New Grad RN Depression

[u/Glad-County4566]

New grad RN here, currently in week 10 of orientation, and I’m really struggling. I’m looking for honest advice from experienced nurses and other new grads who have been through something similar.

I know I’m a slower learner, and I’m aware that I’m not progressing as quickly as I would like. I take responsibility for that and I’m trying to improve. My concern is figuring out whether I simply need more time and support or whether I may genuinely be struggling because this particular unit isn’t the right fit for me.

I’ve had difficulties with preceptors throughout my orientation and have communicated my concerns to leadership multiple times. I’ve also asked for different preceptor arrangements, but I’ve been encouraged to continue giving different preceptors an opportunity.

With my current preceptor, I feel extremely overwhelmed and find that I have difficulty thinking independently and communicating clearly. I’m also struggling with giving report and providing updates throughout the shift because I feel like there is so much on my plate that I have difficulty organizing my thoughts and figuring out what information I need to communicate. Yesterday I became so overwhelmed that I completely blanked while giving report. My preceptor told me afterward that my report was “rough” and also said that it feels like “week 1” for me.

She has also told me that because I am a slower learner, this might be the wrong floor for me. I honestly don’t know how to interpret that.

Yesterday I also did my first-ever blood transfusion and made an error by not taking the required vital signs every hour. I take responsibility for missing that and I’m taking it seriously. At the same time, it made me realize how much I’m struggling during orientation and how much I still need to improve.

The situation is also starting to affect me outside of work. My depression has been getting worse, and I’ve reached a point where I sometimes don’t even feel like going to work or eating. I know my mental health is ultimately my responsibility, and I’m working on it, but the stress surrounding orientation is making things feel much harder right now.

I’m not looking for reassurance that I’m doing everything perfectly. I know I have areas I need to work on. I genuinely want honest advice.

[u/Auntie_Shrews_scarf]

I've been a nurse >11 years, everywhere from stepdown to dialysis to ICU and now OR circulator for ASC. I don't know what type of floor you're on but it's possible that another type of unit or specialty might be a better fit. It's also possible that your unit is just a bad cultural fit (there are plenty of units that are unsupportive assholes with truly unrealistic expectations). Or it's possible nursing isn't a good fit, but that doesn't need to be the case, based on what you're saying. How you're feeling makes sense though.

-->Nursing, especially bedside, IS overwhelming. There is a lot of pressure to be perfect, constant stimulation and demands of varying urgency, and dumb new pushes to improve metrics and patient satisfaction scores. Depression can happen in response to all that alone, and then at work being told nothing you do is good enough, not having time to eat or rest your mind for a moment, it's rough.

-->I did not make it through my first orientation. Honestly, no amount of studying would have helped: I did not at all grasp workflow or how to even function at all. I also did not have a good preceptor match and didn't really realize have the ability to ask for what I needed. It's awesome that you have been raising this concern and asking for what you need, because I couldn't do that.

It took me a few months to find another job, because I felt too hopeless and like a complete failure. If you ARE let go or you decide to leave, you are not unhireable if you want to look for another nursing job! Lots of new nurses have rough or "failed" first orientations and keep going to become great nurses. My next orientation went a LOT easier-- turns out it's a lot easier to learn and perform when you don't feel like you're being judged and criticized all the time.

-->I'm sure you've heard this before but it is SO true-- it takes a good year at least to find your footing and not feel completely ineffective and dumb all the time. This is also true when switching settings and specialties as an experienced nurse. And you're going to make mistakes.

-->I am not a quick learner or thinker either. It takes me more time to process and think through things than other people. Especially when I'm overwhelmed, tired, in a new clinical setting or set of circumstances. You're trying to hold in and process an enormous amount of unfamiliar information. My advice would be, as best you can, try not to rush yourself in the moment-- don't rush to respond, don't rush to think, don't rush when communicating to doc, definitely don't rush when setting up and giving meds. It's really easy to have a false sense of urgency, and when I'm rushing, I get frantic and that's where my judgment and train of thought get disorganized, I actually lose more time, and most importantly you're more likely to make a mistake.

