Two weeks into orientation, constantly terrified. Is this normal?

[hollyleaf]

New grad two weeks into orientation desperate for any advice or encouragement. Please be gentle.

I've started orientation in a level one trauma center ER. I'm the newest of my unit's new grads, and I just finished the last day of a six day stretch of 12 hour shifts (following my preceptor's schedule). I like my unit and I have a good preceptor. But I really need advice because I'm making myself absolutely miserable and don't know if anyone else has felt like this.

I grew up in a highly critical environment and I have always had trouble with confidence. I was really enjoying orientation and then a couple days ago something just snapped and I feel like I'm going too slow or doomed to be a bad nurse.

I knew I'd have questions as a new grad but I didn't know it would feel like this. I didn't extern in school and I see new grad former externs on my floor and feel stupid compared to them. I find myself asking 12549 questions a day to my preceptor out of paranoia of doing something wrong. I'll forget to take vitals on time or will accidentally break my sterile field and I can't stick an IV to save my life.

I've never endangered a patient, but I just feel so behind compared to the others I work with and like I'm learning slower than them and that that means I'll be a bad nurse. My program never let me stick an IV or put in a catheter (I can do Foleys well now, but I have not had a successful IV). I stand there like a moron during traumas asking if there's anything I can do to help because everyone knows what they're doing but me.

My preceptor says I'm doing fine as does my manager, but I keep convincing myself that they're just saying that because they feel sorry for me. I know that's stupid and I need to get a ***ing grip, but I just need someone to tell me I'm not alone feeling like this.

I'm off for the next week but I genuinely want to throw up at the thought of going back next week and messing something up again. Even the smallest mistakes horrify me.

Is this normal? Does this feeling go away at least SOME eventually? I'm in love with nursing and I've looked forward to this for so long, but I'm terrified of feeling like this forever. I've read this feeling can last up to 1-2 years into nursing and I feel like I'll genuinely lose my mind if I feel this bad for that long. 

[path0gems, ASN, CNA, LPN, RN]

All I can say is you are NOT alone. I am a new RN grad, was previously an LPN in an assisted living home and am in my 2nd week of orientation on a transitional unit and I am miserable, constantly upset and anxious, and wondering if things will ever get better. I hope it does for both of us.

[gere7404, BSN, RN]

I’ve been in the ER three years and have a CEN and TCRN — I still ask questions when I don’t know something and learn something new every time I go to work 

relax, it’s normal. 

[RNa23]

Hey there! I’m one month into orientation as a new nurse. I work in the CVICU at a level 1 hospital. It’s normal to be scared to death! I didn’t get to do my first IV until my last semester of nursing school, and I did my first foley anything last week. IV’s can be difficult, especially with trauma. Low blood volume equals flat veins. I personally run into the issue of severe edema. All of which makes getting a successful stick 1,000x harder. Skills take time. I have started to get sticks more and more, but it’s definitely been a bumpy ride. When it comes to questions, one of my dear instructors used to say, “only smart nurses ask questions.” We are learning right now, it’s OK to ask as many questions as you need to for the safety of your patients and yourself. I promise you your preceptor doesn’t mind, if they do, shame on them. I have anxiety everytime I hit the floor because I am inexperience and I am anxious about handling top tier issues, but that anxiety just makes you more aware of your surroundings and your patients condition. Hang in there! Keep on learning, you’re gonna do great. Don’t sweat the small stuff (poor IV skills, etc.) 

[JKL33]

On 7/20/2022 at 11:41 PM, hollyleaf said:

I grew up in a highly critical environment and I have always had trouble with confidence.

Very unfortunate. But over time you can begin to see things differently. It takes a lot of internal work and it takes a little faith that everything is going to be okay. Right now you are in a situation where confidence would be on the lower end even if you didn't struggle with confidence to begin with.

Side note about others who appear to be doing well: Sometimes they are and sometimes they aren't. Resist comparing yourself to what others appear to be.

