Forced to Resign at the end of a Versant Residency Program

[sanaalam]

Since I graduated nursing school I have always found great advice on this site to guide me along the way. Unfortunately I never saw myself in this situation. It took me a almost 10 months to find a new grad job in California and I was so excited it was a great hospital and in pediatrics med/surg. In my second phase of of residency I was unable to handle 3 patient load required on our unit. I made some medication errors, not that I hurt the patient thank god. However it showed to my managers that I was unsafe. Part of my anxiety was having more 2 preceptors who just very different. One made me feel super confident and I did work smoothly and the second was always picking on each step and undermining my confidence. Her expectations were so high and she made me feel stupid. I finally was given one more chance and the managers helped me by giving me new preceptors and gave me room to grow. I switched to night shift and had an extension for 1-month. I was always so uncomfortable and anxious that I was going to make a mistake. I was doing well and then made the mistake of forgetting to double check insulin when multiple things came up. I was in my last week and I was felt like I was going to make it out of residency!

Since I was making such progress they said they wanted to give me the option to resign and I had to choose right at that instant or they'd have to terminate me. It was the hardest thing to do as I signed my resignation letter, turned in my badge, and walked out the door.

I've been quite lost for some time and am trying to get back into the applying game. There are so many questions I don't know the answers to.

1. For instance if I worked for 5 months do I still qualify for a new grad residency program?
   
2. Do hospitals hire someone who was at another residency program?
   
   
3. Can I apply to another Versant residency program or would I get denied?
   
   
4. Should I list my 5 month experience on my resume as Registered RN I or RN Resident?
   

I would like to try outpatient clinics or home health jobs but I don't have the minimum 1-year experience. I feel embarrassed when I read about other new grad's experience with getting fired. It seemed they had worse situations such as more patients in their work load and in more harder specialties. I was on a transplant med/surg unit and I usually got RN I assignments. I find more fault with myself than I do with my place work except for how they trained preceptors. When I reflect on all this I dont know how to respond to the burning question about why I resigned when people ask?

I would really appreciate some guidance. I just want to get back into the game and I try again to see where I fit in. If there is anyone else whose left pediatrics or in a similar situation I 'd like to know what areas of nursing you chose next.

[LadyFree28, BSN, LPN, RN]

I resigned at the end if my residency; I was in the PICU; not a Versant Residency; but a residency that was going through major changes, and for me, it wasn't a good fit for ME; and that goal was long term goal.

I'm actually in good standing at the hospital; If I wanted to apply to another position I could; however, my option is to build my new experience as a RN (former LPN) a lot stronger than I had; it took me four months to get a job; now I am a unit supervisor in LTC; I am a resource nurse; and since having this position; I have been getting interviews. I have been an RN for a year; this happened all within 6 months; I have worked as a RN for four moths total.

Since you have been in a residency; I think you may be ineligible for another residency; I would check the requirements before applying to another residency.

Cast your net wide, sell your experience, and find an eloquent way to say "I wasn't a good fit."

[sunmaidliz]

I was given the option to resign at the end of a really lousy new grad orientation. I took the termination because it made me eligible for unemployment.

Nursing sucks, darling. You got caught up in why it's so hard for new nurses to transition and why there are now an abundant of policies that exclude new grads. Most of it has to do with confidence. So, let's look at several pointsL

-A med error doesn't make you unsafe. It makes you human. We have all made med errors. Your preceptors, your managers, the head of your residency. The fact that they gave you a *chance* after you made a med error is... well, pretty bad. Because studies have shown that when nurses are disciplined for med errors, the more likely they are to cover up errors in the future, which is actually very unethical. You were set up for failure. And that's nursing.

-After 5 months, they should have better prepared you. Since this is a residency program, it's designed to make nurses succeed. They should have had ways to deal with your lack of confidence, how many patients you could take on. Residency programs are residencies for a reason. They are supposed to be designed to make a nurse completely functional at the end of it. They failed YOU.

- Just because it's a *residency* doesn;t mean they are a residency. A lot of the time, it's a fancy way of precepting new grads for less pay. I don't know much about the Versant residency but I wouldn't get too caught up that you didn't make what you think is a good residency. The fact that you were assigned preceptors that didn't help you grow, that they penalized you for med errors, they didn't address your needs.

I am from California, too and I know how tough the market is. After I left my new grad position, it took a full year for me to find another one. It was nearly impossible to get into a residency with the competition so bravo to you. I took a job at an LTC, HATED IT, and got fired after three months for the stupidest reason, like Nancy felt that I disrespected her because I talked over her and I had unauthorized overtime for the day I stayed 4 hours late ON MOTHERS DAY (I have a 2 year old) because someone called off "sick" that day. Stupid.