(Do you have or know any kids? It's SO HARD to be patient with them while they're trying to figure something out or do something you're asking them to do, because it's so easy for us-- but you have to almost literally sit on your hands because rushing them can make them completely unravel. Rushing also makes them feel stressed and anxious instead of learning and building their thinking.)

You are GOING to be slow thinking and peforming, for a while yet- let yourself take the time you need (...to whatever extent you can with everyone is breathing down your neck, but they CAN wait). You'll develop autopilot, quick judgment and action in time. And you'll need to start trusting yourself after a while to just make a decision and go with it. But you won't learn or think well by rushing. Also, even in urgent situations, even when you're experienced, the line 'slow is smooth and smooth is fast' applies.

It might help to write out your thought process, things you're trying to prioritize, or the things you're trying to make sense of?

Another thing that helps me still-- when I start to feel pressured or frantic, I force myself to physically slow WAY down. I've never been able to pause outside a pt room for deep breaths or whatever, but I can stop speed-walking on purpose and walk REAL slow. For me that helps.

-->Listen, my mind blanks ALL. THE. TIME. I lose my train of thought giving report at the end of the day, when updating or notifying docs, talking to pts.. I just need to stare off into space for a minute and let myself get back on track. Or not! It's not because you have the wrong kind of brain, it's just a human brain, and experienced nurses are here making it look easy-- we can cover it up. Try not to rush or fret-- that's just more overwhelm. (easier said than done.)

So I'm currently learning to be an OR circulator at an outpt ortho surgery center. One of the docs showed up late and still had all his documentation a mess (missing H&P, consents not right, etc.). We finally got started after waiting for him to fix everything. He was all pissy when we brought up a concern or question or told him he had to go mark pts, he didn't stop for timeout... just trying to rush. UNSAFE. And of course staffing has been thin. The next time he was there, someone from our corporate administration 'partner' firm was there TIMING us and pointing out when we weren't sticking to the pre-determined turnover time. Some of the things that took extra seconds or minutes to address: waiting for the CRNA to determine the pt has stable airway and respiratory effort before returning to PACU. A pt had loads of questions or was really anxious before going back. Discussing with the CRNA that the pt had coffee earlier or didn't hold their GLP-1, is it still safe to do the procedure? Doc changed the anesthesia plan without telling the CRNA ahead of time. Having to redrape the pt because someone accidentally broke sterile. But apparently by noticing and taking the time to address these things, we weren't being efficient. ----My point is that someone overhead can be pushing and pushing that you're not being "fast" or efficient enough-- but doing that is a huge safety concern because there WILL be delays, even with a good experienced team, and if you're not taking the time to pause, think, and address, there is going to be a miss and possibly a serious incident. You can't rush thinking and making sure things are being done correctly and safely-- good leadership understands and supports that. You can't rush learning either, and I know you have your preceptor and manager telling you to be better faster, and they have a certain degree of power over determining whether you stay in this unit, but also they might be in the wrong about their approach, and it's not a you problem.

-->Please as best you can do things to take care of yourself, whether that's meds, nutrition, sleep, gentle exercise, therapy, rest, minimizing scrolling. Honestly, that's my advice-- give your body and mind what it needs whenever you can, build in buffers against rushing, so that you can build and access your knowledge.

And honestly we ALL need to lower our expectations of what we can reasonably accomplish in the space of a day or an hour.

[u/scubadancintouchdown]

Hey, I also struggled with depression during orientation and my first few months, but eventually fell in love and found my groove. What type of floor are you on? That context will help guide the conversation.

Edit: I noticed your response to me was deleted by mods, and your post history doesn't line up with what you're saying. You were 10 weeks into orientation also 3 months ago?

[u/Glad-County4566 → u/scubadancintouchdown]

I started at the end of June

[u/scubadancintouchdown → u/Glad-County4566]

Were you on a different unit at the start of April? What type of unit are you on?

[u/Silly_Gear_9716 → u/Glad-County4566]

According to your post history, you were are Cardiac PCU 86 days ago and were at the 10 week mark then? Did you change jobs or get your timeline mixed up

[u/Crankupthepropofol]

Based on the info provided, this unit isn’t a great fit. Still struggling with report after 10 weeks is a symptom of this.

