When will I get the hang of it?

Nurses New Nurse

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Sorry for another vent. Just been fustrated with myself at work lately. I've been working on my own as a RN for a month and a half, and I'm still not able to take a full patient load. There have been times when I felt I managed my time well enough to practically take on a full patient load. However things at work have been getting busier and busier since after New Years. Even though I have less patients than a lot of the other nurses, I still feel almost overwhelmed. I'm always on my feet answering patient questions as best I could, provide care, give medications, call doctors, get patients ready for procedures, etc. I try to get most of my charting done early in the day like I know I should. But then after that, I get so busy I don't find time to really catch up on my charting until after I give report to the oncoming shift. Whenever I try to, I keep getting interrupted with patient call light and such. And some patients just take up so much time that I feel like I'm behind quite a bit. The charge nurses sometimes have to remind me of newly written orders or whether I have done certain things or not. Each day I keep trying to think of ways to better my efficiency, but end up still behing behind. It is really fustrating. However it is really hard to measure how I'm supposed to be doing at this point since I'm the newest and least experienced nurse on the unit. Everyone else has at least a year and a half experience. One of the experienced nursing assistants told me I'm doing really well, but I still wonder.

Specializes in LTAC, Homehealth, Hospice Case Manager.

Hang in there! Everyone has a different pace of learning. It's not fare to compare yourself to others. I learned this the hard way. Maybe if you try to ease up on yourself a little you can relax & it will get easier. I am my own worst critic & because I have extremely high expectations of myself this is what I had to do. It gave me a new perspective on my performance & I feel I'm doing better. Try to have patience with yourself...it will all come together eventually. Good luck to you...:wink2:

Specializes in Psych, Extended Care, Med/Surg.

Welcome to our world. You will get different answers from so many different people on this subject you may ask yourself why did I ask this question. There could be so many different reasons why you feel this way that you don't even think about and may never understand. I've been told it would take at least a year to 5 years before you become comfortable with what you are doing and some may never. As a new nurse you probably are still thinking about your instructor having their eyes on. It could be that you are being given the patients with more complex problems because you are the new one. You may be doing everything right and taking great care of your patients while others are taking short cuts, some good, some bad. You may have the patients who love to talk and working with others who don't answer their patients and just ignore them. I worked with a nurse that was out and done half her charting a 1/2 hour after we started from seeing all 10 patients. Tell me you can do a head to toe assessment that quick correctly, I think not. Are your orders and notes correct, are your patients still alive when you leave, are you alive? Then you did your job. Don't forget this is a 24hrs business. Keeping going and you will learn to become faster at what you do and build your confidence. I use to call back in and sometimes return after my shift to make sure I did everthing and everything correctly. Don't forget there is all types of Nursing Jobs out there and if whatever your doing now does float your boat try another. I worked 5 years as a CNA, 8 months as a RN in Extended Care and Med Surg, and now over 6 years in Psych. Keep going and good luck.....

Great advice Male*RN*777!

OP, it's great if your facility isn't pressuring you to take on a full-load yet. Many facilities want newbies "up to speed" in just a few weeks or months yet I've been in office jobs where newbies weren't given the same amount/kind of work as more experienced folks until after six months or more!

A month and a half isn't that long, really. There's no reason for you or anyone to expect you to perform on par with the experienced staff.

Yes I do seem to be taking care of more complex patients these days. I don't really mind that because that's how I learn. And there's still a lot of skills I have never done before or still not comfortable doing them by myself. Pretty much all the other nurses on the floor are willing to help. However they are really busy themselves with their own patients so it takes awhile before help is available. And whenever I give medications, I always double check, or even triple check (especially for the patients who have a whole bunch of medications to give). And there are times when patients or family members ask a lot of questions. Even though answering the questions takes away from me getting my work done, I don't want to leave the patients with questions unanswered.

It will all come with time. There is a 'click' around six months and you will feel better. Hang in there!

In the meanwhile, make yourself a good assignment sheet. Mine is blocked out by hours, so before I start, I fill in each patient's hourly stuff to do thruout the whole shift. (VS/assessments, meds, etc). Then I cross them out as I go. Yes there are always interruptions but at least its a framework and helps you remember things. I chart notes asap. Call a doctor, write a note. Get a weird finding or pt complaint, write the note. Takes a few minutes and saves many at the end of the shift. Check charts beginning, middle, and end of shift, sooner if expecting new orders. Group reasons to call the doctor so that its fewer phone calls. Enlist help from techs as much as you can--ambulating, emptying foleys, getting water/snacks for pts, changing beds...I do whatever of that stuff I can but I do ask for help when I need it.