That gave me a total of 6 months experience. To be honest, I didn't want to do a residency. By the time I left my second job, I had been out of school for 2 years. And secondly, after a lot of soul searching, I realized I didn't like bedside nursing. Not because I didn't like the patients. I LOVED being there for the patients at the bedside and that's why I went into nursing. But it's the culture of floor nursing that I don't like. How managers can be bullies, how there are cliques and drama with your coworkers.

6 months of experience put me in a better position than a fresh new grad and I found another job rather quick. I took a position as an RN supervisor at a blood bank. I had to think outside the box to find that job and got turned down for a LOT of jobs becaues I lacked the magical year. And blood bank nursing is known not to be heavy on the clinical skills you will need on the floor. But it works for me because I will probably never set a toe on the floor again. But it might work for you and I'll tell you why.

-You have the skills. You are very smart and you can do it. Your problem with that the culture or nursing psyched you out. And that is not a failing on you at all. Switching gears and working a low stress job might fill in the blanks to get you your magical year and giveyou time to build your confidence and reflect on your past experience. I bet after you fill in the gap you will be stellar!

You can always try an LTC but LTC nursing is... well, it takes a special kind of nurse to do LTC nursing. It's hard work and you don't utilize the skills you did in acute care. And there's a culture to LTC nursing that is icky. If the hospital culture psyched you out, I don't think you will be happy in LTC and it will be a LOOOONG 7 months.

One final thought is that the hospital is not the end-all-be-all of nursing. There are a lot of ways to connect with patients that avoid the icky-ness of floor. Don't get tunnel vision and think that the only place you should be is in the hospital and in a residency.

And in terms of what to tell people when they asked why you left. "It wasn't a good fit". Everyone understands that one. If they ask why, just say "I feel as if I can learn and grow as a nurse much more effectively in an environment like your facility/hospital/company" and no one will argue with that.

Good luck.

[HouTx, BSN, MSN, EdD]

Failing to double check insulin is a not a "mistake", it was a deliberate choice to deviate from acceptable practice - maybe driven by time constraints, but still unacceptable. This is a risky behavior. Very different than accidentally picking up the square pill instead of the round one or misreading the administration time.

[sanaalam]

Thank you for replying to my post with your encouraging words and sharing your experiences with me. During my orientation I also felt like bedside nursing wasn't for me. Originally I thought I would do bedside/acute care nursing for a few years and move on. I am finishing my masters in Ambulatory Care. I took the Masters Entry level route and did an accelerated program after getting my bachelors in a Psychology at UCD. I have volunteer experience in quality improvement and I did really well on my residency project since I have a lot of advanced nursing classes under my belt. I see myself in this area of nursing in the long term future. Sadly I just feel stuck b/c most jobs I look at that are not in acute care want at least 1 year minimum past acute care experience. Most of them want more than 1 year acute care experience. I definitely understand the importance of having such clinical experience in order to do these non-acute care jobs.

My question for you is how did you make yourself marketable on your resume and cover letter for the following positions you got after your orientation. So far when I apply I just put RN I for my first experience instead of RN Resident. Is that wise?

Also since you live in CA can you please tell me which LTCs are more likely to hire new grads? At this point I am going to apply to residencies, outpatient, and non-clinical positions. I don't know if LTC are for me based on what you said but I am willing to explore and figure it out.

[sanaalam]

Thank you to those of you who replied to my post with your encouraging words and sharing your experiences with me. During my orientation I also felt like bedside nursing wasn't for me. Originally I thought I would do bedside/acute care nursing for a few years and move on. I am finishing my masters in Ambulatory Care. I took the Masters Entry level route and did an accelerated program after getting my bachelors in a Psychology at UCD. I have volunteer experience in quality improvement and I did really well on my residency project since I have a lot of advanced nursing classes under my belt. I see myself in this area of nursing in the long term future. Sadly I just feel stuck b/c most jobs I look at that are not in acute care want at least 1 year minimum past acute care experience. Most of them want more than 1 year acute care experience. I definitely understand the importance of having such clinical experience in order to do these non-acute care jobs.

My question for you is how did you make yourself marketable on your resume and cover letter for the following positions you got after your orientation. So far when I apply I just put RN I for my first experience instead of RN Resident. Is that wise?

