Reality Shock...

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Hi everyone!

I am about to be graduating this June, and as a part of our nursing homework we are to talk to new nurses about the socialization to nursing after graduation. Did any of you guys experience a reality shock? If you did, how long did that shock last? Also, did you recover from the shock; if so, how?

I would greatly appreciate all of your responses! Hopefully they are not too intimidating for my future! :rolleyes:

Amen, Gonnabee! I just had my first code about 2 weeks ago and I was so aloof. Out of nowhere, several (ICU, ER) nurses came onto the floor asking about this and that regarding the pt. I was never informed during my orientation on what to do/how to prepare during a rapid response. Thankfully, the pt was stable.

The biggest culture shock would be the amount of "short cuts" I see some nurses do. Working at LTC opened my eyes to how much those facilities are understaffed. I now work in a gero/psych unit and rarely see nurses do an assessment. Granted, the pts are usually more stable than those on other units (i.e. med/surg), but still...things can get missed if an assessment isn't done.

Another thing is the amount of (paper) documentation and how repetitious it can be. Computerized charting is so much more convenient and efficient, but unfortunately my hospital hasn't caught up with the 21st century. Even the med/surg units don't use computerizes charting.

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funny u should ask because I just posted about my reality shock on another thread about something else.

My reality shock has been the amount of responsibility that is on my shoulders. As an ER nurse I am expected to be able to manage whatever comes in through the door. Half of the stuff I have never seen, and the other half I am just getting used to.

Also, the lack of a sense of emergency in some of my techs. I ask for help with an EKG and my tech continues browsing the web. Again, the responsibility is mine, and so I do it myself. Now, most techs are NOT that way, but when you get stuck with the lazy one it sux.

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Specializes in PACU, Surgery, Acute Medicine.

My biggest reality shock, and it shouldn't have been after all I've read about it, is how awful other nurses can be to work with. Of all the many, many things I have to complain about regarding my particular unit (which I am getting off of the day I'm eligible to transfer), the very worst is how rude and mean most of the other nurses are. It's contagious and so very detrimental.

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for example: think about juggling 6-8 patients, some really sick, total care, under different services, with several co-morbidities, tons and tons of meds to be given in a strict amount of time, several tests per day, several orders for patients, 12plus hours on your feet, someone about to code and family members demanding a better food tray....ALL AT THE SAME TIME. do this, be safe be quick and BE SMILING or else. and don't you dare miss an order, a med or a CHANGE in patient condition. it is an enormous responsibility.

Surferbettycrocker has it right! I feel the same way, only some days I'm juggling 11 (with an LPN). It's been a VERY big shock to change careers. I went from business to nursing and I'm still glad I did, but I know that I won't always work in med-surg. I don't know how you're supposed to do this job when you're older. It's just unreal how much is on a nurse's plate each day. I've certainly never worked this hard in my life, but I was right that it would make me happier than sitting behind a computer all day. It's certainly frustrating when a family member is freaking out about something like a food tray or repositioning when there is something more pressing that needs to be done with the patient or one of your other patients. I really think that acting is a necessary hat you have to wear because you'll want to look at some patients and family members like they are f*ing nuts.....and you certainly cannot....lol

It's been a wild ride. I'm right at the six month mark and I'm ready for the next six months in my unit. Some day I figure I'll have to move to ICU or some other critical care area to save my sanity. There's just too much to do and too much stress to work with this many patients and families each day. I am, however, very lucky in that I found a unit with GREAT coworkers on it. They really have been sanity savers. When I'm overwhelmed I can usually get the help I need from a charge nurse or another seasoned nurse. It's been a great place to learn and I know how lucky I am to have found it my first time out :)

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Specializes in ED, ICU, lifetime Diabetes Education.
Some day I figure I'll have to move to ICU or some other critical care area to save my sanity. There's just too much to do and too much stress to work with this many patients and families each day.

It really isn't much better in the ICU. We may get only 2-3 patients but these pts are total care and can't do anything for themselves. We the RNs have to do hourly (and sometimes Q 15" or Q 30") VS and Q 2' full assessments. We have to turn and reposition our patients Q 2' and we often do not have techs to help. The assessment sheet is 8 pages long to complete and we have to write a note or narrative at least every 2 hours. We have to monitor the vent settings. If a pt has to go to CT scan or cath lab, or anywhere else in the hospital, we have to go with them and find another RN to watch our other pts. Different doctors frequently come and write new orders and we have to constantly check the chart for orders and scan them down to pharmacy. We have to monitor and titrate several drips and document any changes made. I haven't even touched on the families of the pts.:uhoh3: A pt is coding in the next room and I have to run to assist. The family of the pt I left complains to a hospital rep because I didn't finish brushing their loved one's hair before I ran off :madface:

In any area of acute care nursing there is going to be tons of work. Go into the ICU because that is what your heart really wants, not because you think it will be any less stressful.

