Considering leaving hospital after new grad internship

[GypseyGirl]

Hi all. I finished nursing school in May 2011 in California and have been looking for a job as a new grad RN, which as all new grads know has been really difficult in this economy. Before I did my RN program, I worked in the home health setting for a couple of years as an LVN. I worked as a private duty nurse and my patients needed more help with ADL's than serious medical treatment. Since the job market is so terrible in California for new grad RN's, I've been looking all over the country.

I was accepted into a new grad internship in the midwest, so I moved across the country by myself for this 13 week internship in MedSurg. The pay is very low compared to California (less than $20 an hour). But honestly, I don't care much about the pay- I feel like I needed the experience and it's been awhile since I've been in the hospital setting so I thought it would be good for me. I did not sign any contracts with the hospital since there's not a guarantee of a job after the internship, but I think they intend to offer a job if I do well since they are training me. I'm in the Float Pool right now and doing classroom training and working with preceptors on the Med Surg unit.

My main concern right now is that after being in a hospital setting on the unit, I feel so uncomfortable and like it's not the right place for me. It is very different than home health and the nurses here have 8-10 patients. It is so stressful and chaotic and I feel completely overwhelmed. Every day I come home so stressed out and overwhelmed. Honestly, I never really wanted to work in the hospital setting but many jobs I've applied for all want a year of acute care experience. I felt like maybe this is something I need to do to get that experience and then move onto an area outside of the hospital (like community health, outpatient clinic setting, etc.) The patients are so acute in the hospital and I'm not used to dealing with so many time management issues, and knowing how to treat these patients. It's so fast paced and I feel lost. The other interns in my class seem to all enjoy the challenges and the fast pace, but I feel overwhelmed and like I really don't want to be there! I know everyone says your first year in nursing is the most stressful, but I wonder if some people are just not cut out for floor nursing. I felt very confident and happy working in home health, but feel completely the opposite on the Med Surg floor.

Part of these feelings may be emphasized by feeling homesick- I really miss my family and friends and lifestyle in California (and the mountains!). I am 3 weeks into the 13 week internship, and I do intend to stay for the internship because I DO want to learn more clinical skills and grow as a nurse. But honestly, I really don't think I want to work in a hospital setting. My question is- if I left after the internship, do you think I could possibly get a nursing job in another area (outside of the hospital) and the internship would be valuable experience? Or do you think employers would frown upon leaving after an internship? I think if the hospital offers a permanent job on a unit (not on float pool) after the internship, we have to sign a year contract.

My question is- if hospital nursing is something I really don't want to do, should I leave after the 3 month internship and just put the internship on my resume, or try to stick it out for a year for the experience and just be really stressed out and unhappy? I can do it if I really have to, but if the hospital setting is not really what I want, is it really necessary? I want to do the right thing, and feel so confused right now. I don't know if it's worth the mental stress and also the risk of losing my license. (I have heard on the night shift that they sometimes have up to 12 patients, which really doesn't seem safe to me for any nurse- let alone a new grad!) I would really appreciate any advice! I don't want to keep bouncing around from job to job, but it is really important for me to find an area of nursing that I can do well in and have some enjoyment. I just really don't think it's in Med Surg!

[xtine618]

I think one year is also short. 2 years is better, but 1 year is still better than 13 weeks. My family faced relocation to a place that none of us wanted to move to (my husband is in the Army) and I seriously cried for 3 days. When I was done, I told myself that I would like the place we were moving to. I didn't have to love it, but I was going to like it. That made all the difference in the world. Your attitude will make a HUGE difference in how the rest of the year goes. You've already made one of the hardest decisions, which is to relocate in the first place! You're braver than most of your fellow new grads. When your year is up, start looking for jobs where you want to work, but don't quit until you've found a new position. In the meantime, find something fun to do on your days off. Join a club or a gym or somewhere that you can meet new people. Also, see if after your 13 week internship, you can get a 12 hr shift position. 3 on and 4 off!. Good luck to you. Give yourself a chance to like the hospital setting. You never know, you might want to be a bedside nurse for life!

[Tarabara]

OP in your posts I see a lot of I'm scared of this and that and worried and nervous, etc. To be honest it sounds like you just want to run away because you're scared. You're only 3 weeks in, of course you're still uncomfortable! And in a new city! I moved out of state for my first job too, so I do have empathy, it's tough. But it can also be a very rewarding experience. No you're not going to be able to give every patient as much attention as when you had 1 home health patient but that doesn't mean you cant provide care and comfort to them.

[wish_me_luck, BSN, RN]

How many nurse jobs have you had? Is this your third RN position?

[BrandonLPN, LPN]

I don't think you're giving yourself enough credit. Look at all you've accomplished. You had a successful career as a LPN. You went on to get your RN. You had the guts to move across the country. You won a highly competitive internship spot. If you did all this, you can tough it out for a year or two and get that invaluable experience for your resume. Trust me, with your determination and your LPN experience to back you up, you can kick that floor's a**!