Also since you live in CA can you please tell me which LTCs are more likely to hire new grads? At this point I am going to apply to residencies, outpatient, and non-clinical positions. I don't know if LTC are for me based on what you said but I am willing to explore and figure it out.

[elprup, BSN, RN]

yes, be sure to put that volunteer experience on your resume and anything else we talked about. That would be great!

[sunmaidliz]

In LTC, no one double checks insulin, particularly when you are checking blood sugars and are giving insulin to 20 pts. No one has time for it and giving insulin a unit off won't create havoc. But I guess that may be the difference between acute care nursing and long term care.

Those who replied, saying you failed and made risky mistakes and that you need counseling - those are the nurses that make floor nursing miserable. Those are the nurses who eat the young and intimidate new nurses out of the hospital. The ones who see things only through a negative lense to see someone as not good enough.

Most likely your confidence got to you. You CAN handle many patients. You have the skills, you have the knowlege. You just lost your confidence in yourself. I think that's the biggest problem with new grads - they just don't believe in themselves. But with posters like GrnTea, it's easy to feel like you can't do it. That's the hospital culture I'm talking about. And that's the hospital culture I want nothing to do with.

You can either see it as a complete failure on your part or a failure on your residency. Most likely, it lies somewhere in the middle. But you need to see it as a stepping stone to the next step, whether you take total responsibility or are only responsible for what is your part. Most times when things don't work out, it isn't COMPLETELY you. But it's good to see where it is you so you can learn from it and move on in the future. If you take responsibility for what isn't yours, you won't learn what you need and end up with some pretty dysfunctional habits.

Every nurse who passed nursing school and the NCLEX is capable of being a nurse. No one has a lack of skills or know-how. We were all taught from the same foundation. So trust your foundation. You CAN do it.

And don't listen to anyone else who says you are a failure. And I honestly think the residency failed you. Residencies aren't perfect and any residency that makes a nurse feel less-than is a residency that sets one up for failure. Any residency who penalizes nurses for med errors is not a good residency. Any residency that perpetuates the unit culture of eating their young is one that will have new nurses who "fail".

You don't need counseling, You need a unit that's a good fit. That's all.

[iPink, BSN, RN]

OP I understand about your concerns with jobs wanting at least one year of acute care experience. So that's why we encourage you not to give up. Don't let this residency experience get the best of you. Be up front with your preceptor next time that you desire an extension. I've seen some really odd things done from even the most experienced nurses.

Focus on getting that one year and moving into a different area if possible. We just have to pay our dues so keep applying.

[sanaalam]

Thank you all for encouraging me to try again. I have applied to a few residency positions and whatever I can in an outpatient setting - flu clinics, outpatient centers, and home health. I really want to get that one year of nursing down.

I also have tried to apply to Clinical Research places looking for an RN. I got a call this week and from an immunologist whose willing to train an RN. The position involves talking to patients but its more heavily focused on research. The research is funded by NIH (National Institute of Health) and affiliated with UCLA. I have an interview next week. I definitely am going to the interview but I know I wanted to have few years acute experience before I went down the road to branch out into research and quality improvement. I just feel like if I do this it may be hard to get back into bedside nursing.

If there is anyone whose been an Clinical RN Researcher want to share their experience or have done something similar please let me know. I'd like advice on the advantages and disadvantages of taking on such a move.

[sanaalam]

I was reading advice from different people on whether using a resume service is helpful for someone in a situation like mine. I found

Nurse Resume Service | Certified, Award Winning, Writing Excellence that Works!

and nursingresumepros.com/Get-Dream-Job‎

Can anyone whose been in a similar situation as mine use any of these services for cover letter and resume help?

[MissM.RN, BSN, RN]

Sanaalam,

I agree and disagree with previous posters. We all make mistakes: I recently forgot to cut a tablet in half, therefore overdosing my adult patient with 5 extra milligrams of Flexeril. I notified the patient, the physician, and filed a safety report on myself. And then kicked myself in the ass for an hour :-D

Your mistakes seem a bit more worrisome.

To answer your specific questions:

1. It depends on the facility you're applying to. Some facilities define "new grad" as a recently licensed RN with less than 6 months experience. Check individual job postings for their definitions.

2. I would guess that most hospitals wouldn't care if you completed a residency other than their own, but the key word is completed. You haven't completed one, and you were asked to leave.

3. Worth trying that Versant (is that a company?) will hire you again. They keep HR records like anyone else would, but maybe they have a job in less acute environment.

4. List your experience as RN resident. You were not yet functioning as RNI, as you were not off orientation caring for a full patient assignment.