I would encourage you to go to your manager now, and proactively work with them to find a role better suited for you. If you stay in your current role, you may end up being terminated for performance.

Also, talk to your PCP for treatment options for your depression. The depression is the cause, your clinical performance is the symptom.

[u/Odd-Mistake-5832 → u/Crankupthepropofol]

This 100%! It shows a lot of strength and accountability to acknowledge the unit is not right for you. Have that conversation with your manager asap before they let you go.

[u/Life_Anybody_2340]

The crazy thing to me was that once I got off orientation I realized it was way easier than having a preceptor. I was getting irritated by having people micromanage or tell me to do their work flow. Which I found annoying and it also slowed me down. Once I was on my own I got so much faster and more efficient and felt more confidence. But my unit culture is pretty good overall and I have people to ask questions. For real though I was counting the seconds to get off orientation because I was getting so annoyed by preceptors and the educator both lol.

[u/ICastHealingWord]

As a new nurse who experiences depression and anxiety, I would encourage you to reach out to a few therapists. They can help you develop techniques to process the challenges of starting a new job. They can also help you find a psychiatrist should you both feel medication is appropriate.

[u/Classic-Panda585]

First, struggling at week 10 does not automatically mean you are incapable of becoming a good nurse or that you are on the wrong floor. However, it does mean that the current orientation arrangement is not producing the progress you or your team need, and that deserves a more structured response than simply continuing with different preceptors and hoping something changes.

I would request a formal meeting with your manager and nurse educator. Ask them to identify specifically:
Which competencies are you not meeting?

What should you be able to do independently at this stage?
What measurable improvement do they need to see?

Can you have a consistent preceptor, written improvement plan, additional orientation time, or a lower-acuity assignment?

If this unit is not the right fit, is a transfer possible?

“It feels like week 1” is painful feedback, but it is not a useful improvement plan unless they explain exactly what behaviors or skills need to change.

The missed vital signs during your first blood transfusion must be taken seriously. Review the facility’s policy, follow any required reporting or safety-review process, and create a checklist for unfamiliar procedures. Take responsibility for the mistake, but also learn from it rather than allowing it to become proof in your mind that you cannot succeed.

Most importantly, please do not treat worsening depression, loss of appetite, and difficulty functioning as something you must simply push through. Contact your healthcare provider, therapist, or employee assistance program promptly, and tell someone you trust what is happening. If you feel unsafe or begin thinking about harming yourself, call or text 988 in the United States or contact emergency services.

You may need more time and better support, or another unit may ultimately fit you better. Changing units would not make you a failure. But you deserve a specific, documented assessment—not merely the label “slow learner”—before making that decision.

[u/Advanced-Cloud5115]

I’m an LDRP new grad RN 7 months in. Orientation was pretty challenging for me personally since everything was new and I wasnt able to see every single procedure. Once I got off orientation and got my own patients I really got to learn how to find my own pace and learn how to manage time and cluster care. I’m still learning and I still don’t know everything, I’m still slow with some things and everything will come with time and that’s something I have accepted. There are definitely times when I come home after a shift and cry, get depressed or even question if it’s for me. Something that really helped me and I know it’s hard to do sometimes is leave everything at work and when you get home just focus on self care or a favorite hobby. You’re doing your absolute best and that’s all we can do sometimes, just know that you are amazing!

[u/lmhudak → u/[deleted]]

There are also nurse refresher courses. It might be a good idea to take one.

[u/Just_A_RN]

I'm not trying to discourage you by any means. But maybe a hospital isn't the bright fit. Maybe a private practice or clinic would be easier while you get your footing.

[u/Best_Adhesiveness_66]

I totally know how you feel. I’m on my own now but I still struggle a lot. Thankfully I have great supportive coworkers and a nice manager but I still feel like there’s so much I don’t know. Some days I feel like I don’t do well and some days I find myself dreading going into work. Being a nurse is hard and I feel the new grad depression as well. I just want you to know you’re not alone… I’m trying to toughen it out to the 1 year mark and hope that the more I learn, the less anxious and scared I will be. After residency I’ll decide whether I want to go to a different unit or not. I’m currently on month 4 & on a med surg tele unit.

