1 week left of orientation- scared to death

[BoonersmomRN]

This post is going to ramble...sorry! My head is full and spinning..sorry!

My preceptors keep saying I am doing " great" but I feel like a lost puppy:)

This coming week will be my 12th week and that is the end of orientation. I feel very comfortable with feeders/growers, CPAP, stable vents, and unstable vents. What I DONT feel comfortable with because we haven't had too many of them are- UA/UV lines ( I have only had this once!), admissions ( only had 1!), and transition babies ( again only had 1).

My manager says that basically you get what you get- as in there haven't been any oscillators in my 12 weeks...so I have never had one. The 1 admission I did get was thrown at me 10 mins before time to leave and I wasn't prepared at all...like I said 1rst one and my preceptor decided to "switch" with the nurse on DR so I could get this admission ...and I don't know the process or the charting/paperwork involved so it took a LONG time. I will talk more about this in a sec.

I know they will start me off with feeders/growers and let me work my way up but I'm still a scared mess. Every night before I go in for a shift I cannot sleep. I won't think about work all day until my eyes close and then BOOM all I can do is think about work stuff and not sleep at all. On nights when I don't have to work the next day I sleep like a baby.

back to that admission...I had another nurse ( not my preceptors) " observe" me for 15 mins during this admission ( my only)and take me aside and in so many ways...basically tell me that I stink. That I was slow, that I didn't know the process, that my head to toe was out of order, that I needed too many directions, etc. Well she also emailed the manager about this and the manager pulled me into her office to tell me she deleted the email because it was inappopriate of that nurse to say those things to me and she isn't holding a grain of salt to what she said and that my preceptors are giving her great feedback about me that I am independent and a quick learner.. So, basically I already have 1 nurse on the unit who thinks I am not good at all and who TOLD ME to my face and who emailed the manager. Lovely. Thing is while she was cold about it to me- things she said were right. I was SLOW. I did NEED direction. My head to toe WAS out of order.

Another thing that is bothering me is that another nurse who came off orienation 3 weeks ago is already being assigned to the DR/OR and she is not NRP certified and I was *told* that we could not have that assignment until we went through NRP which is at the end of this month. Now that nurse says she doesn't mind and she's been taking the assigment.- that's her business...but if I come off and get assigned to that before I go through NRP ( and yes we are the only nurse going) to the OR/DR's unless it's a micro or multiple...I am NOT going to accept that assigment and put my license on the line..when I am NOT trained in NRP. I would be an absolute fool to put myself into that position wouldn't I? So thats my thought there.

I am so sorry this is so disjointed. I have so many thoughts rushing through my head and I can't seem to organize them.

Basically I am scared to come off and get an assignment I have had zero orientation to. I am scared I will screw up what will then be my 2nd admission. I am scared they will assign me to DR/OR when I do not have NRP. I am scared I will get a UV/UA line that I have only dealt with once...10 weeks ago!

Please someone just tell me I am normal........or you can be like that other nurse and go ahead and say I stink

[elizabells, BSN, RN]

No no no no NO! You do not stink!

Okay, A - your head-to-toe was out of order? Bollocks. You're not in nursing school, and unless your unit has some reason to demand you do an assessment a given way each time, she's just being nasty on purpose. I'm not sure I've *ever* done an initial assessment in the exact same order twice.

B - I swear, the next time I hear about a nurse riding an orientee for being "slow" or needing "too much direction" I'm going to have a fit. So... you want them to do something they've never done before fast and without asking questions because that's in any way safe? You're NEW. You're SUPPOSED to be slow and ask questions.

C - Thank your lucky stars you've got your manager on your side. And think of it this way - yes, as you said, you've got 1 nurse who doesn't like you and is a snotty little brat. But you have a manager who likes you and from what it sounds like multiple preceptors who think you're great. So one person is a jerk. Bah. I'll bet you a million bucks when you're on your own, and you get that oscillator or UV/UA, you'll turn to the nurse next to you, ask for help, and you'll get it.

