New grad sinking fast

Nurses New Nurse

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Hi,

im a new grad nurse and am in terrible need in of some advice. Please any advice is welcome!

I just started orienting on my floor 2 nights ago. & I have to say I am already bombing it. My first night was ok but the second night I was orienting on a PCU & that's where things went bad.

To get to the down and dirty I was an absolute mess. I slowed my preceptor down considerably. Like to the point that I think she may be missing some things because of me. I charted on one patient and managed to miss key components on that. & it's not from not knowing about the pt. It's mostly because idk how to work the darn charting system. In clinicals they had Cerner system which was SUPER easy to use. This hospital uses meditech & I'm struggling tryna figure where everything is.

On top of that, I feel like my hand has to be pretty much held. I don't think I'm making the transition from nursing student well. I've made med calculation errors ( I always review with my preceptor tho), messed up on looking up what meds should be given at a certain time, but the point is I miss key things. I can't look thru 6 pt orders on a chart that I barely know as fast as I should yet. Therefore since i don't have time to look thru everything, I barely know what's going on.

I just feel like I'm too slow of a learner & perhaps acute care isn't for me. I mean I couldn't even put the yankauer to the suction on correctly, I'm struggling with how to use the pumps, how to run the meds, how to set up tube feedings. just all the simple stuff a nurse should know. Today my preceptor told me I wouldn't be getting not even ONE pt to myself. Mind you its my first week but I can't even progress to one pt. Most ppl at least make it to 3. I wouldn't be surprised if they fired me in this week.

my preceptor is pretty nice. But you know how gossip is, especially in a hospital. & I feel like I'm just following her everywhere & ppl are looking at me like "why are you following her every footstep".

even the patients can tell I'm new, which is bad. Has anyone else been in this situation? Should I request to go to a slower unit ( this floor is known to be the hardest floor in the hospital), or should I just try to work somewhere else entirely? I want to be good at this and work in a hospital! but I really starting to understand if ain't meant for ya , it ain't meant for ya.

Specializes in Med/Surg/Infection Control/Geriatrics.
thank you so much for the advice!! I will definitely practice this! I probably could've gotten over some things but it was the med errors that were the most upsetting. I want to safe for my patients. & I don't won't them to suffer because I'm not able to get their medicines together.

I would be very careful about "pulling meds" ahead of time and having "flushes in your pocket." From an Infection Control standpoint, as well as safety, this is not a safe habit to develop, no matter how convenient. Meds are not to be pulled until they should be given, and keeping flushes in a dirty pocket is asking for trouble.

There's no reason to load up like a pack horse if you are organized. You will find your own rhythm but take advice very carefully, not just for your patients, but for your own professional safety.

A new grad who hasn't completed orientation in 2 days. I really have heard it all now. Girl, please.

LMAO!

She's a new grad full of anxiety. We've all been there.

I'm sure your fellow classmates are just as stressed out as you and wishing that they don't have a patient just yet. But observing and learning and practicing skills on several different patients all throughout your shift.

Talk to the manager/preceptor to inform the floor that if they have any procedure, it might be as simple as inserting an IV or a foley or heck it may even be as simple as preparing a patient for a heart cath or any surgical procedures, thus all these skills you get to practice or observe in one day.

One thing though, it'll be really nice for any nurses, or old or new, to know what medications and it's action of mechanism and for you to also know why the patient is getting it. Also, watch for redundancy of the medication with almost the same action, i.e- prilosec and protonix, unless otherwise specified.

As the saying goes, KEEP CALM and good luck!

Specializes in Mental Health, Gerontology, Palliative.

Hey Lovely

Cut yourself some slack.

Nursing is a life long journey of learning. I think it took me at least six months to actually start feeling like a nurse.

You have been given some good suggestions, calm down, take a deep breath and take several more if you need to and please, cut yourself some slack

If u can get more time than others, consider yourself lucky. Most orientations are too short anyways. Don't admit to thinking you will never catch on with anyone.

Pocket Person...you put a lot of thought into your orientation and what works for you; BRAVO! That is what you have to do. Each Nurse's brain operates differently. I too depended on my 'pockets'. I always carried a cheat sheet, with a blank piece of paper to use as my brain. So many interruptions we will certainly forget something. My blank sheet, 'my brain', reminded me of things to do and document. We all have tricks...find what fits for you!

Specializes in case management.

Ditto to what everyone else has already said and also, Meditech is a terrible charting system and does take considerable time to learn compared to other systems.

Specializes in Med surge/ tele.

So update: I did my 3rd shift and it was better. We only had three pts because we were on PCU but I went in calmer & tried to not let my anxiety get the best of me.

The technical stuff such as learning the charting system, and the iv pumps have gone much better. I still want to work on the charting system since on this shift there were still some things I miss when charting. & I need to work on the time needed to review the charts. I would just rather know that I have all my info.

