orienting for 2 months on med/surg and 5 weeks in ICU. I told my preceptor on Saturday that I will probably make every mistake there is to make in my first month in the ED. He just laughed. I am still making a bloody mess almost every time I start an IV. It so so hard for me to occlude the vein while screwing on the hep trap. Yesterday I dropped the hep trap while screwing it in on two patients! I told my preceptor to let me try alone, so he wasn't there to help me! :uhoh3: Yikes! Bloody mess. Thank goodness the patients were understanding. Although one didn't speak English and she and her daughter were speaking Spanish to each other the entire time I was fumbling! I'm sure they were either making fun of me or worse! Live and learn! Then I left a tournaquit on a patient after I started her IV (another bloody mess) and drew bloods. The PCA and Charge nurse saw that I left it on and let me know. Thank goodness they were laughing about it. They told me that they've done it too. Then the charge nurse was teasing me later on, saying that the patient will probably sue because of the tournaquit. I think because of her teasing, I will ALWAYS remember to take off the tournaquit! I am thankful that the people I work with in the ED are helpful and caring toward their coworkers.:redbeathe I, too, spend a lot of time when I am not working reviewing pathophysiology, meds, and lab values. One of the nurses I graduated with who has been working as a nurse for 6 years tells me that reading is fine, but you'll learn all of that (especially lab values and what it means to the patient) through repetition on the job. When I first started in the ED two weeks ago, I thought "there is no routine here, I need a routine". True, sometimes someone will come in with something you haven't seen before, but there really is a routine to the ED. I feel more confident this week that I will be able to handle it. That may change tomorrow, but I'll persevere!

Thanks an6el177. I'm glad I am in the ED to gain some experience, but I'm afraid I may do something really bad due to my lack of experience. I realize that I am the type of person who likes to have a routine in my life. I'll hang in there for another week, but I think I want out. I worked for a steel company (not as a nurse) prior to working as a nurse at a hospital and hated my job for the last 5 years. I don't want do to that anymore. I want to love to go to work. Right now, I dread it.

I am currently orienting in the ED of a small hospital. The average census per year is 22,000 patients. I have had 5 days of training there so far. I will be on orientation for 3 months. The hospital hired me for the ED, even though I had no med surg experience and hadn't worked as a nurse for 7 years. They had me orient for 2 months on a med/surg floor and 5 weeks in ICU prior to starting me in the ED. I DO NOT feel ready to be an ER nurse. I thought every day would get better - NOT HAPPENING! Every day makes me feel more incompetent. I was just beginning to feel somewhat confident in the ICU when they put me in the ER. The fast pace and chaos is not for me. Some people tell me to stick it out, that it will get better, but I'm not so sure. I don't want to be a quitter, but I think you have to be more experienced and even a new grad to be a competent ER nurse. I need more experience. I graduated from nursing school 14 years ago and worked for one client in the home care field from 1998 - 2002. I find it very difficult to remember all of the things I learned in nursing school. I think I will bid out of the ER as soon as I can.

I made my first med error tonight. I was supposed to give 5 Units of Insulin IV, but gave it SQ instead. I also am a new nurse in an ED. My preceptor notified the doctor right away and he changed the order to read SQ, but my nurse manager will be informed. I'm not sure what will happen. The patient wasn't harmed. I feel the same way you do. But we should take the advice given in the other posts. I think we will be more vigilent when administering meds due to our mistakes. Let's forgive ourselves and move on like Jules says.