Rocky Start/Orientation and Nurse Confidence

Curious1alwys, BSN, RN · May 5, 2023

nursel56 said:

Yeah, but ants aren't so bad...? we private duty nurses love to trade war stories to a certain extent. There is also Home Health Case Management if you can handle the driving.

I found private duty worked well for me, and I was determined to avoid situations that amped the anxiety level, and ended up taking cases with people on ventilators, and I was the only one there.

The recruiter wouldn't stop "encouraging" me to give it a try, and it worked out well, with just enough challenge, because part of me wanted that, despite the anxiety symptoms I had which sound very similar to yours.

I found the overall good fit was a combination of acuity, pace and unit culture. A scary unit can be offset by a supportive and approachable nurse manager, and a "safe" job can be hell with too much too fast, and indifferent or hostile co-workers.

Anyway, I don't think it's time to give up on nursing, wish you the best and am amazed you handled job number one as well as you did. Feeling panic before every shift is awful.

Thank you for your response and especially your empathy at the end there. ?

Curious1alwys, BSN, RN · May 5, 2023

NRSKarenRN said:

Private Duty home care --1 on 1 care, much less stress.

Do they train you with vent/trach care if you haven't done that in a long time? I suppose some companies would. ?

Home Health Columnist / Guide · May 5, 2023

Curious1alwys said:

Do they train you with vent/trach care if you haven't done that in a long time? I suppose some companies would. ?

Yes, many will train you. Bayada Pediatric Nurse Training (East Coast Company) is an example.

mdsRN2005, ASN, BSN, RN · May 10, 2023

Before you abandon ship from nursing altogether, consider other specialties that might be a good fit. I personally think you'll be stressed in any inpatient position due to the chronic understaffing and ever increasing patient acuity.

Have you considered postpartum? Compared to L&D, it seems much less acute and busy. I've never worked it but I have a friend whose preferences are similar to yours who loves it. She doesn't do as much "technical" skills but focuses a lot on teaching the new moms. Since it'd be a new and very different specialty for you, you should definitely get an orientation (albeit likely a brief one).

You also may want to consider preop in an outpatient surgery clinic. You do have to hurry a bit but it's hardly every life and death. Just quick IV and assessment. And you get to chat with them while they're still awake.

Also if you like kids, consider school nursing. I've not done this either but know a couple nurses who have. It has more of a focus on prevention/wellness and very few technical skills. With your chatty personality, I'm sure the kids would love you! I think the pay is often a bit lower, but many school nurses in my area get Summer temp jobs to recoup the difference.

I hope you are able to find a job you love and excel at. We have so many nurses leaving the profession right we don't need to lose a good one! Good luck with whatever you decide and keep us posted!

hollyjoi, BSN, RN · May 10, 2023

This position may not be a good fit for you right now. You could try a transition to acute care residency program for RNs. This would help you regain your skills.

miabella, LPN · May 10, 2023

My gosh, I thought I was the only person who felt this way! I have been a nurse for almost 7 years and I still don't have confidence in myself. I think my lack of confidence has gotten worse actually. I have severe imposter syndrome and get so anxious. So completely understand where you are coming from. Thank you for posting and sharing! It's made me feel a little better and that I'm not completely alone. Sorry I don't have any words of advice or encouragement.

londonflo · May 10, 2023

Curious1alwys said:

o I'm toying with the idea of leaving nursing altogether for a position more suiting of my personality where I am not the one responsible should things go south. Th

This is a totally off the wall suggestion, but have looked around your area for "nursing hiring fairs"? Like at the local nursing ADN/BSN school or established hospital. With students graduating now, they may have already occurred but may be not. Get your resume updated, good quality paper and well written. Include your climb from new grad, to educator, to a possible outpatient position. Of course include all your continuing education programs.

I am old but in the 1980s when there was a dearth in open nursing positions, there was a strategy used where a new/older grad would call and make an appt with the Nurse HR rep in neighboring areas "just to find out about the company (informational meeting". You are not there to file an application, just learn about the company. Be prepared with questions that showed your research into the company to stress you really have a genuine interest in the company.

Some times the HR RN knows about any upcoming openings or will learn of one soon..send a thank you note promptly.

Just some suggestions. Best wishes, and good luck.

DallasRN · May 11, 2023

Given your history of anxiety, etc., and after 6 years of "experience" and still not feeling confident, I think you really should explore other options. Life is too short to spend time in positions that make us miserable. There are many different types of employment opportunities available to nurses that don't involve hospital/bedside positions. Look into worker's compensation positions - reviewing medical records, contacting providers for records, and interviewing (usually over the phone) injured workers. Many insurance companies hire disability case managers - office workers/no patient contact. Some companies hire health coaches. Are you able to relocate? That might up your chances of finding something more to your liking. Nursing is not a "one size fits all" type of thing.

In the meantime, I do believe you would benefit greatly from counseling. There just isn't any sense in going through life with negative thoughts when counseling and/or medication can help. Best of luck to you!!

londonflo · May 11, 2023

I am not trying to hijack this thread but I think in the last month I have read a minimum of 10 posts from RNs wanting to get out of nursing. We all probably feel like that at some time but few can find a financially viable alternative because of skills that are honed for a our job classification may not transfer easily without more significant university education..

I am wondering if it would be helpful to have a thread where people who have moved to non-nursing jobs or become entrepreneurs or just found a part time job that helps them go part time in nursing can describe what they did?