I still hadn't had the chance to really sit down and talk with my preceptor about where I am at and just where we want to see this orientation go in general. I know some people have said "fake it till you make it" in terms of showing your confidence level on the floor But that is somewhat hard for me. My confidence level on the floor could use some improvement and I have been told this many times during clinicals. & I really want to improve on is the confidence as well. Idk if that's something I should mention to my preceptor tho. As I said my preceptor is good. She's helpful and instructive. I just have reason to believe she has been gossiping about me and has been avoiding Working on the general Tele floor with me. So I really want to ask what I can improve on to know where I truly stand.

Another reason why this transition is so hard for me is because I have it in my mind that since I am no longer a student, that I shouldn't feel this incompetent. Plus there is the fact that i hadn't worked in a hospital prior to this.

And once again Thank you to everyone for your advice, I took in quite a few suggestions the other day. It was nice to be able to vent and get some helpful advise on these worries without having them spread around in a rumor mill on the floor or being given the side eye like i might have been given if I was talking to some other nurses. I know you have to be strong for your patients and do what needs to be done above all else. I just want to make sure I can give my patients what they need.

Specializes in Critical Care; Cardiac; Professional Development.

But you ARE still a student. Yes, you have a license, but everyone pretty much knows that no nursing students come out of school actually ready to be nurses now. They have passed an exam that indicates they could be ready to start thinking like a nurse. Your first year of work is your final year of school.

I have trouble understanding after three days that you have "cause" to think your preceptor is gossiping about you. Know that it is part of her job to share how you are doing and to get support from other nurses as well. Precepting can be very difficult, especially if the individual being precepted is an anxious sort. Most preceptors want to do a good job and it sounds like you are getting the support you need.

You will be fine. I had a preceptor who was a nurse for 25 years and exceptionally good at IV starts...in short, it took me 2 years to get proficient at IV starts. I shook like a leaf for months after I became a nurse, and on a really busy med-surg unit, that was tough. I used to dread sticking needles in people, but guess what..after I got some experience, saved a couple lives, got through a couple codes, went home crying more than once, I finally got good at needles, my biggest fear, and along the way I became a pretty good nurse. Give yourself a break. You will be fine.

Specializes in Trauma RN.
So update: I did my 3rd shift and it was better. We only had three pts because we were on PCU but I went in calmer & tried to not let my anxiety get the best of me.

The technical stuff such as learning the charting system, and the iv pumps have gone much better. I still want to work on the charting system since on this shift there were still some things I miss when charting. & I need to work on the time needed to review the charts. I would just rather know that I have all my info.

I still hadn't had the chance to really sit down and talk with my preceptor about where I am at and just where we want to see this orientation go in general. I know some people have said "fake it till you make it" in terms of showing your confidence level on the floor But that is somewhat hard for me. My confidence level on the floor could use some improvement and I have been told this many times during clinicals. & I really want to improve on is the confidence as well. Idk if that's something I should mention to my preceptor tho. As I said my preceptor is good. She's helpful and instructive. I just have reason to believe she has been gossiping about me and has been avoiding Working on the general Tele floor with me. So I really want to ask what I can improve on to know where I truly stand.

Another reason why this transition is so hard for me is because I have it in my mind that since I am no longer a student, that I shouldn't feel this incompetent. Plus there is the fact that i hadn't worked in a hospital prior to this.

And once again Thank you to everyone for your advice, I took in quite a few suggestions the other day. It was nice to be able to vent and get some helpful advise on these worries without having them spread around in a rumor mill on the floor or being given the side eye like i might have been given if I was talking to some other nurses. I know you have to be strong for your patients and do what needs to be done above all else. I just want to make sure I can give my patients what they need.

I think it's fair to say that she's precepted new grads before, so I doubt you're anything different to gossip about. It's normal to feel like all eyes are on you when feel like you don't belong or that you're making mistakes, but I doubt that's actually happening as much as you think. People have their own stuff going on and talking about another new grad probably isn't at the top of their list, so get that idea out of your head if you can. From what I read, it's making you feel incredibly self conscious and anxious, which will only hinder your thinking abilities. I would suggest trying to do whatever you can to cope with your stress in a healthy way and try and clear your mind and only focus on the job and what needs to be done, etc. Kind of like if you're really nervous before an exam, that will cloud your mind and there's a good chance you'll bomb it. And try not to let your emotions get involved. You're there for business, just like everyone else, so worry about yourself because no one else will do it for you! Good luck!!

Specializes in Dialysis.

It took me a solid year to where I didn't feel like an impostor. Just remember, we all started in the same place. Ask questions, help when you can, take a deep breath and focus on the next task.

My first job was working in dialysis in a busy outpatient unit. I didn't have much experience with IV starts in school and suddenly part of my job was sticking not one, but two, 15 gauge needles into people multiple times a day! My first patient I cannulated asked me if I'd ever "done this before." My preceptor looked at him and said, "Of course she has! She's a nurse!" Luckily, as his access was pretty easy I had no problems. I don't advocate lying to people, but sometimes you have to gloss over the details.

You got this!

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