I have had this talk successfully with a younger loved one, please know it comes from a place of helpful motivation, view it from that vantage rather than an opportunity to become even more afraid:

Fear of not being good enough, fear of failure and the like are poison. People who tend to worry about those things excessively can lead to ending up right where they feared. Excessive fear leads to the feared conclusion! Example: I knew a kid who was a great runner, had potential for college-level athletics. But during races he had one medium gear and appeared afraid to go all out. He would inwardly/emotionally break down if someone passed him or people were in front of him. He'd just finish the race, placing lower than his ability. I asked why. He said because he was afraid of running out of energy and losing. (???) Had to gently say, "but you're 'losing' anyway--why not see what happens if you give it everything?? You may still not be #1 but you will learn and grow and no matter what you will feel good about your effort!"--as opposed to not doing as well as you hoped AND developing self-hatred due to knowing you didn't try hard.

This general concept can be applied when people are hobbled by excessive fear of failure or not being good enough in any area of life. They can tend to behave in ways that prevent the (good) conclusion they dream of, and then they are upset with themselves.

So you are someone who was criticized inappropriately. Now you have fears that you are not going to be good enough, not going to learn fast enough, ultimately not going to succeed. Please do whatever you possibly can to correct fearful, negative thought patterns. Things are going to be okay, they are going to get better, you aren't worse than every other new grad that has entered this profession. You are OKAY!!

This is one of those situations where "fake it til you make it" applies--although not in the way people think. Should you pretend you know things that you don't? NO--that could hurt a patient and would also remove your learning opportunity. But should you "fake" some self-confidence, should you start to tell yourself everything's okay and you are doing this and are going to succeed, even though you're very worried about all that right now? Yeah, I think you should. You have to start believing. People who lack confidence are capable of a ton of things that they don't do; they often "can't" do them only because they don't. Fear hobbles them.

A second point about fears. Often the degree of fear is plainly irrational. With a lot of what you are doing in orientation, you're not exactly walking a tightrope over the grand canyon, you know? You're, for example, getting ready to do a sterile procedure. If you breach the sterile field, you don't die and neither does the patient, because you have the opportunity to check yourself and make it right. If you try an IV and don't get it successfully inserted, you are one step closer to getting good at IVs. If you forget to take vitals "on time" or get delayed in doing so, you go do that and keep moving on with your day. If the vitals are abnormal and require a call or an intervention, you will do those things. Orientation tasks (and nursing tasks in general) are not "sudden death" where if you fail you're out. Real life isn't often that way. So don't let your brain catastrophize these things.

Does this make any sense?

I think you can do it. Put your head up, smile, carry yourself with purpose, ask concise questions in an unapologetic manner. Start believing in yourself. Use your mental energy to learn how to take great care of patients. When you catch yourself in a negative thought pattern, re-focus on the learning point (nursing related concept) rather than perseverating on the worry.

Everything's okay. ??

[Wuzzie]

On 7/20/2022 at 11:41 PM, hollyleaf said:

My preceptor says I'm doing fine as does my manager, but I keep convincing myself that they're just saying that because they feel sorry for me.

As an old ED nurse trust me...ED nurses will not lie to make someone feel better. ?

You're doing fine.

[Rita June Jarvis Isaac]

This is normal, everyone moves at a different pace, ICU and ER are considered specialized areas and they are even more challenging to get your first orientation. The skills and monitoring are intense and frequent. Your preceptors are fully aware that you would be terrified. I think expressing yourself and asking for help is very good. Also as an experienced nurse, I would love students to ask questions, this shows they are eager to learn.  Give it time, you will become competent and appreciate your growth.

[Piper98, ASN, BSN, RN]

You are not alone. I am 4m in, one week off orientation and still feel like I have no idea what I am doing. I am in the ICU, and have yet to get a flash doing an IV. Nursing school did not prepare us for how hard this first year was going to be. You are only 2 weeks in and are DOING GREAT. If you weren’t asking a million question and/or were not terrified THAT would be concerning. Give yourself grace and know that you are amazing and you can do this!

[subee, MSN, CRNA]

I would be worried if a new nurse DIDN'T ask questions...lots of them.