So you passed the NCLEX, nailed the interview and landed your first nursing job – you’ve got this. So, wait, why is it so hard? Why is nothing the same as in nursing school? Will I be this exhausted forever? You learned the foundation of nursing in school, but you will learn infinitely more in the first few months on the floor than you did in however many years you were in school.
Learning new information takes brain power and brain power takes a lot of energy. The better you get at something and the more easily that information and skill is accessed by your brain, the less energy it will expend (and the easier it will feel). Your brain is literally rewiring itself to create faster neuron pathways to make your life easier – but it’s not immediate. Not only are you using a ton of brain power, you are also on your feet for probably 12 plus hours and nurses walk for miles back and forth through the unit.
As a new nurse, you are also likely to be working nights or having to switch between days and nights. Nursing is hard and will always, to some degree, be hard. You can constantly learn new skills and gain more knowledge and your patients will always find a way to keep you on your toes (every single one is different!). But remember, it will get easier, and you will develop your style, your pattern, your routine. Here are some helpful tips for kick starting your nursing practice to help you not be so exhausted all of the time.
Burnout is a real thing, and it can happen to any nurse. It can happen at any point in your career – even for new nurses!
Read one of my other posts with a new tool from renowned psychiatrist, Dr. Heim, to prevent burnout.
1. Routinize Your Workflow
Routinization is about more than just creating a routine, it is about cutting out the fluff that doesn’t serve you. When you were learning how to do a physical assessment, I’m willing to bet that you had a script. This script gave you the outline and the order for performing your assessment. Routinization will help your brain from having to reinvent the wheel each day. When your brain isn’t working so hard to think about how to organize your night, you won’t end up leaving your shift quite as exhausted.
Find patterns in your daily shift. Look up every patient in the same way and same order at the beginning of every shift – Name/gender/age, primary problem, labs, meds for the shift, orders pertaining to that shift, type of access (IV, port, PICC), etc. The nurse(s) giving you report will be able to fill you in on what is most recently going on with the patient. Doing a bedside report will introduce you to each patient.
Cluster cares as much as you possibly can. Do a quick triage of what order you will be seeing your patients and then get everything ready for that first patient prior to going in – PRN meds requested, meds due soon, toilet, etc. Next, do your shift assessment and then chart it while you are in the room! This saves so much time later, allows you to ask any follow-up questions, and reduces the likelihood of forgetting anything. I can’t stress enough how much more streamlined your process will be by charting in the room. This is probably the number one thing that made a difference for me.
It helps later when you’re exhaustedly staring at your computer like a cadaver at 0300 as your venti coffee wears off. Being in the room also reduces distractions that will force you to focus on a different task.
“Connecting with your coworkers is also a great way to revitalize yourself during these times. There is no commiseration stronger than bonding over wiping liquid poop from head to hindquarters “
Take this charting time to connect with your patient. I mean really connect with them on a human level. Connecting with patients will make them feel more comfortable with you, and will probably make you feel pretty good. I can almost guarantee that building a rapport and mutual trust with your patients will help you reconnect with the reasons you got into nursing in the first place. When you are feeling overwhelmed, not good enough (don’t let those negative thoughts live in your head), and exhausted: prioritize human connection.
Connecting with your coworkers is also a great way to revitalize yourself during these times. There is no commiseration stronger than bonding over wiping liquid poop from head to hindquarters (how did it even get up there?!?).
Essentially, make your job as efficient as possible to reduce being exhausted. Try to minimize having to leave and come back into the room as much as you possibly can. There will inevitably be many times when your patient will convince you that they don’t need ANYTHING else… until you leave the room and start on your next task and they call you for some pudding. These moments will happen no matter how prescient you might be, but you can at least reduce the frequency by anticipating what they might need. The ability to do this will come with time and experience.
Pro tip: always double check that they have their call light and something to drink. Creating routines and developing efficiency early on will help you a lot. You’ll quickly learn that in nursing you will have one plan in mind and then something will happen that will completely redirect the course of how you thought your shift was going to go. Having a routine will help you stay organized, so that you can respond to whatever comes your way and then know where you left off prior to that. When you cluster your cares your brain doesn’t have to work quite as hard, so you don’t end up being quite so exhausted.
