Month 3 on med surg and I am genuinely incompetent. Does this ever stop?

The question

1. PBPriya between shiftsRN, 1 year, ICU

   Month 3 is supposed to feel exactly like this, and no, you are not behind. Here is the arc my preceptor gave me and it has held so far. Three months you start collecting small wins, an IV you got first try, a call you made that was right. Six months you are functioning, meaning you run your assignment without someone shadowing you. Twelve months you are comfortable, and comfortable is not the same as confident, that one takes two years.

2. SDSkyler on days nowRN, 2 years, med surg to PCU

   The heparin question was the right question. The look was probably not about you, charge was holding four other things and yours landed on top. I say that as someone who has given that look and felt bad about it later. Ask again anyway, and ask the same person. The nurse who asks about a drip is not the one who scares me, the one who does not ask is.

3. HPHarper past the first codeRN, 10 months in, PCU

   Something concrete that helped me. I keep a note in my phone called Things I Did Not Know Yesterday, one line per shift. Two months in it was mostly where supplies live. Now it is why we hold the beta blocker at that pressure. Reading back six weeks is the only way I can see that I am moving, because day to day it feels flat.

4. MNMaya on nightsRN, 8 months in, med surg

   I will push back on one thing. Not every bad feeling is imposter syndrome. Month 4 I felt incompetent because I had seven patients on nights with one aide, and that is not a confidence problem, that is a ratio problem. Before you decide it is you, count your assignment. If it is unsafe on paper it will feel unsafe in your body, and no amount of self talk fixes staffing.

5. CPCasey packing for travelRN, 2 years, med surg

   Two years in and headed to travel. The thing nobody says is that the feeling does not leave, it moves. I am solid with my own patient load and completely lost the second I float somewhere new, and that turned out to be fine. Competence is local. You are not building one permanent feeling, you are building it unit by unit, and your unit is coming.

6. Nursing Mastery

   Month 3 is the hardest month to see any progress from the inside. The calendar is doing work your feelings are not, and experience is experience. Twelve months on med surg is what opens specialty transfers and travel eligibility, and you are a quarter of the way there. Keep a running list of what you handled each month, because at the 1-year mark that list is your interview. It gets better, and the clock runs whether or not the shift felt good.

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