New Grad Blues

[sunshineyday]

First of all, I want to state that I am not writing this to "poo poo" upon the nursing profession. I am hoping that by sharing my story:

A. I will feel better for having vented

B. I will maybe get some constructive feedback

C. Have a chuckle or two in the process

D. Maybe some of you will treat your new grad RN's better

I am a very type A, motivated person . I graduated near the top of my BSN class (I was class President) in May 2008 and was accepted to a prestigious MSN program in the same month. At that time, I had several offers but I accepted a new grad RN position in a CVICU. During my interview I felt I asked all the right questions (turnover rates, ratios, floating, etc.). I started my nursing career with a bright and positive outlook.

Flash forward to three months later. I just quit the hell hole. After working there for two weeks I found out the TRUTH...outcomes were the worst in the city for cardiac and stoke, new grad turnover rates were the highest, and I realized that their "culture of loving care" was just bs lip-service. I found out after I started that the cardiologist left, so I was seeing tele overflow patients ALL the time (wow, so not CVICU - and I turned down ACTUAL CVICU's for this job) and that it was all PAPER charting. There is a bs "PBDS" system that doesn't help the new graduate whatsoever. I sit there and take a four hour exam based off of videos of "clinical vignettes" and have someone critique me for two hours. Then I get back a card with ambiguous "concepts" to work on like "managment of care" and "sense of urgency". Excuse me, but I would argue that the seasoned nurse could always improve on these facets of nursing as we are always learning in this profession.

My first preceptor was a nice person. A former unit educator she was very well connected in the organization = politics gallore. All she did was tell me personal unprofessional stories about having sex with her internet boyfriend and how her soon to be ex-husband's love child baby mamma was causing drama. She spent all day on her PDA instant messaging him and put me into dangerous independent practice situations. One time she walked in on me in the process of changing tubing - huffed and puffed and told my nursing manager I had "exposed my patient's PIV to air and knowingly contaminated the system" BS!!!! What a crock!!! She later half-apologized when she realized I was indeed changing the tubing. Then she goes behind my back and tells my manager that I don't take initiative!!! *** she is a horrible PRECEPTOR and I am not going to lose my license because she is lazy. What makes me laugh the most is that she was a former EDUCATOR??? So I ask for a different preceptor --- what a joke process. Administration made such a big deal out of this and after several meetings later I had a new preceptor. The new girl was better but I was already at a disadvantage because she didn't really know where I was "at" and my manager didn't want me starting from scratch. Plus she was friends with my previous preceptor --- politics, blah blah.

NO TECHS here (grr)!!! I felt like the unit tech. The uncompetent new grad who "should be in med/surg her first year" - all I did was blood sugar, turning, oral care, baths, and gave po meds. If I was lucky I could titrate insulin. They sure didn't like it when I read their "ventilator pathway" and it stated to provide oral care q6...JELLO ever heard of VAP?...I got lectured about providing oral care q2 (i.e. waste of time/bad time management). Their equipment was so outdated and OLD I'd never seen pumps like this before and their philosophy on "back priming" makes me want to puke. Also, their "chart by exception" rule makes me nauseus. Yes nursing notes can be excessive but the rule of CYOB applies also. I had five "preceptors" tell me to "chart" differently. I can go on forever.

The thing that gets me the most is that I was humble, always on time, "fake" positive all the time after things started going bad, and went OUT OF MY WAY (even changing my schedule to DAYS). Why do nurses have a culture of "eat their young"? I worked so hard to put myself through school. I thought I went through "hazing" as a student, but I would venture to say new grads get treated WORSE than students.

So here I am. I think I need some sort of SSRI. I'm depressed, wondering if I went to school for the right thing, and wondering if I will ever find a good nursing job.

I don't know what else to say at this point. Thanks for reading!

[lpnflorida]

Thanks for the compliment Oldie,

[shortlittleRN]

I'm glad to hear I'm not the only one feeling this way. I am at the point I don't know what to do anymore. After my 9 days with a preceptor as a new grad I was on my own. This is a very busy med-surg tele floor. It's been a month now. The last time I worked I had 7 patients. Two patients were total care. 5 were diabetic with AC/HS checks and most on standing insulin orders on top of sliding scale, 5 on IV fluids or meds. One discharge with none of the paperwork done and he was sitting in bed at 10 am with his clothes on ready to go. I cried that day.

Alot of the people I was in orientation with are unhappy. Some have already left. As for me, I am having nightmares, I have starting sleepwalking; never did THAT before! I woke up once standing in my bedroom trying to hook up my radio as an IV pump. Can you say stressed out?

Seriously though. What do I do? I am a new grad with one month experience? Who would want me? And I sure won't be applying for any med surg jobs!! Any advice would be greatly appreciated!

New Grad RN

OMG the sleep walking incident cracked me up. I'd say you're a little stressed... and I thought I was stressed. Honestly though, if you're given that much responsibility as a new grad, it's time to assess other employment opportunities. You have to look out for yourself. After all, new grad or not, it is still your behind that you have to cover...liabilities lawsuits won't care whether you're new or not. Good luck.

[Wishinonastar, BSN]

I used to have terrible nightmares about med errors and being behind. I was always behind in my dreams- hanging 9 am IVs at 1 pm, etc. People have no idea what the pressure does to a person. I got more confident in time, but I guess it is the perfectionist in me that always fears I will make a mistake. Perfectionists make great nurses, but the stress burns them out. I guess I always thought that if there was just someplace to work where the workload was realistic maybe it wouldn't be so terrible.

Home health was my answer. I worked in hospice for a while and at that position there was not enough work to do. They kept our workload too low, and I found it just as stressful. Home health can be insane at times, but you have more control over your work. It gave me the perfect balance of clinical stimulation, and control. It is like working in the hospital, without the hospital stress. I have had vents, chest tubes, IVs, all kinds of lines, wounds, anything you can imagine in the home. Hospitals have actually asked us to come in and teach staff to do things like wound vacs because they don't know how. Sometimes you just have to find your niche.

Don't give up and waste your education. You got into this for a reason. Try a different environment first. maybe you will have to look around but something is out there just waiting for a nurse like you.