Struggling as a new nurse :'-(

tsm007 · May 21, 2015

Struggling too, but just putting one foot in front of the other. I tell myself each day I check off is one more day experience I have under my belt. I don't have any wonderful advice yet because I'm too new, but I just wanted you to know you are not alone. It's really hard moving into the real world of nursing.

BSNRN2014 · May 21, 2015

You're not alone. I just finished crying after an overwhelming day where my preceptor made me feel incompetent. When they nurses eat their young its definitely true. This experience has dampened the joy i had when I first started this profession. I'm not sure what I can do or how to proceed.

Ruby Vee, BSN · May 28, 2015

Hello,
So I am a newly qualified nurse, qualified in January and have started work on a renal ward. I have found it extremely difficult to pick up things and learn all about these types of patients. I study at home every day on my day off but I'm still struggling to remember anything. I feel so anxious at work, my doctor started me on a Betablocker for anxiety which is helping relieve the panic but I still feel so inadequate.
When in an emergency situation I just panic and I don't know what to do. I had a patient with shortness of breath who was really struggling to get his breath and I couldn't think what oxygen mask to put on or at what flow, I just panicked. I asked for help but was disappointed in myself that I didn't know how to manage the situation myself.
I panic about speaking to doctors and families for fear of looking or coming across as an idiot. I will often avoid certain doctors I feel scared of but I know this probably isn't the best thing to avoid people.
To add to the diffilculty im facing personally, my manager has rejected my holiday forms and not spoken to me about what days I could have instead. I have left notices on her desk to ask her what I can do but the letters keep getting moved aside. When I speak to her she is very avoidant and doesn't stick around to discuss issues. Since I have started, she hasn't asked how I am doing on the ward, never mind as a new nurse. If she asked she may have known I am struggling and am in the process of finding myself a new job. I don't feel comfortable speaking with her about my worries, I had a problem with a member of staff during the first month and she made excuses for the staff members rudeness. I know other members of staff are having problems with the ward too. I just wish I could do something.
I often feel like I cant do this. That I've come into a stressful and exhausting career where theres no appreciation for hard work and effort. I love looking after patients but I feel so inadequate. University in the UK did not prepare me for this. US students do the NCLEX, something I think UK students should do. I had one lesson on each system of anatomy in health and one each on illness in that system. I feel like I don't know enough of the basics because it hasn't been taught. Universities in the UK just teach you how to pass university, not how to be competent as a nurse. My whole first year was about care and compassion in nursing and how to be those things, but I've not met one student nurse who didn't come in to University with those qualities. Its not something that needs teaching, If you are not caring and compassionate already - your on the wrong course! I would have spent another 2 years in my nursing course if it meant I would feel competent and knowledgable that I could care for my patients to the best of my ability. Instead I'm in the deep end and have to learn on the job. Its just too much.
Sorry for my rant. I would so greatly appreciate any advice or hear how anybody else is doing.
Lou
xxx

The first year of nursing is very difficult. We've all been there; we've all gone through it. The only way to GET through it is to GO through it. No one graduates from nursing school -- or University or whatever -- knowing how to be a competent nurse. With the death of diploma nursing (in the US, anyway) that just doesn't happen any more. You learn to be a competent nurse after you start your first nursing job. Sucks, but there it is.

Ever read "House of God" by Samuel Shem? It's an old book, but well worth a read because it's "rolling on the floor laughing" funny. One of his "Rules" is "The first pulse to take in a code is your own." Which means, I think, that when your patient starts heading south and you don't know what to do, take a moment for a few deep breaths and to think of ONE THING you can do to help that patient right then. In my experience, you start doing that one thing, and the next thing will come to you . . . and the next. All of this comes more easily with experience, of course, but in order to get the experience, you have to go through that first year of nursing . . . .

"House of God" also states that "The patient is the one with the problem." That means that the patients, their families and the doctors don't really care about your anxiety issues. You HAVE to talk to them. It's part of your job. So just talk to them. They're all people just like you . . . they put their pants on one leg at a time, they have to poop and they even are anxious at times. Just like you. Confidence comes with experience . . . and with acting confident even when you're not. (Fake it til you make it.)

Changing jobs in your first year of nursing is a really bad idea. So is personalizing your manager's reaction to your request for holidays. If you really want to know, TALK to her about it, don't just leave stuff on her desk. As far as asking how you're doing on the ward . . . you're an adult now. If you're having difficulties, tell her. Managers usually don't feel the need to handhold adults.

Good luck with the rest of your first year. You're almost half done!

Ruby Vee, BSN · May 28, 2015

You're not alone. I just finished crying after an overwhelming day where my preceptor made me feel incompetent. When they nurses eat their young its definitely true. This experience has dampened the joy i had when I first started this profession. I'm not sure what I can do or how to proceed.

Nobody can make you feel incompetent without your permission. But if you're still on orientation, you probably ARE incompetent. The purpose of orientation is to get you competent.

