Returning RN scared of making errors

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I have been out of hospital nursing for about 4 years and critical care for over 10. I decided to return to the bedside and am now in an ICU position. So many things have changed since I worked and all the newness of equipment, processes, and type of patients has me completely off my game.

I always felt confident clinically but now find myself not understanding this new patient population the way I feel I should and making small stupid mistakes each time I work. Nothing harmful to the patient thank goodness, just dumb for an experienced nurse. It makes me frustrated and worried about making mistakes. Almost paralyzes me before getting to work but once I'm there I'm ok. Very hard on my confidence and reputation.

Anyone else been or know others in this position and how long this transition back lasts?

Thanks much!

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How much orientation did you receive?

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Welcome KC, yes, I have been out of acute care this time for 5 years and am getting ready to return. I also find it daunting. But it seems to be the environment that I thrive in. I also have 16 years of critical care experience but did not want to return to critical care because of the intensity. I am returning to a tele/med unit and that will be intense enough for me!!! Hopefully, you are receiving a good orientation before jumping in. The patient population has changed and so have many of the protocols and equipment that you most likely were working with before. The attitude of some MDs is still the same, but others are more approachable. Take a deep breath and just sit down with yourself and try to focus on where your weaknesses are and concentrate on them. Yes, you are a seasoned nurse, so where are your strengths?? I think it takes a while to adjust to any new environment and the acute setting is always changing so when you think you have adjusted something else comes around the bend. I am pretty sure I will be getting pulled to the ICU/PCU environment because that is where I have most of my experience. I can understand why you would feel overwhelmed by all the new stuff, but truly what is the worse that can happen? I always play the "worse case scenario" with myself. I guess that sounds a little sadistic but, it helps me stay focused and not feel overwhelmed. If the worse thing is that your patient may code then prepare yourself for that by taking an ACLS class. If you feel you cannot focus on what is going on with your patient because the "rhythm" of getting into a groove is not happening for you, figure out why. What can you do to make yourself more productive and increase your confidence. I think it is normal to feel a little intimidated for a while. You will get your groove back, it just takes a little longer when so much has changed. Find out what is the most important thing to you right now. When I returned to acute care last time the insulins had all changed so that was my focus, I am not sure what I will find this time as I have been working in sub-acute and there should not be a whole lot of changes. But I am sure there will be some. I usually find my groove after being there a while and I have some organizational skills that seem to always get me through. You have to find your own learning curve, it may not be what others think it should be. Don't get intimidated by what they "think you should know" and "what you do know". Access your nurse educator for resources or find another way to improve your learning skills so that you do feel more on top of your game! Good luck, returning to acute care is always an adjustment!! If you are like me and tend to hold onto old books you might review some of your cardiac, respiratory and diabetic stuff, Lippincott still has the general book that covers a lot or just a general critical care resource. You can find a lot at Amazon or on line resources to help bring you up to date. You can do this, there is more to life than worry, if only we all could stop that, think of how much energy we would have for everything else!!! Research out some coping skills for yourself, there are a lot of self-help books out there and now days some on-line counseling might even help!! Go Get UM TIGER!!!

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Yes, good orientation. Actually information overload. High expectations of the nurses which is probably where my concerns come from since I am not at that level. That's where the "what I think I should know vs what I do know" dilemma stems from. There's also pressure to go faster and I know I'm not ready for that when these stupid mistakes happen. At first it was newness but now it's because I'm trying to not get behind.

I thought about maybe having started on a less acute unit first in hindsight as you're doing, but I'm here now so don't want to keep bouncing all over. Thanks for your support and ideas. I have been reading up on my own there's just so much information to know I guess I have to let time have its course. For the sake of the patients and coworkers you just want to have it now, right?

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You will get there!!! Everything is faster paced now!! You still need to learn how to prioritize and learn what is important. There are several web sites that can help you, look on the career/education section of this site.

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