Stressed new nurse

beautifullyblessed1 · Oct 2, 2008

I know the feeling. Im a new nurse (3 months now) on a telemetry floor, and its nothing like I thought it would be! Next week Im gonna be on my own and I was feeling scared, but now I'm learning that you just have to take one day at a time, and not beat up on yourself too much. Honestly, I think with just starting out on your own, the most important thing is SAFETY!!! Like someone said before, we are gonna make mistakes, but the important thing is to learn from them.(Well that and not to kill anybody). So now, I dont beat myself up, I just consider it another lesson learned.

KalipsoRed · Oct 2, 2008

I am a new nurse (graduated in May). I've been working since June. I work for a nice hospital with mostly supportive staff and I had a 14 week preceptorship. I thought I would feel better when I got rid of my preceptor because I couldn't get a pattern for my self while doing her pattern, but the first day I was by myself I thought I was going to die! Apparently my very sweet preceptor had been doing a lot for me and so while I had been feeling somewhat capable while in her care, once she was gone I was overwhelmed. I've been on my own for 2 weeks now and every day I question as to why decided this was the right career choice for me. I want to be a good nurse, but every time I go to work I feel like I'm letting my patients or my coworkers down. I rely on my coworkers for almost every thing I do (not like I make them do it, but I always have a ton of questions about what I'm doing). Sometimes I have so much stuff comming my way (phone calls, patients, transfers, orders, etc.) that I can't pick out where to start. It for sure is not anywhere as easy to pick out as nursing school. (You have 3 patients. One of them is complaining of chest pain, one is complaining of a stomach ache, one of them is breathing 32 respirations per minutes and has a sat. of 84% Who do you see first?....... That's a little easier than: You have the ER on hold wanting to give you report, A family member has just arrived to her father's room and is wanting to see you, and a doctor is waiting for you to come up to the nurses' station. Now what is the answer?)

I feel very unorganized, even though I've tried to create a system of my own by using some of my coworkers tips. I miss things....important things. Like forgetting to administer insulin to my entire team at lunch time, not seeing an order for a PRN blood pressure medicine and not being concerned that my patients blood pressure was 152/107 (because he had come in with pressures like 213/116, so I thought that blood pressures trending 150/100 was an improvement and didn't need to call the doctor about it.)

As far as I know none of my friends from nursing school have missed issues as big as these and it just makes me wonder if with all of the support I have and the low patient ratio (5 to 1) that maybe I chose the wrong field, because if this keeps up I'm going to kill someone.

DreamingTree · Oct 2, 2008

I think KalipsoRed hit the nail on the head. It's hard to prioritize when everything seems important. But, with experience (& mistakes), you do learn to sort through it all. I would: a) take report from ER nurse, b) let the family know that I'll be there in a minute, c) go talk to dr. Just my way of thinking...

Don't discount the value of mistakes. We are only human, & we are new to the job -- mistakes will happen. What I do is figure out how I can adjust my routine to prevent the same mistake from happening again. Here are a few adjustments I made that have helped:

1. On my brain sheet, I have a column on the left side where I list all med times & FSBS. As I pass meds, I cross of the times.

2. I also have a spot to cross of when I've completed my am & pm charting, care plans, and chart checks.

3. As I check the kardexes in the morning, I list labs & tests that will be done (another spot on my brain sheet). This helps me to prepare for when the pt will leave the unit, and to cue me to watch for results.

4. Before I walk in the room, I jot down VS. While in the room, I make note of output (esp. w/foleys). Each has a spot on my brain sheet.

These were just a few examples, but the common theme is the brain sheet. I would be lost without mine, and there's no way I could use the one page sheet that many others use. My sheet has space for only 2 pts -- because I like to have room to write, & stay organized. I only jot down the abnormals & anything that I want to keep track of -- less writing means more time.

Also, on my days off I think about the pts I had & look things up. This helps me to learn for the next time someone has such & such dx. I don't beat myself up for what I should have done -- I just think about what I can do better next time. Again, we're only human & we're still learning.

Finally, I don't fret about asking questions. If I don't know how to do something, I ask. If I'm concerned about my pt's status, I talk it over w/someone. The key is to decide how you think it should be handled & then bounce it off of a more experienced nurse. This gives you a chance to practice critical thinking.

Remember, it's a tough job, so give yourself time to adjust. Don't worry about what others think of you, and don't beat yourself up over mistakes. Every experience is an opportunity to learn.

Good luck!

SoundofMusic · Oct 2, 2008

Whew, I could have written the OP's post myself. As a turn the corner here on my first year in nursing, I find myself more burnt out now than I was even in my orientation time. I also have a family and bills, my oldest to get through college, and I just can't quit. It's a horrible way to feel when you feel trapped.

