Support Stickie for New nurses who are not coping

[madwife2002]

I have read through lot of threads recently regarding new nurses who feel they are struggling and not coping with being an new RN. So I thought it would be good to start a support thread where all new nurses could post about their feelings and experiences. You are not alone, all new nurses feel this way and if they dont I would be extreemly concerned.

[sweetjellies1]

I am a new grad LPN. just started working in a LTC. no matter what i do i never finish on time. I get assigned 26 pateints. alongwith medpass i have to do treatments too:sniff: then the paper work. I constatly ask my self this "will i ever get better at this? is nursing for me? am i cut out for nursing?" it was not easy to finish college and get my license with two little kids at home. but now i am not sure if i chose the right profession. when i started i was positive that i wanted to be a nurse:nurse:.there isnt enough time to finsh all the work. Is anybody else on the same boat...

[RNPATL, DNP, RN]

Feel horrible, and frustrated. I don't go home crying (yet) but I am definitely feeling like I am never going to get the hang of this. I am starting week 4 tomorrow, and I should be up to 4 patients but I am going to have to take 3 again this week because I am not ready for 4 yet. This is week 4 of orientation and there is always something that comes up that makes you late, or forget about something that you needed to do for one of your patients. I absolutely hate this new nurse phase and can't wait for it to be over. I am on a very busy med-surg unit. I still love what I do, but I just wish I could get the hang of it faster that I am thus far.

RossayRN - cut yourself some slack here. If you consider the amount of learning that takes place during your first year of nursing, let alone during your entire career as an RN, then you will see you are doing just fine. I know this post was in November and I have not yet finished reading the thread, but I hope things are going a little better for you now.

[RNPATL, DNP, RN]

I really just discovered this thread and am so sad to read some of these stories. New nurses need to be embraced by our profession and given really and true opportunities to transition to practice so they can realize the difference they make in the lives of patients they care for each day. We need each and everyone of you in the profession today and I am thankful that you have made the choice to become nurses.

I have been a nurse now for almost 26 years and I am not even old yet ... :) But I have seen the ups and downs of the profession and can tell you that being a nurse is the single best decision I have ever made in my life. Your transition can be hard! Fight for the orientation and training time that you need. Remember ... as a new RN your practice is your practice and you need to define your time frame for transition. While I recognize the pressure many new graduates get from employers to "get productive." At the end of the day ... you are the professional and you need to define what you need in order to be effective for your patients. Remember however, there is a lot of learning. Ask many questions - find another RN you feel comfortable with and utilize him or her to guide you. Stay in contact with your nursing instructors, fellow graduates and continue to build a network of nurses around you. Keep your textbooks close at hand and continue to study and learn. Your first year will pass and before you know it, you will be talking the talk and walking the walk. Just remember .... when you finally do transition and you are the experienced nurse - remember that new graduate and provide them with the support, compassion and networking that you needed when you started.

For those of you that are interested .... many organizations have heard your voice and are calling for a much better development period for new graduate nurses .... this also includes LVN/LPNs. The National Council for State Boards of Nursing are working to conduct a study of new nurses transitioning into practice. This study will provide some wonderful evidence as a means to support your concerns. Also, the IOM has called for nurse residency programs that offer new graduates with a reasonable time frame to get use to their new responsibilities. They are hearing you.

NCSBN Link: https://www.ncsbn.org/363.htm

Best wishes to each and everyone of you. Come back and post frequently - tell us how you are doing.

[NG 101]

HI I am a new graduate nurse orienting for two months now. I am stressed because I can not come to reality with my feelings. Every day in work is I continue to struggle even to the easy patients. I can't get over my nervousness and feeling eventhough I try to communicate with my preceptor I still feel not comfortable. She is a strong and great nurse but I feel that I dont have a connection with her. I came to this realization when I shadowed on another floor. At first I thought it was just me and my learning curve, but I had this person that was wonderful. I felt happy and the end of the day not over whelmed and stressed out. The person made me learn by asking me questions and pushing me to understand but being patient. I enjoyed it so much I stayed each hours. When I went back on my floor I did not get that same feeling with my preceptor even tho she was great. Then when I see other people that are orienting with me not struggle I think to myself maybe its me and maybe this is something I should not be doing. I am confused with what I want. I try to study and prepare for work but when it the day before work I start having anxiety and stress thinking about what I can do to improve myself so I can have a smooth clinical day. I feel alone on the floor when I make mistakes and feel that the other staff shy away from me eventho they help me when I ask. I also feel that my preceptor talks to other nurses and get easily frustrated with me. I am just confused and dont know what will be the consequences if I dont make it through orientation or maybe this is not for me and I should quit before this happens. Mostly I cant get over the guilt of not performing 100 percent to my patients. I feel confused....

