Support Stickie for New nurses who are not coping

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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.

Specializes in Management, Emergency, Psych, Med Surg.

I am absolutely amazed when I see on these forums the kinds of patient loads that some of the nurses are expected to take care of. I work on a 34 bed med surg floor and on 3-11 our ratio is 5:1. Often, it is 4:1. As charge I have no patient load to take. We have at least 3 cns's on the floor most times. On 11-7, the nurses take 6 but the charge nurse has to take pts too. We are trying to change this so that the CN on NOC will not have a patient load.

Due to our staffing ratios our customer satisfaction scores for our floor are high. For the most part the patients feel that they get good care. The complaints that we do get are usually associated with food, having to stay in a semi private room or not having housekeeping clean their rooms. But everyone is trying to get it all right in order to reduce patient complaints. These patients are SICK and I am amazed that these new grads are getting up to 10 patients. That is just not acceptable. I am afraid that I would have to make a formal complaint to the state department of health regarding unsafe patient ratios. Diane

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As a new user to this site and a new practical nurse (graduated in June and starting working in July as a graduate, got my license in August) I really appreciated this thread. I know I work in a really crappy place and now know exactly why they offered me a $2000 sign on bonus! I work in a 28 bed rehab unit of a nursing home and am completely responsible for all 28 residents as well as all the other sloppy nursing staff. I work 12 hour shifts so when I come in at 6am I am bombarded with UA's and staple removal that was supposed to happen two days ago--on top of med pass and treatments that are on my shift. We havent had a nurse manager in weeks, so I get stuck doing all the work of that as well. And I can't forget the cranky NP or a few of the rude aides that I work with. I rarely get my charting done before the end of my shift and sometimes, medicare charting doesnt get done for a few days. I get my butt chewed for that, because that's how the NH gets their payment and I remind them that they are running my unit like a hospital but staffing it like a NH. I have requested (nicely although I didn't feel like being nice about it) that the DON show me how to accomplish it all on time--if she can do it, I sure as heck can!! She tells me she doesn't know what to think of the situation!!! I have from 7am-9am to complete my 8am med pass and when two clinical managers worked together they were still passing meds at noon, but they complain if I am passing my last med at 9:15am!! It's crazy and it makes me question my decision to get into nursing--I know its the facility really, but it still makes me question myself. I hate going home every night feeling like I am the worst nurse ever! I am always thinking, "I didn't even really get to see how that resident was doing, I didn't have enough time to measure that wound properly, I should have done more for this resident :banghead:" I never want to be that kind of nurse-the one who seems to ignore the patients--most days I just have no choice :cry: I have asked my husband if I can please go work at McDonalds.....

I love my residents and I love what I actually do--it's just hard to look into the future and know it will get better-- this thread has made it a little easier--atleast for today, my day off LOL Thank you!!!

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I know I work in a really crappy place and now know exactly why they offered me a $2000 sign on bonus! I work in a 28 bed rehab unit of a nursing home and am completely responsible for all 28 residents as well as all the other sloppy nursing staff. I work 12 hour shifts so when I come in at 6am I am bombarded with UA's and staple removal that was supposed to happen two days ago--on top of med pass and treatments that are on my shift.

Wow -- this sounds like a very scary place to work. Can't you find something else? You will never feel like you are a good nurse working in an impossible situation like you've described. I agree -- I'd rather work at McDonald's!

I feel sorry for you and for the residents, but I would get the heck out of there, move on and consider reporting them. They sound negligent and I think you are putting your license at risk working there.

You ARE a good nurse -- you just need to find a sane environment where you will realize that fact.

Keep us posted. I wish you the best.

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just wanted to say this is the best thread yet on Allnurses.com.

