Transition Shock

I believe that is what they call it (Duchscher, 2009).

I thought with a couple days off, I’d have gained some perspective and would feel a little bit re-energized.

Notsomuch. All I feel is tired and discouraged. I dream about work. My mind races with all the things I did wrong during my last two shifts (and I didn’t even really do anything that terrible in the grand scheme of things…hell, I freaking saved a life!). I’m preoccupied and on the verge of tears whenever I think about it too much.

Yep, I’d definitely call this transition shock. And I’m not quite sure what to do about it.

I’m used to being good at my job. But that’s not even the issue. It’s not about my ego. It’s questioning whether I’m in the right place. When my preceptor fired questions at me about why I should be making certain clinical decisions, I couldn’t answer her. I knew the answers. (What order should I have requested for my patient with a fever? DUH…Tylenol). But my brain didn’t click in that rapid-fire, on-my-feet kind of way.

Granted, I was exhausted. But beyond that, I’m a deliberator, an academic. Yes, a nerd. I like to think through problems and research. On my way to work, I listen to podcasts from the Institute for Healthcare Improvement and ponder about how we can change the system.

I don’t get all hot and bothered about patients that require technically difficult procedures or have ten million drips. In fact, truth be told, I avoid them. As S pointed out, if I was a doctor, I would never be a surgeon. The procedural challenges of providing care hold no allure for me – the intellectual challenges and the relationships with my patients and their families are what brought me to nursing.

Juggling multiple patients and feeling like I’m not doing enough for any of them on a holistic level is royally pissing me off.

The highlight of my week was when my preceptor let me focus on one patient for the morning, and I got to help with  his discharge teaching. For those few hours, I felt like I was being a really good nurse. And I remembered why I was doing it.

Then my patient went home and I returned to the chaos of multiple patients and admits and not knowing which end was up.

I’ll continue to stick it out. I’m not a quitter. But the wheels are turning. The beautiful thing about nursing is how many things you can do with it…


Duchscher, J.E.B. (2009). Transition shock: the initial stage of role adaptation for newly graduated Registered Nurses. Journal of Advanced Nursing 65(5), 1103–1113. doi: 10.1111/j.1365-2648.2008.04898.x

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