Raw: Two Months After Graduation. One Month After Employment.

[ixchel]

I watched that video in orientation thinking, "these people are crazy. I'm a ray of sunshine and hope! I am a positive person! I believe in myself and I am ready to learn and BE AWESOME!!!! I LOVE THIS PLACE!!!!!!"

But here I am. Three days shy of a month in on my first job. And there is a bit of dread in my heart. I'm not sure how it got there. It snuck up on me rather insidiously. A couple of weeks ago, I was walking toward my car and I passed some respiratory students. I beamed at them happily and said, "Hello!" As I walked away, I heard one of them say, "Wow that was a happy person!" She was right. There was joy in knowing I could wake up to the hospital, my new home.

What happened? Is it that the high of graduation has settled, and the reality of going back to grown-up world has come back? Is it that I feel so completely incompetent?

I know what you students are thinking while you read this. "I'm going to be on top of the world! I'll never feel that way!" But mark my words - there is this strange feeling that sinks in where you realize that school didn't prepare you for this, and that you really aren't good at it no matter how hard you tried to be, and you have so, so much to learn.

I read that so many times here, and I believed it. I think I held that giant beaming smile on my face because honest to god, I went in prepared for how hard it was supposed to be. Even then, it overwhelms me knowing how much I need to know, but just don't yet. I wish I could take home the charting system to practice. I wish I could take home the omnicell to practice. I wish I could take home the policies and procedures link on the intranet to memorize. But then again..... surrounding myself by the ongoings of my children on days off has kept me sane.

Four days off.

Four.

Why do I feel like I'm always at the hospital? I'm home more days than I am there.

You know what is a little bit more frustrating? I'm a bit of a junkie for the critical care unit I am on. I absolutely love it. And yet.... I have buyer's remorse. I think to myself, "there is no way I'll get good enough for this... Maybe if I chose (med/surg/OB/peds/ortho) instead it would be easier......" Realistically, I know that's not true. I mean, probably not true. I usually STRIVE for a challenge and feel let down when I miss opportunities. I know I'd be frustrated if I were anywhere but where I am. But I'm frustrated, too, because I am where I am.

Being on orientation, I am frequently pulled for other experiences. In 4 weeks, I've had two days with my own patients. I've loved my experiences, of course, but I'm feeling the weight of, "I should be making progress by now, but I'm not getting the opportunities to." I'm not meeting goals. I've gained a lot of experiences, but I haven't met goals. Is trading one for the other good? How does that work exactly?

I have the blues. I'm very much a fighter. I'll keep moving and striving to be awesome. I know it's a long haul before I will feel like I'm awesome. I've waited through nursing school, I can wait longer.

But.... man.

You graduate nursing school, and you think to yourself, "I reached the goal! I'm there!!!!"

And then you pass the NCLEX, and you think, "No more studying these giant ugly books!!!"

And after that, at work you get your first name badge with the words "registered nurse" on it.

And you think, "I made it. I am here. I have arrived."

You save your energy up for that finish line. And then you reach it. And you feel you're on top of the world. No one thinks about what happens next, emotionally speaking. You walk into your first job, and find out that because you were so high on that mountain on top of the world that it is that much further to fall down when you have really hard days.

And you look up to where you were, up there on that mountain, and you remember...

"I wasn't supposed to fall."

[brianbooth, RN]

Cardiacguy7 makes a great point. When I qualified in the UK, many moons ago, it was standard practice for most new nurses to spend their first year on medical, surgical or orthopaedic wards. You learned to walk there, then upped the pace a little, always having experienced people around to catch you if you tripped when trying to run. Should you be the type who wanted a high-stress environment, or one where you watched monitors rather than patients, then after that year you would at least be grounded in the 'basic' skills which are, in fact, the highest-order ones: assessing a patient's oxygenation with your eyes and ears, not an oximeter; judging cardiac function by the quality of the radial or jugular pulse... I could go on.

If I'm any good at anything I do in my day-to-day nursing, it's because a) I was taught at the bedside, with real, live people I can still call up in memory, but more usually b): I once got something wrong, and swore never to repeat the mistake.

Good luck in your future career. If you're mature enough to be reflecting this early on, you're probably going to be fine

[brianbooth, RN]

If I may add a p.s. - after posting the last comment, I suddenly remembered something said to me over thirty years ago:

'If you and another person were stranded on a desert island, with little help of rescue, would you prefer that person to be a doctor or a nurse?'

Think about it.

[JoseQuinones]

ixchel, cast your mind back to pharmacology class as you read your words . . .

You save your energy up for that finish line. And then you reach it. And you feel you're on top of the world. No one thinks about what happens next, emotionally speaking. You walk into your first job, and find out that because you were so high on that mountain on top of the world that it is that much further to fall down when you have really hard days.

All you are experiencing is some very natural L-Dopa receptor fatigue. When you stress over something for a long time, you are flooding your body with epinephrine, cortisol, and the lovely catechalomines. When you reached the end of the process, your parasympathetic nervous system began reasserting control and slooooooowing things down. When you opened that letter saying you'd passed the NCLEX, you got a hit of oxytocin courtesy of your hypothalmus, and it kept pepping you up straight through orientation. Now that "weaning down" is ending. You're a bit like a junkie coming off a high!

But that's okay. You have just proven that everything they taught you in Pharmacology 1.01 is true. Getting a case of the blah's right after a big victory or life change is perfectly normal. Everyone from prophets in the Bible to people winning the World Cup have reported that feeling. It will pass. Eventually the hypersensitivity will go away and you will find your zest and pep again.