[nursingmeatball]

Glad to see this thread... I think that I am so overwhelmed by my lack of knowledge, that it is hard to tell if I like what I'm doing. I graduated in May 2010 and passed boards in June. I work in a Surgical/Trauma ICU.

My positive feelings at this point are: I feel like I can get through my day, do the tasks/things I need to do, give decent hand-off report, am about 75% familiar with policies/procedures/paperwork, I connect and communicate pretty well with my patient's families, and I think I provide good care to my patients themselves.

My negative feelings are: I do not connect well at all with my co-workers, and they all intimidate me. I feel that I am missing the boat on the big picture, and could really easily miss something when it comes to my patient that the experienced nurses would be right on top of. When the doctors round, I just have nothing to contribute, and feel like a complete idiot. Sometimes, my patients will need a chest tube, or an invaisive line or other bedside procedure, and so help me I am all thumbs and my mind races and I don't know what the heck I should be doing, etc. I don't even know enough to effectively express what I'm trying to say in this post! It's been 8 months, and I feel like I will never reach the level of competence that my co-workers have attained.

I left a successful career to persue nursing, and I wonder if I did the right thing. Maybe I just don't have the brains for critical care. Maybe I don't have the right personality. I do like the variety, and caring for my patients, but I'm scared that I will hurt someone with my lack of knowledge and basic ineptitude. I hate feeling like the weakest link on my unit, but that is exactly what I am right now, and everybody knows it. I have no friends on my unit, and don't think that I ever will. Which is not to say that my co-workers are bad people, we just don't have anything in common, and do not click. I don't think they hate me either, but I doubt that they like me. And I'm sure they think I'm a complete moron. Which makes it sooo much harder to approach them with questions.

Anyways, that's about it. I'm glad to have had a place to vent! Thanks :)

[SummerGarden, BSN, MSN, RN]

i want to respond to everyone but it will be hard to do. first of all i am an er nurse and have worked as a nurse for 2 years. to get to this point i had to work one of the worse medical surgical floors in my area and a cardiac step down unit with bad co-workers. also, my er sucks.

this er is very clicky, where patient care comes dead last, because the right nurses are not assigned to the right beds. plus, there are no protocols, the nurses who remained for years do so because he/she has family and friends nearby, not to mention that some nurses are bad because he/she refuses to gain any other knowledge or experience and so leaving would take him/her out of his/her comfort zone. with that said, i feel the same way the rest of you feel about being a new nurse. it is not only hard to learn to provide the best patient care to high acuity patients, but the work environment can be demorilizing. especially, when your co-workers are miserable and mean and so they talk trash about you and your nursing skills to everyone under the sun! thankfully, i came here (to this forum) for support and made it to two years due to shared experiences and good advice.

i noticed that two years later i am miles further in my nursing skills and knowledge compared to the day i first started as a nurse, but i still have a long way to go. i think that is the sad part of nursing. unlike other fields with the exception of medicine, two years later there is still a lot for a nurse to learn in order to be good at the job. i cannot say enough about how beat down and frustrated i have been over the past two years unlike any other occupation i have had to include fast food in hs. the gossip, the finger pointing, and the lack of support i have experienced as a nurse still blows my mind. showing up to work everyday made me feel like an abused woman going home to my abuser everyday. despite this, it will not deter me from continuing in this career and it should not deter you too.

i just landed another job at a better facility with better pay because i have two years of work experience under my belt. so, hang in there everyone...!!! if you have to cry, vomit, etc. before or after work, then do so... but hang on!!! there is better out there once you have experience.