From the last couple of years I have read of someone who became an employee of an animal feed store. I was able to cut down a few years ago (retired now) through selling antiques and still doing that. Anyone become a realtor on the side, interior decorator? Drug rep, NCLEX tutor, blogger/writer? nurse recruiter, community educator, a minister, construction worker ???, I am not talking about MLM.

Any suggestions beyond these?

DallasRN · May 11, 2023

londonflo said:

I am wondering if it would be helpful to have a thread where people who have moved to non-nursing jobs or become entrepreneurs or just found a part time job that helps them go part time in nursing can describe what they did?

I like this idea! And perhaps some could continue to work part-time in nursing to "subsidize" their income but also find their passion outside of nursing. I have a friend who opened a booth at a antique/crafters mall. She still works PRN but loves her booth and the people she meets. Nursing is a tough job - physically and emotionally. It can easily sap your energy. Having that other outlet would probably allow people to stay in the profession on a limited basis.

Lynker, LPN · May 11, 2023

I see everyone else has given yoou wonderful advice, but I want to jump back to that mental health/psychiatrist situation.

Anxiety medications do have the chance to make you gain weight, yes. But your mental health is clearly a problem, and you DO need to find a psychiatrist to help you iron out these problems. If anything, this should be your MAIN concern as it is affecting your life and your work life.

Just my two cents. Once I started getting my mental health under control, my work and home life have gotten much better! Give it a chance!

Wildcats9 · May 11, 2023

Curious1alwys said:

I am not a new grad. But I only have had probably a collective year total in bedside work, likely including orientation. My orientation years ago was disorganized and complicated. I was hired as a new grad float....to around 6 different units at 3 different hospitals. No one to count on, no friends, everyone was pretty much new every shift. Many different preceptors. I received several months orientation but I hopped around all those places. So yes, the first year I was terrified, sick before every shift. Plus, I have GAD and performance anxiety. Hence, was pretty terrified in nursing school too all during check-offs and clinicals. Generally, I love helping people, and am great with them, but feeling competent in hard clinical skills (seems even with practice I suck) and overall nursing judgement eludes me.

Fast forward to now, I've held several different positions. None of which I've ever really felt confident except the one in which I was simply a inpatient clinical educator with no hands-on skills. This is what I do now (6 years) but they changing my job and moving me to the outpatient cardiac clinic where I am very unfamiliar with the charting system and the overall procedures. I know the patients can be pretty acute (severe HF, LVADS, heart transplants, artificial hearts) even though it is outpatient. Things can go south quickly, I know it, and I would be the ONLY nurse there, the one in charge essentially. This position is less stress than bedside but still somewhat acute since it is cardiac.

So I'm toying with the idea of leaving nursing altogether for a position more suiting of my personality where I am not the one responsible should things go south. That's the critical part that gives me so much anxiety! I know this change coming for me in my job is going to be with no orientation back...sink or swim...because they will be short. That's also freaking me out.

I also sometimes think I should find a floor nurse new grad type position or a position in which they are willing to train me again, hopefully this time, adequately. Maybe I could one day really excel in this position? I need to figure out where it all went wrong. Is it me or the crappy orientation I had that has given me zero confidence and sent my GAD/performance anxiety out of control? What's your opinion?

Thank you!

I'm probably not going to have the most popular opinion here and while I wholly understand GAD, I would suggest finding a job in nursing that immerses you in and forces you to practice the skills you're most lacking confidence in. On a daily basis! EVERY nurse goes through that. If one tells you they didn't, they're lying. Or they are seriously lacking empathy and probably shouldn't be in the medical field if they aren't concerned about hurting a patient. I am fairly new to nursing- have only been working in it a handful of years, however, I was a nontraditional student and went back to school for a second degree nursing program in my mid-30s.
Like you, I was scared to death to take blood pressures, because my sister complained about her arm hurting the very time I attempted to practice. I still don't like starting IVs. When I graduated, my first job was purposefully in dialysis, because I knew it would force me to get comfortable sticking patients multiple times a day. Luckily, their veins are like straws.... But it was great practice and I got very confident. I learned to give medications in their CVCs and how to clean them, change the dressing— none of which I would have had the skills to do prior to the job.

Fast forward a couple years, I've been working in orthopedics. I have now just finished obtaining my RNFA certification (first assist) so I've learned to suture and assistin surgery. I was completely intimidated in the operating room but I have grown leaps and bounds over the past year. You are not going to learn anything overnight and I still get anxiety every night before I have a case the next morning. But I know as I continue to gain experience and do it regularly,I get more confident and comfortable.
Yes, you need a supportive team. Instead of letting floor managers interview you, interview them. How supportive are they? Will they help you grow and be successful? How? You have a lot to offer based on your background. The skills will come, but you have to practice and believe in yourself. It is not easy. It will induce anxiety, but you can do it!
Stop letting GAD hold you back and becoming a scapegoat. You went through a lot to earn a nursing degree, I would fight to keep it. Yes, there are other career avenues to explore but you've obviously done something well to be getting these opportunities. While the cardiac gig may not be the right choice, I do believe you could do it. Again, with practice and with tine to learn. THe EKG readings and pattern recognition will come in time as you see them regularly. Again, just my 2 cents but don't discount your ability to learn skills.