Terrified of working on my own

Posted
by Sham_wow (New) New

I was so happy when I was able to get into a residency program for nursing at a great hospital. I was accepted for a progressive care/telemetry floor which has a residency of 12 weeks. During that time, you are assigned a preceptor who basically helps train you on the job and shares the patient load which you. Gradually you end up taking the patient load by yourself (which is four to five patients) but your preceptor is still there to guide you if you need it. At first I was so excited to have this opportunity. I couldn't possibly imagine going onto the floor alone after a brief orientation like most hospitals give you. But working nights has been a big adjustment and it has caused problems in my marriage. I had been out of nursing school for four months when I got the job because i got married straight after graduating and I moved to a different state. Currently I have two weeks of residency left and I'm finding myself becoming immensely terrified of being on my own. I know that my preceptor will still be someone I can ask for advice if I'm working with her, but I find myself always always always unsure of what to do when any new situation arises. And we get a lot of random situations. Patients that are having alcohol withdraw, stroke patients, post surgical patients, and many other situations that I haven't even come in contact with yet. Rapid responses are called often. This morning I woke up and found myself overcome by anxiety about coming off residency and being alone. I know it's good to ask questions but I question everything just because I want to be told what I'm doing is the right thing. I'm still unsure of when to call the doctor and scared because it's the middle of the night. Every time I do call them I feel so shaky it's hard to even think or know what to say. I know that everyone goes through anxiety about this but I'm already someone who suffers from anxiety and I don't want to go to my job every night afraid of not doing my job correctly or making a mistake. It's too much stress. I fee like maybe working in a hospital setting isn't right for me but I don't have enough experience yet to go and find another job. I'm just not sure what to do or how to help my situation.

westieluv

Specializes in Med/Surg, Tele, Dialysis, Hospice. Has 26 years experience. 948 Posts

Everyone feels this to some degree as a brand new nurse, but it sounds like yours is an extreme case. The patient scenarios that you gave examples of are very typical of patients on med/surg floors in any hospital, anywhere.

The good news is that you will be working with other, more experienced nurses who will help you through this. If you have a question or concern, go to them. They get that you are new and they don't want any harm to come to patients either. Have some faith in your education, your own intelligence and intuition, and lean on your co-workers until you get your "sea legs" and feel more confident. You will get through this, thousands of nurses over many, many years have.

Also, thank God for the advent of the rapid response! When I was a new nurse 25 years ago, there was no such thing. You could only monitor them and call the doctor if you thought something might happen or wait until they coded. With a rapid response team in the building, you have a sort of safety net in place so that the patient does not have to code if they go bad suddenly. I would have felt a lot better as a new nurse knowing that I could call a rapid response and get a patient off to ICU before they coded. We could get them transferred if they started to go bad, but it involved calling the doctor and getting the house supervisor involved to approve the transfer, all of which took precious time.

Most of all, just give it time. You are in a brand new role. No one starts out an expert at what they do, not doctors, lawyers, teachers, or anyone else. Time = experience = feeling confident.

Edited by westieluv

Been there,done that, ASN, RN

Has 33 years experience. 6,765 Posts

A terrified nurse cannot take care of terrified patients.

You would have experienced nurses and a rapid response team to assist you. But ... you cannot deal with your anxiety.

There ARE many places, other than a hospital, for a nurse to secure employment. There are many nurses that cannot obtain a hospital position.

Give yours up to one that can handle it.

Edited by Been there,done that

Maevish, ASN, RN

Specializes in ICU, Postpartum, Onc, PACU. Has 9 years experience. 396 Posts

Wow, I wasn't expecting that ^^

It's normal to feel flustered (even nauseated lol) until you get your nursing sea legs under you. That can take some people 3 months or closer to a year, depending on your specialty. On Med/Surg you'll see a LOT of different dx daily (though you will have the "common" ones) so until you get a grip on those and get used to them, you will feel like you're drowning a bit.