And at least you do feel accepted -- at this point, I feel marginally accepted on my unit -- not exactly part of the "in" crowd. I'm a 2nd degree student also and it's tough to fit in with the younger nurses, and also tough to fit in with the older more experienced ones. Lately I find myself just keeping to myself more and more, and not even trying to get into the talk or conversations.

Night shift is also starting to kick me. I take Lunesta to sleep, but walk around in a fog on my days off. I have to FORCE myself to get exercise, and to stay up during the day -- it is no way to live.

I find myself dreaming now of switching units, or even trying a new hospital, just for a change of scenery. It just gets unbearable returning to my position on his unit now. Last night I left a lot of work undone, which isn't normal for me -- I was just so burnt out, so sick of the slavery I'd been succumbed to that day, so tired of the managers poking at me all day, so wanting to just get home on time for a change, that I just left it. I hated that I did that -- but it's just IMPOSSIBLE to get it all done unless you just move your **** every second of the day. Meanwhile, it just seems certain people on our unit get the easier assignments and sit around a lot more -- and THAT is TOALLY demoralizing, especially when they offer no help to you when you are drowning.

Frankly, I'm just sick of this type of work -- just constant tasks, for 12-14 hrs straight -- NOWHERE do people work this hard without food, drinks, and some breaks. NOWWHERE -- it is just absolutely frying to your brain and your soul.

Sorry to be so negative. In so many ways, I AM getting it. I AM functioning well as a nurse. I leave on time MOSt of the time, am learning tons, and am learning how to talk to docs. Lots of good going on, but also burnout is just creeping in.

Cfitz · Oct 2, 2008

Whew, I could have written the OP's post myself. As a turn the corner here on my first year in nursing, I find myself more burnt out now than I was even in my orientation time. I also have a family and bills, my oldest to get through college, and I just can't quit. It's a horrible way to feel when you feel trapped.
And at least you do feel accepted -- at this point, I feel marginally accepted on my unit -- not exactly part of the "in" crowd. I'm a 2nd degree student also and it's tough to fit in with the younger nurses, and also tough to fit in with the older more experienced ones. Lately I find myself just keeping to myself more and more, and not even trying to get into the talk or conversations.
Night shift is also starting to kick me. I take Lunesta to sleep, but walk around in a fog on my days off. I have to FORCE myself to get exercise, and to stay up during the day -- it is no way to live.
I find myself dreaming now of switching units, or even trying a new hospital, just for a change of scenery. It just gets unbearable returning to my position on his unit now. Last night I left a lot of work undone, which isn't normal for me -- I was just so burnt out, so sick of the slavery I'd been succumbed to that day, so tired of the managers poking at me all day, so wanting to just get home on time for a change, that I just left it. I hated that I did that -- but it's just IMPOSSIBLE to get it all done unless you just move your **** every second of the day. Meanwhile, it just seems certain people on our unit get the easier assignments and sit around a lot more -- and THAT is TOALLY demoralizing, especially when they offer no help to you when you are drowning.
Frankly, I'm just sick of this type of work -- just constant tasks, for 12-14 hrs straight -- NOWHERE do people work this hard without food, drinks, and some breaks. NOWWHERE -- it is just absolutely frying to your brain and your soul.
Sorry to be so negative. In so many ways, I AM getting it. I AM functioning well as a nurse. I leave on time MOSt of the time, am learning tons, and am learning how to talk to docs. Lots of good going on, but also burnout is just creeping in.

Wow, I just want to hug you after reading that. It would have been me in 10 months had I stayed on nights on our birthing center.

I am so sorry; you sound so stressed out and spent. Maybe, since you've put in a year there (congratulations by the way - that is a HUGE accomplishment) it is time to try something new?

SoundofMusic · Oct 2, 2008

It very much is time for me to try something new. I wished I'd just gone into meds or L&D to begin with, but I was afraid I'd lose my general nursing skills.

I don't know -- I've just got to improve my attitude, I guess -- learn to survive. It's hard. I have an 18 month committment to my hospital, so I can't get out without paying a penalty.

I may be able to switch units, though, within the system, but I'm not so sure it's any better anywhere else in my hospital.

I feel like a boxer who has been beat up and is sitting the in the corner getting my wounds wrapped, waiting to be coached and propped up and and kicked out again into the ring. One can only find their 2nd wind so many times before you just get the whole thing knocked out of you.

I learn something everyday, though -- small lessons. I've had some close calls and have made many vows to myself how I will improve my practice -- those are the good things. I may need to learn better ways to recharge on my off days also -- it's hard with kids and a house, though.

