When did it "all come together" for you?

Hey guys! have been working as an RN for a year now, but in LTC. Just switched to a Cardiac Critical Care/ Tele/ IMC unit in a community based hospital. I had a month of orientation classes and now it's my third day on the floor. My preceptor is great and I feel like I'm progressing each day. First day I just shadowed, 2nd day I took our 4 patients but preceptor was in room while I did assessments, gave meds, etc., today I felt like I took a little more charge and did more things on my own, though my preceptor was always available and checking, which is great. I'm just wondering- how long did it take you guys to finally feel comfortable at your job and confident in your skills? Maybe its just personal but I feel like I doubt myself! I also get very intimidated by certain nurses (today one of my patients went south very quickly and everything happened soo fast, I ended up transferring him down to ICU but the nurse was so snippy, I got intimidated giving her verbal report!) and also with MD's. Maybe it's just that I'm not confident enough in my skills yet to really feel comfortable... I know it takes time, just like with any job! I just really want to make a good impression. This is a place I would like to stay for a long time! Just wondering how other nurses felt starting a new job... Thanks!
You are still a new nurse and now in a new area. Give yourself at least 6 months. It will take that long or longer to learn the unit, the MD's and what they prefer in different situations etc.. It also takes time just learn the supplies and the terms they are called on your unit and how to find them quickly. I am still learning and still have not got it all together yet.. Not really sure if that is possible. Even nurses with 15 years experience struggle on a new unit or different area and yet they still learn something new almost daily.. Each day/shift is something new. Give yourself time and lean on your preceptor and other stuff for help. It will come together in time. Tele is tricky to begin with, so many changes and not knowing which ones should or shouldnt be called to the Dr. You will learn them as you go and know when to call and what to do.Hang in there and best of luck to you

When I made the switch from med-surg to ICU, I was told it would take a year for me to feel comfortable in the critical care area. They were right. I switched hospitals after 3 months there because as the low man on the totem pole working in a unionized hospital, I was always the RN to be floated out when ICU census was low. So, I averaged a shift a week in the ICU. Got tired of that and moved on to a much bigger facility's trauma/surgical/cardiac ICU. LOVED IT!!! Learned SO much! Took about 6-8 months for me to feel comfortable there but I'm a quick learner.Always ask questions of your coworkers. If you are uncertain about whether to call the Dr about something...always CALL!(after checking with a senior nurse first). I'd rather get yelled at by the Dr for calling him or her than not making the Dr aware of something and having it come back to haunt me or harm the pt.

What you are describing are learned traits of the job. Like, not being intimidated by the "Snippy" nurse who is likely miffed at getting the admission in the first place. Simplify your approach as follows....Now that you are in acute care, focus on the basics, ABC's, vital signs, medications, treatments and analysis, (in this order). Understand that when a patient does go "South" you apply the same BLS and ACLS protocols regardless of diagnosis (learn those protocols by rote).Be Timely in providing interventions in acute situations.Do your best, but understand that patients do have bad outcomes despite that best effort. (Once this concept is mastered, the fear is gone).

To be adequate? 2, maybe three years.To kick a**? About 5.

great advice by flyingicurn

Quote from KaitRNHey guys! have been working as an RN for a year now, but in LTC. Just switched to a Cardiac Critical Care/ Tele/ IMC unit in a community based hospital. I had a month of orientation classes and now it's my third day on the floor. My preceptor is great and I feel like I'm progressing each day. First day I just shadowed, 2nd day I took our 4 patients but preceptor was in room while I did assessments, gave meds, etc., today I felt like I took a little more charge and did more things on my own, though my preceptor was always available and checking, which is great. I'm just wondering- how long did it take you guys to finally feel comfortable at your job and confident in your skills? Maybe its just personal but I feel like I doubt myself! I also get very intimidated by certain nurses (today one of my patients went south very quickly and everything happened soo fast, I ended up transferring him down to ICU but the nurse was so snippy, I got intimidated giving her verbal report!) and also with MD's. Maybe it's just that I'm not confident enough in my skills yet to really feel comfortable... I know it takes time, just like with any job! I just really want to make a good impression. This is a place I would like to stay for a long time! Just wondering how other nurses felt starting a new job... Thanks!

What you describe is exactly how I felt and continue to feel at 7 months in. Every day you will learn something that will make it easier. Unfortunately there will still be a shift that will knock you to you knees and there will always be a "snippy" nurse somewhere to deal with. Just try to do your best keeping the pt. first, ask questions when in doubt, and remember that even the best most experienced nurses have the occasional shift that pushes them over the edge. I have witnessed that and have tried to help them if I could. I'm thinking at least a good year to year and a half to feel comfortable. Hang in there and best of luck.

Thanks so much for ll the words of encouragement. I do think everyday will get better and I do feel like I'm learning more and more each day. It's just nice to know that this is a normal feeling that other people have to! Nursing is not easy so I know it will never be "comfortable" but I do have faith that I will become comfortable with MY skills as a nurse the longer I practice. Thanks guys

For me it "came together" somewhere between 1-2 years of working in the same area. I just recently switched to a new area (adults after doing peds), and it's definitely a bit of a struggle adjusting.

I work out patient surgery. Wednesday I admitted and discharged 8 patients in 6 hours, all my charts completed. Thursday I had one higher care patient, (not sicker, just needed more things done) and after my 8 hour shift I STILL felt like I had never gotten a handle on his care or the charting!!! Sometimes it just never "all comes together."

PS I've been a nurse I've been a nurse 26 years.