Read my other post on how to improve at any nursing skill!
2. Make Your Schedule Work for You
Let’s assume you work three 12-hour shifts, and that, as a new grad, you will probably work nights. If you managed to land a day shift position straight out of the gate, that’s great! There really are quite a few benefits of working night shift – and yes, I’m talking about that sweet, sweet shift differential. Whether you work 8-, 10-, or 12-hour shifts, nursing is a straight up work out. Despite spending roughly 75% of your time walking around like a zombie whose only source of life is caffeine, only working three days a week has some perks. Ok, I will quickly digress to address the fact that I said only three, I have been straight up ready to fight people who say nursing must be easy because you only work three days. It’s definitely a pet peeve, but at the same time, it is three shifts which can allow for some quality time away from the hospital. Be prepared to use at LEAST one of these days off as a throw away day that you can fall into a blissful black hole of non-existence (i.e. sleep).
Nurses love sleep. Like love it. We are basically either exhausted or asleep. Whether it’s us sleeping, or our patients sleeping, it’s the next best thing to having an open room and not getting an admit all night. For me, clumping my 3 shifts together worked the best. I was able to just knock them out and then optimize my number of days off in a row. By the third shift, I might have lost all sense of time and personal identity, but it’s what I preferred. I also know people who hated doing three in a row, because it was too exhausting. Find what works best for your brain and your body and try to stick to that as much as possible (the schedule will never be perfect, and sometimes it will just feel awful regardless).
3. Make the Most of Your Days Off – Even if That Means Doing Nothing
So, besides sleeping on your days off, take a moment to do something nice for yourself. Sometimes that’s sitting on the couch for 8 hours binge watching Queer Eye on Netflix, but sometimes that’s doing a hot yoga class and kicking ass. I’m not going to lie, it probably took me a solid eight months to feel like I had the energy and will power to start going to the gym after starting my first nursing job.
Give yourself the grace to take the time you need if you feel exhausted all the time. I really do think you will start to feel better once you get back to the gym for the first time. If it works for you, even try going on days you work to energize yourself for your shift. For me it was a lot easier to wake up at 4:30PM to go to the gym right before a night shift, than waking up at 4:30AM before a day shift. If that doesn’t work for you, then it doesn’t work – and that’s ok.
“Call your mom “
If there is something you have always loved doing and you feel like you don’t have time to do it now that you’re a nurse. DO IT! Even just a little bit. If that’s sewing, horseback riding, baking, running, underwater basket weaving: whatever it is, do it. It might feel hard to start doing it, but once you do, I promise, you will be glad you did.
Reconnect with your friends you haven’t seen for awhile. Face it, you’ve probably been putting off seeing friends since you first realized how hard Foundations of Nursing and Med Surg 1 tests are. And convincing your friends to let you do physical assessments on them doesn’t count!
Also, call your grandma, or your mom, or whatever loved one you haven’t seen for awhile. Honestly, it really doesn’t matter what you are doing with your day off as long as you leave work at the Kronos (or whatever clocking in/out system you use). You spend enough of your passion, love, energy, sweat, tears at work; you don’t need to be spending your mental energy on work when you should be enjoying your days off.
If you have a hard time falling asleep after your shifts or on your days off, read my post on how to quiet your mind to fall asleep.
Trust me when I say, you’ve got this.
I promise that you will have waves of, “yes, I’ve got this” and “wow, wtf just happened?” Eventually these waves will kind of even out, but there will always be good days and bad days. You’re not alone because you feel exhausted after every single shift – most nurses do. You’ve made it through nursing school, you’ve passed the NCLEX, you landed a job – you’re basically unstoppable, even if it doesn’t feel like it. I hope these tips help you catch up enough to feel a little less exhausted than you normally do.
What do you do on your days off to recharge? What kind of content do you want me to address? Please comment below, I would love to hear what you think and how you make it through your long shifts. Don’t forget to subscribe to stay up to date on all of my upcoming posts!
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