I guess now many of us are heading into our 2nd year in nursing, which i hear can almost be as hard as the first -- :cool:

cpnegrad07 · Oct 2, 2008

"heading into our 2nd year in nursing, which i hear can almost be as hard as the first"

---Gawd, i hope it ain't true:no:!!

blaaveispiken · Oct 2, 2008

These were just a few examples, but the common theme is the brain sheet. I would be lost without mine, and there's no way I could use the one page sheet that many others use. My sheet has space for only 2 pts -- because I like to have room to write, & stay organized. I only jot down the abnormals & anything that I want to keep track of -- less writing means more time.

Wow-- you have some great tips on organization. Would you mind sharing your "brains" and attach it to a post in this thread? Thanks for the tips!

DreamingTree · Oct 2, 2008

Wow-- you have some great tips on organization. Would you mind sharing your "brains" and attach it to a post in this thread? Thanks for the tips!

Glad you liked them, but don't be fooled. My husband says that I'm not as organized as I seem on the surface. :wink2: Here's a link to my brain:

http://drop.io/ShiftOrgSheet

There are two versions listed, but the newer one came out wrong with the upload to that site (instead of two per sheet, it only has one). The newer one has a box for labs/tests & a few other changes. If you like it, the site lets you download the file, and you can fix it.

Good luck.

SuperSN2008 · Oct 3, 2008

hi there, i'm also a new RN and i work in the ED and everything has been HELL! the worst part is that i have a horrible preceptor who 'eats her young'. ive come home many days crying from work asking myself why the hell i went into nursing. all i can do is be patient, take things one day at a time, and stand up for myself.

hope things get better w/ u. you're not alone.

ANH_RN · Oct 4, 2008

This is really funny to think about and read. I kind of had a little bit of a breakdown this afternoon after I realized I missed a doctor's apt. because I had no idea what day it was. I feel like I'm losing my mind.

I just had my first night out of orientation the other day and I nearly started crying by the time I left. I realized a couple things I forgot to do and I've pretty much stressed out over work my whole 3 days off. I pray and hope all the time that I don't make a big mistake. I try so hard and try to focus and get everything done but sometimes I just can't believe the kind of work and tasks they expect us to accomplish in a 12 hours time. I know you can always stay over and finish up but seriously. It blows my mind, really. I talked to my husband about what I could go back to school for and how I could make good money in something else. I feel that bad. I am almost on the verge of crying just thinking about it. The only thing that is holding me together is the fact that everyone tells me 'it will get better.'

I'm really scared. Did I make the right choice? Is this really for me? These are the questions that constantly trickle through my head and wear me down. Just know that you are not the only one that feels overwhelmed and it's nice to know that I'M not the only one that feels overwhelmed.

ShiphrahPuah · Oct 4, 2008

I am in the same boat, questioning is this really for me? Did I blow several years of my life in nursing school for THIS where I feel like a slave and work 14 hours (supposed to be 12) without ever having the time to go to the bathroom or eat? (Yesterday, none of the nurses on my unit took a lunch or went to the bathroom, and one was joking she is probably going to get toxic shock syndrome because she never had time to get to the bathroom to change her tampon!) Will the stress and the lifestyle kill me or take decades off my life? This is a second career for me as well, and I never felt so incompetent in my previous jobs. I took time off when I had kids to stay home with them, and my skills for my first career (computer programmer/analyst) became obsolete, and instead of updating them, I went to nursing school. Now I am wondering what the heck I did to myself, and I daydream about what OTHER degree I could pursue to make a decent paycheck without compromising my health and without completely checking out on my family.

I thought in school that prereqs took a lot of time, but I love school and didn't mind. Once I was in nursing school, I could not believe the stress and looked back at how easy prereqs were. I pretty much hated NS, but I was driven work toward my goal. Now that I am a nurse, I look back at NS and think at least I got regular pats on the back in the form of grades. I am so stressed out in orientation because it seems like there is SO much to learn. I only have a couple weeks left, and I can't imagine how stressed I will be when I am on my own. If I had known that it all would have just gotten progressively more stressful and that I would feel like this was slave labor, I doubt I would have pursued this route. I LOVE interacting with patients, but the loads are so high that it seems the only people who are on top of everything are the nurses who I think are not so patient-friendly. I had a very different idea of what nursing would be, and I hate getting pulled in twenty different directions and not really being able to give the patient care you learn about in the ideal world of nursing school. I feel nauseous on the days I wake up for work, and on the days I am home I cannot get anything done because I feel catatonic.

My only hope is that I have heard over and over that it does get better. I hope that is true.