Struggling With New Job

Davey Do · Oct 24, 2021

Our feelings of anxiety decrease when we feel more confident in our abilities, and that takes world and time, lizdimi.

Your words of "My patients are safe and I know what's important" instilled a feeling of confidence in me for you, as you seem to know your priorities.

My medical nurse wife Belinda and I were discussing anxiety on the job just the other day. Belinda said, and I'm paraphrasing here, "A little anxiety is good because it motivates us to act. Anxiety which is crippling is bad because we loose our ability to rationally act".

Although it may not seem like it at the time, lizdimi, this experience could be one of the greatest learning episodes of your career. You will be a better nurse because of successfully dealing with it.

I could give you all sorts of congruent examples in which I have experienced similar situations involving anxiety, but who wants to read an old retired nurse's war stories?

You, lizdimi, will prevail. The best to you.

JBMmom, MSN, NP · Oct 24, 2021

Stepping into a float position as your first acute care position brings additional challenges. You don't have the comfort of he same unit, staff and patient population on a daily basis. And, you're making the transition back from a competent nurse in your old position, to a learning nurse in your current one. Give yourself some time, you will get it.

Unfortunately, many staff also don't know you and being a float there will be an expectation of a level of expertise that you just might not have. That could be part of why the nurse took you to task for the occurrences during your shift. Just continue to do your best and things will come along. Take care and good luck!

Davey Do · Oct 24, 2021

I thought I'd follow up my previous post with a little meat & potatoes advice:

First, when experiencing anxiety in a situation, don't forget to deep breathe. We need to oxygenate those brain cells because we're gonna have to use them.

Next, we need to have a running monologue in our head on the task at hand. "First, I'm going to do this. And then, I'm going to do this. I'm going to put one foot forward, and then I'm going to put the other foot forward" sort of thing.

Do not allow any other voice in your head that says something like, "Remember to do that other thing you need to do when you're finished with this". Listening to that other voice will cause us to feel overwhelmed, thereby increasing the feeling of anxiety. FOCUS ON THE TASK AT HAND.

When we have successfully completed one task, we need to give ourselves a little pat on the back. Regular internal gratification will buoy us on more than fleetingly sporadic external gratification.

As you have already done, lizdimi, review your situations, applauding successes all the while, empathetically critiquing your shortcomings. Don't be too harsh with yourself, as long as your motives are selfless.

Good luck!

lizdimi54873 · Oct 24, 2021

I can’t tell you how much I appreciate all your posts and feedback!! It’s so heartening to hear that I’m not alone and that there’s is some credit to my feelings. I think part of my dilemma has been going from a job where I had coworkers that I worked with daily and who knew me and my work ethic to a job where I have to prove that daily in order to get some credit as a nurse on my own. I actually think t will be good for me in the long run!

your advice about taking tasks one at a time and being confident but having a healthy bit of anxiety is really good! I’m so grateful for this feedback!! I’m going to go into this shift tonight being a little kinder to myself and taking time to think instead of lettting my anxious thoughts take over

JKL33 · Oct 24, 2021

3 hours ago, lizdimi54873 said:

last night I was in peds for the first time

3 hours ago, lizdimi54873 said:

I’ve only been off a very short orientation for a few weeks

Were you adequately oriented to the areas in which you would be working? If there are areas where you have almost no familiarity I would ask them straight up for a little more time orienting in those areas. "I'd like to spend a couple of shifts with a peds nurse before I am assigned there again."

Also, remember to use your resources. It's sometimes hard to think of them in the moment.

3 hours ago, lizdimi54873 said:

The oncoming nurse held me a accountable for these things and I felt utterly incompetent.

Make your self-assessments based on what you could have done better and what you did well, not primarily on the next shift's commentary. Try to use your resources in real time, make the best decisions you can and accept that's the way you chose to handle a thing. If someone else doesn't like it, have the mentality "I'll take that under advisement" rather than feeling incompetent and apologetic.

I'm sure you're doing fine; things will come together.

FashionablyL8, CNA, LPN · Oct 26, 2021

Lizdimi, you sound like a caring, safe nurse- and one day you may be mentoring new nurses in the same situation as you are right now. You're aware that patient safety is most important, you're learning and able to look carefully at how you can improve. I hope I'm as competent as you a year into nursing! I just took on a job as a float nurse and although it's not acute care, I'm nervous about not having the same pts/floor all the time.

The oncoming nurse may just be one of those ppl who is very hard on others. JKL is so right, judge yourself by what you know you could improve on. Honest assessment by others is good but negativity is not.

I must say, Davey's advice of only thinking of the next thing you need to do is something that has absolutely saved me in many hectic job settings. It keeps the focus and prevents getting overwhelmed.

Best of luck- sounds like you're doing great ?.

2BS Nurse, BSN · Oct 29, 2021

If I encounter a situation where I feel I'm not up to speed, I will study a little at home (usually over a cup of coffee when I'm relaxed). I may pull up a Youtube video if I can find the relevant content, login to Lippincott, UpToDate, etc.

Do you remember reading about Patricia Benner's Novice to Expert theory in nursing school? We tend to have unrealistic expectations of ourselves when starting a new position. The fact that you actually care speaks volumes!

https://www.nursingald.com/articles/16408-patricia-benner-novice-to-expert-a-concept-whose-time-has-come-again

Been there,done that, ASN, RN · Oct 31, 2021

Float nursing is tough. I took my first float job with 25 years experience and found it difficult. There was no way , they were going to float me to peds. It is an entirely different skill set, that requires a LOT of additional training.

Emergent, RN · Oct 31, 2021

I remember people intimidating me as a new nurse. Years down the road I acquired a lot of broad experience in a variety of settings. I ended up interacting with some of those people, they were still working the same shift in the same unit, and actually weren't all that great.

Some people just like to kick the dog. They are threatened by the new, bright nurses who will eventually surpass them.

LibraNurse27, BSN, RN · Oct 31, 2021

It seems unreasonable to have you quickly orient to both adults and Peds and then be expected to work both independently. Peds is its own specialty with entirely different skills and med doses, diagnoses, dealing with parents, etc. I would NOT feel comfortable on a Peds unit even though I have years of acute care experience with adults. I would need a long orientation like that of a new grad. Is it possible you can ask for more orientation or not to float to Peds? That sound so stressful!

Dani_Mila, BSN, RN · Mar 15, 2022

Show is your transition so far? I'm in the same predicament. I work in acute rehab and got a job in the hospital and I feel so lost. People are nice but they do give you that "newbie" look. I am definitely overwhelmed to the point that I'm having second thoughts.