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

During orientation, we were shown this video. It showed a new nurse happy to begin her career, but then she crashed. She became depressed, and frustrated. She came to quickly hate her job, in spite of being enthusiastic and excited when she started. She felt like a failure and isolated. She was miserable.

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."

I am a new grad RN, hired into ICU and in the last two weeks of my three months orientation. I'm feeling a lot of the same sensations about my lack of knowledge, the high stress environment, and my coworkers who like to order me around at times. I have a ventilated pt and my heart felt like it would jump out of my chest the whole time. Thank you for sharing, and thank you for confirming this conflicting feelings are natural. I feel so lucky, so happy, and so proud I landed this position yet I don't want to go back some days. I feel lonely on the unit and as if everyone does everything before I get a chance. I want to be on my own, yet I've never been alone. I've always had someone at the bedside with me. The way I cope-- is to make jokes and try to be light hearted. I try to always be humble, watch what others do, and savor the observation/directions I get.

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In response to the OP...I guess I'm fortunate because I will never experience the eye opener you experienced. This is because the instructors in my program are CONSTANTLY reminding students we won't possess very much practical knowledge when we graduate. We've been told that our first year in the trenches will most likely be very, very difficult and stressful as we adjust to a hugely ambitious and unforgiving learning curve.

One instructor even stated that some of us will make it academically, but won't survive as nurses (he phrased it more gently...something along the lines that some of us will discover nursing won't turn out to be the career we thought it would be). I've also been told by a clinical instructor that if I want to work in ICU, I will **have** to spend a good chunk of my days off studying and reviewing pathophysiology. She stated ICU requires a really in-depth knowledge of patho well beyond what might be taught in school if one wants to excel in the ICU. I trust that assessment.

We've also been told (and it was stated in our intro to nursing class text) that it will take many YEARS to reach the level of expert nurse. IIRC, competency comes after 1-2 years of full-time experience. I guess I'm fortunate in the sense that I will have no illusions as to where I stand as a new nurse and thus, no shock. This won't make it any easier for me, but at least I won't have any expectations of walking into the job knowing what I am doing dashed. I know I will have a LOT of work to do to even gain basic competency.

Graduation will be the beginning of a long slog, not the end. I'm thankful the teachers in my program are preparing us well academically while also tempering our expectations as to what our first year will likely be like, and how much learning and skill mastery will be ahead of us.

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I am a new grad RN, hired into ICU and in the last two weeks of my three months orientation. I'm feeling a lot of the same sensations about my lack of knowledge, the high stress environment, and my coworkers who like to order me around at times. I have a ventilated pt and my heart felt like it would jump out of my chest the whole time. Thank you for sharing, and thank you for confirming this conflicting feelings are natural. I feel so lucky, so happy, and so proud I landed this position yet I don't want to go back some days. I feel lonely on the unit and as if everyone does everything before I get a chance. I want to be on my own, yet I've never been alone. I've always had someone at the bedside with me. The way I cope-- is to make jokes and try to be light hearted. I try to always be humble, watch what others do, and savor the observation/directions I get.

From your post, it really sounds like you are doing everything right -- keeping a good attitude, being humble, taking direction, observing with purpose, and being grateful for the opportunity you have been given. As you gain skills and confidence, I can imagine you will enjoy going to work much more and also, you will begin to feel more like a member of the team (and thus, feel less alone). Best of luck to you!! :D

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Specializes in critical care.
In response to the OP...I guess I'm fortunate because I will never experience the eye opener you experienced. This is because the instructors in my program are CONSTANTLY reminding students we won't possess very much practical knowledge when we graduate. We've been told that our first year in the trenches will most likely be very, very difficult and stressful as we adjust to a hugely ambitious and unforgiving learning curve.

One instructor even stated that some of us will make it academically, but won't survive as nurses (he phrased it more gently...something along the lines that some of us will discover nursing won't turn out to be the career we thought it would be). I've also been told by a clinical instructor that if I want to work in ICU, I will **have** to spend a good chunk of my days off studying and reviewing pathophysiology. She stated ICU requires a really in-depth knowledge of patho well beyond what might be taught in school if one wants to excel in the ICU. I trust that assessment.