Good luck, and I promise you'll be fine. It took me forEVER to lose that nauseated feeling before work.

Oh, and I never had an oscillator on orientation either.

[NICU_babyRN, BSN, RN]

omg omg omg-what a brat!!!

Serioulsy i have some NOT SO NICE words for this nurse who is being a brat. On your first admission and EVERY admission after that you should have help. I help nurses who have been working in my NICU for 10+ years admit. Help with the paper work and charting, getting the baby comfy, labs, prime IVF...it's allllll team work!

NO you should NOT to do DR/OR if you are not NRP certified and this other nurse who you mentioned is going is really asking to get a nice rude awakening if something goes wrong. Additionally, I had to have someone go to OR/DR with me for 6 months after I was done with orientation and I am so glad they came! I still sometimes take someone if I'm going to a micropremie delivery.

It's totally normal to be scared and you will do a better job b/c you will be more vigilant. And there is no real "ORDER" in which you have to do your assessment in! Sure you generally work head to toe, but dude...she wanted you to go in a specific order?

UA/UVs are not too hard (as you probably recall from orientation) and you will soon see them more and more. You'll get more comfortable and people WILL help you! Just don't be the nurse who shows outward confidence but who is mortified inside and ends up making a mistake that could mean a life. When you have questions...ask them!

If one is not assigned to you, find a "buddy" at the beginning of your shift. This "resource" person should know a little bit about your pts ("stable vent, npo, TNP via PICC") and they can be your point person!

You'll be fine! I had to take tylenol PM for a few weeks after orienation, but eventually I calmed down!

P.S: I was that outwardly confident person for a few days and then I realized people were much more willing to help me once I asked questions rather than THINKING I knew exactly what I was doing and turning help down when people checked in on me. It's much better to ask than to wonder.

[BoonersmomRN]

Thank you both so much! I really needed to hear that:)

I do have great preceptors... I had 1 bad one but I was switched off and the other 2 I have had ( 1 on nights/ 1 on days) have been amazing. Turns out the bad one was just having some personal issues and was not in the right " frame of mind" ( according to my manager) to precept well.

LUCKILY the nurse who said all of that to me is a day nurse and I will be on nights...so other than giving/getting report from her I shouldn't have much more interaction shift wise.

[hikernurse]

I'm edging up on my first year :). It's tough, but it gets better. I'm still very nervous when I get to work...and at work and even afterwards sometimes.

The thing is you're not supposed to know everything, just know who to ask. I've found several experienced nurses who I call my "go to gals" because they're smart and willing to teach.

Admissions shouldn't be all on one nurse. We usually have 4-5 nurses working on each admit. It would take forever if only one person did it. And how else are you supposed to know what to do without someone giving you direction ? That gets better, too.

As far as assessments go, you've just got to get in where you can. As long as everything is assessed, what's the problem :).

It sounds like you're on the right track; just keep plugging away. There's always a bad apple in the bunch, but don't let her get to you. No doubt, the other nurses are well aware of her attitudes and won't begin to hold it against you.

One day you'll realize you've done a smooth admit, actually asked a parent if they have any questions regarding their baby's diagnosis/POC/etc. without being afraid that they will have a question, and find that you're the one the newer people are asking for help--and darn it, you know what to do .

[tetitto]

Thanks to everybody for all the post about this topic.

I just finish my 12wks of orientation, and boy it was so difficult in the beginning. I am a foreigner nurse with 10+ years of experience, but things are done different in any unit, so I struggle a lot because I am a " experienced nurse" and I should not be slow........but well I was like that at the beginning mainly because trying to overcome the fear of working in a different country speaking English as second language was not that fun as I expected....now it is.

Anyways, I think now I am more part of the team and yes we get more help when we ask questions and for help.