[snuggler]

I too am a new grad, graduated in May, got my license in June, and started work on a cardiac intermediate care unit. I feel so overwhelmed, like I'm always messing something up. It's so hard dealing with the jerk doctors and techs who give you attitude. Giving report is a nightmare to me sometimes, the night shift nurses can make me feel like a complete idiot. I dread going to work, can't sleep the night before my first day back because I dread what kind of patients I will get... and what else I might screw up... I want to just skip this new unexperienced nurse part and fast forward to the experienced nurse part! Don't get me wrong, I love being a nurse, love taking care of patients, but the stress can be so overwhelming! Thank goodness for 4 days off!

I could have written this...

Thanks everyone, for this thread. I am a new grad on a hectic Telemetry unit, about 2 months into orientation and will be on my own (yikes!) by the first week of Jan. I am terrified, overwhelmed and frustrated. Yesterday I came home and cried uncontrollably for about an hour. For the reasons that have all been talked about: making stupid little mistakes, forgetting to do things, being talked down to by other nurses, working overtime to finish charting and having ***** doctors snap at me. It is all adding up and I am questioning my ability to ever be a good nurse. I do think it will get better but I too wish I could just fast forward past this learning curve into the "experienced" RN role because I can't think of a worse place to be Thanks for the support!

...and this...

I am working on the cardiac/telemetry floor in a hospital that boasts about being one of the biggest charities in our area - because we take all of the uninsured that the other hospitals turn away. This population is burning me out.

I am tired of taking care of lifestyle issues that are "emergencies" here in the hospital, but yesterday and tomorrow (at home) will just be the patient's status quo. I am tired of being a drug dispensing machine. I am tired of feeling looked down upon by coworkers. Not all of them, but a fair few seem to think of themselves as "Super Nurse" and think of me as something of a speed bump in the road to providing the kind of high quality care that only they themselves are capable of.

By the end of a three day run of 12 hour shifts I literally do not care about much of anything at work, and I live in terror that this innate lethargy is going to cause me to miss something that could hurt a patient and/or end my career.

Nursing school was so hard, and I sacrificed SO MUCH to complete it. The thought that I did all of that for a career that I could see myself growing to hate terrifies me.

I want to cry when I see nurses who are pushing retirement age coming into the hospital to do the same ****** work with the same ****** hours that I am. What are they doing there?? I can see the arthritis in their hands and the ache in their walk. Is this what I have to look forward to?? I am exhausted when I get off of work and I am young and healthy - I can't even imagine how these women feel at the end of the day.

Some days I feel trapped and scared that it is never going to be better.

[wolfpackRN]

I'm a new RN, and all of my clinical experience was in a hospital. Of course, the only job that I could land was at a LTC/rehab facility. So, the atmosphere alone is totally different and new for me. Depending on the unit I'm on, I'm in charge of up to 32 patients. Which means med pass, treatments, and charting. If nothing happens, if there is no incidents, new orders, or something crazy. Or a full moon.

My preceptor has basically thrown me out there. I was passing meds my first night to patients that I have no clue what their deal is. So I'm trying to shove crushed meds down this lady's neck, and she's the most difficult patient to try to give meds. But I have no idea. I don't quite understand the different areas of this facility. There's 160 beds, 6 diff units, and I can't figure out how it's divided, and no one will tell me. But from what I've gathered, all the normal people are upstairs, and all the demented ones are on the ground floor.

So I've been here for 7 days, the first day was all paperwork and massive amounts of info shoved into 8 hours, and I guess I was expected to retain it all. Then I'm put on a med cart, trying to get things down, and I really have no idea what I'm doing. I got to shadow for one day, and while shadowing, she still couldn't finish everything that is required in the correct amount of time. So how the hell am I supposed to learn? So it's day 7, and I'm asked if I can handle this on my own? I told her no, I don't feel that I can safely care for these patients alone. And I asked what I can do to improve myself, and I don't really get an answer.

So now it's day 8, I still have no freagin clue what is going on, I'm trying to ask questions and not really getting an answer, I don't know where to find things, I'm not allowed to bring any personal books in with me (ie like a pharm book, bc 'theres one at the nurses station', and when someone else needed it today, guess what.. it wasn't there... funny eh).