Tennis star Boris Becker was at the very top of the tennis world—yet he was on the brink of suicide. He said, “I had won Wimbledon twice before, once as the youngest player. I was rich. I had all the material possessions I needed ... It’s the old song of movie stars and pop stars who commit suicide. They have everything, and yet they are so unhappy. I had no inner peace. I was a puppet on a string.” Becker is not the only one to feel that sense of emptiness. The echoes of a hollow life pervade our culture. One doesn’t have to read many contemporary biographies to find the same frustration and disappointment. Jack Higgens, author of such successful novels and The Eagle Has Landed, was asked what he would like to have known as a boy. His answer: “That when you get to the top, there’s nothing there.”

Our Daily Bread, July 9, 1994

[ixchel]

So much wisdom being shared here. Thank you!

[thinwildmercury]

Wow, JoseQuinones, that was such a helpful post, thank you!!

[snwqueen83]

Oh I love that!

[AliceTrout]

Reading this post and many of the comments has really made my day. I am six months post graduation, working my dream job in the ICU.

Some days I have felt just like OP in terms of the "buyers remorse". It's usually because I get down on myself for feeling like I have to struggle harder than my more experienced coworkers or classmates that went to other floors. But then I do this: I ask myself which floor I would rather work. This reminds me that I would much rather struggle my booty off, spend days off reading up on CC topics, and eat my pride by asking constant questions any day over changing to another floor. I fought darn hard to get this job and by golly, it was and is worth it!!

I also agree with the whole "let down" of starting work. Nursing school ingrains this idea of working toward goals, small and large that will culminate in the all coveted RN position. So first you think I must survive this test...semester...year...graduate. Then you are worried about getting a job and passing NCLEX. Then all of a sudden one day you are standing there in your scrubs, RN badge proudly hanging off your chest...and you are like...well now what do I have to look forward to? What's my next goal? You have had a goal pushing, driving, and motivating for at least the last two years and now you feel like you have nothing. That is powerfully depressing, no denying it. So the solution I have made for myself regarding this? More goals! I have already started to study for my CCRN even though I can't even sit for the certification for another half year or so. And I have been sorting through different graduate level programs and talking to coworkers with advanced degrees their experiences and thoughts about different degrees and schools.

This stuff helps, but I don't think anything ever takes away the stress and sometimes stomach-wrenching fear/dread/turmoil/anxiety that comes with being a new nurse faced with a giant heaping pile of responsibility. I am blessed to have some amazing coworkers to help answer my questions (oh so many questions!) and provide me with a little spine when I need it (calling *that* doctor). There is really something to be said for those kinds of coworkers. Everyone likes to talk about the ones that "eat their young", and yeah, they exist. BUT I rather focus on the ones that share their hands and their minds with us new kids. They are the true heroes of nursing! :)

[brianbooth, RN]

If you have just qualified as an RN, and you aren't terrified by the responsibility and privileges which are now yours and yours alone, then you might just be in the wrong job...

The good news is that the terror will become mere gut-wrenching worry after 30 years or so. The bad news is: you will never. ever know enough. Patients have an unedifying habit of not performing as the textbooks say they will

[ixchel]

Alice, I absolutely love your comment! And I do also feel the same way about my floor. I have moments when I ask, "what was I thinking?!" but then I just know... I wanted this enough to fight for it, and I got it. I may question that choice and my sanity at times, but I know no other floor would make me happy.

[kelleytison]

iPink RN, where did you move to?

[grudgrime]

What a great post and a bunch of great comments to follow. I have recently graduated with my BSN. Five years of working towards my goal. Then I passed the NCLEX in 75 questions.

I remember when I first applied to nursing school and went in for the interview. I thought to myself "Am I really doing this? I know nothing, I have no hospital experience, why would they accept me?" Sure enough I got in. Then My first semester started and I thought "This is too much information, I will never learn any of this", flashcards and notes and study sessions later, I know some of that stuff like the back of my hand.

Somewhere around my senior year I realized I actually DID know more than my sophomore year. Lab values were sitting in the back of my head, I didn't have to reference a note card to see what someone's hemoglobin should be. I actually understood left heart problems, right heart problems and I felt good. Then I graduated. I again felt like an idiot as I started to study for the NCLEX. I scheduled it so I had four weeks to study and I still didn't think that was enough. As the day came closer all my confidence turned to terror. Then suddenly I sat with a blank stare, and realized the test was the following morning. I was going to put the books down, step away from the computer and relax, eat well and get to better early. I was calm, I was prepared and I went in to take the test. I still felt calm, I did what I needed to do. I was always a well prepared person, I always studied hard and I did everything in my power to pass this test. I sat down at the computer and answered the questions without freaking out then BLAM...the screen went blank after 75 questions. I got to my car and I was shaking. "What did I just do? I should have spent more time on each question, I was the seventh person to sit down and the first one finished, I should have stayed up later and studied". I was sick (literally couldn't leave the bathroom) for three days. Then I got my results and I passed...WHEW...another milestone, another victory.

NOW....I am applying for jobs and going on interviews and I feel inadequate once more. I am so excited to land my first job, yet so terrified about "knowing nothing". I know I have a head full of information and I know they will train me for months, yet I am terrified to walk onto that floor one day and take care of that patient.

I can't thank you all enough for sharing your thoughts and wisdom. I know it will be scary to start, but I also know that I will be trained, just like in school, the hospital will want me to succeed and will provide me with what I need to do so.

[iPink, BSN, RN]

iPink RN, where did you move to?

I hardly revisit threads I post in that's why my response is late...but I transferred to postpartum at an all women's hospital. I never leave my shift stressed or exhausted. I absolutely love it!

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