What have I gotten myself into.....?

UnicornRN · Jul 17, 2012

I was a police dispatcher and 911 operator for 9 years at a very busy communications center. I can handle stressful situations. I graduated nursing school in May, I've been on the floor 3 days and I feel exactly the same way you do. I was warned that there would be good days, and bad days and to keep a journal of what I learned every day so that on the bad days I could look back and see that I have been accomplishing something and maybe it wouldn't feel so overwhelming. I suppose I'll start the list this week since the thought of going back has me in tears because I feel so inadequate. You are not alone.

**LaurelRN, MSN · Jul 17, 2012

Lgood,

I don't think it really depends what unit you start out on- I think we all feel that overwhelming sense of OMG!! How am I going to do this and did I make a mistake. Relax, take a deep breath and think.

You need to get into a habit of organization. If you don't have a sheet you use to make a list- get one, make one, borrow one..whatever. Get into the habit of writing a "to do list". If your patient has serial H&H's Q 4..write down, 8,12,4 (or whatever time they are..and check them off as you get results)

Whatever your facilities charting is make a to do list for that too. Like head to toe (8am..or pm..depending on night or day), Pain 8,12,4...Plan of care- NIC/NOC(or whatever you use there)...you get the point.

See what time you have meds due...write them down and check them off when you give them...PS.just a side note here...take it from an ICU nurse who goes to the rapid responses...PLEASE, PLEASE, PLEASE...check BP's before you give meds, Check Potassium levels before you give K+, and make sure there's a decent FSBS and the patient is eating before you give insulin.

And always check your labs/xrays at the first of your shift!!

Once you get into the habit of things...you'll get to the point where you won't need it.

you've done the hard part! You're a nurse!!

Just my :twocents: ....Hope it helps

MountainRN53 · Jul 17, 2012

You are lucky to be working on a busy Med-surg floor because you have the opportunity to learn so much so fast! I'm sure you will eventually say I don't need to do this or that anymore because I have crossed that bridge. Great "experienced" advice from Laurel.

iluvivt, BSN, RN · Jul 17, 2012

Well how long is your orientation and do you have a good preceptor? A good preceptor can makke all the difference in the world and if you have one latch on to that person and appreciate all they do b/c it takes a lot out of you to be good at that. I agree it's imperative to get organized....... so see what other nurses do to accomplish this and copy them or take the best parts of what they have to offer and desing your own system. I made my own worksheet out for years and once I designed one that I liked I never deviated from how I used it. keep a little notbook in your pocket forthings you need to look up but that can wait and look them add after your shift. You must keep learning and growing professionally. An RN license verifies that you are safe to practice at a minimal level and if you want to be great..it's a long process. keep a journal and every few weeks or so write down your progress so you can see your are making strides and reaching your goals. This will help you keep things in prespective and by all means..GET FEEDBACK from your preceptor

Mulan · Jul 17, 2012

Even old, experienced nurses feel overwhelmed at times.

nursefrances, BSN, RN · Jul 17, 2012

Lisa, hang in there. It will get better. :) There was some great advice given already. :up: When I was new, I would ask myself at the end of each day, what could I have done differently to make things more time efficient, or faster, or better? Such as making sure I have all supplies before I go into a room and not have to go back and forth a bunch of times. This still happens once in a while on a busy day. :bugeyes: Make sure and give yourself credit for the small things. (Example: Hey, I was a little faster when I did this today, or I knew about that, etc.) And each week you will notice things getting a little easier, a little bit at a time. Everyone always says six months to a year to get better/feel more confident. And this was true for me. As a nurse there is always something new to learn, we will never know everything. Just do your best, keep learning each day and let yourself grow. If you make a little mistake, learn from it and go on. Good luck to you.

krocks1218 · Jul 17, 2012

I am a new grad from an ADN program and am waiting for a job opportunity. However, I have been working as an LPN for years. When I was handed 30 patients to medicate and do treatments on I felt like going on a kamikaze mission instead. However, as I gained experience, I got my rhythm and you will too. Most important is trust your instincts. If you aren't comfortable with something, DON'T be afraid to ask for help. Good luck!!

zieglarf, LVN · Jul 17, 2012

New LVN - working LTC for just over a month now.

