Terrified! Advice.

Hello,

I have had the newly minted employee jitters many times over as a LVN and now RN. Your fear and uncertainty are normal. :) Here is a few things I have done to help me get through them...

- Instead of saying "I have to...", say "I get to..." Super corny, I know. It is a statement I frequently regard as total BS in the moment of panic BUT, ultimately, it is true. Sometimes the best opportunities are disguised as hard work. Think about everyone who is struggling to get a job. You get to be in a different league. You get to practice independently. Remember those times in nursing school when you thought you couldn't do it but you did it, and you are going to get to do more.

- Make a list of things to "hit" when charting. Take heed when your preceptors are giving you constructive criticism, and incorporate this into your list. Have this list handy at all times. This will serve you better than having to remember all the little details while in the midst on a busy shift.

- Print out pertinent policies and procedures and put them in an easily accessible folder. This way you're not scrambling to find them in the heat of the moment. Also, if your P&P has guidelines on minimum charting and assessments for your unit, incorporate that into your charting guide. Sometimes coworkers who give you advice do not differentiate between personal preferences and official policy. This folder will help you make your own decisions on how to give care.

- Come early. I come 45 min to a hour early and research my patients H&P, labs, look at the previous nurses' assessments, go through the orders with a fine tooth comb etc. As a new RN, I know that I will not piece together the big picture as quickly as my coworkers. So instead of trying to keep up with them (which I won't), I get a headstart.

I feel for you! I'm off orientation in 4 weeks and I'm terrified. I feel like there is now way I can get this done, but what other choice do I have but to keep plugging away? There are a good number of newer nurses on my floor and they all tell me they felt exactly the same way, it's a difficult unit, I will eventually "get it", and I'm doing just fine. I really hold on to that!

In the long run, we can only do what we can do. Two seasoned nurses on my unit were having bad days yesterday and it actually helped to hear them say what a rotten day they were having and that they felt like they couldn't do anything right.

I'm pulling for you! Let us know how it goes.

Thanks for the advice and kind words! I wish I could just get it together! So scared!

First off, cutting your orientation by 2 weeks just because nurses have quit should not be the norm. They should have a PRN team to cover open shifts and/or offer OT to nurses already working on the floor. You were given that orientation time for a reason, so that you could properly learn the job. I'm not so sure this happens as often as it does in the nursing profession (training being cut short, etc).

However, you obviously can't say anything about it lol, so, you just have to make the best of it and be a nice, flexible, new employee. Otherwise, they could decide to let you go it you say anything, etc. So, smile, and make the best of it. Learn everything you can in these next 2 weeks. You'll make it. You're already up to 4 patients...it's just a matter of taking on those extra two. On your next shift, make sure you take 5 patients, and then the shift or two after that, make sure you're taking a full load on your own. Make sure you write a list of any last minute questions you have or things that you have not done yet that you need to do, and ask your preceptor if you can start an IV or two or whatever you feel you need before orientation is over. Just say..."Since I'll be coming off orientation earlier than expected, there are a few things I would like to do before it's over, and a few patient dx I have not been exposed to yet and would like to be assigned that patient if possible."

I did this on my orientation, and it wasn't cut short. I was exposed to mostly everything that is common on our unit, and very critical patients, but I felt that I needed more IV practice, NGT insertion (since I had only placed 2 on orientation), so I asked anyone on the unit if I could start their IV's and NGTs if they needed one started.

At the end of the 2 weeks, if you truly don't feel safe having a full load, then you do need to speak up. (Just don't confuse being nervous with safety. Everyone is nervous starting on their own, but if you're not able to handle a full load at that time, you need to speak up).