fskye

So I was the nurse put on probation for being too "anxious". I was nervous that I would need to do stat tasks that I didn't know how to do. I was told "you're never alone" and "you can always ask for help." So I got off orientation but found my concerns justified. Even on nights, my pager is constantly going off for pain meds, doctors calling, beeping IVs, critical labs, infiltrated IVs, bed alarms and stat orders. So I get chastised by the doctor because the K got started 30 minutes late because I couldn't get an IV in. And the patient complains that I didn't give him his Dilaudid for 20 minutes because I'm gowned up and struggling to change a dumping ostomy. And the oncoming nurse chastises me because I forgot to sign off on a PCA. In theory, most people are willing to help, but in reality, they're usually very busy already, running blood or down in radiology giving Ativan or repeatedly dealing with a demented patient because we don't have any sitters. I feel incompetent and can sense their frustration and irritation when I have to ask for help yet again. It's a miserable feeling to be held responsible for things you feel you cannot do in the time required. But I am trying. I'm running all shift and so miserable and so tired I could cry. And I usually do cry during my one pee in 13 hours. I don't cry in front of others because I know I could get in trouble for being "anxious" again. So. I know I'm going to get better and faster as time goes on if I last that long. But that's not going to be immediate and meanwhile, I'm so stressed I've gone on Metop and two antidepressants. Is this common? What do you suggest?

I gave report today to a newer nurse that included pertinent information about an error that a previous nurse had made. It was necessary in report because monitoring was required. Not five minutes later, I heard that new nurse whispering that information to a group of nurses who are known for being cliquey. The other nurses made disparaging comments about the intelligence and nursing abilities of the nurse who had made the error, who is otherwise a good, experienced nurse. The mistake was not life threatening and was made because she wasn't notified of a relevant change in the patient's condition. But while I think the new nurse was clearly out of line for sharing nurse and patient information, I believe she was trying to find a way to bond with rest of her coworkers who are known for excluding new nurses. Like it or not, a lot of people bond through gossip and shared secrets. I think management also sets the tone of the unit. If the manager looks the other way to cliques and "mean girl" nursing, it makes a ripe environment for gossip and tearing down other nurses.

@HouTx, I believe I can "cognitively stack" tasks. However, as I stated, I am anxious because I feel the weight of trying to accomplish tasks within the necessary time frame. I'm still learning and know I am not as quick as a nurse who has been doing the same tasks for years. I admit I find your post discouraging and unsupportive. Unless I misunderstood, you are saying that if a new nurse is anxious and struggling with multitasking, it is not related to inconsistent support, multiple preceptors or new grad anxiety but results from simply trying to do the impossible because one doesn't have the ability to cognitively stack tasks. If most new grads were able to seemlessly learn time management, prioritization and multitasking in twelve weeks in a high acuity environment, I would be more inclined to agree with you, but I think this is a very common learning curve. I'd hate to discourage other struggling new nurses reading this thread with your theory that reduces the issue to merely not having an innate "natural capability" to support such a "cognitive load."

@conquerer, no, I didn't and would never share that with my nursing manager. While I have some serious and extremely stressful personal issues right now, I do try to leave my personal business at home as best I can and focus on work. @werebadger, I too have PTSD for some horrific issues in my past, but I have done well with years of therapy. I just didn't realize how much it would affect me as a nurse. The stress of being a new grad on a high acuity floor has stirred a lot of that up, but I'm aware of it and working on it. @hppygr8ful, I'm going to look into meditation and diaphragmatic breathing. Thanks! I appreciate everyone's advice and have been thinking about the situation. I will try to remind myself that I can only do what I can do. I am not an experienced nurse and cannot do these tasks as quickly as one with years of experience. I have to remember that everyone started out where I am. My job is to keep the patient safe and that will mean asking for help when I don't know. And if my best effort isn't enough, then worrying won't change that. The challenge will be remembering that once the **** hits the fan.

My NM called me into her office yesterday and informed that they have extended my orientation for two more weeks and was asked to sign a formal statement placing me on an extended 30 day probationary period because I am too "anxious", that they worry that I won't be able to handle stressful situations. I was told a before that I "looked anxious" so I focused on appearing calm but have been told that while I appear more calm, my preceptor can still sense that I am anxious. My preceptor believes I am "suppressing" my anxiety now, and it is causing the serious health issues I have been having. It's plausible since suicides and mental illness are common in my family, and I have inherited the severe depression and GAD that was well managed with medication until I became a nurse. My NM said my preceptors report that my nursing skills are good, that I'm a quick learner, and my charting is excellent, but I don't handle stress well when all the orders come flying in, when I'm admitting a patient, another is puking and wants Zofran, another needs stat labs and radiology is on hold about my patient in CT. And it's true. I do feel flustered and unsure of what to do although I'm slowly learning how to prioritize what needs addressed first. My NM has been very supportive, but I feel humiliated that I am the only one of the new hires being put on probation (although I know that I am almost twice as old as and aware that I don't multitask half as well as I did in my 20s.) Some of the other nurses have made unintentional comments that undermined my shaky confidence. I give 100%, coming in early to prepare, rarely sitting or eating in 12 hours. I come home exhausted after every shift and ice my swollen knee and study drugs or complications that I was unsure of. The other nurses I started with tell me I should just say, "**** them" and be confident, that I worry too much about what other people think, that I'm too hard on myself, but then again, I'm the only one on probation. My anxiety, however, really stems from the fact that I am still learning how to do some procedures and need to get someone to help me or, if I know how to do it, I'm not as fast as a more experienced nurse. This slows me down considerably and I feel panic rising that I simply cannot do everything that needs done in the required time frame because I am new, unsure and have to get someone to help, the patient's family is watching me and my hand shakes and I fail at lab draws and IVs or putting in a Foley. And, yes, I did ask if I could possibly transfer to a less intense floor and was told that they usually require a full year before you can move. I don't want to take Xanax or Ativan when I'm working because I fear it would slow my thinking even further. I need advice from experienced nurses on how to get a handle on my anxiety coming off orientation on day shift on a high acuity unit with the added stress of knowing I am being carefully watched and may not have a job in 30 days. She said to relax and go home and enjoy my holiday before I go back into work, but I'm spending Christmas stressed out and depressed. I have kids to support. I desperately need to get it together.