I, too, am a new grad at a county ER. we are supposed to get 6 weeks of orientation and since the end of the first week, my preceptor has constantly been telling me I'm "behind" schedule, too slow and etc....I'm finishing my 4th week, and now am on 4 patients.

about a week ago, i had my first very tough day where i told all my friends i was thinking about quitting. since then, i had two days (actually night shifts) that were fairly easy, but recently i had one shift that was very difficult and then another which was so difficult i just kept telling myself "tomorrow I'll call in sick and then give notice and quit." 2 hours into the last shift, i told my preceptor "I needed help", i was in over my head and she just said, "yeah, i know." it wasn't until the end of the shift when she gave me help. So i spent the majority of the night thinking about how maybe this just isn't for me.

so far, i did take a sick day off but have not yet called in to say i quit. I am looking on this website for more advice about how to hang in there. This is my second career, so i have 20 years working experience and I keep telling myself, to figure out a way to hang in, but my heart seems to be telling me- it might just be time to change careers for the time being before finding a hospital/nursing job with a better new grad training program. (I have another 'non-nursing' job lined up so i wouldn't be crushed for rent/food if I quit this nursing job).

thanks everyone for the help and hang in there, too.

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Specializes in IMCU.
just wanted to say this is the best thread yet on Allnurses.com.

I, too, am a new grad at a county ER. we are supposed to get 6 weeks of orientation and since the end of the first week, my preceptor has constantly been telling me I'm "behind" schedule, too slow and etc....I'm finishing my 4th week, and now am on 4 patients.

about a week ago, i had my first very tough day where i told all my friends i was thinking about quitting. since then, i had two days (actually night shifts) that were fairly easy, but recently i had one shift that was very difficult and then another which was so difficult i just kept telling myself "tomorrow I'll call in sick and then give notice and quit." 2 hours into the last shift, i told my preceptor "I needed help", i was in over my head and she just said, "yeah, i know." it wasn't until the end of the shift when she gave me help. So i spent the majority of the night thinking about how maybe this just isn't for me.

so far, i did take a sick day off but have not yet called in to say i quit. I am looking on this website for more advice about how to hang in there. This is my second career, so i have 20 years working experience and I keep telling myself, to figure out a way to hang in, but my heart seems to be telling me- it might just be time to change careers for the time being before finding a hospital/nursing job with a better new grad training program. (I have another 'non-nursing' job lined up so i wouldn't be crushed for rent/food if I quit this nursing job).

thanks everyone for the help and hang in there, too.

Guess what at 4 weeks if you were caught up regularly with 4 patients in the ER you would be missing or skipping a lot! You sound like you are doing phenomenally. I haven't precepted a lot, but when I did, if my preceptee got a little behind, I let her handle it, but picked up the slack when things started hitting hard and heavy, but if she was truely BEHIND BEHIND, I would go in and take as much of the load as needed to get her where she could breath. I am not the fastest as I only have one year experience, but most good preceptors that I have seen allow the preceptee to have as much autonomy as possible. Some will tell them they are too slow, but not the better ones. Maybe she just means that you are slower than you will be when you are experienced or slower than she would be. I would not get discouraged. Sounds like you are the kind of preceptee that I would love to have. One that is not afraid to get in there and get down and dirty, but who knows she needs help and asks for it. Bottom line....as long as you are on orientation it is her responsibility to get the patients seen. If she doesn't get in there till the last minute, you must be doing better than you think you are.

I can't tell you how many times I wanted to quit my first few months. Orientation wasn't bad but when I was on my own, it was the pits. We had at least 4 predetor nurses and I think they gave me the most acute patients on the unit, I have had 3 vents, 3 traches, 3 tube feeding, 2 in restraints and 2 on isolation all on the same night. It was rediculous to do that to a new grad, but I am glad that I hung in there. Like you I could have gotten another Social Work job in a heartbeat, but I really didn't want to. I wanted to make it in Nursing, and I am so glad I hung with it, because I love my job!

Mahage

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Thank you so much for taking the time to respond. I have used both your response and the help of my friends and family to make some decisions about changing up this job.

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You are very lucky to have been switched to a less acute floor to get some experience. I graduated in June, got my license in August. I started on a high acuity med surg telemetry floor. After 12 weeks of orientation, my manager said I made too many mistakes and wasn't progressing fast enough. I was given 36 hours to resign or be terminated. I have gone over my situation with my professors and other experienced nurses and they have told me that the mistakes I made were normal new nurse mistakes and none of them harmed a patient. I think my manager wanted someone who could hit the ground running, and I am a typical new nurse. I too am a second career nurse and graduated in the top ten students of my class of 150. I feel humiliated to have lost my job. I am looking for a new one, but nobody wants a new grad. Everyone wants a nurse with a minimum of 1 year experience. So, I guess I want to tell you to hang in there. It could be worse!

