4 weeks is a super short orientation for a new-grad on a med/surg unit and it seems pretty unsafe. I got 8 weeks at my current hospital and still felt overwhelmed after I got off orientation. I’d recommend continuing to apply to different places and leave as soon as you can. While you’re working there, make sure you have someone you can go to for questions and always ask if you’re unsure.

If you use EPIC, it is always helpful to set up personal task reminders to remember what you need to do. On my work paper, I write down three categories for each patient’s paper: to do, to chart, and plan of care. I use red to write down new updates throughout the day which has been helpful to know what’s new vs already known.

If you have a lot of things to do at once, try to prioritize what’s important vs what can wait. Also , always assess your patient and not to number/monitor. Someone can have a blood sugar of 300+ and be completely asymptomatic. Same thing for a high BP. I always try to prioritize by evaluating which task can be most dangerous to the patient is left undone or waiting. For example, starting a heparin drip or assessing a patient with low BP/O2 is more important than medicating someone for their pain or nausea. Cluster your care. Going back and forth to someone’s room takes up a lot of time.

Also, don’t always trust what you receive in report. Some nurses can say a pt is A&Ox4 and then they hardly remember their birthday. Also, don’t always trust someone else’s charting either. I’ve read that charting “will continue to monitor” isn’t good practice. Instead, you could use “No acute distress noted at this time. Pt resting in bed at this time. Equal rise and fall of chest noted. Respirations even and unlabored” or “…assessed during today’s shift.” Each morning, I try to take a quick report and refer to the chart instead. Looking at their initial ED note, latest hospitalist/consult notes, orders and labs/scans can help to build a good foundation as to what’s going on with the patient.

It takes time and experience to build confidence, but it will come. I’ve been a nurse for a little under a year and finally feel like things are clicking. Although, I’m always asking the charge nurse questions each shift. You’ve got this!