What's next? I hate my job

Taylor1432 · Dec 13, 2018

Thanks for the help :grumpy:

Dontstressdoyourbest, RN · Dec 13, 2018

Taylor1432, just the fact that you wanted to become a nurse and help others speaks volumes to your ability and character. First come up with a really good worksheet of your patients, their dx's, etc. Secondly, gaining experience in specialty nursing will not happen instantly and not within 5 months. As hard as it will be to gain knowledge in differant areas 'over time' you will know when you feel more focused and natural in one area versus another. I hope it helps as I went through different specialty areas until I found my niche.

barcode120x, RN, NP · Dec 14, 2018

I actually posted a similar post (well not exactly about hating my job, but more about struggling with anxiety from the job and whatnot) about 3 years ago here asking for help when I first started working as a new grad nurse on the telemetry floor. The new grad blues is what many call it including myself. You'll get through over time. Happens to everyone including myself.

Right now, it's all about learning and getting a routine down for yourself as well as time management. It's great to come early, come earlier if you don't feel prepared. Get your papers on your 5 patients. Sort them in terms of acuity. It's OK to not know your patients name. Keep your patient's SBAR/handoff sheet on you at all times and pull it out before you enter their room. I always do that the the first or second time I enter my patient's room so I know their name and have all their info in my hand.

Charting and passing meds will NEVER go away, the only way to speed it is up is to organize and do time management and to cluster your care. If you have 0800 and 0900 meds together, bring them and do your assessments between that time frame. There is no reason to give a med at 0800 then leave and come back at 0900 to give a med (unless there are specific orders to give a med at certain time or there are reschedule issues for doses). Also, in terms of doing nursing tasks (assessment, starting IV, change tubing, etc etc), schedule them around the meds or during times you know you will go in a patients room. If you need to help clean up your patient, bring the meds in, bring your IV start kits with you, etc. If you think it will take awhile to do a nursing task, do it later if you're currently busy. Try not to waste time running in and out of patient rooms. Bring everything together aka clustering care so you go into patient's rooms less amount of times = saving more time. Unfortunately, there's no really way to speed up charting until you get used to the clicks.

You as a nurse are not expected to never every detail about your patient. You will only have them for 12 hours, maybe one or two more shifts but that's it. Don't put yourself down because you don't know your patient that well. Spending time with patient's doesn't necessarily equate to how good you are a nurse. There are many times where my total time spent with the patient because they were "easy" was an hour, or even less. That doesn't make me a bad nurse. If a patient is stable and doesn't need anything and all orders and nursing care are done, there is no reason to force yourself onto them. Do the care that is required and a little extra is always nice, but if none is needed, no need to put yourself down.

Just like you, the only main things I got out of nursing school were meds, main diseases, and communication. Everything else was learned on the job and through experience over time.

In regards to your report, you are not there to tell the full news story on each of your patient. Tell the main points, your assessments, recommendations, and move on.

I only answered based on what you posted in your OP, but if you need more detailed advice, I would be more than happy to help you. I'm only 3 years an RN myself, but have plenty of knowledge to share especially about the first year of nursing.

Persephone Paige, ADN · Dec 14, 2018

My support is pretty basic. Do you show up for your shifts? If your answer is 'yes,' you are WAY ahead of the game whether you know it or not. I work on a busy med-surg floor too. I am two weeks into the clinical orientation after having stepped away from the bedside for 22 years. I was hired for days because they have call ins all the time. I am slow as a tortoise just now, but you know what? I'm there. And that makes me doing twice as much as the nurse who calls in. The post above has some great pointers for clinical organization and I will be trying to incorporate them into my own practice.

But the patients that I am patient with, I'm helping. Our floor is like Taco Bell take-out all day long. I kid you not! At any point today there were at least 2 of my six patients unable to make it to the restroom in time. I spent more time cleaning up poop than nursing. These poor people were mortified, but I made them feel less ashamed and upset about their predicament. I made their day better. And I didn't learn that in nursing school and I didn't forget it in my 22 years away from the bedside. No matter the time spent at the bedside, make it kind and you are doing a good job.

zoidberg, BSN, RN · Dec 22, 2018

If it helps you feel better, I think i'm a good nurse, and very often, I forget my patients names!! :roflmao:You will get the hang of it!

RatherBHiking, BSN, RN · Jan 15, 2019

What you're feeling is normal and you WILL get faster and more organized and be able to keep up but it takes TIME! Use brain sheets (google some and try them until you find one YOU like), use sticky notes for all those new orders and requests that just came up and mark them off as you do them. Write down anything you want to know more about and on your days off look them up. Keep a handy little notebook in your pocket and common IV meds you give write down how long to push if you can't remember, procedures for giving blood so you don't forget the steps, or whatever makes it easier and less time consuming for you to refer to. Make sure you take breaks. I know it's hard with so much to do but many things can wait 15 more min. Then hang in there until you can transfer to a different area if you want but DON'T GIVE UP! We've all been there.

