Support Stickie for New nurses who are not coping

Mahage, LPN · Jul 27, 2009

wow. i thought i was the only one.
help. i'm not doing well and I don't know what to do. First time poster.
I graduated cum laude and sigma theta tau, 2 months ago. I was hired onto an elite unit in critical care and was so happy and excited. Within my first 30 days, I was disciplined for problems with multitasking and making mistakes on my charting. However, I get consistent praise from patient families and high marks on communication skills with families and doctors. When a new preceptor scared the pants off me, I just couldn't do anything right. It's as if the fear of demonstrating my skills in front of her wiped my memory out completely. It was a day from hell. I made a critical mistake and hung a drug incorrectly. Right rate, wrong line. No harm came to the pt but the preceptor wrote a 2 page documentation regarding her concerns of my ineptitude. I'm shattered. I seem to do well with learning when I kept the same preceptor and had time to think before acting. WHen I was told that I am not going to make it if i can't be safer, faster and with better documentation, my heart just started sinking. I'm a second degree BSN with prior experience in technology, sales and health education and I"ve never felt like such a failure. I can't sleep. I can't eat. I feel depressed. i'm on the verge of tears about feeling so stupid. The CNS has written a plan that I am to follow to improve or ... there's not be a mention of what "or" is but i assume it's being fired. It's entirely possible that this unit was too complicated for me as a graduate without any prior hospital experience but i feel so trapped. I don't know what to do. Do I continue to try and do my best? Do I agree with my preceptors assessment and leave before orientation is over to try and get another unit job that is less acuity/ more repetitive? Will I be left without an opportunity to transfer?
My CNS says my alternatives are to stay and try harder, leave the unit and apply for other jobs in the org ( would i get even a recommendation?) or to quit altogether.
I'm getting so depressed. I am trying so hard. I feel like such a failure.
I have problems with organization when faced with a new type of patient or experience.
Can anyone help me? I have noone to talk to.
I am seriously considering leaving nursing The very thing that drew me to it was seeing nurses transform my family when my mom was ill. I vowed to be a compassionate advocate for patients and their families. Being with them has always been the best part of any day. But not if i can't be safe. Not if i could harm someone. I couldn't live with myself.
help?

You sound an awful lot like I felt on my first job in Medical Intensive Care Unit at our large teaching hospital. I had a horrible time, making mistakes due to anxiety. I had one preceptor who delighted in my problems and when she saw that I was catching on to the process while working with one patient, she threw me another one, long before I was close to ready. (I had 1 night with one patient on my own and then she threw the other one at me. It was cruel and dangerous.) Then I heard her tell another nurse that I wasn't even safe. Well I asked to be assigned another preceptor who was wonderful, but by that time, I had already accumulated enough failures that I felt I needed to work in a less stressful environment. I asked for and was transferred to the Intermediate Care Unit, where I hung on with everything I had, and still had days where I felt like an absolute failure, but have survived so far. Somedays I love it, other days I hate it, but it is what I want to do today and I actually do look forward to going in to work. I don't know if IMCU is actually any less stressful than MICU, but I was so determined by then, and I realized that it was not me, but it was a combination of an attitude that some preceptors have and the fact that I had to build and develope basic skills before I could be adequate on any unit. My first preceptor was not willing to allow me opportunity to develope basic skills before giving me a full load. IMCU is not an easy place to work, but I was determined. I have considered transfering back to MICU, just because I don't want to be bested by anybody or anything, but for now I will just stay where I am. (The unit manager had told me she would love to have me back if I decided I wanted to return.)

There is no shame in transfering. There is a world of difference in being a top notch student and in performing as a nurse. We come in with our heads full of knowledge but when we start applying that knowledge and we can't even open the darn duplex iv bag, keep the patient in the bed, keep him from pulling his tubes out, get some help from someone to change a patient, get our meds up from lab and decide whether to call the doc on the patient with the dropping blood pressure or restrain the one pulling off his vent tube first then it is awfully hard to apply the knowledge that we bring with us. I do believe that it is easier to learn basic skills in a less intense environment and then build on them in a unit, even though I only took one step down instead of going to the floor.

Stop kicking yourself and decide which action you are going to take. Is it working for you there? Is it going to work? Ask yourself and listen to your gut. Good luck regardless of which way you go. You are not the problem.:dncgbby:

Mahage

JVRB4 · Jul 27, 2009

Maybe you could request a different preceptor or atleast an opportunity to try a couple of shifts with a different preceptor to see of it would help. Maybe just a different teaching style would help you to relax more and in turn be able to think more clearly. It's very hard to think clear and make intelligent decisions when you feel like you are being tested all the time. Gentle guidance, nudges in the right direction, suggestions and/or tips from a more experienced nurse while allowing you to develop your own style may be all you really need. If you truly feel that this unit may be too much for you to begin with as a new grad then maybe you could begin applying for other positions such as med/surg or ask explain your feelings and request a transfer within the facility. I'm sure others with more experience than I have can offer more/better advice. Good luck!

bluelou · Jul 27, 2009

thanks to you both for listening. It helps just to say it out loud.

It's definitely got a lot to do with my anxiety as I've had a few preceptors so it's me.

