Being a nurse was a lifelong goal/dream for me. I excelled in nursing school and could barely contain myself while waiting for my new career to begin. However, now that I've started working, I feel like all my longtime dream of being a nurse, as well as all the intense studying I did while in school, was for naught. I'm so overwhelmed and stressed out! My 2 preceptors are awesome, but I just can't grasp time management, staying organized, multi-tasking, and staying on top of charting while trying to care for patients of varying acuities, handling discharges/admits, passing meds, performing procedures, calling doctors, checking charts (which I always forget to do!), etc... let alone attending to the emotional needs of my pts. I feel disillusioned with nursing.... I feel like all I do is push pills and fiddle with the computer and phone.
I work PM shift on a 28 bed Medical-Oncology unit. I graduated nursing school in May and begin working in August. My manager has noticed how stressed I am. Oftentimes, we are so busy that I don't get to eat until 9pm or later (and I'm severely hypoglycemic to boot!). I'm currently at 4 patients, but I can barely handle three.
I hate not knowing what happens to my pts if they aren't on the unit when I get back from a day off. And the pts that pass.... well, I still haven't gotten over those cases. I'm not one who can easily detach herself from her pts whatsoever!
I know I need to give this more time, but maybe this unit isn't the right fit for me... maybe acute care isn't where I should be. Perhaps ICU would be a better fit, where I can focus on only 1-2 pts (granted, they are more complex, but I wont have to worry about juggling a handful of other pts as well). I like the thought of long-term care (I LOVE establishing relationships with pts), but I don't want to work in a nursing home. I've always wanted to work in peds too, but those jobs are hard to come by.
Any thoughts as to what type of nursing might be better for someone like me? I'm so lost..... :-( I love nursing and feel so horrible that everything is going so wrong.
I would say this -- give it time and see what happens once you're off orientation and have your patients to yourself.
Once this happened to me, it almost cut my stress level in half as I finally realize I am the master of my day, not a preceptor. And now you can just go to the Charge nurse with questions when you have them, or feel free to look them up on your own time.
With less stress, your mind works better, and you start making the connections mentally with a lot of things. You'll also still make tiny mistakes, but can work to fix them yourself and no one is worse off for it.
I am amazed that I go home almost ready to go to sleep because I'm just not nervous anymore. As long as I get everything done, check off those orders, leave the patients in a good state, get the paperwork done and clock out on time, mangers are happy and I'm happy.
Not to say it still doesn't all drive me nuts -- the co-workers, the families, and crazy docs, etc. But I enjoy the independence and feel proud to get out alive most days. But I really bust my butt at work - rarely get a break for more than 20 mins.
I also look back and wonder why preceptors were so tough and made such HUGE issues about such little things, and didn't stress other things enough. Some of them weren't the greatest teachers, to be honest.
I understand...when I first started working as a CNA....boy, how am I going to manage 14 patients? It took time to develop my system of how to organize my care....just like it will for you.
I believe that being in the hospital helped me learn quickly how to be organized. When it comes to the whole time managment issue, it's something you have to pick up with practice. My first day it took me about 8 hours to get all my charting done...then I still had to verify orders and do chart checks, and make sure I didn't miss any meds.
I'm not sure, but it seems to me that maybe you just need to tell your preceptors that "hey, I need some tips on how to organize my rounds and my care...i feel like I'm drowning!" When it comes to eating, I feel your pain..I usually don't eat until after 11PM (6 hrs on duty). However, I usually try to eat something before I leave the house...PB sandwich, a small portion of what I'm eating for dinner, or even a couple pieces of fruit and a granola bar. Have you tried that? Or even ducking in the breakroom and having a glass of water and a granola bar for 5 mins during the first 2 hrs?
If you work on nights, maybe just someone telling you how they organize their shift would help. we work with different kinds of patients, but I'll give it a shot.
First, I get report. Then I sign on to the computer and look to see if I have any medications coming due, or if any patient's labs are off. Then I look at the charts to see if I have any orders still needing to be verified or entered. (we use a color wheel on each chart to tell at a glance....red=orders to enter, yellow=orders to sign off).
If I have any fresh surgeries, I go in and check their pulse ox and assess how they are doing overall...I go back around to do my head to toe later. Then I check in on all other stable patients, see if they need anything, and go back up to my "computer on wheels".