I was told to improve communicating effectively with parents, pharmacy, lab. xray, etc because sometimes I am ashame to do so due to the strong accent I have................well........everybody has been nice and they say it will come with time and my teammates try to get me to speak more at work. I appreciated when my preceptors said." here is the phone" and I was like

I LOVE NICU:redbeathe

[iHeartNICU]

I'm in the same boat. I have 2 more weeks and then they're setting me free. It's a scary thought for sure but I know that I will be ok....not because I know everything or have seen everything because that is so far from the truth, but because I have a lot of people around to ask questions whenver I feel unsure of something. It's always better to ask and risk looking dumb or whatever then do something you aren't sure of and have a bad outcome.

It sounds like you are doing FANTASTIC and there's just one person who would probably be rude no matter what the case. Don't take it personally. I know it's hard....I've had a few people like that too but the majority are awesome and very helpful.

I just had my first admission yesterday and I felt so discombobulated (sp?).....I think we'll get it after doing it at least a few times. Everything comes with time. Just look at how far you have come since day one of orientation. You're gonna do terrific!!!!!

Oh, and about going to the OR/DR....I would not go if I was not NRP certified. If something were to happen even if the docs are there....it could be disastourous (sp?). You worked too dang hard in nursing school and now through orientation to loose a license.

Anyways, Best of luck to you!!!!!

[lvnurs9]

I think you will realize shorty that you will settle in a routine and become more comfortable. As far as lines and admissions...you should always have help. If you have a kid with lines, just remember to treat them with care :) Just ask someone if you don't remember how to draw off the UA and have them stand there while you do it. Some of our new people don't get a kid with lines for several months and forget. Even I forget sometimes haha. As far as admits...just remember the basics. Hook the baby to the monitor and get your first set of vitals. (obviously I don't know your protocols, but the basics should stay the same) You can always get an in depth assessment a little later. Once you get your vitals, get your eyes and thighs done and try to get an IV in place...or if they are going to put in lines...let them. Stay calm and remember, they can actually be fun once you get the process down. I always helped admit when people in my pod got a baby. Then I asked to have them. One month I was admit everyday I worked! I love to admit :)

Congrats and good luck!

[viccar82]

Wow. I have to say that I might be a little scared too. It does not sound like your unit is supportive or appropriate in their assignments and help. I sometimes have felt that way on my own unit. (I love L&D but never used to get it and another friend who ended up quitting but hated L&D was L&D nurse practically every shift for 2 weeks). Just try your best to remember that EVERYONE was a new nurse at some point and don't let the 'mean' very experienced nurses (who sometimes expect a lot out of the new nurses) get to you. I've found that eventually though if you do your job, you'll win them over (or at least seem to gain a their respect at work). Keep your chin up - YOU CAN DO IT! Just make sure you talk to co-workers you can trust when you're feeling stressed (or post here to us). Don't let it get to you and make you quit, we need good NICU nurses out there. :)

[BoonersmomRN]

Well good news so far

I have now been on my own for 2 weeks and have been FINE! Granted I havent had to do another admission...but I have held my own with CPAP, Vents, Ostomy's, etc etc!

I also get everything done on TIME when I am on my own... I love it! :)

[viccar82]

AWESOME!

[dance45]

I feel your pain. I recently went back to work after 7 years off and I had worked NICU previously for 8 years. Talk about nervous as a long-tailed cat in a room full of rocking chairs. I felt like the biggest fraud on the block, and still do many shifts. I certainly feel like more is expected of me since I did NICU before. I still feel like an idiot half the time and I've been back at work for almost a year and a half.

The nurse who emailed the manager was totally inappropriate. It's a shame that she was not more supportive and helpful. I've always heard that nurses have a tendency to eat their young; she's just living up to that. Hopefully, she's the exception and not the rule in your unit. Don't let one person muck up your whole mindset.

You will become more confident and comfortable as time goes on. There's nothing you can do except get the experience and learn from your peers. It does get better.

My biggest piece of advice for you would be don't EVER be afraid to ask a question. Whether it's respiratory, meds, asking the docs or seeking answers from your fellow nurses. It's better to ask and feel like a complete boob than to assume you know the answer or can figure it out yourself. Especially when you're starting out, you don't know what you don't know.:nuke: