Support Stickie for New nurses who are not coping

turnforthenurse, MSN, NP · Jul 22, 2011

I graduated in December 2010, passed my boards on March 24th, 2011, moved to Texas in May and started working exactly 1 month ago. I work in a progressive care unit and I am cross-trained to work in the ICU. I love my job, and everyone has been very nice and supportive regardless of what question I have, but I feel like that is all I do is ask questions! I am having severe confidence issues and now I'm starting to experience anxiety...over little things such as whether or not I forgot to pass something off in report. I had to put in a provider order last night and although I read the order back to them, I'm STILL wondering if I even put it in correctly with the correct instructions! One night I gave pain medication but forgot to document the reassessment on the MAR. I was in the patient's room and the patient was sleeping/comfortable so I wasn't concerned, I just forgot to document. I documented that I GAVE the medication, though, which I feel is more important. I kid you not, I went to bed that morning then woke up at around 1pm in a panic over that! These little things are bothering me so much I'm losing sleep over them. I went to bed at 0830 this morning and woke up at 1230 thinking about report and thinking about that provider order...which wasn't signed off by the provider by the time I left, and I told the day shift nurse to possibly call and re-clarify...I'm so worried I accidentally put it in wrong or something, and I'm afraid the nurse will call the doc to re-clarify and the doc will say "what! I didn't order that! who is the dumb nurse that put that in it?" and then have me reported It was an order regarding medication parameters; however, this medication was scheduled for 0900 the next morning. None was given on my shift, therefore no harm could have resulted. But then I'm afraid I am going to get another call from my manager saying I need to put in orders correctly...this is why physicians need to put in their own orders >_

I already received 2 calls from my manager...one was regarding quality management. Pt was a new admit, admission was done on previous shift but the day shift nurse did not initiate any quality measures. So I wanted to look like I was on top of things and initiate them. I did everything correctly but I failed to convert the pt's home meds to inpatient. That was my SECOND NIGHT at work! I didn't get the call until a couple of weeks later. QM demanded an "action plan" so my manager is going to show me how to convert those meds to inpatient, and QM also wanted me to write a paper on the issue (not my manager). My manager was very cool with it, told me she didn't want me to feel like I was being singled out or anything and apologized for telling me that I had to do this. It was disappointing, though. Then I was talking with the other nurses I work with and they told me NONE of them convert the home meds to inpatient - it is the doctor's job! So now I am all confused The other call I received was this week regarding an order that was not initiated. It was ordered on day shift, and it wasn't done...and I somehow missed it. I was just told to make sure to check the orders. One of the nurses I worked with last night said it happens, don't sweat it. Regardless, this is all pretty disappointing to me

I work tonight and tomorrow night, too Everyone I have precepted with said I am doing a great job, and everyone is always asking me if I am doing okay or if I need any help with anything. And speaking of report, I hate how some nurses just give you this mean look the whole time! It is so intimidating!

Is this NORMAL? I'm still on orientation...I'm on my 4th week this week, with 6 weeks total. My last week will be spent in the ICU orienting, then afterwards I am on my own. But that's the thing, I already feel like I am on my own. Every preceptor I have been with turns me loose to do my own thing, and of course ask if I need help or if I have any questions. And if it isn't my preceptor, there is always someone available. I'm learning, but at the same time I'm wondering if this is how I should be precepted. There are some nurses who started out as new grads and only got only a couple of weeks before they were free to be on their own. They are doing just fine, but still.

I also feel like I don't know everything that I should. It is just hard trying to tie everything together, and nursing school is VERY different from real world nursing. Not to mention the absolute INFORMATION OVERLOAD with all of the charting and learning how things are done at my institution.

Mrs. SnowStormRN, RN · Jul 25, 2011

I am so depressed about not being able to find a job that I have considered changing my 1st name to something that sounds more "professional." It will be a yr in Dec since I have graduated. I have 8 years of LPN experience and that isn't helping me. I still cannot get a RN job.

LisaFis · Jul 28, 2011

Hi,

I have been reading on allnurses for a looong time but have never posted before. I am a second career RN. I loved school, did really well, worked in the hospital while going to school and am absolutely struggling with the stress and fear that I am experiencing at work. I am in critical care and just coming off of orientation. I don't even know where to begin there's so much running around in my head. I hear a little bit of myself in everyone else's posts. I worked so hard to get here, wanted this so badly and it feels nothing like what I had hoped. I have a constant feeling of incompetence, clumsiness and intense pressure. I get overwhelmed SO easily, and I and am so afraid of making a mistake. When I think I have made a little progress there's always a setback around the corner. I feel like the "feel good" parts of nursing get lost with a 3 pt load. I don't know what has happened to me, but this is not how I had hoped for things to be. This has turned in to a mental battle of the fear, anxiety and stress instead of an awesome learning experience. I have tried many things to redirect and lessen the stress-I even started seeing a therapist-JEEEZZZ what has happened to me. I am sad and praying that I will develop the confidence that I am so lacking. I thought I was tough, but work is affecting my personal life which is frustrating and depressing too.

