Support Stickie for New nurses who are not coping

rabbitgirrl · Dec 24, 2008

Thank you for the encouragement and the tips. I wish it was just one unreasonable person in a sea of kind, helpful mentors. I think we all know better! Your support is deeply appreciated.

NurseBrittney · Dec 24, 2008

I just wish the one nurse who thinks she is the end all be of all of nurses would kindly shut her mouth and stop stating her opinion as fact....

that would really make things much easier for me.

marilynmom, LPN, NP · Dec 27, 2008

I am at my 6 month point in the PICU and things have gotten better. I can sleep and am not nauseated before I go to work now as much but I still get really anxious and nervous my first day back. I still have diarrhea at times before work though...lol. Going to night shift has really been good for my anxiety and stress. I feel that I have more time to learn, can do better assessments, etc. We do have more codes but they are not as stressful as they are during the day.

I have a *great* team of nurses I work with--it really couldn't get any better, we get 1 hour lunch breaks almost every shift, great support, help when I need it, etc. But I still get freaked out and think about quitting often and finding an "easier, less stressful" job. But I know that isn't out there in nursing and I know I am fortunate to work on such a great unit.

But it is just a very stressful and hard job at times! I wonder why I put myself through this stress and I dream about working at Starbucks or my old bookstore where peoples lives didn't depend on me and things like codes, self extubation, etc doesn't even happen :)

I just keep telling myself that wow I have learned so much since I graduated nursing school and look how far I have come. Things that used to freak me out don't anymore, and the more experience with situations I get the more confident I will feel about handling them (I get stressed when I don't know *what* to do....that is basically my main problem, and only comes with experience).

Just wanted to post my 6 month update. I'm hoping the next 6 months goes by fast! Can't wait to have that first year under my belt!

margo2007 · Dec 30, 2008

I feel exactually the same way! I feel alot better know I am not a lone.

madwife2002, BSN, RN · Dec 30, 2008

Hi I am back sorry I have been absent from this thread I have had some family issues.

I am so glad this thread is helping new RN's I try so hard to help the girls at work because I know how important it is to make them understand they are not alone, and that we all felt that way at least once in our lives.

Everytime you face a new challenge at work it is always daunting but nothing is as hard as when you first face life as an RN on your own.

I would love to do more with new grads as I so enjoy them, they have so much to offer and are uptodate most of the time on new and current research. They keep me challenged and are more helpful than they give themselves credit for.

dsoginer · Dec 30, 2008

I have a sheet that I use to give report from; as the shift progresses I add info to the sheet so that it is complete for each pt before the end of the shift. Here is the basic info that is needed for report:

Name

age

Dx

secondary Dx

Wgt

last BM (or void if needed)

Diet status (regular? NPO? and why)

IV site/ central line

what is hanging

what is the rate

when the bag went up

site care if given

any meds hanging & infusing, If have extra tubing hanging for Piggy back, (always label) but tell the nurse what it is for, when it expires, rate etc. when last dosage was

any pertinent drugs being given, say Igb or Demerol given with lidocaine, etc.

any reactions to meds

any changes to the med schedule

Primary MD name, consulting Md's and when they came,

what action they took

new orders

Dressing care/changes and times

skin integrety issues

where all drains are located , what they are,and when last emptied

Pertinent Labs (any high or low)

what labs are needed, when and who are to draw/collect them

if pt is incontinent and what type/size of diaper they are wearing

Any specific nursing interventions were performed or need to be performed

Any procedures that will be performed on the pt and when

Any other revelant information needed depending on which dept you work in

And ALWAYs end with "Do you have any questions

Any one else have something they feel is needed?

Good luck

Quilter0225 · Dec 30, 2008

I have a sheet that I use to give report from; as the shift progresses I add info to the sheet so that it is complete for each pt before the end of the shift. Here is the basic info that is needed for report:
Wow, that is a lot more detailed than my current method. Do you have a certain way that you organize things on the page? Do you use one sheet per pt? I use the back side of my kardex for each pt. I also give a systems assessment/report starting from head to toe.

flyakite80 · Jan 1, 2009

I have a sheet that I use to give report from; as the shift progresses I add info to the sheet so that it is complete for each pt before the end of the shift. Here is the basic info that is needed for report:
Name
age
Dx
secondary Dx
Wgt
last BM (or void if needed)
Diet status (regular? NPO? and why)
IV site/ central line
what is hanging
what is the rate
when the bag went up
site care if given
any meds hanging & infusing, If have extra tubing hanging for Piggy back, (always label) but tell the nurse what it is for, when it expires, rate etc. when last dosage was
any pertinent drugs being given, say Igb or Demerol given with lidocaine, etc.
any reactions to meds
any changes to the med schedule
Primary MD name, consulting Md's and when they came,
what action they took
new orders
Dressing care/changes and times
skin integrety issues
where all drains are located , what they are,and when last emptied
Pertinent Labs (any high or low)
what labs are needed, when and who are to draw/collect them
if pt is incontinent and what type/size of diaper they are wearing
Any specific nursing interventions were performed or need to be performed
Any procedures that will be performed on the pt and when
Any other revelant information needed depending on which dept you work in
And ALWAYs end with "Do you have any questions
Any one else have something they feel is needed?
Good luck

Don't forget about past medical history, allergies, and precautions (isolation, fall, seizure, etc.).

M&M+RN · Jan 19, 2009

:typing Hi everyone, I'm a new RN also, I just want to let my fellow newbies to hang in there. Organization plays a very important part of your day, make your own routine that works for you...lesser writing, use symbols/characters/acronyms. Don't be afraid to ask questions. Mistakes happen and you learn from it. Take a a deep breath. Take care of your health since it can wear and tear your body.