When I first started I had a preceptor tell me (not a new concept, by the way) that there will always be someone more experienced and capable on the floor with you to bounce ideas off of or ask questions of. Remember that and it should take some stress away. Also, try to relax and ground yourself so that you can fully take advantage of your preceptor and internalize the teaching they give you. At this point you can only do one thing at a time and do it well. Don't freak because you don't have the multitasking (or "nurse brain") thing on point; you're not supposed to. Although if you did, good for you! haha

I remember that feeling and it goes away. Also, if you've done your darndest and things still don't seem to be adding up, see what the manager will do about giving you a couple more "O" weeks. Just don't expect to feel comfortable straight off orientation. The learning continues much longer than that, but if you want to do nursing it will come to you eventually. Trust me, I didn't think it ever would for me and it did. Eventually. :sarcastic: You haven't done this thing long enough to know for sure that it isn't for you. If you still feel this badly about it after a year or so, then yeah, maybe you should change areas. If everybody based their nursing futures on how they felt in orientation, I daresay there would be far less nurses at the bedside than there are now! :wacky:

xo

Been there,done that, ASN, RN

Has 33 years experience. 6,765 Posts

Wow, I wasn't expecting that ^^

It's normal to feel flustered (even nauseated lol) until you get your nursing sea legs under you. That can take some people 3 months or closer to a year, depending on your specialty. On Med/Surg you'll see a LOT of different dx daily (though you will have the "common" ones) so until you get a grip on those and get used to them, you will feel like you're drowning a bit.

When I first started I had a preceptor tell me (not a new concept, by the way) that there will always be someone more experienced and capable on the floor with you to bounce ideas off of or ask questions of. Remember that and it should take some stress away. Also, try to relax and ground yourself so that you can fully take advantage of your preceptor and internalize the teaching they give you. At this point you can only do one thing at a time and do it well. Don't freak because you don't have the multitasking (or "nurse brain") thing on point; you're not supposed to. Although if you did, good for you! haha

I remember that feeling and it goes away. Also, if you've done your darndest and things still don't seem to be adding up, see what the manager will do about giving you a couple more "O" weeks. Just don't expect to feel comfortable straight off orientation. The learning continues much longer than that, but if you want to do nursing it will come to you eventually. Trust me, I didn't think it ever would for me and it did. Eventually. :sarcastic: You haven't done this thing long enough to know for sure that it isn't for you. If you still feel this badly about it after a year or so, then yeah, maybe you should change areas. If everybody based their nursing futures on how they felt in orientation, I daresay there would be far less nurses at the bedside than there are now! :wacky:

xo

Wasn't expecting what exactly.. the truth? OP has stated her anxiety is deep seated and unmanageable. She does not need to be coddled here, she needs to find a setting that she can handle.

"a couple more "O" weeks" is not not going to make a dent in her level of anxiety.

xoemmylouox, ASN, RN

Has 13 years experience. 3,150 Posts

I would say you need to address your anxiety. Being a new nurse is intimidating and sometimes downright scary. That being said if your "everyday" anxiety isn't managed I doubt there is any new grad job you will be comfortable.

Just know that most new grads are a bit worried when they are starting out. You aren't going to always know what to do or say - that comes with experience. Don't be afraid to ask your coworkers. Try to be prepared when you call the MD - have the most recent vitals/labs in your brain and write down your questions before you call. That way you don't forget to ask something.

Sham_wow

3 Posts

I never said my anxiety was deep seated or unmanageable. Nor am I asking to be coddled. I don't know why you're coming off aggressive.

mightynurse4

23 Posts

OP, it is normal to feel some anxiety about being on your own at first. None of us know everything, even after we get experience. Nursing is lifelong learning. I have often found that the fear of certain situations is worse than the actual situation. You don't know what you CAN do until you do it. I agree with previous posters, having rapid response is an amazing asset. I do not have that luxury at my small hospital and have assisted in codes many times. You will be surprised at what you can do once you get going. Build strong relationships with your coworkers and they will always have your back. You can do this, have faith in your education and training and go for it. When new situations arise, ask for help. Even seasoned nurses need a little help sometimes. Just make sure to return the favor down the road (help pass meds, start IVs, etc.) And ask questions in report such as how the reporting nurse handled a situation. Good luck!

