Transition Shock--Novice Nurse

[mom22many]

CT here; passed boards over this past summer. Got in on a Med-Surg floor on days 7a-7p starting at $29.14-36 hours with benefits. Felt like a million dollars because I have struggled and fought to pursue my dream of being a RN. As a single mom with limited resources and 4 children in tow I felt lucky to even get an interview and then was extatic to get offered a position. I just got off of orientation which was originally only 6 weeks and they gave me a 7th week because I suggested I needed another. I was realizing as the weeks went on that this may not be the right place for me but I am aware I need to suck it up and "fight" my way through each shift, for my patients and for my family. Managment seems supportive at times when i actually see a member of managment, but managment is ultimately controlled by their managment and the all mighty dollar. Three full time day nurse have given their notice and left for other facilities.Was told call bells are everyones responsibilty but I feel im the only RN answering bells and when I do go into a patients room I open up a can of mess. I know that there is a "transition shock" between graduate nurse and professional nurse and I am feeling it. There is so much to learn to be able just to hold my own and give good care to patients. As a new nurse I find that I have difficultly delegated to the PCT's at times and everyone is so busy and I don't think it's logical to spend five minutes hunting down a PCT when I could complete the task I'm going to ask them to do. I am developmenting a good system on my assignments but may need to switch it up. I use the large index cards and find it has worked well but having to carry around 5,6 and this week 7 of them many not be the best. There is an accudose and I have to go into med room for each patient throughout the day. The carts we use just have a laptops on them. I can not pull all my meds for the day I have to continue to go into med room for each individual patient which is so time consuming. It's a 32 bed unit in a rural hospital on the border of 3 states. On good days there are 2 PCT's and 3 nurses and I have yet to see the unit full. During my time on orientation the nurses carried 4-5 patients but I understood it was common for them to carry 6. On my orientation I barely got up to 5 patients. I do see that management never takes acuity into the picture only census so this week I got 7 patients; 5 at beginning of shift, one being an admission, then 1 transfer from ICU and 1 admit from the ER. Transfers always seem to come at change of shift, during report. 3 of my patients were on contact, I had 2 dressing changes including packing a wound, PICC dsg; 2 accuchecks AC, 1 detox, 1 who yanked out their saline lock and who was constantly confused and trying to get up. 3 fall risks, many IV antibiotics and many 8,9,12,16,18 medications plus coverage for my 2 accuchecks and this one nurse who was doing all she could to keep up on medications and documentation. Bells constantly going off and another pair of hands never to be found. I rarely get out on time and now without my preceptor my shifts tend to run 14 hours. I am frustrated and questioning my entire path. I have read through some other posts here and staffing seems to be an issue with many facilities which is so frustrating because management wants good scores on these surveys but do not allow for staffing levels to be able to give responsible care. The reality of Nursing is heartbreaking currently and maybe with gaining more experience and knowledge I will feel good about where ever I may be. I am a caretaker that is in the essence of my soul, I am smart, I am kind, I want to help others in their time of need. Just wondering about other novice nurses in Med-Surg or suggestions of areas of nursing you have experienced and liked and why. Thanks for reading.

[Ruby Vee, BSN]

Take a deep breath . . . OK! Paragraphs, please. I had a difficult time reading your long, unbroken post.

The first year of nursing sucks. Almost no one is happy with their job or their life in that first year of nursing. We all went through it, and the only way to GET through it is to GO through it. Make up your mind that you're going to suck it up and make it through that first year or so before you make any major decisions or major changes. As Winston Churchill said, "When you're going through hell, keep going." That about sums up that first year of nursing.

My first year was 35 years ago, but I remember it vividly. On days I had 4-6 patients, on evenings I had 12-15 and on nights I had 25-30. I'd barely get through one med pass and it was time for the next. No time for handholding, and critical thinking was done on the fly or, more likely at 2 AM when I should have been sleeping. Most days, I cried all the way to work and all the way back home again, I was so miserable. But as the year progressed, I found that I was crying less, getting through that med pass quicker, having the time for critical thinking and there were even brief moments where I felt competent. One day it just "clicked." I realized that I (mostly) knew what was going on. That took more than a year for me, but then I was a tough case.

We've all been through that first year. Hang in there. You'll get to the other side, too.

[ceebeejay]

As hectic as you describe everything, it seems like you have an amazingly mature and good grasp of everything! I am a novice nurse as well and I don't have sage advice. I am sure it will get better, just because you will get better at what you are doing. As you get your skills mastered, you will have more time to think about where those PCT's are hiding and how to gain more control over the other situations going on. In the mean time, relish each day's accomplishments. It's hard, but take time to pat yourself on the back now and again, because this is your life happening.