Reaching the 3month mark...Unhappy, need advice STAT!

[TaniqueRN]

I know that as a new nurse within the first three months of orientation you're not going to learn and see everything. And this I understand. But at this point in orientation I do not feel as though I've done much and I feel as though I should have done more. I like my preceptor. But at times it's hard to get her attention when she is orienting another preceptee or trying to solve the other preceptee's problems which arises. Also, she even acts as charge nurse. She has a lot on her plate. But because of this I believe that skills I should learn before I go off orientation have not been done. For example, yesterday was my first time attempting to put in an IV. I was unsuccessful. I should add that she was too frustrated to show me so someone else stepped in to do it.

In addition, I work on the surgical unit. It is very stressful, especially during the week days. So much admissions and discharges. What even makes it worse is that I'm trying to practice

delegating but it is hard when there are 45 patients, 3 aides (one of which is a sitter). So when there is no one to delegate to, I do it myself. And in a given day what happens, I miss 12 oclock meds for one patient. I give my last 6 o'clock meds at 8pm. I finish documenting at 9pm in a 7am-7pm shift. Can you say I'm burnt out already and I'm not even on my own, even though I do feel that I am most of the time.

There have been days that I feel as though I should drop everything and quit. There are days that I like (weekends). At the end of those busy days, I do not feel as though I spent enough time with my patients. I do not feel as though I paid attention to them as much as I should. I find myself apologizing for being late and/or following up with my promise. New nurses on the same unit who have been off of orientation for a few months verbalize hating the place. That stresses me out too because I start to foresee in their place a few months from now.

[TaniqueRN]

I do not want to quit; however, I do not want to lose my mind or my license. Any advice?

[IcySageNurse]

That's hard, but I would recommend that if you're not happy you start sending out applications for other jobs. If nothing works out, suck it up and deal with this one for a while. If it does, you could give your two weeks notice. Doesn't hurt to have options - don't stay somewhere where you aren't happy. Too many nurses "Settle" because they think nursing is SUPPOSED to suck. Well, it shouldn't - no job should be dreadful or make you want to quit!

[Aurora77]

We've all been there. At three months, you're just not going to be a great nurse. The only way you resolve the issues you're having is with time and practice. What will different about another hospital job? Hang in there, it will get better.

Also, you aren't going to get all your skills solidified in orientation. I work on a surgical unit as well. Sometimes I'll go weeks without starting an IV since our pts come from ER or surgery with them. Some weeks I'll start several. Same with Foleys, NG tubes, etc. it just takes time to get good at these things.

[RitaD]

It takes time to develop a routine and skills. It will get better.I always say give a job 6 months to learn the basics.

[FLmed]

Sending you a big hug. Try really hard to give 100%. If you can look in the mirror at the end of the shift and say that you gave it your all, then give yourself a pat on the back. If things take longer-- oh well. You're doing your best to stay safe, and that's the most important thing. Don't stop asking questions for fear if what others might think or if somebody else is busy. Try to give this job a full year. This will open the door to other options, perhaps less stressful options.

[FLmed]

Also-- it doesn't help that your hospital is so short staffed. Hang in there!!!

[TaniqueRN]

Thanks everyone for the encouraging words. I know no matter where I go, it will be stressful. I'm going to continue to fight. However, the staffing issue is a big issue. It's a safety concern and I will not let it jeopardize my license. I'm at a point where I'm taking my work stress home. And this is not healthy for me one bit. So hopefully I can given it a year and apply to other jobs so that I can be closer to my family.

[dudette10, MSN, RN]

Your preceptor is a charge nurse with TWO orientees???? I feel for you (been there, done that), but--and please don't take this the wrong way--you need to give your preceptor a great big hug and thank her for trying!

Also, please don't worry so much about the skills. Work on your time management and critical thinking. When you are able to get some downtime, offer to other nurses to do IVs and the like. The skills will come in time.

