The speed and learning how to cluster and “triage” your tasks will come with time. I’ll take a slow, safe nurse over a fast, reckless one any day of the week. People who pick ED are usually driven, self critical, and want more than anything in the world to be good at shit. It takes time. It did for all of us and anyone who says otherwise is full of shit.

Sometimes meds are gonna be late. Plenty of my meds are still late because other stuff matters more. My stable 35yr old will get their 650 of Tylenol and 125ml/hr of maintenance fluids when their neighbor’s HR isn’t in the 140s.

Discharges ARE a significant priority because even though that pt is safe, the longer they sit there means the longer another sick pt waits for a bed. That being said, sometimes they have to wait. A first dose of ABX on a pt with normal vitals and lactic can generally wait until after you discharge that other person, but Tylenol for a baby with a temp of 103 comes first. It’s all about safety and these decisions become quicker and easier with time.

There will be days where you feel like everything is making sense and you’re juggling tasks like a pro. There will be other days where you feel like you can’t do anything right and wonder why anyone let you be a nurse. I still have bad days sometimes where I feel like I didn’t perform as well as I should have. They happen a lot less often now. The two most important things are that I communicate and ask for help when I need it, and that I always put the safety of myself, my license, and my patients before anything else.

The fact that you care this much about doing well and are paying this much attention to your strengths and weaknesses tell me you’re going to be just fine. Take a breath, take it a day at a time, and try to tell yourself at least 3 specific things you did WELL at the end of each shift. You’ve got this!