I had sleepless nights too, I was scared of moody doctors, got yelled at... almost cried. I once thought maybe nursing isn't for me, then I realized I still love nursing, I keep telling myslef "I love nursing", and nobody is perfect, I'll just have to do my best.

I encountered those nurses who won't even look you in the eye when giving report, like they're not listening, I feel disrespected but I kept going with my report and ask them if they have any questions. It annoys me, but only a few nurses do that at my work.

Be confident!

Galore · Jan 21, 2009

I have read through all these posts and seen so much of what I was and sometimes still am feeling. I just hit my 6 month mark in the NICU and have been off orientation for the past 3 months. For those just starting out, I'd like to give some encouragement and say that it CAN get much better. I still have days where I cry and feel anxious before I go in to work, but those are getting rarer and usually I find once I actually get to work it's not that bad and I have a fine night.

I think part of it has been adjusting my attitude and expectations. I'm the type of person who wants everything to be perfect and to give the best patient care possible, so when I make any little mistake I beat myself up over it. I hate when you are driving home or going to bed hours later and you remember some trivial thing you forgot to do. I have seen seasoned nurses make many little mistakes too so I have learned to give myself some slack. As long as no one gets hurt I chalk it up to a learning experience and think of ways to prevent it next time. When I apologize to oncoming shift if I missed something or was busy, some of the kinder older nurses say "hey, your babies are still alive and doing ok, you did your job just fine" and sometimes that's my mantra. Although some of the older nurses may disagree, it's not going to kill a baby if they didn't get bathed :)

I've noticed a lot of people have also experienced the disheartening phenomenon of feeling like you're running around all night while your coworkers miraculously seem to get it all done and have time to take multiple breaks and sit around online all day. I give my coworkers credit for often offering to help, but it is almost always during the times I don't need anything and when I do everyone is also busy. But guess what, I'm getting more efficient and am even starting to have some downtime to relax on some nights.

A couple of things that have helped me:

- at the beginning of my shift, I check my patients bedsides and make a list of any supplies I need, even if it's really obvious or I won't need it until much later (sometimes you get busy and "later" comes too quickly!). One trip to the supply room and then I know I have everything I need before I'm in the middle of patient care.

- same thing with going to the med room, if I'm making a trip in there I make sure I get anything else I need like flushes, labels for IV lines, etc.

- I found myself getting suddenly busy and behind doing my end of shift tasks while all the other nurses were sitting around for the last hour (things like hanging new lipids, changing suction canisters out, lab draws). By observing more experienced nurses, I figured out that I can do some of these things much earlier than I thought I had to, so they are out of the way.

- If I'm going to do a procedure, I grab an extra of whatever I need (sterile gloves, IV needles, etc). Sometimes it comes in handy, and if I don't use it I can always put it back. I feel it jinxes me to just get one :)

- This is a big one: utilize the charge nurse! One of ours just sleeps at the nurses station half the time. Even though she sometimes looks at me like I'm crazy when I ask for help, I now don't hesitate to ask her for help with IVs or whatever else I may need. They are getting paid for a reason, I stopped feeling like I have to be Super Nurse and do it all myself.

This is a nice thread to vent and realize we are not alone. I think we have to remember why we went into nursing and try to stop letting the little things and negative personalities get to us. On some days this is easier than others :)

PeaceonearthRN · Jan 22, 2009

Exact same situation here. Every chance to take a shot and it is taken.
I'm a second-career nurse and I've had the opportunity to mentor new hire computer programmers (my previous occupation for 20 years). I never made them feel small, only encouraged then to try a different way in the future when mistakes were made.
Anyone who has mentored previously, or raised children, or trained a dog knows that slamming, terrorizing, and belittling is counterproductive. So why is that the story on nursing units?????????????

Good thought! When does it become unacceptable to not have a positive approach in place to 'develop' newbies?

Regarding skills sets and time managment. Has anyone ever thought about being specific instead of giving vague criticisms? I have a GREAT charge nurse and am fortunate each time she teaches me. She is a gem a very RARE gem!

KalipsoRed · Jan 31, 2009

"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."

The ER in any hospital is a rough place, especially for new grads. Personally I don't think new grads should be allowed to work in the ER without 6mo to a year of experience. I worked as a tech in a huge ER for 4 years before graduating RN school. I was lucky enough to know how rough it was for the nurses by being a tech in the ER first. They offered me a job when I graduated but I turned them down to go to a telemetry/step down unit in a smaller hospital. I am sooooooo glad I did that. I thought it wouldn't be so bad because I had ER experience....I was so wrong. Telemetry/step down is hard....everything is hard when your a new nurse, even if you had hospital experience. I had to go to the night shift after 6 monts on days because days were overwhelming....nights are better and I have learned so much from both shifts! I felt bad for doing something "easier" at first because I want to be able to take care of "hard" patients but you know what? You have to crawl before you can walk.

As far as your precptor letting you drown, I know that seems very unkind of her, but she is really doing you a favor. My preceptor did not let me become overwhelmed during my 10 week orientation and my first week on my own I thought I was going to die. It is better to be overwhelmed and have someone there to ask questions to than to be overwhelmed and alone. You are going to feel like quitting many many many times over. Don't do it! I would suggest that you consider doing something easier like a telemetry floor or med/surg if you continue to find the ER to overwhelming 6 months from now. Don't feel bad about it. You can go back to the ER when you feel more comfortable with your skills, and you are doing your self right and your patients by not taking on more than you can handle. Anywhere you go you will probably feel like quitting for the first few months, but if after 6 - 8 months in one place if you are still going home on a regular basis crying or feeling sick when you know you have to go to work, then you need to go to a different setting.