I didn't get this system really down til about 5-6 months in, but I can tell you...I always get a dinner break, and I have never left more than 15 minutes late (unless I stayed longer on purpose). Stay positive! You can do this! :)

I feel the same way. I am a grad nurse. I am very conscious of what I do, what meds I am giving, etc. I find it difficult deciding when to call the doctor about certain situations. How high or low should a BP be before you notify the doctor.....? When I was preceptoring I did not have the opportunity to call the docor as I was not allowed to take orders. I guess I will learn as time goes on and I become more confident.

Sorry for another vent. Just been fustrated with myself at work lately. I've been working on my own as a RN for a month and a half, and I'm still not able to take a full patient load. There have been times

I know exactly how you feel...no matter how hard I try to stay ahead of the game and be organized...something always comes up and slows me down...then I start to feel like I'm drowning...I guess as long as we stay working in a hospital...will just have to get use to the sink or swim feeling. Hope things start to get better for you.

Specializes in ER, Med-Surg, EMS.

Hi,

Its ironic I read this today b/c I am a newly (1 mo ago) LPN now working part time as such and a FT RN Senior Student graduating in May 2007! I know just how YOU feel! So do I!

I have worked in my hospital for 5 yrs as a ICU Cardiac Tech while in Nursing school. While that helped me considerably with patient care, etc. being a newbie nurse that gets like 4 or 5 patients (usually 4) on the Med~Surg floor I feel just like you do. It seems I', running all the time while my more-experienced peers have time to hang out at the nurses station and chat all day. Of course some of these nurses do only what they 'must' - and some don't.

Here is some wishdom a few of the more 'seasoned' nurses gave me:

1) Go into your room and get your assessment done as soon as possible. If the person is sitting their chatting and talking up a storm with you you can be pretty darn confident that they have an Airway, are Breathing, and have Circulation!

2) Keep chit-chatting with the patient to a minimum. be polite, courteous but don't stand around for 15 mins BS-ing. That where I was making a mistake. if they want to just chat, chat, chat politely let them know that you have OTHER patients that you need to go visit NOW as well and move on...I'm seen several of my peers have to leave the room while the Pt is still chatting about some small-talk stuff. While this might seem rude at first - remember - your these to provide CARE to MORE THAN 1 PATIENT! Your NOT a 1:1 nurse to patient provider.

3) At the beginning of my shift I take all my Pt's Kardex sheet(s) and copy the FRONT of the sheet right away. This way I do not waste precious time copying stuff off of it at the beginning of the shift wand waste valuable time writing stuff. I staple them to the back of my Assignment Sheet and at the end of my shift I dump it into the HIPPA-approved SHREDDER BIN. If I am not sure of anything 20-30 mins into my shift I can simply flip over the Kardex copy sheets I have with me and look things up. Saves a lot of time!

4) I take ALL of my Pt's MARS out of the MAIN MAR BOOK and put them in my OWN 3-rings binder for MY shift of MY assigned Pt's. I think take small Post-Its and place 1 at the top of each patients last MAR sheet with something on it like: 1500 1800 2000 2300. That means at a glance over my MARS I can see what I need to do with ANY of the MARS at each hour. Its fast and easier then TRYING to memorize times.

Hope this helps...

I have been working on a med surg floor for 7 months , I did night shifts 7p-7a for 6 of those months i just recently went on to days 2 weeks ago. Whew am I exhausted 7a-7p. I worked night shift so i could get my organization skills down. the past 2 weeks being on day shift (a 4.00 and hour drop in pay to go to day shift) have been a nightmare. Some days are better than others. Some days I feel on top of things then all of a sudden I find myself falling behind, discharges, admissions, people going for all sorts of tests, patients going down the tube, physician orders whew. I have gone in for report pay three times in the last week, I am exhausted. Tonight I had a new admission from the ER and told the secretary to call physician , did not realize physician already called and orders received got a five minute lecture from the doctor that a good nurse would always check orders first before call dr. and ranting that he had to pull over out of traffic to answer a call that was not necessary, and maybe he should report me. whew I can understand why he was upset, I should have checked orders first but it was close to end of my shift and I wanted to expedite things, learned a valuable lesson. will things get better I hope so. feel like I am drowing here. Hang in there hica. Like I will.

Specializes in M/S, dialysis, home health, SNF.

My first year I couldn't hit the broad side of a barn with an IV needle. I didn't feel like I'd "arrived" as a nurse until my 6th year.

Hopefully, you'll be able to look back on this year as simply a hump in the learning curve. I'm sure you're doing well; remember, it isn't how fast you get everything, but are you a conscientious nurse? Are you doing what's best for the patient? Are you asking questions and doing things according to protocol, or cutting corners to appear "caught up."

From what you have said, I think you're just too hard on yourself. Six weeks on your own isn't even a drop in the bucket. We've all been there.

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