[ProgressiveActivist, BSN, RN]

To the new nurse: I admire you for taking a risk and moving hundreds of miles to start your career. You will be a much better home health nurse with some hospital experience under your belt. Conversely you are going to be used and abused by a greedy corporation that values profits over human lives.

New grad internships can be brutal. If you have a preceptor, enlist her help with tasks until you get your time management down. If your preceptor is not supportive then ask for another preceptor. I hope that you have good ancillary staff.

What is going to make or break you is the caliber of the experienced nurses on your unit. Find a mentor. One with high character, high intelligence and high nursing acumen. If you can't, then get out now. Someone you can go to for help with the NGT, chest tube, peritoneal dialysis or difficult IV start.

At the end of your orientation, if you don't feel ready to fly on your own, say so. Tell them I need another month of orientation. Make this nightmare work for you. If your patient is deteriorating don't hesitate to call a rapid response, ever. And don't quit until you line up another job. Start looking now.

I was exactly in your shoes 20 years ago, in a nasty inner city ward with 10 patients from day one. I left after 2 months and I leave it off my resume. No regrets.

[PacoUSA, BSN, RN]

It makes me angry you took a spot that could have been given to someone who wanted that and to work there. Plus, internships cost money (now, I said in another thread that money shouldn't matter if there's threatening and discord being created on purpose but that doesn't seem to apply here).

This was my response exactly. This is the kind of thing that makes it harder for the nurses of tomorrow to get jobs - when their predecessors demonstrate a lack of loyalty and longevity, the hospitals just presume that the trend will continue and quite possibly will not be as generous. I just started a new grad job, and I will be here for at least 2 years, because I know what type of investment they make in new grads.

[Selkas]

I can understand your feeling overwhelmed as I have heard that from ALL my nursing friends. However, what disturbs me most is that you, without the intent of staying, took on a new grad intern position from someone who actually wants it to work at the hospital. Someone like myself. I have sent out hundreds of resumes, phone calls, letters, etc. to obtain a new grad postion and nothing so far b/c I don't have any previous nursing experience. When I hear that you only want the training and not work at a hospital before taking the position is JUST NOT RIGHT! While new grads like myself will continue to struggle thru the nursing market being frustrated with every rejection or lack of response and people like you take on and throw away the opportunity like it's nothing. Well....to you it isn't anything. If you want to quit, then do it! But do it before the hospital wastes money on you, and you take up the valuable time of the preceptor that could be spent on students who really want it. You are being selfish. Sorry, but nursing is about putting others before themselves.

[ProgressiveActivist, BSN, RN]

Try Bayada Home health as a bridge position. They will hire anyone. The pay sucks but the training and clinical support is very good.

[Faeriewand, ASN, RN]

Stick it out for a year at least. You cannot leave anything off your resume as any hospital or organization does a check on you and it will show that you worked at the ploace for only a month or so. You are making an investment in your future so just stay put. By 6 months in it will get easier. Also, I would complain about the 8-10 patients being not safe for patients. You could try to switch to telemetry if they give you five patients.

Once you have a year experience come back to CA! Of course, don't leave your job until you are hired here. Many hospitals here are looking to hire experienced nurses. I would most definielty hire you if you told me you had to juggle 8 patients while nurses here take on 5. Good luck! :)

[Selkas]

Thanks I will. I just want to work! Hospital preference but any other RN will do. Trying to stay positive but it gets very hard sometimes, esp b/c I don't have a job and have 2 dependents. I'm now looking for temporary work any place doing anything. But, at least, they will know in advance that it's temporary. Thanks for your info.

[GeneralJinjur]

I would also recommend sticking it out. While many of the worries you mention are standard for new grads, some are just related to having moved. My dad started out in the military and we continued the pattern of moving often throughout my growing up years, so I am very familiar with not being comfortable in a new area. It just takes time and a willingness to look for the good in your new place. In your case, you may not have the time to get comfy in your area until your internship ends and you are working. I think it would be a smart move to take the job if it is offered.

Every reason you listed for taking this position is still valid. Keep that in mind as you struggle through this awkward new grad period. You have the advantage over so many of us by having worked as an LPN. You mentioned how many of your peers appear to be relishing the fast pace and general chaos of the floor, but I would not be surprised to find them venting the same fears to their support system.

[CherryAnn1967]

You know in your gut that this pace does not fit your personality. You do have the right to change your mind. There is a plethora of areas in nursing to go into. Consider clinics, insurance companies, government agencies, county health department, milatary, school nursing, state run facilities in all 50 states. If you are willing to move, move for what will enrich you the most. Why train for hospital nursing if you don't plan to work in that setting. You can tell yourself that now you have the experience but with technology and the rapid growth in nursing five years out of the hospital your knowledge will be obsolete.If you want to gain skill while working for an agency/home health you have the ability to take classes to become fine tunely trained. You can learn these skills at a slower more comprehensive pace. You can go back to your old job enroll towards a BSN if you don't already have it