The first week was 'orientating' - which was mostly following another nurse for two days and three days of me doing stuff and running to her every five minutes about something.

The second week I worked more independently and thought I was doing pretty decent.

The third week as my responsibility increased and there were treatments I needed to do and hadn't even known about the first two weeks - I felt the panic coming in. I could barely get everything done. Then I had an re-admission from the hospital and I didn't have a clue of what to do. So MUCH paperwork. School never prepared me for ALL of this.

I spent the rest of the third week sick to stomach and terrified that I was going to be fired; and the state was going to take away my license. I was so freaking overwhelmed and I just knew - I KNEW - I was going to make some kind of fatal error and kill someone or at the very least - make the facility lose their license.

Nobody died. Nobody got in trouble. Nobody got fired. I got a basic routine down. I have a better understanding of what to do and when to do it.

I started my seventh week today and I mostly feel OK now because I've got my routine down pretty good. I get thrown out of whack all the time when something comes up but I can get back into my routine pretty quick. The absolute best thing at my facility is that all the staff have been helpful and answer my 'stupid' questions without hesitation or judgement.

Tonight, I had family voice concerns about Mom urinating too much. I have no clue what it could be. I check the charts for any changes in meds. No still the same - she takes Lasix but has been for months. I report it at change of shift and the night nurse is like 'hmm - is she diabetic?' Turns out she has a hx of diabetes - but is not currently on medication for it. Didn't I learn something about polyuria and diabetes in nursing school?

I'm learning something everyday about my job. It could be skill, illness, or facility related, etc, etc - but I'm always learning something new. I'm loving it!

FMF Corpsman, MSN, RN · Jul 17, 2012

my first week on the floor was somewhat hectic and disorganized but you have to figure out what works best for you. there have been some excellent tips on here so far and you’d be wise to incorporate them in schedule if they work for you, but if they don’t, say thanks and find something that does. one that did work for me, and many others use a similar adaptation, is writing everything down. i have (had, i’m retired now) a base copy of a sheet that never changed with the standards of room #, patients name, vitals, spot for a brief history, any pre-ops?, procedures, labs, whatever, you get the idea, yours may have different information on it, but i would fill out all the info out on the computer and then run the copies out on the printer and save myself the time of having to write it out day after day. it would already be there; i’d just pull one out of my locker and fill out the new information during report. it made me a great deal more organized and allowed anyone else to look at my sheet and see whatever they needed to see without a lot of explanation needed or me having to slow down and having to tell them. it also made giving report a breeze, because all the 411 was right there, i didn’t have to try to remember everything, was that this patient or was it the other one.

MN-Nurse, ASN, RN · Jul 17, 2012

I'm scared that I won't catch on and be able to remember all that is necessary to care for this type of workload. Help!
.....Lisa

I had what I considered a very good background to work as a med surg nurse. But every day during orientation and for many days after, I was terrified as I got my assignment....

Then, one day, I noticed as I was walking through the parking lot there was something missing. I felt different.

Just like that, the sense of dread and terror I always felt when I went in to work was gone. I felt totally normal, similar to how I felt walking into other jobs I have had. Knowing the work was demanding and difficult, but I would handle it.

It takes a while to get there, but most of us do.

DeLana_RN, BSN, RN · Jul 17, 2012

I remember that sinking feeling as a new grad... when you look at your pt, know something doesn't look right, and decide you need to get the nurse - and then you realize... you are the nurse!

Seriously, I started out on a stepdown/telemetry unit with an 8:1 ratio... pure insanity, even for very experienced nurses. I made it for a year, then moved on -, and what I learned was invaluable (nothing much scares me anymore )

You will be fine, it gets better. Just give it time.

All the best!