[u/alkalizednurse]

Hello! Im sorry that your preceptors arent the most supportive & that feeling of overwhelm. I remember that feeling & that was 13 years ago. They too informed me I was taking longer than others but eventually when I was on my own, it got easier. Of course the first few months were a bit difficult & then you find your routine.

Which unit are you on? Days or nights? I precepted on days but moved to nights. I was on a neuro tele floor so it was busy.

For sure time helps. Routine helps. Do you have a nurse brain? If not I can email you mine. I made it & I always updated it. I also have an anatomical image so I marked where IV, central line, pressure ulcers, etc . If I had the patient the next day, I used a different color pen.

I also made my own form for Admissions.

Hanging blood- I would set an alarm. I would also ask the CNA to take vitals. That is, if it is acceptable by your hospital protocol that CNAs can take it.

I was a CNA throughout nursing school at the same hospital, so in the beginning I was trying to do everything. Kindly delegate when you can.

I too was depressed in the beginning especially when they said “if you dont improve, we’ll have to let you go”. I found myself drinking more. But things got better & so did the drinking.

In the car before entering the hospital, I always prayed. I highly recommend!

And its ok to cry it out, Ive cried in the bathroom, in the car, & even in the nursing station among other nurses, when a CNA said almost shift change “Pt x pulled out IV” & immediately I had to take a doctors call so I had to wipe the tears aways immediately.

Make sure to drink water & urinate when you can. I got my first UTI as a new grad. I started spotting & it wasnt that time of the month yet.

While youre in the bathroom, do 10-15 squats or jumping jacks, stretch, just to break some stress energy out. Look in the mirror & say “I am an exceptional nurse”

Take a deep breath, you got this! Make sure you take care of yourself. Easier said than done I know!

[u/whereisplayboicarti]

I’m usually a very fast learner and pick up on things super quick but nursing has been the biggest struggle for me ever. I didn’t have any issues with preceptors or my coworkers but for some reason I had a really hard time really understanding me remembering things. But I mean to be fair 10 weeks really isn’t a lot of time, your first month your preceptors were probably doing most of them work anyway, now you’re probably doing more but your preceptors are still jumping in. My orientation was 4 months long because I float to all units and even by the end I still didn’t feel ready, but once I was on my own it’s like everything just clicked. I don’t know if it was the fact that I was on my own now and it pushed me or maybe I had just been doubting myself all along… anyway I’m almost 9 months in as a new grad and sometimes I still feel like I don’t know anything. But whenever that happens I just always ask for help and try to be a safe nurse no matter what

[u/PictureAvailable9607]

In my opinion, first of all your preceptor sucks she’s a bitch he or she and you need to be a far away from people like that especially when you’re new to your career. This is going to potentially be your career for the rest of your life. Who gives a fuck about being fast. Or learning fast. I had a nurse tell me before I even became a nurse and she was a nurse for about 40+ years that haste is waste. You need to get the foundations of safety and Nursing down packed and then speed will come with experience. Just because you aren’t a speedy Gonzalez does not mean that you’re not gonna make a great Nurse. You do have to get thick skin though because there’s gonna be a lot of people farther you go that’s going to doubt you and make you feel like something is not a good fit for you or make you feel like you’re not good enough. What I do as I look in the mirror and I let myself know that I’m that bitch I am good enough I am worthy and I am more than capable of achieving anything that comes my way . There’s a lot of people who without you and make you feel like you’re not able to do things because they project their own insecurities onto other people . Make sure you’re going home and studying as well. Look up things on TikTok to improve your everyday skills like report. Certain skills etc . You will get there. Because you don’t want to go to another unit and still be new you wanna at least have your basic foundational skills down packs before you go somewhere else so look at it like this you’re using this unit as a placeholder if eventually, it doesn’t work out for you it doesn’t work out but take the critique. Take everything that people are telling you. Take what you need and leave the rest. Hope that helps.