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Specializes in IMCU.
You are very lucky to have been switched to a less acute floor to get some experience. I graduated in June, got my license in August. I started on a high acuity med surg telemetry floor. After 12 weeks of orientation, my manager said I made too many mistakes and wasn't progressing fast enough. I was given 36 hours to resign or be terminated. I have gone over my situation with my professors and other experienced nurses and they have told me that the mistakes I made were normal new nurse mistakes and none of them harmed a patient. I think my manager wanted someone who could hit the ground running, and I am a typical new nurse. I too am a second career nurse and graduated in the top ten students of my class of 150. I feel humiliated to have lost my job. I am looking for a new one, but nobody wants a new grad. Everyone wants a nurse with a minimum of 1 year experience. So, I guess I want to tell you to hang in there. It could be worse!

I am so sorry this happened to you. The big hospitals will be hiring new crops of grads in Jan. and again in June. If you don't get something before, maybe you will get in that batch. They did not treat you right. They should have given you more time on orientation or given you the option of transfering to a less acute floor. That was poor management.

Hang in there, you will find your niche.

Mahage

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wow

thank you thank you for starting this thread. i am a second career new nurse-graduated in september, in my 5th week of orientation on a busy post=op floor and i just had a little meltdown tonight-and i wasn't even at work! i just started thinking of how much i don't know how to do and it freaks me out. thankfully, i have a wonderful preceptor who is understanding and is there along with me through my day. she checks my meds before i give them and goes in to assess when it's something i've never done before, i.e. suctioning a trach, setting up feedings for a jtube,etc. i don't know how some new nurses on here have learned anything when their preceptors just sit back and relax. i am having a lot of difficulty with the nursing techs and other nurses who get frustrated with me when i don't know how to do something or i am slower than they wish me to be. i start worrying so much about how i look to them, i feel like an idiot sometimes! i also see many nurses done with all their morning meds, paperwork, etc and i am hustling trying to get everything done. i think a lot of it may be that i am a classic overachiever. it's really hard for me that i am not "a good nurse" yet, even though it has only been 5 weeks. i wonder how i will manage when i am on my own and i am scared to have a day when i won't know what to do, who to call, and so on. i'm glad i came across this thread because it makes me realize that we are all still learning and that i need to forget about what other people think or how they act- taking care of people is my job and that is the priority, even if i am slow or need to ask a billion questions. sorry for the long rant, i feel so much better

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Specializes in IMCU.
wow

thank you thank you for starting this thread. i am a second career new nurse-graduated in september, in my 5th week of orientation on a busy post=op floor and i just had a little meltdown tonight-and i wasn't even at work! i just started thinking of how much i don't know how to do and it freaks me out. thankfully, i have a wonderful preceptor who is understanding and is there along with me through my day. she checks my meds before i give them and goes in to assess when it's something i've never done before, i.e. suctioning a trach, setting up feedings for a jtube,etc. i don't know how some new nurses on here have learned anything when their preceptors just sit back and relax. i am having a lot of difficulty with the nursing techs and other nurses who get frustrated with me when i don't know how to do something or i am slower than they wish me to be. i start worrying so much about how i look to them, i feel like an idiot sometimes! i also see many nurses done with all their morning meds, paperwork, etc and i am hustling trying to get everything done. i think a lot of it may be that i am a classic overachiever. it's really hard for me that i am not "a good nurse" yet, even though it has only been 5 weeks. i wonder how i will manage when i am on my own and i am scared to have a day when i won't know what to do, who to call, and so on. i'm glad i came across this thread because it makes me realize that we are all still learning and that i need to forget about what other people think or how they act- taking care of people is my job and that is the priority, even if i am slow or need to ask a billion questions. sorry for the long rant, i feel so much better

It is so good to hear from someone who has a good preceptor. I had several good ones, but wish I had been able to work only with one preceptor, a good one of course! I got lots of good info and demonstrations but never had the true experience of doing the who thing from start to finish, because I kept bouncing around because of scheduling, then they would put me with the charge nurse and I would only get one patient. We handle 3 on our unit and do all our own order entries except when we get a new pt. then charge generally does them. My preceptors would always do the things like chart checks, order entries and lab reviews, even hang my electrolytes, so I didn't have too! They were too nice, then when the day came that I was on my own, ooooooohhhh! That was rough. The ones who told me they would help me, did when they were working with me and this made an extremely steep learning curve a little more doable. I think most new nurses feel the way you and I do. I am a little over a year out and still make mistakes.