So my preceptor asks me if I think that I really belong in LTC and that maybe this isn't for me. OMG are you freagin kidding me??? Maybe being an orienter isn't the right freagin position for you. So I told her that I am just frustrated with myself becuase I'm not getting things done on time. For instance a med pass that takes the other nurses an hour to get done, is taking me like 2 hours. And I'm frustrated bc it shouldn't take me that long, but I don't see an opportunity for change. And all I get in reply is... only you can change that.

wth?? I'm asking you for advice, because you've been watching me.. so tell me where I can improve. I'm so frustrated. And now after that comment being made, I'm fearful of losing a job I haven't even really started yet.

[amdale]

I am soo glad I found this thread. I have felt very hopeless at times. I just hit the 1 yr. mark on a med-surg floor. I was started on nights. The first wk off orientation had a team of 8. Whew, many times I would cry either at work or on the way home. Many times I wanted to quit but my motto has been perseverance furthers. I am now on days and have teams of 6. Many days this is way too much. I feel as though I don't know my pt. and worry will I catch the important issues as the day progresses. I feel very inadequate as nurse. Sometimes I wonder how I even made it this far. I have been reassured by others including my nurse manager but my insecurities surface. I love the hands on interactions with my pt..just don't think I have enough time to spend with each. I am often working late to catch up. I try to organize my day but you know how that goes Dr.'s, family members, pain meds now, suddenly there goes the organization and now I am behind trying to play catch up. I know that it is 24 hr. care but I hate to leave the next shift trying to clean up behind me so I stay late. Any advice? Thanks.

[nursingmeatball]

your final words are an inspiration to me:

"the gossip, the finger pointing, and the lack of support i have experienced as a nurse still blows my mind. showing up to work everyday made me feel like an abused woman going home to my abuser everyday. despite this, it will not deter me from continuing in this career and it should not deter you too.

i just landed another job at a better facility with better pay because i have two years of work experience under my belt. so, hang in there everyone...!!! if you have to cry, vomit, etc. before or after work, then do so... but hang on!!! there is better out there once you have experience."

this has given me a small glimmer of hope. i could have written most of what you did about your experiences as a new nurse - the bit about feeling like a "speed bump" in the way of the other "super nurses" was dead on accurate to my feelings and present experiences. but to know that you have progressed, and are determined to persevere, and that you are finding new opportunities out there with your hard earned experience is a relief to me. i know i am not a stupid person. i know that i am likely more intelligent than some of the "super nurses" on my floor. but i simply have not progressed to their level of experience yet. and maybe, just maybe, once i have been there for 5 years, i will be at or above their level. it is something to look forward to. and shame on me if i get to that point and do not treat new rns on my unit as i would have liked to be treated.

[DroogieRN]

I could have written this...

...and this...

I am working on the cardiac/telemetry floor in a hospital that boasts about being one of the biggest charities in our area - because we take all of the uninsured that the other hospitals turn away. This population is burning me out.

I am tired of taking care of lifestyle issues that are "emergencies" here in the hospital, but yesterday and tomorrow (at home) will just be the patient's status quo. I am tired of being a drug dispensing machine. I am tired of feeling looked down upon by coworkers. Not all of them, but a fair few seem to think of themselves as "Super Nurse" and think of me as something of a speed bump in the road to providing the kind of high quality care that only they themselves are capable of.

By the end of a three day run of 12 hour shifts I literally do not care about much of anything at work, and I live in terror that this innate lethargy is going to cause me to miss something that could hurt a patient and/or end my career.

Nursing school was so hard, and I sacrificed SO MUCH to complete it. The thought that I did all of that for a career that I could see myself growing to hate terrifies me.

I want to cry when I see nurses who are pushing retirement age coming into the hospital to do the same ****** work with the same ****** hours that I am. What are they doing there?? I can see the arthritis in their hands and the ache in their walk. Is this what I have to look forward to?? I am exhausted when I get off of work and I am young and healthy - I can't even imagine how these women feel at the end of the day.

