Everybody has it that bad. I promise.

A colleague-shaped blur went past me this week and resolved itself, once I caught up to it, as Marcia, one of the new nurses on our floor. She just got out of her internship and has been looking a bit white around the eyeballs lately.

"What's up?" I asked. "D'you need any help with anything?" 

"No..." she replied, "It's just one of those learning experience kind of days."

Ooooohhhh yeah. I remember those days. Sometimes (meaning about three shifts out of five) I still have them. There is nothing worse than being a new nurse and having Learning Experiences every. damn. day. you work.

Because, no matter how hard you try, you still feel like either an asshole or an idiot (or both) by about noon. This is common, and it's caused by the fact that you think you've actually learned something in nursing school. 

Not that I'm bagging on nursing school. It's like this: You learn all this very useful information, and all these valuable facts, but you don't--you *can't*--learn how to put them into practice until you've been, well, *practicing* for a while. Coming out of nursing school and expecting to have a handle on being a nurse is a lot like taking driver's ed without ever getting into a car, then expecting to be able to handle rush-hour traffic. On a different planet. With totally different physical laws.

Part of the problem, I think, is that you're trying to put things that you learned in a static fashion into practice in motion. I know that's a weird way to look at it, but bear with me. When you're in nursing school, you get a case study or a scenario to work with, and you can go through it step by step in a logical fashion.  You're sitting down, what you're working on is the only thing you have to deal with. Once you get out onto the floor, though, you have that scenario *and* about fourteen other things--literally--happening at the same time, and you have to keep track of all of them, and call bells are going off, and people are falling over in the bathroom, and you're running down the hall. 

Not only does your brain have to get good at sorting, discarding, and shoving things into medium-term memory, but you have to do it all on the run and while paranoid. 

This is why new nurses have breakdowns, start drinking, and think about going back to banking.

The good news is that things do get better. I don't know how it happens, but somehow your brain gets good at remembering five or six things for an hour or two, ranking those things in order of importance automatically, and then (most important) discarding them once you've dealt with whatever they are. Thinking back, it took about six months for that to start happening for me, and another year for it to get really good. Now I can go to the grocery store without a list and not forget anything. It's a good skill to have.

Also, you get used to thinking on your feet. It'll get to the point eventually that it'll be hard for you to really grasp a new concept without being in motion as you learn it. There's some neurological basis for that, but I'm down two Hop Head Reds at the moment and can't remember what it is. Anyway, you'll get so used to learning and coping while on the fly that it'll seem weird to discuss a problem with a doc if you're standing still.

And finally, you'll lose your pride. I don't mean that in a negative way: you don't turn into some sort of snivelling creature who winces any time anybody corrects you. I mean that you realize that mistakes happen multiple times a day, and catching and correcting them before they do harm is the important thing. You'll also learn that nobody knows everything, and even experienced nurses screw up in impressive, mind-boggling ways. Your ego learns to lie down and take a nap while you're at work, and mistakes quit seeming so damn personal.

Listen: I screw up at least six times in a shift, every shift. Most of the time, thanks to experience, I catch those screwups before they head out the door. Sometimes, I manage something so amazing that it qualifies as a Learning Experience, Nuclear Grade--and I've been doing this full-time, in one specialty, since 2002. Thankfully, my pride doesn't take a hit (or not much of one) every time that happens, because I've learned that I'm not the only one.

There are also things that I still do not know. Some of them are very basic; others are kind of arcane. I ask a lot of questions (one of the docs has nicknamed me the Elephant's Child) and do a lot of reading and try to get in on cool bedside procedures when I can. Those habits are among the most valuable you can develop as a new nurse. Not only do they mean you'll never stop learning, but an honest curiosity about things will put you in good stead with doctors and other nurses who like to teach and learn themselves.

Eventually it will all come together. You'll look up one day and realize you've filled out your chart's checkboxes in three minutes, your patients are all medicated and comfortable, and you actually have time to pee. Six months later you'll have time for lunch. Two years later you'll have enough downtime to fill in a couple of boxes on a crossword. More than that, you'll be able to form a synthesis with speed and accuracy and keep a dozen metaphorical balls in the air without flipping out.

Getting there sucks. The nightmares suck, the fear that you're going to hurt somebody really sucks, and the anxiety is awful. But it all does ease out over time. 

New nurses, listen up: Cut yourself some slack. Be easy on yourself when you look stupid, as you most certainly will. Don't expect to be an instant expert, or even instantly competent at everything. Recognize that you have strengths and play to those. Recognize your weaknesses, too, and learn how to hedge around them and how to compensate.

And for God's sake, don't go back to banking. We need you here with us. I am glad and proud and tickled to death to be working with you, because you teach me so much. You also remind me why the heck I got into this business. So thank you.

And if you need some help, don't hesitate to ask. We've got twelve hours, after all.