Nurses do not eat their young, although you may have had an overwhelming day with your colleagues. If you go into the situation looking to be "eaten", you will be -- whether or not those particular nurses actually eat their young. Get over the victim mentality and vow to learn what you can from each and every nurse you encounter. A positive attitude makes work more fun and actually makes the learning process go better.

windsurfer8, BSN, RN · May 29, 2015

Interesting post with a lot of blame. 1. No University on earth can 100% prepare you for the real world. 2. No boss has to ask you how you are doing. Might be nice, but don't expect it. 3. you want a "career with appreciation"? You get it when you get a paycheck. If you want people to tell you how great you are better try for rockstar. 4. If you panic every single time you are in a stressful situation why would you expect "appreciation". Read your post youself. It is all about other people and what they have not done for you. You are in the WRONG CAREER if you are constantly thinking about what others are supposed to be doing for. Attempt to quit feeling sorry for youself and go succeed. There are people suceeding all around you. Get in there..work hard..ask questions...be positive. Appreciate what you have and don't blame others. You will be amazed how much better life can be.

Aonedayatatime · May 29, 2015

I am also a new nurse. It is difficult to know the right move at every step. I also went through a period of extreme anxiety. I found this only made my performance worse. I decided to rest in my days off and give myself a restart. I made a promise to do the best that I can. When I didn't know an answer I would find out and we will learn together. It was important for me to also speak up for myself. I would give report just say the patient iv gauge and fluids type and rate only to get cut off by my preceptor to repeat what I just said. This damaged my confidence. I benchmarked my speaking with SBAR. Such as the current situation for the patient x in room 1234 is blank.... It helped to make people listen and hear what was being said. Hang in there. Us new nurses will learn together how to be amazing nurses together!

stcabr · Jun 1, 2015

I have been a nurse for almost two years now! Believe me we all been there. I remember my first few months driving home from work crying...thinking that i can't do it. Well....you can and you will! Try not to take criticism personally, but let it be a learning experience. In my opinion it takes at least a year to build up your confidence. I felt the same way about talking to doctor's and patient's family...but again confidence comes in time and if a family member asks you something that you are unsure of.....just tell them that you have to get back to them and look it up. You have to be an advoate for your patient...so it is important that you feel knowledgeable and comfortble talking with MD's. But again...this comes with time.

I was fortunate enough to work with a fanastic manager, who was always making sure I was on the right path of being successful. I work on a great unit, where 95% of us look out for each other and help each other out when the other is busy! Your work environment is very important!

Nursing school does not teach you everything. To this day, I still struggle with IV insertion, still have to look up things, I am not familiar with...but I am a better, more confident nurse today than I was when I started! Being a nurse you will learn new things all the time...no matter how many years you have under your belt! In my experience, it is a rewarding career with such diverse opportunities! Stick with it! Give yourself time! In a year from now you will look back and see how far you had come! Good luck!

sistaAfua · Jun 1, 2015

aonedayatatime, I love your advice cos you've advised me as well and it will take me a long way as a new nurse struggling to get my first job. I hv a casual job now, there was this evening all i heard was nurse someone its bleeding from the nose. I was the only nurse on the floor cos its a longterm care. I took a deep breath, took the woman out of the environment meanwhile am thinking of what to do next while wheeling her in the chair. I thought of ABC, so how do i stop the bleeding first? Action i applied an ice pack to constrict vessels, within 2 mins the bleeding had stopped, now what else i asked myself. Took the vitals, asked her if she had it before and what led to the bleed she couldnt answer all i needed, but at the end of the day i was proud i could even make the decision alone, the next thing i called the other floor and was told to leave a note in doc's binder, and then documented it in progress note which i knew. so like you saying it comes with time and exp, and somettimes you fake till you get the confidence but other times you will need to asked from experienced colleagues. Good advice!

ArrowRN, BSN, RN · Jun 4, 2015

I'm 5 months in my first job, still getting the hang of it. Surprised you actually have the time to study...I'll leave work at work, studying from a book and not reading your hospital policies could only get you confused. A renal floor is difficult to work on, that being said focus on one thing at a time. First passing meds on time, charting correctly/timely and getting tasks done on time. I know it makes for limited scope of work but honestly thats about all a new nurse can handle...very task oriented. Ignore your critics at work, they all been there even though many tend to forget. There is a long progression from novice nurse to expert, which they should have taught you in nursing school. Even at 5 months I still don't have it "down". Oh and never stop asking for help. You recognized something was wrong with your patient and the first thing to do is ask for help rather than going it alone. Sometimes I even ask other nurses to "hey listen to these lungs, think they wheezing, I not sure"...nothing is wrong with asking for help, what will be horrible is not asking and having the situation turn from bad to worse.

Please let your days off be "DAYS OFF" or else you will burn yourself out. I'm not saying don't read anything if it interests you but don't spend like 4 hours studying like how you did in nursing school, maybe like 15 minutes and thats it...the rest of the time go to the beach, walk your dog, exercise, watch tv all day or something other than nursing.

ixchel · Jun 4, 2015

OP, the first year sucks. It really, really does. I just finished mine. I still have quite a bit to learn, but a lot of the anxiety has faded. (((Hugs)))