Some days I feel trapped and scared that it is never going to be better.

I had to double-check to see if I actually did write some of these...

It's official. Nine months in and I am Not Coping. I began on an intermediate care/step-down/telemetry floor where the ratio was 4:1, had a great preceptor, great co-workers -- recipe for success, right? Wrong. Hospital in the throes of being taken over, nurses jumping ship left and right for greener pastures, a director with a very, very brown nose and suddenly the ratio is 5-6:1 with no PCTs, no transport, every patient a train wreck, staying late at least two hours each shift to tie up loose ends, missing the docs (and thus not seeing orders til hours after they've been written), just trying to put out fires, clean up a (literal) $h!t storm every day, and on and on and on... Uncle. They win. My confidence is shot. I cry every day I work. I am not nursing -- I am just trying to keep people alive until the next shift. I wonder if I can even cut it as a nurse. I know I can't do this much longer.

[avroman13]

Ughhh, Had the worst day of my nursing career today. Mind you, my nursing career started on August 16th 2010, so I'm sure I have more to come. Honestly though, I don't know if I can handle this. My job seems like a really abusive relationship. I feel so used and worn out when I'm done. It is 40 hours a week (that means it's always more than 40), I work 5 days a week, 8 hour shifts, usually varying by week - day, evening, or night shift. I feel like I don't even know who I am anymore. I used to think I was someone who valued family time, and I want to be that person. I have a beautiful six month old baby girl and a five year old boy, but this job keeps me away from them so much, and exhausts me so much that I have no time or energy for them when I'm not working. Today I cried like five times. Let's see if I can recap my day...five patient assignment:1) young male with chest pain, intractable hiccups, leaking foley, spiking a fever, tachycardic, on tele - all IV medications with only one iv access, so I was in there hanging bags all day. Needed stool and urine cultures, foley d/c'd, 2 peripheral blood cultures, 2 ekg's, went for ultrasound. 2) urine klebsiella infected with a swollen stoma for his urostomy. got 2 runs of magnesium. Angry because he was supposed to get a PICC line placed yesterday and is unsure when it is going to be done, apparently the PICC team didn't see the order for the consult...3) Pt. with small bowel obstruction and poorly managed pain on a PCA which needed 2 dosing readjustments and a syringe change today. NG tube to low intermittent wall suctioning. 4) My crazy patient, who refuses to ask for help to get up and constantly is falling, so we have him in a posey bed, constantly takes off his oxygen and desats to the 70's, is supposed to have a 1:1 sitter who is a no call/no show, refuses to use the call bell when he needs anything - instead yells "Nurse, Nurse" at the top of his lungs, swears, makes nasty comments, and monopolizes the nurses time. 5) Encepholapathic patient who is not alert or oriented, needed a lactulose enema, slapped me while I was doing it, which followed with an explosive bowel movement across the room when she all of a sudden tried to get up. She needed blood cultures X2, a rectal tube placed, she had her demanding husband at the bedside who kept asking me to draw repeat ammonia levels - which I did and then got reamed out by the provider for doing. My fault . An NG tube was placed since she was unable to swallow her meds and then 4000ml of golytely bowel prep to make her stool was ordered to be instilled into the NG tube - 500ml bolus every 1 hour. I'm sure that's not all, and on top of it - we had no tech/aide this morning so we were responsible for patient hygeine, vital signs (all of which were q4hours), blood glucose checks, etc. I shouldn't complain because I did get a lunch (which I have to devote to pumping breastmilk for my 6 month old :)) and 3 of my 5 patients could walk on their own. Maybe this doesn't seem like much to some of you super nurses, but to me, it was overwhelming, and I cried during my shift in front of one of my patients, a provider, and some fellow nurses. Needless to say, all of my documentation was done at the end of my shift, and left a lot to be desired. I just feel like I can't do my job competently when I am under such pressure. So then I had a few bouts of crying as I left and on the drive home and tonight at home. I just feel like I should be taking much better care of my patients, and my own family, and since I have so many responsibilities and so little time - I feel like I have to half-a$$ everything just to get it done! Okay, thanks for having a forum for stressed out new nurses :) I think just venting and writing this out helped!