I was at work an hour late today mainly because of a mixup with my patients PCA pump. Someone either accidentally cleared it, it malfunctioned or the patient has a key.:no: I never thought about verifying the level it was at when I came on shift so I couldn't say for sure what it was on, but when I went in to clear it this morning, it said she had only used 1 mg. I don't believe this is the case. I didn't know what to do but report my concern to my charge nurse. She asked me had I verified the level at the beginning of shift and I didn't because it isn't required. Bet I do next time. I don't like it when something goes awry to do with narcotics. It can put you in a very bad position. The day nurse and I verified together how much was left in the cartridge and marked it with a maker. I bet I do this from now on. Anyhow, hopefully no crisis will happen as a result of this, but I have definately learned something. My charge didn't seem upset about it, she just said to be sure and verify levels of PCA's when coming on shift. Makes sense to me!

Mahage

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Specializes in Stepdown, ECF, Agency.
Thanks for this support stickie,

I am a new grad nurse going on 6 months on a med/surg floor and still feel overwhelmed. We have team nursing where we have 10 pts., 5 of them are RN pts and the other 5 go to the LVNs but I am still in charge of all 10. Other nights I only have 5 pts with 2 that are TPCs.

I love nursing, but sometimes I want to quit because it is just too much work. Also, I still am having trouble giving reports to the next shift. What is the best way to give report where a nurse will not look at you and have an attitude regarding hand off reports.

Any advice would be appreciated. Thanks.

rosstat2

"Also, I still am having trouble giving reports to the next shift. What is the best way to give report where a nurse will not look at you and have an attitude regarding hand off reports. "

I hope this is not just more discouraging, but know that you are not alone. The last place I worked, there were ONLY TWO WAYS that we were allowed to give report (per the flyers posted around). The first person I gave report to looked at me like I was an idiot, and told me that her way (different) was the ONLY WAY that we were supposed to give report. The charge nurse came over and backed up the hand off nurse, and I went home feeling as if I had failed, yet again.

I don't see any standardization, anywhere, ever, that I have been, only people who are ready to be very critical if you don't read their minds. I am so disgusted with nurses and nursing. I am ashamed for my collegues and ashamed to be a nurse.

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Specializes in IMCU.
"Also, I still am having trouble giving reports to the next shift. What is the best way to give report where a nurse will not look at you and have an attitude regarding hand off reports. "

I hope this is not just more discouraging, but know that you are not alone. The last place I worked, there were ONLY TWO WAYS that we were allowed to give report (per the flyers posted around). The first person I gave report to looked at me like I was an idiot, and told me that her way (different) was the ONLY WAY that we were supposed to give report. The charge nurse came over and backed up the hand off nurse, and I went home feeling as if I had failed, yet again.

I don't see any standardization, anywhere, ever, that I have been, only people who are ready to be very critical if you don't read their minds. I am so disgusted with nurses and nursing. I am ashamed for my collegues and ashamed to be a nurse.

Don't over react! She is taking up too much space in your head. I have found that most everyone wants the same basic pattern start with head down and give a report of systems. Include iv's and lab tests. Include BM's and any tubes and drains in the appropriate system. Let them know of any upcoming proceedures and we give a history initially including current and the MD's involved. They then have the opportunity to ask questions. If someone has a specific way they want report it is probably some variation on this and I would just learn to give it in the format that particular nurse wants unless she is asking something absolutely unreasonable. I have one who thinks I should KNOW and remember all the lab tests and the results. I just flip to the rounds report and go over them with her. She deals with it, LOL! She will pick apart any weakness she finds. One time she had a fit on me because I couldn't remember which nare the ng tube was in. :argue: Well now, I remember, but early on I could not. I certainly will not let her or any other jerk turn me against nursing. There are loads of good nurses who have helped me enourmously. The bad ones just hurt so bad, but they will not win. I am too stubborn and too good a nurse for that, LOL!

Mahage

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