I'll pull all my 6pm meds, and go give them. Before I give them, I do the head-to-toe on the patient. After that, I'll go assess any patients who didn't have 6pm meds. I'll then go back to the station, and see if I need to call docs or round with any docs who are there. If not, I sit and chart on 1-2 patients(takes about 15-30 mins a piece). Then I take a break....go sit and eat something or drink a couple glasses of water...go pee(cause you don't always get to!) If I have an admit, I'll take my break first...go back around on my patients, and then go admit the patient.
If not, I go back around on patients. Give pain meds or 8pms and go back to the station and chart on whoever's left....usually by this time it's 10pm....I go back and check on my patients before bed...take pain meds, answer questions, explain that either myself or the aide will be checking in on them hourly, do NOT hesitate to push the call button if they need ANYTHING at all, and to have a good night.
Then, it's usually about 11pm. I grab all my charts, and do my chart checks....then I'll go have dinner about midnight. Then round, then stock supplies at the station(syringes, flushes, alcohol pads, etc)....Being on orientation, I'll then look through my packet of info and go "hey, x....how would I do postmortem care when a patient dies?" or so forth(things there's no ensuring I take care of in 10 weeks)......
Then, I'll take 20-30 minutes and rewrite report for days....we use a SBAR sheet for report, and it is VERY good....everyone is different, but I just go top to bottom to keep myself organized. If I get to a section that I'm going...hmmm, I don't remember when I gave them vicodin? I go back to the charting and look at the system...then write it down. I know I'm much more likely at the start of the shift to be able to remember things and put them in there....but then I'm tired, and I forget what I wrote 8 hrs ago. so I look to be as accurate as possible.
Then it's about 3AM....I just update my report sheet with new issues and pain meds when they happen, and give report from 5-5:30 am....and I've punched out late once in 7 weeks.
It takes time....take whatever you need, and don't give up on yourself....know that you provide needed support to your patients at the end. Good luck.
Being a nurse was a lifelong goal/dream for me. I excelled in nursing school and could barely contain myself while waiting for my new career to begin. However, now that I've started working, I feel like all my longtime dream of being a nurse, as well as all the intense studying I did while in school, was for naught. I'm so overwhelmed and stressed out! My 2 preceptors are awesome, but I just can't grasp time management, staying organized, multi-tasking, and staying on top of charting while trying to care for patients of varying acuities, handling discharges/admits, passing meds, performing procedures, calling doctors, checking charts (which I always forget to do!), etc... let alone attending to the emotional needs of my pts. I feel disillusioned with nursing.... I feel like all I do is push pills and fiddle with the computer and phone.
I work PM shift on a 28 bed Medical-Oncology unit. I graduated nursing school in May and begin working in August. My manager has noticed how stressed I am. Oftentimes, we are so busy that I don't get to eat until 9pm or later (and I'm severely hypoglycemic to boot!). I'm currently at 4 patients, but I can barely handle three.
I hate not knowing what happens to my pts if they aren't on the unit when I get back from a day off. And the pts that pass.... well, I still haven't gotten over those cases. I'm not one who can easily detach herself from her pts whatsoever!
I know I need to give this more time, but maybe this unit isn't the right fit for me... maybe acute care isn't where I should be. Perhaps ICU would be a better fit, where I can focus on only 1-2 pts (granted, they are more complex, but I wont have to worry about juggling a handful of other pts as well). I like the thought of long-term care (I LOVE establishing relationships with pts), but I don't want to work in a nursing home. I've always wanted to work in peds too, but those jobs are hard to come by.
Any thoughts as to what type of nursing might be better for someone like me? I'm so lost..... :-( I love nursing and feel so horrible that everything is going so wrong.
SoundofMusic
1,016 Posts
I would say this -- give it time and see what happens once you're off orientation and have your patients to yourself.
Once this happened to me, it almost cut my stress level in half as I finally realize I am the master of my day, not a preceptor. And now you can just go to the Charge nurse with questions when you have them, or feel free to look them up on your own time.
With less stress, your mind works better, and you start making the connections mentally with a lot of things. You'll also still make tiny mistakes, but can work to fix them yourself and no one is worse off for it.
I am amazed that I go home almost ready to go to sleep because I'm just not nervous anymore. As long as I get everything done, check off those orders, leave the patients in a good state, get the paperwork done and clock out on time, mangers are happy and I'm happy.
Not to say it still doesn't all drive me nuts -- the co-workers, the families, and crazy docs, etc. But I enjoy the independence and feel proud to get out alive most days. But I really bust my butt at work - rarely get a break for more than 20 mins.
I also look back and wonder why preceptors were so tough and made such HUGE issues about such little things, and didn't stress other things enough. Some of them weren't the greatest teachers, to be honest.