When did you swap chaos for calm?

[tango.in.paris]

hello! firstly, i've started this thread in general nursing (as opposed to first year after nursing licensure) because i'm hoping to attract responses from seasoned nurses (but feel free to move).

i've only been graduated for a year, and i have some friends coming out now. my mates are beside themselves with terror at the thought of finally going it solo, and even after a year down the track, i have more days than not when i second guess myself, doubt my ability, look daft, and generally get my stethoscope in a twist!

so i thought it could be really heartening for my mates, myself and other relative newbies to hear from the more experienced amongst us about your first year/s - not specific stories per se - but rather how nervous you were; how long did it take you to feel settled; when did the confidence kick in; did swapping student threads for a uniform instil a certain sense of ability? etc.

i know that nursing is a continuous learning curve, but at some point your general nursing actions must have become second nature, more free of stress and panic then full of it! i would love to read your experiences. cheers! :nuke:

[TheCommuter, BSN, RN]

I have not been in the nursing game for very long, as I only have 4 years of experience.

I still feel a continual sense of chaos during every single shift. I have not encountered the calmness in nursing that you have mentioned.

[ukstudent]

When I talk to new grads, and I'm not that far out from being one myself. I tell them it's like learning to swim. You go to school to learn how to "swim". You pass the classes, and as hard as you had to work and study, in the end you must know how to swim. You pass the nclex - surley you know how to swim.

Then you get your first job and find out that as hard as nursing school was all it taught you was to doggy paddle in the shallow end of the pool. That the teachers that you thought were so hard were actually supporting you and protecting you, a bit like a floaty. You didn't have to call Doc's and get orders. If the pt asked you a question and you didn't know the answer, you could always say "I'll get your nurse", now you are the nurse. The pool you now that to swim is deep.

This deep pool is what you have to swim each day. Your preceptor hopefully is supportive while teaching you new swimming strokes and the physical and mental stamina to swim all day/night. Changes in my patients, going to CT, transfering, admitting I thought as having a wave machine turned on. In the beginning I nearly drowned almost every day. My preceptor would let me go under a bit and then save me. As orientation goes on the preceptor should be saving you less and less.

At the end of oreintation, will you be able to swim? Not really. A weak crawl and a strong doggy paddle is what you will have. If you are in a supportive unit, they will watch over you and support you as you become a stronger swimmer.

After a year you should be a basic swimmer. You will occasionally still start drowning with large waves, but most days you can swim though.

Years 3-5 you should be a strong swimmer and at this point most of the chaos has turned to calm.

Don't forget that every now and again a tusami comes along and can start drowning even the most expereinced nurses (20 + years). So we should all look out for each other and be each others life guards. Don't let your fellow nurse drown.

[Morning-glory]

Somewhere in year five after graduation I was working nights and it suddenly hit me that I was a good nurse. It had be a busy night on med/surg with admissions and one death. I knew what was going on with all my patients and I was calling the shots. Before that I knew I was OK at the job, but I was still insecure about my own abilities. The actual panic on every shift left me after about a year and a half.

Good luck, it does get better. Changing specialties can help too.

[RhiaRN75, RN]

In general, I started to feel comfortable after about two years as an RN. I worked that floor as a CNA for a few years first and also had many clinicals there, so I guess in theory it was actually longer.

I will never forget my CNA interview. During the tour, the manager showed me where the traction supplies were kept. She was rather offhand about it- "Here's the traction room- you'll be setting up basic traction and also caring for pts who have external fixation. Any hardware you need is usually in here." External fixation???? On an ortho floor??? Haven't we moved past torturing people this way? Dear lord, I'm going to have to help someone bathe while their leg is in one of these torture cages and is bleeding everywhere. Doesn't that hurt? What if I bump it wrong? What if I trip on the weight? What the heck does she mean, what I need is usually in here? Where the heck else would it be?

I did what any poor soul would do- ran to mommy for solace. In my case, mommy is a hardcore nurse who doesn't tolerate whining. Her reply? "Really Rhia, of course an ortho floor has traction. External fixation isn't that bad. My only advice about the weights is that you better not trip over them- pay attention! If you can't find what you need in the traction room- go to OR."

The OR!! You mean cross the red line? You threatened my very life over that red line. (Mom worked OR, among other things.) I knew not to cross the red line before I knew your name wasn't Mom. Now I have to torture people, never trip, AND cross the red line?

Well, I've done all that and more, except trip over the weights. Everytime I see traction weights, I think of my mother, lol. Pay attention, indeed.

I really didn't feel confident until I took my first travel assignment. I thought I was confident before or I wouldn't have tried traveling, but thinking it and knowing it are not the same. I didn't truly recognize that I sorta knew what I was doing until after working as a float nurse with less then one shift of orientation. Here's the pyxis, the linen, the rolodex and the stock room- good luck. About a week into it I realized- holy crap! I'm actually doing this!! Pyxis, linen, phone numbers, supplies.... everything I need except for the location of my pts and the employee bathroom. Well, maybe a map. It was a big hospital! Woo-hooo, call mom. Again- "Really Rhia, of course you're doing well. You're a good nurse."*

I've learned though, confidence is to be tempered. I learn something new all the time, and fate has a habit of reminding me that I'm not super-nurse or beyond being wrong. I definatly do not want to trip!

*In all fairness to my Mom, she's a great person- not an unsympathetic witch. She is very supportive, but very blunt when it's needed. She also knows when to be blunt and when to be tactful, and I very much appreciate it. If I ever write a book, I'll title it "Really Rhia! Words of Wisdom from My Mother".

[november17, ASN, RN]

Probably about 8 weeks into orientation on my first RN job. I think being an aide for several years really helped helped me - I already had organization down and I just needed to get settled into a routine.