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It really isn't much better in the ICU. We may get only 2-3 patients but these pts are total care and can't do anything for themselves. We the RNs have to do hourly (and sometimes Q 15" or Q 30") VS and Q 2' full assessments. We have to turn and reposition our patients Q 2' and we often do not have techs to help. The assessment sheet is 8 pages long to complete and we have to write a note or narrative at least every 2 hours. We have to monitor the vent settings. If a pt has to go to CT scan or cath lab, or anywhere else in the hospital, we have to go with them and find another RN to watch our other pts. Different doctors frequently come and write new orders and we have to constantly check the chart for orders and scan them down to pharmacy. We have to monitor and titrate several drips and document any changes made. I haven't even touched on the families of the pts.:uhoh3: A pt is coding in the next room and I have to run to assist. The family of the pt I left complains to a hospital rep because I didn't finish brushing their loved one's hair before I ran off :madface:

In any area of acute care nursing there is going to be tons of work. Go into the ICU because that is what your heart really wants, not because you think it will be any less stressful.

I totally agree with your statement! I was a new grad starting off in the ICU and I transferred with one week left on my orientation to the ER. I don't know why people think it will be less stressful in the ICU than on the floor. I guess the 2:1 pt ratio is what gets them. I know how it is to have a crashing pt, so unstable if you turn them a hair, their BP will tank. I know how it is to chase a pulse ox all night, especially when the pt is desatting to the 70's and you have to bag them AND they have 100% FiO2 on the vent. I know how it is to constantly run your butt off titirating drips all night for either high HR's or too low BP's. Then on top of that, you are responsible for Q 1 hr vital signs, and your 3 head to toe assessments per shift. Plus, charting any changes or everytime you have to titrate a drip.

It was like being in a pressure cooker. Your pt can code at any moment and you have to be able to respond in a quick and efficient manner. Forget about family members. You have no time to talk to them when there is a code going on in the next room. Everyone on the unit is running to that room.

I challenge anybody who think the ICU would be less stressful than the floor to try it for atleast one week. And I'm talking about at a Level I trauma center when the norm is gun shot wounds, stabbings, assults, on top of medical codes.

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Specializes in Emergency, Trauma, Critical Care.
My biggest reality shock, and it shouldn't have been after all I've read about it, is how awful other nurses can be to work with. Of all the many, many things I have to complain about regarding my particular unit (which I am getting off of the day I'm eligible to transfer), the very worst is how rude and mean most of the other nurses are. It's contagious and so very detrimental.

I would agree with that. I wonder how much more efficiently some units would run if nurses were all there to do the job and just help each other. I know there are always those crazy nights where everyone is slammed. But I have seen my fair share of nurses who are having an easy day, sitting around, and simply ignoring those running their butts off.

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Specializes in Case Management, Psychiatric Nursing.

Nursing School got us through the NCLEX the real learning will be when your on the floor.

Good Luck! :up:

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I graduated last August, took my NCLEX-PN in Nov. passed. I started to job hunting around Thanksgiving, applied in person and online to about 50 places. I went as far as 25 miles away from home to apply ( beg) for a job. Two places called back for interview, they didn't want new grad. Finally, Feb this year, i got hired by rehab. facility where 20 miles from home. I was graceful and excited about it.

The reality of job hunting is shocking! A nurse can't find a job? Many think i am telling a joke. But it is true, be prepare it for at least 2-3 months before you can land a job as a nurse.

Shocking at work, Everday at work is like a race, you have to be fast to get things done on time. 2 hours medication passing, only if you are lucky without getting interrupted by phone calls, incidents, low blood sugar, or upset family members etc... You rarely hearing anything positive about what you have done, always something you didn't do or done incorrectly.

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we were giving the reality shock model as apart of our orientation and were told to expect to go through it many times, i would say im up to abotu cycle 6 (in four months) has lasted from a day end to end, over a week, or over a month. I'm in a mental health job away from my training area and i agree nurses can be very brutal! its funny how as a student u just did the job but as a nurse they suck u in!

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Specializes in Telemetry.

I think the shock for me came on the New Grad unit when I realized all the paperwork that was involved. As a student, I didn't have to take orders off for four patients on a tele/med surg floor, patients who have 3 or 4 doctors scrabbling over charts to write orders, then patients going into Afib with RVR at shift change, and calling the cardiologist, and getting orders. The doctors, the families and the charting, all the stuff that takes up so much time that I didn't do much at all of during nursing school.

That being said, I LOVE it. I spent years in a job doing far more paperwork than I'm doing now, and in a much less rewarding position.

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Specializes in ED, ICU, lifetime Diabetes Education.

I know what mean you mean about the paperwork. When worked for the federal government, I thought it was crazy with all of the forms to fill out and signatures needed just to order a box of pencils. The paperwork for one pt is worse.

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