New RN- One Year Update

It has been over a year since I began working as a RN and I all I can say is, what a ride! I still feel those pangs of anxiety (or dread) before most shifts and I am still not confident in all my skills and knowledge, although I would say with the passage of time there are obviously some improvements. By all accounts I should be feeling super confident at this point in my career but alas I don't, at least not fully. Lately I have been reflecting on my experience these past 14 months and am currently in the process of improving my situation somehow.

Why am I still a nervous wreck?

Honestly I don't know but I am pretty sure it has a lot to do with the fact that I am responsible for people's lives? I also feel that the constant "rushing" (particularly in med-surg where a 1:7 to 8 ratio plus an admission or two has become the norm) is completely contrary to my meticulous nature. To make matters worse I never leave on time when I work in the hospital, ever (I can only recall one instance where I left on time and I was actually floated to another unit). I am also still part-time so technically I am "less experienced" than my full-time counterparts and feel I have to do a little more to "catch up to speed."

What about ambulatory care?

Ambulatory care was going well, or at least so I thought. I am still per-diem but I was working close to 20 hours per week so I essentially didn't need to work full-time in the hospital and I had the extra money without the extra stress. Unfortunately my hours have been more inconsistent and sporadic lately, which in turn makes skill development even more difficult than they are in the hospital. Full-time prospects, at least at my current location, no longer seem to be a possibility any more which is not only disappointing but has left pondering what my next options are (I still would like to retain my per-diem gig but need to obtain full-time hours at a "main" job).

What are my goals/plans for this year?

For one, I want to work on my time management. This is something that I struggle with even one year later (I am organized for the most part but there is not enough hours to do what needs to be done and actually document it). I need to control my anxiety too but it hasn't decreased much in a year (I would like to avoid resorting to anti-anxiety meds but if things don't get better in year 2 I will consider it). At this time I am currently looking to leave med-surg nursing as I do not feel it is the best fit for me but I am once again limited by the fact that I cannot do overnight shifts.  

MSN any time soon?

Probably not. My brain is still fried from nursing school almost 2 years later and I am not in the right frame of mind at this time to return to school anyway. My main focus right now is making more money, finding my niche (or at least an area of nursing I can tolerate and grow in), and hone my skills. I am tired of feeling like I am all over the place.