Rainbow_RN, BSN, RN · Mar 8, 2019

I'm a new grad with similar feelings. I think it just takes time to get your brain used to the new career. I'm told nobody has an easy first year. Even the first two years can be tough. Hang in there. You are not alone

TriciaJ, RN · Mar 11, 2019

Do you use a worksheet? If not, you need to develop one. If you use one, you need to get better use from it. It should have a space for each of your patients, their name, room number, diagnosis. IVF solution and rate, med times, scheduled treatments, diet order; all the basics. It will help you not only remember your patient's name (glance at it before you enter the room) but organize your care, keep track of pertinent changes, not be caught off guard if you need to call the doctor and give a more complete and concise report.

It stays folded up in your scrub pocket and at the end of your shift it goes straight into the confidential shred bin. Do not trust your memory; it will let you down. Your eyeballs will soon be trained to instantly find whatever information you need and you'll wonder how you managed without it.

Ruby Vee, BSN · Mar 15, 2019

On 12/12/2018 at 9:09 PM, Taylor1432 said:
I am a new grad who started orientation on my Med/Surg unit in July of this year and was on my own by the end of August on AM shift. So all together I've been on my own for 3 and a half months.
Some days are worse than others but overall I just feel like a terrible nurse and I hate my job. It sounds awful but I honestly feel like I am doing my patients a disservice by being their nurse. Here are the reasons why...
-I feel like I'm missing things that come so naturally to other nurses. Everyone says, "you're new, you can't catch everything" but what if that was your family member?
-With my 5 patients I find it so hard to know what the plan is for all of them. I can't ever remember their names half of the time (which I am ashamed to admit). I'm just so distracted by all of the other things going on. I even come in early to prep and I STILL don't feel prepared. I don't spend nearly enough time with my patients because I'm so busy charting and doing other tasks/passing meds.
-Did I learn anything in nursing school? I'm having a hard time remembering a lot of the common disease processes and medications. I went to a very reputable school. I feel like I forgot everything already.
-Every time I give report I feel like I missed so many things.
I was a CNA for almost a decade(most of those years on my current unit!) and I always knew I wouldn't like med surg. My main interests are PICU, NICU, ICU and ED. After this, I don't feel competent enough to work in these specialties so I am feeling pretty hopeless.
**Did any of you start out in a Med/Surg type setting and go on to thrive in critical care??

I'm sorry this is so long. If you took the time to read it, thank you! I could really use some advice. After being in healthcare for so long, I didn't expect to struggle this hard. I really feel like giving up.

I started out on Med/Surg, then after five years I went on to critical care. I've been thriving in critical care now for decades.

You don't have enough experience to work critical care, and that's fine. You haven't worked Med/Surg long enough to learn all you can learn. It takes about a year to become comfortable in a new job, and about two years to become competent as a new nurse. So, you're about six months in. You're right on schedule, believe it or not.

Just because it looks like things "come naturally" to other nurses does not mean that they do. They had to work to get it together, just like you. The good news is that after a year or two, it's going to appear as if things come naturally to you, too. What if it was my family member? I have faith that your colleagues are also keeping an eye on things. The things that you don't catch, the next nurse will. And vice versa. If neither of you catches it, the charge nurse will, or the provider. And you're learning. If you miss something big once, you'll never miss it again, right?

It is normal for a new nurse to become overwhelmed with the tasky things and lose sight of the big picture. You'll learn. It's also possible that you may be prepping wrong. Do you have a brain sheet? Make sure you fill in the patient's full name, diagnosis and (depending upon where you're working) doctor. Make a note of the big picture -- something like "new onset Type II Db, blood sugar control & pt. education" or "R/O MI -- Cath lab today". Record the times you have to give meds (I also write the med names, because if I don't know a med it prompts me to look it up) and treatments. Now you've got an outline for your day. Write down pertinent labs and when you need to recheck them. There are several posters on here who have showed good examples of brain sheets.

As you go through your day, make notes on your brain sheet in a different color of ink for things you want to make sure to pass on in report. Keep track of questions the oncoming nurse asks you -- those are things you want to remember to answer.

Keep a list of things to look up when you have time, even if that time is when you're home. Disease process, medications, normal lab values, what that test is all about, etc. I used to carry a spiral notebook in my pocket with questions and the answers after I had looked them up. That was before the internet.

You're doing just fine for a new grad with six months of experience -- you're right on track to be considered for ICU in a year and a half.

ILoveHorsesRN, ADN · Mar 22, 2019

I graduated in 1989 with an ADN. I don't know if this would happen these days, but I knew I never wanted to work in Med/Surg. I always wanted to work with babies. I started in a new grad program in the NICU and never looked back. You should really try to find a training program in one of the areas you mentioned. Why suffer in med/surg? There is no reason for it. I wish you luck in finding what you desire.