We've also been told (and it was stated in our intro to nursing class text) that it will take many YEARS to reach the level of expert nurse. IIRC, competency comes after 1-2 years of full-time experience. I guess I'm fortunate in the sense that I will have no illusions as to where I stand as a new nurse and thus, no shock. This won't make it any easier for me, but at least I won't have any expectations of walking into the job knowing what I am doing dashed. I know I will have a LOT of work to do to even gain basic competency.

Graduation will be the beginning of a long slog, not the end. I'm thankful the teachers in my program are preparing us well academically while also tempering our expectations as to what our first year will likely be like, and how much learning and skill mastery will be ahead of us.

Love, I say this gently and with the hope that you are right, but I went into it with the same preparation, foresight and advice, but still got knocked over. Don't believe it won't happen to you, because it still could.

I'm 6 weeks in now. The initial shock has faded into, "okay, I can do this." I know this will be better as I get better and I take it a day at a time. This month, I will be switched to solely nights, which has it's own stress, but I'm actually looking forward to the change. I've realized my current preceptor gets the highest acuity patients, which, of course, means crazier days. That's good in some ways, but frustrating in others. I'd like to feel what smooth days feel like so I know I'm getting the basics down. (Yes, I know "smooth" is relative!) All in good time.

Thank you for the feedback and support!

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Love, I say this gently and with the hope that you are right, but I went into it with the same preparation, foresight and advice, but still got knocked over. Don't believe it won't happen to you, because it still could.

I'm 6 weeks in now. The initial shock has faded into, "okay, I can do this." I know this will be better as I get better and I take it a day at a time. This month, I will be switched to solely nights, which has it's own stress, but I'm actually looking forward to the change. I've realized my current preceptor gets the highest acuity patients, which, of course, means crazier days. That's good in some ways, but frustrating in others. I'd like to feel what smooth days feel like so I know I'm getting the basics down. (Yes, I know "smooth" is relative!) All in good time.

Thank you for the feedback and support!

LOL No gentle voice needed. I'm simply admitting I know it is going to happen. I know I am going to get hit by a train the first year and there is absolutely no way of preventing that, no matter how prepared I am. It is completely inevitable. You seem like you are getting through it very well despite all the challenges, and I completely admire you and wish I were in your shoes and already on my journey to competency! :D

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Specializes in critical care.

Checking back in, almost a month later....

It's been rough. I have increased my patient load. I feel like I can't keep up at all. The days fly by and desperately I hope I can just manage to fit in lunch. This whole time I've just been telling myself.... In time I'll be able to do it. All I need is practice.

I had a mini freak out over a legitimate medical problem that thankfully turned out to be me jumping to the worst conclusion possible. (I can be half dead with the flu all by itself and not care, but you give me a weird skin thing coupled with flu-like symptoms, and I freak out.) Anyway, when I got checked out for that, my blood pressure was 163/115. That was the highest reading of the whole experience, but even with metoprolol, it wouldn't go below 140/90, and it only stayed that low for maybe a half hour.

I had a follow up to that visit 2 days later, and over that two days I really did some soul searching. I'm thankful for all of the posts here validating how hard this first year is because I know it's normal to feel so overwhelmed. However, it doesn't make it THAT much easier. I asked my NP for an antidepressant, which I started Friday. If that doesn't do the trick by itself, I'll go to a counselor. The thing is, if I didn't have so much recent chaos in my personal life, probably I could absorb the stress of work and blow it off when I'm home. But for a handful of reasons, home hasn't been the solace I've needed. It's a lot all at once from every direction.

Anyway, it's taking a bit of courage to bare this here, but I was thinking if anyone finds this article and feels as bad as I have lately, they might feel better to know they're not alone.

Thank you, AN, for the realness you have always shared. I couldn't imagine this blindsiding me with absolutely no warning whatsoever.

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Thanks for the update ixchel.

