Struggling New Grad

[DH1234]

I am new grad nurse, and I just got done with my 4th week of orientation on the floor. But I feel like I am developing more slowly than the other new grad nurses on the floor. I only have taken 2 patients on my own...only 2. And I am freaking out. I feel like I should be progressing more quickly. One of the new grads on the floor already is taking a full patient load of 4. I think the reason that I am so behind is because I basically have a different preceptor each week compared to the other new grads. Everyone time I had a new preceptor they kind of wanted me to shadow them the first day to see how they did things than the second day I had them in the week they would give me 1-2 patients on my own. I guess it is partly my fault because in the beginning of the week I should have verbally express that I have taken 2 patients on my own before, so let me try 3 patients today. I feel like the 1st day of every week I am starting back at square one. And do not worry I am going to voice my concern to my nurse manager at our next one to one meeting.

Also, I am so bad at communicating with the patients in the sense I am not comfortable with educating them on some things. I am not familiar with all the post-op education for the different surgeries we commonly see on the floor. I am still learning meds and the different procedures. Also, my hand off report is awful. I feel like I should have been a lot further along since I had my immersion clinicals on this floor when I was a student. Do you have any advice for me? I want to become a good nurse but I feel like the rate I am going at I am going to be awful nurse or I am not going to make at a nurse.

[JBMmom, MSN, NP]

Take it back to basics and give yourself time. Have your preceptors or management said you should be further along? Maybe they understand part of the slowdown is because of your change in preceptors, as you mentioned. As for handoff report that's probably the easiest fixed. Find yourself a report sheet that you like. Make your report a story, the same way, every time. For example, if I were giving you report it would be something like:

Name, age, admission date, diagnosis. Quick synopsis of symptoms that brought them to the hospital and where they came from. Pertinent lab results or procedures done. IV access and current infusions. Oxygen level. Activity level. Do they have a Foley, other drains, etc. Then goals for the day/shift and discharge plans. I'm sure I missed some things, but once you get a narrative that hits all the highlights you will listen for the main points and pass them on as well. Ask coworkers for report sheets that work for them.

Everything else will come with time. Four weeks in you can't know all the education points on all the procedures, those will come. And you still have a preceptor to fill in the blanks as needed. Focus on learning your meds, and procedures you will be responsible for. Take it one day at a time, and break that into chunks, do look at it as blanket "doing well", "not doing well", what are specific things you feel comfortable with? Surely there is something you're getting the hang of. Cut yourself some slack, and ask your preceptors for specific feedback on what's going well and where they think you need the most work. That's what they are there for. Good luck!