Scared and don't know what to do...

sharpeimom · Apr 18, 2009

you're brand new and going the transition from student into nurse. you're still so new that if someone calls, "nurse.." you look over your shoulder for your instructor because you aren't a nurse... but guess what? you are a nurse. a real nurse. keep a sheet of paper divided into sections - - one per patient. at the end of your shift, you can destroy it. just don't use names. use first initials. do you have someone you could practice basic techniques on until you pick up speed and organization? on your off time, make up patients and make a care plan and write down every last tx, med, adl, etc., pretend you're talking the doctor when he rounds, etc. and it will help you gain confidence. quit expecting to be on a par with the more experienced nurses because that only comes with time. it's perfectly ok to tell a patient, "i don't know but i'll be glad to get that information and get right back to you." then do it.

it's hard but try not to panic or become anxious because that just makes things worse and you won't be able to concentrate. another thing is to learn all the common meds you work with backward and foreward so you don't have to stop and think, learn about the problems and conditions seen most often

on your unit and how they are treated. for me, once i quit panicking and relaxed, it all began to fall into place gradually.

sharpeimom:paw::paw:

live4today, RN · Apr 18, 2009

First...you need a hug -- (((meeppeep))) :icon_hug:

Second...as a new grad of three months, you should NOT be on your own on a specialty unit in the first place. My question to your nurse manager is: How the heck did that happen under his/her watch? :rolleyes:

When nurses choose to not start out on med/surg floors, and yet choose to start out on critical level specialty units to begin their learning as a nurse out of school, this is often times what happens to them...not all new nurses...I said "often times...for some...". :twocents:

Now that you are there, perhaps you should stick it out, but ask the union for help in extending your orientation under a preceptor who knows how to orient new staff...especially new nurses. Cardiac is complicated enough when you have experience as a nurse in other departments let alone as a new grad.

If Cardiac is NOT your first love of nursing, seek a different unit to orient on. I recommend Med/Surg. On Med/Surg, you get a variety of diagnoses to learn from, a variety of pharmaceutical meds to master, and patients who will be admitted with histories of old cardiac diseases secondary to their admitting diagnoses. This will give you the variety you need to ease your way into the nurses profession.

Med/Surg is a specialty in and of itself...always has been, but many new nurses will avoid Med/Surg because they think it won't be challenging enough. Believe me when I tell you this..........it is DEFINITELY challenging enough, especially if you take on med/surg in a university hospital.

I wish you well. Let us know how things go. :icon_hug:

Ayvah, RN · Apr 18, 2009

What kind of mistakes are they? Are they medication mistakes or mistakes about procedures or something else? What I would recommend is to talk with someone about every common procedure you do, and write down all the things that need to be done for them, such as if the patient is scheduled for X, then they need to be NPO for 4 hours, and hold this med or that med. This will be an invaluable reference for yourself. Never be afraid to call MRI, or Xray or the therapy departments to ask about prep work for procedures. Feel free to consult a pharmacist at any time too.

If you are having trouble with meds, write down all the common ones and look them up to know them. And/or come early to work (like 45 minutes or more) and look up all your patient's meds before your shift starts, that way when you go into the room you can rattle them all off and what they are for with confidence.

Are you having trouble with tele? If so, most hopsitals should have ekg classes that you can sign up for. Never be afraid to ask another nurse for a second opinion about a tele strip or your patient situation. There are so many gray areas in healthcare that it is important to involve others if you are concerned about your patient.

3 months is still very new on the unit. Hospital nursing is very rough for multiple reasons.

Good luck!

Pediatric Critical Care Columnist · Apr 18, 2009

I'm in total agreement with the others who are incredulous that you're on your own after only 3 months. That is RIDICULOUS!! You should still be on orientation, with someone supervising you from a distance and providing you with resources, tips, pointers, BACK-UP. Our unit has a 16 week orientation which is easily extended by up to 4 more weeks if the nurse needs it and is felt to be capable of doing the job with that extra support. They also get 60 hours of resource shifts, meaning that there is someone assigned to sort of watch over the new nurse and help out when needed. So on my unit you'd only be 3/4 of the way through orientation and a LONG way from taking on a full load all by yourself. Bring THAT up with your manager.

meepmeep · Apr 20, 2009

Wow, I can't believe you guys have a way better orientation. Sadly, none of the health authorities here offer an orientation longer than a month. I'm only able to request an extra week or two of orientation at most. My situation is actually pretty bad. They gave me a choice of either staying another month on cardiac surgery or try 3 more months on a med/surg unit. I opted to choose 3 months on medicine. I don't really like medicine, but at this point I have no choice and my license is at stake if I don't progress in those 3 months...

EwokRN · Apr 21, 2009

Hi. My situation is kind of like yours. I actually just graduated from a 2nd Degree BSN program in Dec '08, and I just got this job Feb '09; however, they told me on April 10th, that I might want to transfer out of this Medicine unit after only 4 weeks of floor orientation. Technically, I'm still employed at the hospital I'm at, because they believe I have potential. After some soul searching, I found out that the 6 week orientation that the hospital I'm at for Med Surg floors doesn't really provide the orientation that I need as a new nurse on a Medicine unit.

I actually have an interview on a Telemetry unit as a new grad at another hospital, which offers a 12 week orientation for Med Surg nurses. At the hospital I'm technically employed at, they didn't give me the opportunity to really organize my orientation schedule. They pretty much said, hey, you'll work 12 hour shifts with 3 days break in between, and guess what, you'll forget everything you learned. At this other hospital, I'll be working 8 hour shifts and therefore have more time to hone the skills in between. With that said, I'd say you're pretty lucky that you're given an opportunity to practice 12 weeks on a Medicine unit at that same hospital.

When I was talking with my mom, a retired RN, and practicing skills in front of her, she mentioned that my skills were kind of slow, and that I needed more practice. THen, I figured out that if I could hone my skills more, then I would have more time to focus on the critical thinking part that so many of the nurses said I lacked. Maybe you could do that, and see if you can hone your skills with a more experienced nurse?

Just a suggestion. I wish you the best!