One of the biggest problems I see with people in charting is that they try to chart on everyone all at once and manage their time that way. Although they might think they have an hour to chart, there is always something that comes up to delay it even more, and they almost always end up staying late. Try it a different way. Chart on one patient when you have 10 minutes. Then another when you have 10 minutes. When I switched to that method, I rarely have to stay late to chart.

You said your 12 meds are late. I know the morning is filled with to-do lists before you even start--assess, pass meds on the big morning round, treat blood sugars, delegate or help do morning care--but have you found ways to cluster as much as possible? When you get report and see your patient, assess pain and take a look at VS and pull any PRNs with the am meds so you don't have to pull/give twice. If meds are an hour apart, see if you can give them at one time safely. Clustering is the only way to get everything done.

The grass is not always greener in the first year. If you go to a different place now on the same type of unit, you'll face the same problems, plus you'll have to learn unit-specific processes all over again. I firmly believe that if you don't have the nursing part down, going somewhere else brings more problems than it solves.

Staffing is an issue nearly everywhere. Never believe the ratios given during interviews. They are rarely completely true. I was told 5:1, but I usually start out at 6:1 because there is a plan to discharge someone. Then, with a second discharge during my shift, I will get two admissions. That's eight patients in a 12-hour shift, with the discharges and admissions taking longer than just having the same six patients during a shift.

I know you may not like this suggestion, but I found it helped me. I did nights for more than a year and now I rotate. I'm thankful to have worked nights because I was able to work on time management. There are the crazy nights where time management is essential, but I think nights is a great starting place for new grads. Other, more experienced nurses may have more time to assist and teach you. I learned everything from my night charge in that first year. I did a ton of IVs on nights, placed NGs and Foleys on night admissions, did total care on trach vents (my favorite type of patients, actually). Comaraderie is good on nights. One of my favorite shifts (no, really!) was a low census night, and there were only 2 RNs and 1 CNA who also helped out on a sister unit. The only way we got everything done was to work together.

Good luck to you.

[TaniqueRN]

Thanks very much dudette10. Tonight will be my first time on the night shift. I'm excited and nervous at the same time. But I do hope to learn at a better pace on the night shift. On the day shift, I didn't get much downtime, especially during the weekdays. Just so I wouldn't stay later, I would spend my lunch time charting assessments and writing notes. But I'm really going to try and give it my all.

[Larry3373]

Thanks very much dudette10. Tonight will be my first time on the night shift. I'm excited and nervous at the same time. But I do hope to learn at a better pace on the night shift. On the day shift, I didn't get much downtime, especially during the weekdays. Just so I wouldn't stay later, I would spend my lunch time charting assessments and writing notes. But I'm really going to try and give it my all.

Going to nights helped me. It may start out hectic, but it will oftentimes slow down after that initial med pass. I feel much more competent after a few months on nights

[littlenurse21]

Can I just add in that I have been feeling the same way and have begun to question whether I want to stay at my job or not. I have found myself going home with tears streaming down my face on several occasions. The culture on my floor is so aggressive. They expect to grow their nurses over night. My preceptor sounds similar to yours. That is where the problem towards my learning experience is occurring except that I am getting ridiculed and torn apart for not knowing everything. Or not being able to critically think through everything. They expect you to be like them right away while not taking the steps to teach or at least provide a learning ground. But here is the real icing on the cake, I am 10 weeks on an a floor with heavy acuity [our pts are what ICU pts would be at other facilities] and am expected to juggle 6-7 of them.. and because i have not reached their expectations throughout my orientation.. i am being faced with the possibility of being LET GO. Now mind you, I can see if I was making errors etc, but its over the fact that i am not where they expect me to be right now. for that, i am being told that they think my floor is too much for me to handle.. and here's the cherry on top: ive worked at this hospital for 5 yrs while i was attending nursing school. its heart breaking. i never had the notion that orientation would be such an employment "trial" phase based on what i've described. again, if it were errors etc or conduct issues, thats completely understandable. But there is not a single thing I'm doing wrong except for the fact that im having the typical troubles any other new grad would have. im just so disheartened with what im facing at a place i used to feel so passionate toward. its unreal.