Would REALLY appreciate some advice!!!

[Soneshine]

Hi!

I'll try to make this quick. I am a nurse working 12 hr nights on the medical unit at a smaller hospital. I am a fairly new nurse (almost a year). The turnover is pretty high and I will soon have to be the nurse training new nurses; become more of a resource. While this extra responsibility means increased personal growth, it makes me incredibly nervous. There are some nights that I still have so many questions myself!! For example, I still have inserted an NG tube (has never come up). I'm still not very good at starting IV's, ect ect....

My big issue is this: I tend to be more of an anxious person (always have been). I have a serious lack of self-confidence. I like what I do, but most nights feel overwhelmed and generally inadequate. I don't think that I got the best on the job training. I have had to spend a lot of my personal time (days off) researching the proper and best methods for patient care (med admin, general nursing skills, organization, time management, ect). I do ask questions still when I have them- I believe in patient safety first. Okay!!! My point: I can't figure out if I dislike my job b/c of my issues with low confidence- or if it's not the right fit for me? Prior to being an R.N., I worked as a CNA for 10 years (mostly in LTC). I didn't like how physical it was, but I miss getting to know patients on a more intimate level and feeling like an important and needed part of the team.

I currently get along with my co-workers, but I don't feel a strong sense of comeraderie or connection. I feel like I'm just feeling the gap for the most part. I don't know if I would want to work in a LTC facility due to the physical aspect of it- but think that I need to be in an environment where I feel more connected to the patients and my fellow co-workers. Any advice or support would be greatly appreciated!! I apologize for writing a novel. Guess I needed to vent too!!! Thanks

[CaLLaCoDe, BSN, RN]

since you are new, please give it some time. i too was a cna for three years prior and oh how different nursing is! you will definitely find your nitch! i too felt overwhelmed, felt insecure, felt that i wanted to return to cna work. definitely these feelings of yours are real, but give it some time please and find a mentor...another nurse whose style you admire and then proceed toward your goal of being the outstanding nurse you know in your heart you are! ! ! ;-)

[brwneyegal]

I think you are being way to hard on your self. The first year of nursing is always hard because you learn sooo much information and try to remember everything when out on the floor, but you feel like you know nothing. If you said you felt comfortable with everything and were the best nurse ever I would be worried. The small amount of anxiety makes you a better nurse. Because of it you will check and recheck before you do something. I have been a nurse for 11 years and sometimes I still have questions. That should never stop. If you do not know something or are not sure about something you should ask or seek information about it so you can learn it for the next patient.

As far as IV skills you will get better with pratice. NG placement depends on the floor you work on some floors never see an NG others have tons of them. DO not be so hard on your self. If you are choseen to orient someone just tell them what you know and if a question comes up that you can not answer you tell them "I do not know, but I will find out.

[CRNAinwaiting]

There ae areas that you could get that connection...like home care etc...or rehab...anything that the pt is there longer than 48-72 hours... Nursing and CNA are different arenas.. I too was a CNA wayyyyyyyyyyy back in the day... yes you can help them physically but as a nurse you are there to see any changes in their status...you might be the difference between a bad outcome and a quick rapid assessment /phone call and save....the CNAs in the hospital environment have an important job too...they are your eyes and ears... when you cannot be at the bedside for this reason or that reason....*S*

[sasha1224]

It is a good idea to get at least that one year before moving on, however, there are times when one just knows the current position is not the right fit. As others have mentioned, the CNA and nursing role have different focuses(foci?) :) One thing I noticed in your post was connecting with patients. Another option besides LTC would be the LTAC. I started in one about a year ago after working in hospitals for >10 years. The patients are generally admitted for a month to several months and are considered "complex" but no longer needing hospital care. I still get to practice skills(ng, trach, vent, peg, wound care, IVs, central lines, drips, etc) and my ratios are good(3-4 pts usually a tech). And I get to know the patient and see their progression. For my area, these types of facilities are newer so not sure what the rest of the states have experienced. Overall, I do enjoy this, as I still get the challange, critical thinking and skills, i also get to know the patient and watch as they progress(as a note not all progress, some come here and will not recover, we help them and families through the dying process). Sorry so wordy! Hope things work out for you.

[RN1989]

Hang in there. It sounds like your emplyer has contributed to your issues - and I believe that your issues are valid. I commend you for actually taking the time to do research to learn what you don't know, even in your off time. You sound like a conscientious nurse who is in the field for all the right reasons. I wish I could clone you. Continue to be a safe conscientious nurse. If you feel that you are not in a place to orient new staff - step up and say so. Do not let them intimidate you into doing something you don't feel comfortable with yet. You will know when you are ready. And then you will be able to be one of the best kinds of teachers to new staff - someone who really cares about more than just the money you get paid!

[deeDawntee, RN]

I think medicine units are notoriously a 'one year and move on to something different' environment. A lot of nurses do it. Good for you for sticking with it and for rising up to a mentor-like position. I don't think that is unusual in medicine units in hospitals across the country. That you do not feel as confident as you would like is totally normal. You are still a new nurse, but have just about completed that tough first year! Congratulations! I think confidence waxes and wanes throughout one's career. I started in the ICU about 18 months ago and again had to deal with insecurity. I still have a knot in my stomach at times when I walk into work wondering what patients I will be taking care of. I just do a lot of positive self-talk and know who my resources are if I have questions. You never stop having questions as a nurse. It is OK not to know everything and still be a competent nurse. You can look up info yourself and you always have tons of willing and helpful coworkers to help you. For instance, I have been known to call the Oncology unit if I have a question about cancer, and you know what, most people love to share their knowledge with other nurses. Don't you? That helps me feel more confident, knowing I have a whole hospital full of people I can use as resources if I have questions!!

Whether or not you should move on is another question. I had 6 nursing positions the first 2 yrs or so I was a nurse. It is an accepted part of the 'nursing culture' to try different areas until you find your niche. I was never turned down for a position because of it. If you have the sense that you would like something different than what you have, I would say, trust your gut feelings and explore all that nursing has to offer! That is one of the very best things about nursing!

Good luck to you!! Follow your heart!!

:yeah:

[steelcityrn, RN]

You will know when its time to go. You will feel sick everytime your on your way to work. Thats a good sign to start looking.