Mahage, LPN · Jul 27, 2009

thanks to you both for listening. It helps just to say it out loud.
It's definitely got a lot to do with my anxiety as I've had a few preceptors so it's me.

Okay, so maybe it is you, but like I said earlier, functioning as a nurse is extremely different from being a top notch student. It takes guidance and practice. Just maybe the preceptors who were so critical smashed a bit of the self confidence that you had without you having the oportunity to learn the processes and the flow of the unit. Sometimes those of us who do take on a big chunk because we know we are capable find ourselves on the low side of a very steep learning curve and are extremely intimidated. This in no way means we can't be good nurses. We just have to find a way to navigate that learning curve. I think the more intense the environment the steeper and the harder it is to get to the top of it.

Again, give yourself a break.

Mahage

shinyblackcar · Jul 27, 2009

Dear bluelou, I feel your pain, I truly do. I'm also a second-degree BSN who started right out in a highly acclaimed teaching hospital's ICU (pediatric). I sucked it up for 2 months until I finally decided that my mental health was more important to me. People who don't know anything about ICU nursing say "just stick it out for a year"-- I just have to laugh when people say that because that is *not* the place to "just stick it out." If you are truly unhappy there but you force yourself to stay, you will crash and burn. I was having full blown anxiety attacks before each shift. Once I took a step back and realized that there are environments outside the ICU where I could prosper, the decision was made. I am now looking for another unit to work on and although job searching isn't that fun, it sure as hell beats the alternative. Whatever you decide, I wish you the best of luck. I do believe we can be nurses AND happy at the same time. :)

chcgoblue · Jul 28, 2009

Hoping this is where I can get some advice. I was an LPN for almost 20 years. I worked acute/subacute/longterm and home care. After feeling like I had done all I could as an LPN I went on and got my RN. Now I am ready to quit nursing altogether. It was the worst move I have ever made. I cant find a job in a hospital, I did a critical care internship that lasted 4 months, but had to give it up due to the 80 mile commute. I have tele experience, am acls cert. trach/vent experience. I am stuck in home care because that is all I could get. I am at my wits end. I feel like Im worthless, no one will even talk to me. All I have been told is that my LPN experience dosent matter. I do agree the RN role is different, but all that experience dosent matter????? If I could find a different line of work I would move on, but im 41 and have been a nurse since I was 20. I never thought I would be in this position. Please, any advice, Im losing it.

Mahage, LPN · Jul 28, 2009

Hoping this is where I can get some advice. I was an LPN for almost 20 years. I worked acute/subacute/longterm and home care. After feeling like I had done all I could as an LPN I went on and got my RN. Now I am ready to quit nursing altogether. It was the worst move I have ever made. I cant find a job in a hospital, I did a critical care internship that lasted 4 months, but had to give it up due to the 80 mile commute. I have tele experience, am acls cert. trach/vent experience. I am stuck in home care because that is all I could get. I am at my wits end. I feel like Im worthless, no one will even talk to me. All I have been told is that my LPN experience dosent matter. I do agree the RN role is different, but all that experience dosent matter????? If I could find a different line of work I would move on, but im 41 and have been a nurse since I was 20. I never thought I would be in this position. Please, any advice, Im losing it.

My guess is that your problems with getting a job is due to the downturn in the economy. I know it has effected hiring in nursing. I would also guess that you would be very likely to get a RN position in long term care. I think Home care would be interesting myself. If you are working PRN that may be the source of your frustration, not having a regular job. I would definately apply in Long Term care and rehab facilities. Polish up your resume to emphasize the benefits of your 20 years experience and your acheivement in gaining your RN. Sell yourself girl, you are a winner, you just have to put yourself out there in a postive light. If I were hiring nurses, I would hire you in a heartbeat before any of the 20 somethings with little or no prior healthcare. All things being equal, I think you have a much better chance than most. Look at the little things, are you presenting a professional resume and appearance? Do you communicate with confidence? Anyone who tells you your LPN experience doesn't matter either has an attitude problem or have never worked with the super LPN's that I have had the pleasure of working with.

Mahage

rmejia97 · Aug 22, 2009

I feel like I just rea my story!! I feel exactly the same.