Been there,done that, ASN, RN

Has 33 years experience. 6,765 Posts

I never said my anxiety was deep seated or unmanageable. Nor am I asking to be coddled. I don't know why you're coming off aggressive.

" I'm already someone who suffers from anxiety, It's too much stress. I'm finding myself becoming immensely terrified "

Sounds deep seated and unmanageable. My suggestion was not aggressive. My suggestion was ..get a job outside of the hospital.

macawake, MSN

Has 14 years experience. 2,079 Posts

A terrified nurse cannot take care of terrified patients.

You would have experienced nurses and a rapid response team to assist you. But ... you cannot deal with your anxiety.

There ARE many places, other than a hospital, for a nurse to secure employment. There are many nurses that cannot obtain a hospital position.

Give yours up to one that can handle it.

I don't see how you can offer such definitive advice based on a single post on an anonymous forum. Simply quitting this position without indentifying and dealing with the source of OP's anxiety will likely not solve anything. That kind of new nurse anxiety will most likely just follow OP to her next position even if it's in a lower stress/acuity environment.

OP, I experienced something similar to what you're describing when I was a brand new nurse. In my case it took me completely by surprise since I was a second-career nurse who'd previously worked in a high-stress job and had a reputation of being unflappable, calm and rational under pressure.

I actually ended up leaving my first nursing job in med-surg/telemetry before the one-year mark. I remember sharing my thoughts and concerns about feeling overwhelmed and convinced that my inexperience would get someone killed with a physician at work, a cardiologist just a few years shy of retirement. He listened patiently and told me that it was good that I'd identified ten (I kid you not :lol2:) different ways how each my patients could go south because it would make me vigilant. The he added: just don't let your worries paralyze you. Then he concluded by saying "it's a lot harder to kill a patient than you think, brand new nurse macawake".

I stayed for a few months longer but realized that I was making myself miserable. I finally made up my mind and told my nurse manager that I was giving notice. She asked why and I told her. My very first nurse manager was a thirty-year veteran, a stern, gruff battle-axe of a woman who never cracked a smile. (I realize that battle-axe is normally used with a pejorative connotation, but I use it with affection in this case. I have enormous respect for this woman's professional competence). She looked me in the eye and asked me if I thought that she would have let me off orientation if she thought that I was going to kill her patients? She paused for a bit then said: You should know, I would entrust my parents, my husband or my children into your care. Now, you do whatever it is you need to do.

Well, that was my story :) In hindsight I can see that I was asking/expecting of myself to perform at the level of a nurse with five or ten years experience, at a point in time when all I had was five or ten weeks on my own.

OP, what kind of feedback has your preceptor given you? Does s/he think that you're up to par? If s/he does, I would trust that. Perhaps all you need is to simply take the bull by the horns and jump right in. Perhaps your anxiety issues run deeper and you might also benefit from therapy. It's hard for me to judge, but please know that you'll never be entirely comfortable and relaxed when you start out in your first nursing job. Truth is, if you were 100% confident and convinced that you know it all, you'd scare me.

I think that westieluv offered excellent advice:

The good news is that you will be working with other, more experienced nurses who will help you through this. If you have a question or concern, go to them. They get that you are new and they don't want any harm to come to patients either. Have some faith in your education, your own intelligence and intuition, and lean on your co-workers until you get your "sea legs" and feel more confident. You will get through this, thousands of nurses over many, many years have.

Best wishes OP!

Edited by macawake

Sham_wow

3 Posts

Thank you for sharing your story with me. It's good to know that I'm not alone in feeling the way I do. My preceptor says that I need to work on my time management skills a little but other than that she usually gives me good feedback.

loriangel14, RN

Specializes in Acute Care, Rehab, Palliative. 6,923 Posts

OP , you will not be working on your own. You have coworkers. If you need help, ask. Deep breath. You can do this.