LadyLuck5 · Aug 5, 2011

I can not begin to express how grateful I am for finding this thread---it is getting me through my first 6 months as a new RN in an MICU. I read a little bit of this and the new nurses advice threads right before my shifts as a little pick me up to get me motivated for the night. It is so comforting to know we are all not alone in our shared exhaustion, terror, happiness, and sorrows. Like many others- I am a career changer---married, new nurse working the night shift 7-7 for the first time ever in my life. The first night shift I did I felt like I literally was going to fall over from exhaustion, gave the crappiest report off's ever-did not even care all I could focus on was remaining vertical enough to make it home to sleep. Since then- thank god-my physical state has gotten somewhat better- with the help of Ambien-but my life outside of work has completely ceased to exist. I am either sleeping- trying to eat and work--being married does not help- my husband and I just bought a house and the process of moving etc and working has pushed my almost to the edge. Ugh---I am not a very religious person---but working this job - trying to save lives-hope and pray to not hurt anyone-while trying to maintain a fraction of a life-has called out my inner need for strength from some higher power. Nursing is hard-very hard- then to through that with trying to cope with working night shift is what I like to call nursing to the extreme! It is sooooo comforting to hear others speak with the same emotions and to hear caring veterans speak of truths that it will get better-there is hope-don't give up, take deep breaths and let all ego and fears go- WE CAN DO THIS!

chocolateskye · Aug 6, 2011

I am glad to hear that most of you are not giving up! I myself graduated in 2009 and have had really bad experiences as a nurse every since. I to see me in the posts that others have posted. For me I show up with a smile, Im ready to help anyone forget clicks, I ask questions and show up every shift and on time and maybe I have been to trusting of others and should remember that these co workers are not my friends.....but why? I accepted my job to join the team to see these people as much as I see my own family probably more than I would see my friends why cant I form bonds with these women and men? Yet I get let go after my orientation period? I am finding that no one wants the responsibility of training a newer nurse, no one will pull you to the side to tell you hey here you have to do blah to make it ....why? Im starting to wonder if it is because they themselves are feeling one complaint away from being let go? Me personally, I would like to work for a company that supports newer nurses with evidence based practices ...a company that takes into account new nurse fears one that educates so that there is growth and competence, confidence is sure to follow after, and the ones that have been properly trained and not overworked and under staffed can pay it forward and not eat the young but that is just my dream for nursing.......back the reality of back stabbing, rumors for no good reason, managers and supervisors that will not train or teach just carrying bones back to the corporate folks to avoid the ax themselves! i too am hanging in there and I feel that I can do this no matter what they throw at me ......Im a freakin nurse! I rock! We can do this and we all will look back and remember what it was lt was like to be new or less experienced and pay it forward I hope : )

Lenae05 · Aug 27, 2011

New nurse here, graduated May 9, 2011 and now I am in a long term acute care. It's a "specialty hospital". I HATE it!! I have been on the unit 3 weeks, 3 12's and I feel like my employer wants more from me. I'm in my mid 40's and I'm feeling like I made a huge mistake going to nursing school. I love people, love taking care of my patients, etc., but the paper work, the meds, the doctors, etc. is too much for me. There is another new grad working with me and she really likes it. I have to drag myself to work. I so want to quit!! Yesterday I had 3 pts. 2 on vents. I just think I'm not cut out for this. Is there any field that someone can recommend to me to try that is not so high streesed? I don't want easy, but I do want to keep my patients safe.

turnforthenurse, MSN, NP · Sep 5, 2011

I have been on my own for awhile now, and I am nearing the end of my "probation" in about a couple of weeks...

I still love my job, but I still can't help the fact that I always feel like I'm forgetting to do something, or if I'm "missing something." It's like a constant state of anxiety. That part sucks!

