Hi All-

I am a nursing student and am almost finished with my 3rd semester of clinicals. I have been working at a hospital as a Patient Care Tech for almost 4 months. Tonight, someone inadvertently ruined my night and took away all my motivation to study by sharing a piece of news with me - recently the hospital where I work hired an RN to work as a Tech. They told her that if she works as a Tech for 1 year, they will "think about" hiring her as an RN. I know the job market is bad, but I didn't think it was that bad. Working as a Tech is hard. On a nightly basis, I have 10 - 15 patients, sometimes up to 30 patients if we are short-staffed. I answer all the call bells, help the patients with their ADLs, do all the vitals, do EKGs, draw up labs, and about a million other things. Some nights I don't have time to eat, drink, or pee the whole shift. I study my @$$ off for school, trying to learn as much as I can. It is hard work, but my motivation is that I know there is a prize at the end. To hear that my "prize" isn't really there is really disheartening. It's as though all my hard work is for nothing.

To make matters worse, I ended up in such a horrible mood that I drew up a lab and put the blood in the wrong colored tube. I had to go back in and re-stick the patient. I couldn't even give her a valid excuse, because this patient actually WORKS at the hospital in the SAME unit where I work! She knew I screwed up. After I stuck her the second time, I found out that I put her blood in the wrong tube AGAIN!!! After the second time, I started crying because I felt terrible and a co-worker offered to do it for me.

So not only did I learn that there are no jobs and I will have to be a tech forever, I made a total moron out of myself by not only using the wrong tubes for the blood - not once but twice. And crying at work was the icing on the cake, because now people are going to think that I can't handle things because I was crying.

What should I do? Any words of advice?

Be prepared to apply anywhere and everywhere just like all the rest of the new grads. Things may or may not change by the time you actually get to graduation, but count yourself lucky that you are forewarned prior to actual graduation so that you can put steps in place to make the most of your job search after.

You just had a bad night, everyone makes mistakes. You will land an RN job, and the economy is not likely to stay crappy forever. There have been ups and downs in the economy for decades, and nursing has always rebounded. You're also almost done (assuming you're in a 4 semester program), so just stick with it. Also, many women have cried at work, and we all get through it.

Sounds like you had an awful night! I can understand why you'd be so upset. But all is not totally hopeless! The job market sucks for just about everyone right now regardless of career choice, but --

1) You have health care experience as a PCT. That is going to be vital in helping you find a RN job. As someone who did not work during nursing school, I can tell you how disheartening it was to see probably 75% of new grad jobs going to in-house staff. The unit that I did my capstone on opened up 5 new grad positions when I graduated and they all went to in-house staff. I wasn't even considered. Even if you find that you can't get a job in your current hospital -- just *talk* to HR staff and they'll tell you that PCT experience is one of the first things that they consider when going through resumes.

2) You work in healthcare. You know people who work in healthcare. You may not be buddy-buddy with your nurse manager but you might work closely with people who know other nurse managers, etc. Or you have RN friends who might be willing to go to bat for you to their nurse managers. I'm a fairly introverted, quiet person and the thought of having to network to get a job has always been a prospect that I found horrifying. But being in the group of my peers at nursing school who graduated without a job offer and did not have one immediately after passing the NCLEX --) I was watching friends who "knew someone" on a unit get interviews and even job offers.

3) Nursing job prospects vary drastically by region. There are jobs out there, although not everyone has the ability to relocate.

4) You may not end up getting a hospital job. Or at least getting a hospital job right out of school. When I would look through my job prospects through the narrow lens of new grad acute care positions...I would get panicky too, because you knew that when one job opening closed a new one was unlikely to open in the near future. I - along with several of my peers who could not land that coveted hospital job - ended up in home health. Couple of my friends found acute care positions...in mental health. I guess there you have to weigh a desire to work with not working in your desired field, as well as the possibility of being pigeonholed into one particular field because you didn't get that acute care experience right out of school.

Anyway, not everything is doom and gloom. Not always easy. (Although I graduated with a BSN in the Midwest and I'd say that most of my classmates who worked as PCTs had job offers before graduating or right after passing the NCLEX.) But you're taking all the right steps to making the job hunt easier for yourself.

First, don't go by what a coworker says, as they're not the ones who ultimately hire you. That would be the NM and HR. Perhaps your coworker meant well by "warning" you, but unless they are directly involved in the hiring process, they don't know the whole story.

Second, it's true that working as a PCT in a hospital is no longer the "in" for a RN job that it used to be. It still helps because you're in their system and you've made connections, but don't bank on your hospital automatically handing you the RN job prize because you were there as a PCT--it could happen, but most likely you'll still need to apply, interview and earn it.

Third, being a PCT is a great foundation. It is healthcare experience, it's networking opportunities, it's a chance to see a lot of what you learn in school in action...and it's also lessons in managing time and prioritization. Granted, your priorities are going to shift quite a bit when you become a RN since the duties are different, but the fact remains that if you can juggle 20+ patients as a PCT, you should have an easier time learning how to manage half as many patients as a RN. Plus you're learning how to function on a hospital floor under real-world conditions: hectic nights, short-staffing, demanding patients...things that often blindside new grads when they set foot on the floor for the first time and reality shock sets in.

Last, you may not get that experience in acute-care right out of the gate...but that's OK. There are a lot of opportunities that are outside of the box for RNs and you will be able to use a lot of your nursing skills no matter where you go. Remember, nursing skills include a heck of a lot more than inserting tubes and setting IV drips. I do disagree with the view that if you don't start in acute-care that you're pigeonholed...IMO you're only pigeonholed if you let yourself be. It may be harder to make that jump from one specialty to another, but it's not impossible.

Don't let one person's opinion get you down. So you had a bad night--we all have them, even when we are nurses. You're human. Brush yourself off and get back in there! :)

and that nurse who got hired as a tech for a year? maybe a little birdie told the nurse manager that she wasn't very good and telling her that she;d need to do a year of being a tech would either get her outta there or teach her skills she needs. you may not get the same message. you really cannot tell from what happens or what you hear, because you are in no position to know if it's true.

chin up! sally forth!

I would sit down with my manager and say how much I've learned at Hospital X and how I hoped to continue employment with them after licensure. I would ask about my prospects of future employment. I have students graduating who were unwilling to work as a tech/Cna or intern, so they will not be as likely to be hired as those with this experience. Don't assume things; ask directly. Neither assume that you automatically have a job on graduation, and don't assume that continued employment is out of reach. Be proactive and ask.

Thanks everyone! Tonight at work I talked about it with two of the nurses who work with me and they basically told me that during school you will hear all kinds of things about your job prospects and most of it will be rumors and B.S. And that even though some things may be true, things change all the time and to just start applying for jobs once I graduate. I feel a little bit better about things now that you all have helped me put them into perspective.

Although I wish I hadn't made that mistake, making a mistake and crying is probably not that big of a deal to anyone except me at this point.

I'll definitely take everyone's advice and keep working hard as a PCT, talk to my manager, and apply for tons of jobs once I graduate!