Terrified new nurse

[ShinyNewNurse]

Hi everyone!

I'm a brand new nurse. I just passed NCLEX in November, and started on my floor just yesterday (after two weeks of nursing core orientation). I've started on a Med-Surg/Oncology floor, where the only things LPNs can't do are administer a a hand full of IV meds and need a sign off by an RN for our assessments. Other than that, we do everything else. Yesterday was supposed to be my "shadowing" day which in fact turned into me doing a lot of work. There are a lot of skills that I never even got to do in nursing school, but each new nurse gets 13 weeks of training with a preceptor before we're put on our own. My preceptor even told me that LPN school here doesn't do new LPNs any favors by not giving us more exposure to Med-Surg concepts (clinical wise.) My question is.. did any of you feel absolutely stupid your first day? I felt like the dumbest of the dumb. From patient care to trying to memorize how to use the Pyxis.

[Wuzzie]

Are you kidding?!!! I felt stupid for at least a year and still feel it some days after 30 years! You're doing fine.

[Ruby Vee, BSN]

YUPl Felt stupid pretty much most of my first year, and I probably WAS stupid most of my first year.

Shadowing a nurse (commonly employed as part of the interview process prior to a job offer being extended) and orienting or precepting are two different things. The way you learn how to be a nurse is to BE a nurse with a preceptor as backup. So doing the work is common and expected.

Carry a little notebook in your pocket and jot down things you're likely to forget, from your Pyxis password (you'll need it the day you've got a burn on "that finger" and your fingerprint won't register) to the phone number for X-ray. That way you won't have to waste anyone's time asking the same question over and over. Ask questions, but don't ask the stupid questions. ("Can you tell me how to get in touch with pharmacy again?" "HELP! Mr. Pee needs a Foley. What do I do?") It is better to ask a question that shows you've at least tried to find an answer. "Mr. Pee has an order for a Foley. I've read the procedure and I think I have all the supplies I need, but I've never done this before. Could we go over the procedure before we go see the patient?"

The first year of nursing is miserable, but it does get easier. Good luck! There are plenty of threads about this, especially on the "First Year After Licensure" forum.

[ShinyNewNurse]

Unfortunately, shadowing isn't a part of the interview process at my hospital. I went through two weeks of nursing core orientation, and the first day on the unit is supposed to be shadowing.. basically just observing the preceptor without doing anything hands-on. That's how it was explained to me. And after that day us over, you still are helping your preceptor care for her patients. You don't even get a patient of your own until eight weeks in, and then they slowly build you up to six.

[NotMyProblem MSN, ASN, BSN, MSN, LPN, RN]

I carry a closeable clipboard that has a calculator on the outside clip. Inside, I have my work schedule taped to the inside cover with my computer login information written on it, scissors, hemostats, blank SBAR forms, a copy of a directory containing department extensions, a copy of the hospital's Residents (photos and pagers), extra pens, and pertinent handouts for patient education.

On the outside of the clipboard are the completed SBARS from shift report with a printed MAR stapled to each one, and a piece of plain white paper used for a cover sheet to protect patient information. On that cover sheet is my name and phone# (can't tell you how many times I've been asked for my cellphone extension and I had no clue what it was), the tech's name(s) and extension(s), and the charge nurse's name and extension (for emergency purposes). Even though I choose to print out the MAR as a visual reminder of meds due, I still write down the room numbers and times for scheduled meds that have unusual times.

Even with all of that preparation, somebody is going to call and ask for the ONE thing that I've not included in the above. It NEVER fails. There goes the deer-in-the-headlights look.

[Vespertina]

Ohhhh hun it's baptism by fire. I'm about to be in my 2nd year as an LVN, and there are times I still wonder if I'm competent enough; I still have so much to learn (in the grand scheme of things, as I wish to further my education). Slowly but surely you will gain expertise, but each day is a learning experience in either a large way or small. It's perfectly normal to feel stupid the first day, as did I. Just remember for the sake of everyone involved, including your clients, it's better to swallow your pride and ask "stupid" questions, than it is to try faking it till you make it in terms of experience. I'd say Ruby Vee has the right approach, by researching your question as much as possible before asking it. Every nurse I have opened up to about needing to learn new skills from together has been nothing but kind and helpful to me, and not only did I gain knowledge and confidence, but it also strengthened co-worker bonds.