Suzuki Ryabusa · Sep 5, 2011

I'm in the same EXACT boat as you MelosaurRN. Got hired on June 19 of this year. 2 weeks left until I see the "ORT" in my schedule switch to 071B or permanent RN staffing. I, too, feel I still makes some mistakes here and there. Nothing major. Just tiny things that sure make me feel like I'm an idiot. My preceptor always assures me that things will fall into place, that she was once in my position and felt like an idiot. But I do catch her on occasioin with that frustrated look on her face, the slight agitation, etc. I feel as if she can't wait to get rid of her orientee new grad so she can get back to "normal." I feel bad for her because she is a very fast pace type RN who gets bored easy if she isn't challenged with her normal workload. But...at the same time I almost feel that I'm not getting the training I DESERVE because of it. I do admit, however, that our communication has improved greatly over the past 2 weeks and we actually do our own "post-conference debrief" after we clock out. She talks about how I can improve by multitasking (which you can't do if you're having to learn the individual tasks first to get it right the first time), delegating to our CNA's, clustering our patient activities so as to minimize the mutliple, time consuming trips from Med Room/supply room/computer/nurse's station/back to patient bedside, time management etc. I feel I'm improving but still miss little things like a UA that should've been sent yesterday that was a "now" order and I just finally sent it in today. Thank God it was a Sunday, the results came in before the physician came to see the patient and note the results, etc. I do miss a med once in a while due to having my time taken up by a patient with a higher acuity + demanding. Today was very mellow up until the 1600 hour when all hell broke loose. All of a sudden, I was needed 6 different places all at one time (need to perfect the prioritizing skill) and physicians that wanted to speak to me either "now" or the "speak now or forever hold your peace" type, or the ones I've been trying so desperately to page all day needing to get orders so I can better care for my patient, only for them to show up when I'm most vulnerable and unavailable. I'll stick with it because somewhere in my twisted little brain of mine......it does get better.

d33ng · Sep 15, 2011

This is a great thread but i wish there was a thread for nurses that are not coping well with how bad the economic is going. I don't know how to post stuff on here or else i would start one myself. I'm so sad right now, my bills are outrageously high. I'm living off my savings, people i live with just don't understand how hard it is right now and I'm so annoyed of the dumb jokes here and there.

Sorry everybody for this post i just need to vent...........

Lauren5066 · Sep 15, 2011

I am a graduate nurse working night shift on a telemetry unit. This week is my first week off orientation and I am a nervous wreck. I feel physically sick and I am dreading going to work. I constantly feel as though I am a fish out of water. Does anyone have any advice on how to calm my nerves and stay sane? :bugeyes:

dudette10, MSN, RN · Sep 17, 2011

I'm starting to have a very difficult time in the past couple weeks.

I'm stressed out, unable to enjoy my off time, and the last shift I worked, I wanted to quit nursing all together. I finally cried last night. I've managed to not do it, but I was watching TV and some stupid advertisement for a Lifetime TV show came on, and it sent me over the edge. I wasn't crying about the show, but all this pent-up emotion just came pouring out.

I try to keep anxiety to a minimum before a shift, but I can feel it growing as soon as I take report. Every preceptor organizes her day differently (and I've had more preceptors than you can count), and I'm expected to adopt her ways. But, "the ways" change every single time I have a different preceptor, so I'm unable to organize my time in a way that works for me. One will intro herself before report, so I will try to do that with another preceptor, and she says, "no, no, no...you've gotta do this first." Then, I'll do that other thing first with another preceptor, and she says, "no, no, no...you've gotta do this first." On top of it, I'll be told to do task A, but then get pulled away by the preceptor to do task B. When task B is finished, she then gets irritated with me that I don't have task A done.

My last shift was an absolute disaster, and I know that my paperwork was atrocious because of it. In fact, it's probably been atrocious all along, but I didn't know enough to know any better. If I was told how to do paperwork by one preceptor, then another will say, you have to fill out this section and this section and this section, but the first (and second and third) preceptor never does it. So, I don't know WHAT has to be filled out and what doesn't by the nurse. I'm beginning to piece it together based on new information from each different preceptor, but there's never a "whole." For example, I had patients with a certain condition for three weeks before I was ever shown a flowsheet for the condition because my preceptors up until then never filled it out! Other paperwork? You have to check it against this. No, no, no...you check it against this! No, no, no, you don't put that notation there....you put it there! Get the discharge out of here. No, no, no, discharge can wait...you need to do this. No, no, no, no, no, no, no...do it this way, do it this way, do it this way! I'm spinning in circles by the second hour.

There is no consistency!

Ratios are max at the start of shift, and admits keep on a-coming. When one person calls off, all hell breaks loose.

I'm not learning; I'm reacting. I've heard rumblings that they can't keep new hires. Newer nurses have said under their breath to me as we're charting side by side, "I need to get out of here." One orientee told me that she's already looking for another job. I've heard rumblings that agency and registry HATE this unit. I had one agency nurse say only two sentences to me the whole night: "Did you work here before your graduated?" I answered, "No." She said, "Good luck" with that look on her face. I wonder why.... :idea:

I'm not even going into the inconsistency with patient care. I'm not talking about individual nurse practice. I can recognize that...I'm talking about the big stuff.

I still feel that the grass isn't always greener...don't know if I'm stupid or not for feeling that way. I'm gonna stick it out for at least two years. If I bail now, I will blame it on myself and feel that I failed.

dorstan14 · Sep 21, 2011

My sentiments exactly. I feel like a turtle. My preceptor is very nice and tries to encourage me, but at times I still feel incompetent and slow (literally and figuratively). She praises my critical thinking and my attention to details. She told me the rest will come in time. However, that doesn't give me more sleep at night. This is my 4th week of orientation and I still feel like an idiot at times. I really hope it gets better. I feel like I don't know crap.