I'm only a month in myself, I truly feel like this is on the job training. I'm constantly having to reorient my brain to being "the nurse", so that when tele calls to tell me that one of my patients is having a run of a-fib I can take the appropriate action, i.e call the Dr. Instead of looking like a dear in headlights. I work on a critical care floor and we get a lot of critical labs and such, I'm so afraid of missing something or under reporting something. What a steep learning curve, aaaaahhhhhhh!!!!!!!!!

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Specializes in critical care.

Hang in there, love. We can do this!

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Specializes in ICU/CCU/MICU/SICU/CTICU.

Being a new grad is always hard..... Even experienced nurses who change jobs are overwhelmed at times. I have been an RN for 15 years, all my hospital experience has been in ICU's (mostly cardiac, with occasional medical overflow).... I have an interview tomorrow for an ER position........ I'm a basket case! Yes, the ICU experience will help.... but it's not the ER....so I have been going back to sites to refresh myself with things that I haven't dealt with in forever.

I always tell new nurses that yes, they say that the first year is the hardest..... I say its more like 2. In a year, you get your confidence level up, you can manage things....... but you're still learning. Nursing and medicine change every day. Even now, 15 years later, I still learn new things. When you stop learning something new, you need to rethink the career.

Add to it stress of home life..... You mentioned that you have been put on an anti-depressant..... EVERY nurse I know (closer than just a co worker) is on one...some even 2. When you are stressed your brain doesn't function and as you mentioned doesn't absorb things. Make sure that you take time for yourself........even if its just a few minutes a day.

I'm sure things will get better at work as you gain experience and confidence. I truly hope things get better for you personally as well.

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Specializes in critical care.
Being a new grad is always hard..... Even experienced nurses who change jobs are overwhelmed at times. I have been an RN for 15 years, all my hospital experience has been in ICU's (mostly cardiac, with occasional medical overflow).... I have an interview tomorrow for an ER position........ I'm a basket case! Yes, the ICU experience will help.... but it's not the ER....so I have been going back to sites to refresh myself with things that I haven't dealt with in forever.

I always tell new nurses that yes, they say that the first year is the hardest..... I say its more like 2. In a year, you get your confidence level up, you can manage things....... but you're still learning. Nursing and medicine change every day. Even now, 15 years later, I still learn new things. When you stop learning something new, you need to rethink the career.

Add to it stress of home life..... You mentioned that you have been put on an anti-depressant..... EVERY nurse I know (closer than just a co worker) is on one...some even 2. When you are stressed your brain doesn't function and as you mentioned doesn't absorb things. Make sure that you take time for yourself........even if its just a few minutes a day.

I'm sure things will get better at work as you gain experience and confidence. I truly hope things get better for you personally as well.

Thank you so much for sharing these thoughts and experiences. It helps knowing antidepressant usage is pretty common with nurses.

I have to say.... It's been two weeks since starting it and the difference is immeasurable. And switching to nights has been a godsend. If I fall behind, I can catch up. I feel like I'm "done" at the end of my shift. I stepped up to a full patient load last week and I'm really doing well with it. I have my spark back. Such a wonderful change!

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Thank you so much for sharing these thoughts and experiences. It helps knowing antidepressant usage is pretty common with nurses.

I have to say.... It's been two weeks since starting it and the difference is immeasurable. And switching to nights has been a godsend. If I fall behind, I can catch up. I feel like I'm "done" at the end of my shift. I stepped up to a full patient load last week and I'm really doing well with it. I have my spark back. Such a wonderful change!

Glad to hear it! I'll be switching to nights soon and am looking forward to it. I love the work. It's challenging, but we have a great team. I am just amazed at how much my brain hurts by the end of the shift and feeling like I'm on high alert long after I leave.

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Specializes in critical care.
Glad to hear it! I'll be switching to nights soon and am looking forward to it. I love the work. It's challenging, but we have a great team. I am just amazed at how much my brain hurts by the end of the shift and feeling like I'm on high alert long after I leave.

You'll find the team is even closer at night. During down time, you get to know each other better. You're more autonomous because you're not calling the doctor every time something happens and there is far less ancillary staff. You get more opportunities to really think things through and make decisions. And you have time to do that - it's not fly by the seat of your pants like days. It's just a different, more comfortable vibe. And if your facility has differential, you get paid more for easier shifts. All around win. ?

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