Struggling new nurse

[jeamzo]

I recently graduated and started a new job. It is a telemetry/med surg unit in a small town hospital. I have finished two weeks and I feel very overwhelmed and emotional. The second day I was given 3 patients and I have had pretty much 3 since then. There was no gradual transition. I was immediately given a phone and had families and doctors calling me. Me calling aides to delegate. Charting on everyone. Doing all of the head to toe and rounding assessments, passing meds, hanging fluids and abx, insulin, everything. I come home everyday crying because I hate my job so much. When I asked for less patients the nurses gave me two for one day and kept telling me how I will have 5 and need to get used to it and the next day I had three again. I have taken admits and discharged already. I get really behind and they ask what I would do if I had 5 patients right now. I went straight to get my RN so I was never an LPN and have zero experience other than nursing school. I dont feel like this is normal orientation, especially since I was offered 12 weeks of orientation. I feel like they are trying to rush me through. I have been seriously considering changing jobs already. I hate leaving my family and new baby for a job that I absolutely hate. I love being a nurse. I love educating and helping and learning new things. I dont know if it is because of the training, the facility, the fact that I have had my heart set on the NICU or mother baby ever since I went through that rotation, or the lack of support at this smaller hospital, but I HATE my job. Do I leave and find something else that I love? Do I tell the new job that I have been at this one for a few weeks and its just not the right fit?

[JKL33]

I have two separate thoughts:

1) I think I would buckle down in this situation. Any other experience is likely going to be similar.

2) SMH!! I really don't understand why it apparently is so freaking difficult to understand that a large number (IME) of new grads are going to do best by being allowed to conquer a very well-defined objective first. Learn to do everything for this one patient. Learn it well. Take up a 1/4 of the orientation with just this. Add in a patient q week for the next several weeks, then spend the last portion managing all of them. Freaking DUH. For goodness' sake.

[Kallie3006, ADN]

I agree with JKL33, the next place could be worse, not enough staff... you're a warm body and bam, your off orientation early due to not having enough nursing. (Not that this would happen but it could.

Being overwhelmed is normal, it can take a year or more to get in the grove and feel comfortable, and that does not have anything to do with whether you are a good nurse or not, so dont think that.

I think that you should at least be taking 2 patients, with calls from family and doctors. If you need to find the information out dont be afraid to ask the family for a name and call back number, find it and call them back as soon as you can. If the patient is AAOx4, ask the family if they would like to speak to the patient directly. With the doctors- know how they did the previous shift, did you get told in report something that was off ect. Know the labs, write down the ones outside on the limits. If you dont know an answer say so, they can get peeved all they want, you will find out ect, " I'll need to check on that, would you like me to call you back with the information in a min?" In time you will learn what's important and what's not, what each doc wants yada yada. When the docs round, see if you can be in the room ,not always an option but helps when you are able. Ask the doctors what they want to know so the next time they call you are ready, tell them you want to learn and be prepared for their call.

Do you have a brain that you have found that you like? Of not google some, print them out, figure out which one fits your work style. Try to cluster your tasks when possible, if you have meds at 8,9 and 10 go in and start them all at 855ish.

Do you have Wows or computers in the room? Gather supplies in the am, flushes, alcohol preps, tubing , empty syringes ect this helps from unnecessary trips. Work smart not hard. Try to chart assessments in the room when you do them and try to do them first thing, this helps with charting plus gives you your starting baseline in case there are changes.

Ask for help when you need it, talk with your manager about the additional patients and see if you can at least do 1 week at 2. You are learning how to be a nurse, how to use their charting system, what the doctors want ect. This doesnt happen overnight.

Days are rough!! Would you be able to go to nights? Nights is a beast in it's own way but not near as many calls, families, doctors or tests ect. Can you go in a little earlier and get the info for your patients from the comp before report time? This could help you have all the info and feel better prepared for when the calls ect come.

Remember you are new and this too shall pass. Keep your head up and do the best you can do

[inthecosmos, BSN, MSN, RN, APRN]

A nurse/patient ratio of five is GOOD in today's shortage. I take 6 on an intermediate unit at a large community hospital. I would recommend setting up a discussion with the unit manager and educator (if you have one). Tell them you feel like you're struggling and in order for you to succeed, you need some better guidance and an opportunity to learn to prevent burn out. Explain that you feel overwhelmed and need additional orientation time. Stand up for yourself, but do not rashly quit one job for a potentially disasterous one.

Once you have one year of experience, you can easily move on to your dream job!