MagnoliaRN · Aug 24, 2009

Wow! I had no idea everyone else seems to have the same problems as me. I graduated in May 2009, passed my boards in June. I was at the top of my class. I was the annoying one with most of the answers and the one people came to for help. This is my second career and I am older than most in my class. I was shocked when I started my ICU internship. I had no idea I was starting highschool again. The clicks and the rumors were ridiculous. No one even knew me or said two words to me in the beginning. I have a big personality and I am very friendly. So, I was the "cocky, know-it-all, B*%$#, with an attitude". I was floored. I had a young preceptor, who I had no problem taking orders from and asking questions of. I thought things were going relatively well until we had our meetings with the manager. I spent every meeting crying like an idiot, mostly because I was shocked and had no idea why they were saying the things they were. I am not sure how my preceptor could judge me since she was always on the phone or flirting with the RT guy. She wasn't around when I needed her and made my first med error because she wasn't around. I went home hysterical, luckily nothing happened to the patient. I complained to the manager that I had specifically told my preceptor twice that the patient was way over my head and my preceptor said, "well, you need to take the more difficult patient, I will be here when you need me". The guy was on a vent with 9 IV's hanging, 4 of them titrated drips. Not to mention the IVP meds and NG tube meds. I would spend all my extra time just watching the IV meds and making sure they were running and that the numbers were correct, while also staring at the monitor. I was scared too death all day. The manager then told me, well sometimes you are going to have difficult patients and you will have to figure out how to work through it. Needless to say I had to pick my jaw off the ground. I almost quit after my med error. I felt like if they aren't going to be there when I need them, then I am not safe enough to do this job. I didn't spend the last 4 years of my life in school to graduate and kill patients. It was very disheartening. Luckily they changed my preceptor to a well seasoned nurse, who is by far the pickiest and most obessive of the bunch. We get along fabulously and has no idea why the other preceptor said the things about me that she did. I am still worried before each shift, because you just never know what you may get that day. I am still not confident in many skills and with working with the more critical patients. But slowly I feel I am starting to get there. I have a long road ahead of me. Your preceptor can make or break you!

sistasoul · Aug 24, 2009

I am so happy I found this thread. My heart goes out to the nurses who feel like failures. We all have worked so hard to get through school and then feel like we are incompetent at work.

I graduated in May 2008. Could not find a hospital job so I took a full time position at a LTC facility and passed meds. In April of 2009 I was lucky enough to get a part time position at a local hospital on their ortho/neurology unit ( I work 40 plus hours a week). I received 3 weeks of training with charge nurses (who were always so busy with other tasks that they really could not help). Usually new grads get 3 months training in the new grad program but the market is really tight for nurses without experience that I just took what I could get to obtain some hospital experience. My manager told me I was not a new grad and that taking care of nursing home residents was the same care as taking care of hospital patients. At this point I had not hung an IV med since nursing school. Well needless to say I have made my share of mistakes and have felt like quitting on more than one occasion. I have went into the med room and just broken down. If it were not for the supportive nurse on my floor I would not have survived in this position. I am just glad to know that my feelings are normal.

I too wonder how the more experienced nurses can get out on time and sit around and chat. I run myself ragged with no meal breaks and still get out 2 hours late every evening. I do see some experienced nurses getting out late at times also. I leave every night feeling like I am a bad nurse because I could not give the patients the care I feel they needed and deserved. I tell myself that I became a nurse to care for my patients and not to do the ton of repetetive charting that is required. I just feel so overwhelmed sometimes with the multiple things that happen all at the same time. When I come in for my shift at 3 PM I usually cannot start seeing patients until 5 Pm because of orders from the previous shift still not being noted off (first shift is so busy too that they sometimes do not have the time to do this- includes new meds), and from various other pressing issues that need to be taken care of before I can start assessments and med passes. At this point Meds are late and I just keep running.

Well I have 5 months under my belt and I am determined to make it to one year. My manager has been a lot more supportive of me - probably because I help her out with staffing needs and I am a team player. I just hope I start to feel confident soon as it is tiring feeling incompetemt all of the time.

Thanks for letting me vent...................

rmejia97 · Aug 24, 2009

Wow! The more I read the more thoughts rush through my head. It's 3:30am where I'm at and I can't sleep. I'm off on Monday, but then I work on Tuesday and I can't stop thinking that I'd better get some rest so that I'm not lagging on sleep when Tues comes around. I can't stop thinking of ways to make my day go by smoother at work. Why do I feel like a total idiot when I'm at work when I managed to get through nursing school with good grades and did well in clinicals? How long will it take before I start to feel like I can safetly take care of patients? How long before the seasoned nurses stop laughing at me during reports? Ugh....nobody mentioned it would be this difficult adjusting.... :confused:

madwife2002, BSN, RN · Aug 24, 2009

Wow! The more I read the more thoughts rush through my head. It's 3:30am where I'm at and I can't sleep. I'm off on Monday, but then I work on Tuesday and I can't stop thinking that I'd better get some rest so that I'm not lagging on sleep when Tues comes around. I can't stop thinking of ways to make my day go by smoother at work. Why do I feel like a total idiot when I'm at work when I managed to get through nursing school with good grades and did well in clinicals? How long will it take before I start to feel like I can safetly take care of patients? How long before the seasoned nurses stop laughing at me during reports? Ugh....nobody mentioned it would be this difficult adjusting....

When you say laughing why are they laughing it does sound very unprofessional to be doing that. I can hardly believe some of the horror stories that happen to the new grads. These 'seasoned' nurses were once new grads so you would think they would have some compassion towards other co-workers.

I can only hope when all the new grads who have posted on here, remember when you are a 'seasoned' nurse and treat your new grads with more compassion. Because even though you may not know or feel it right now-one day it will be easy to you.

What you tend to find is when Nurses have it hard in the begining they dont remember what it felt like to feel so insecure all they remember is that they had it hard, and they think everybody has it easier than they did the years before. So some people actually enjoy seeing nurses struggle in a kind of perverse way, it makes them feel better by saying 'they didnt have it as hard as I did when I was a new nurse'