What are my options outside of a hospital setting?

[Exhuasted]

So I'm in my last semester of nursing school (for the second time), and apparently my clinical instructor thinks I'm not cut out to work in a hospital, and I'm pretty sure the only way she's going to allow me to pass is if I shift my focus towards other options. I know I can't handle long term care. I don't really see RNs in clinics, it seems like there's a couple of CNAs and MAYBE an LPN. I thought about possibly a dialysis clinic, since there is more of a need for RNs there than most other clinics, but at the one here you start at 4:00am, and there is simply no way I could do that. I know scheduling may sound like a ridiculous reason to rule it out, but I already struggle with 6:30 clinicals, if I had to be there at 4:00 I would be sleeping an impossible schedule, I would be waking up at 2:00, which would mean I would need to go to sleep no later than 8:00, and I just could not do that, I already have sleep issues and I can't fix my sleep cycle (no matter how hard I try). I would LOVE to work nights, I sleep great in the morning after being up all night, but then night shift is mostly hospital and nursing home... Can someone please help me explore my options? Or figure out if this just isn't for me and I've wasted 3 years and countless breakdowns, which is what I fear most...

Edit: even if floor nursing is not for me, could I possibly handle pre-op?

[NorthernNurse BSN,RN]

OK... Your professor is not going to fail you because you want to work in a hospital. I know of quite a few RNs who work in clinics where I'm from. I also find it strange that the clinics are mainly hiring CNAs and rarely LPNs where you're at... did you perhaps mean CMAs because that would make more sense to me. I can't say whether bedside nursing is for you or not, but if your instructor seems to think so then there's a reason for it. Why does he/she seem to think you're not cut out for bedside nursing? Perhaps if we know why then we could make other suggestions.

[ItsThatJenGirl, CNA]

Do you think you can handle it? Why is this your second time in nursing school? What sort of feedback have you gotten from your other clinical instructors?

[SopranoKris, MSN, RN, NP]

Once you pass NCLEX and have your RN, it doesn't matter what your clinical instructor's opinion is, you can work where ever they're willing to hire you, including a hospital.

However, since you clinical instructor doesn't think you're cut out for the acute care setting, it's important to evaluate *why* she has this opinion of you. Do you struggle with time management? Difficulty managing multiple patients? I would seriously consider the feedback you've been given and determine what you can do to improve upon it. If acute care is what you feel fits your lifestyle/sleep schedule better, then try to do your best to set yourself up for success.

Also, regarding getting up early for a 4 AM shift: never say it's impossible. It's simply a matter of getting used to the change. I never thought I'd like night shift at all. I've been on nights for 2 years now and the thought of a day shift schedule makes me say "no thank you". If you would have asked me that 2 years ago, I would have said no way

Good luck to you :)

[Exhuasted]

It's my second time because I failed clinically last semester. Yes, she will fail me if she thinks I'm not competent. She thinks I can't handle a high stress environment. The only negative feedback I've ever gotten in previous semesters was that I need to be more confident. Now I'm still told I need to be more confident but by the same person who will turn around and chew me out in the hall over nothing or squirt a full saline flush in my face (and yes she really did that) or humiliate me in front of the whole class just because she can. She says that I spin my wheels and get too anxious.

[HouTx, BSN, MSN, EdD]

Agree with PP's comment about clinic & office staffing - it's largely MAs & LVN in my area also. RNs are only working at the larger multi-specialty clinics... Usually to staff infusion suites or other specialty services.

Unfortunately for new grads, very, very few ambulatory settings are able to provide sufficient support (e.g., residencies, extended orientation, etc) for newly licensed nurses so they just don't hire them. Home care is generally not an option either because it's just not safe for new grads to work without a qualified experienced Preceptor or RN close at hand.

[applesxoranges, BSN, RN]

In my area, home care is starting to become an option for new grads. I won't judge whether it is right or safe but some start out in home care. Long term care isn't necessarily bad but it's a lot harder and if crap goes down, you don't have the back up you would in the hospital. I wouldn't want to work there because it's a lot harder.

We have a call center for bed booking and transfers into our system which I am going to go work at soon possibly. However, I think they want experienced RNs in ICU or ER setting.

Also, couldn't you say you plan to move to a larger city where you can work in a clinic? Without actually doing it? Or you could say you are considering long term care. There are a lot of different options. Skilled rehab. There are in patient physical rehab units which the nurses used to joke they can see why nurses "retire" to go there because it was nice and easy. There is psychiatric nursing. There are outpatient psychiatric units. Dialysis clinics. Urgent care clinics.

So some options:

Skilled Rehab

Outpatient psychiatric

Inpatient psychiatric

Dr. offices

Research

Infection Control

Utilization Review

Insurance reviews

Urgent care

Nursing Home

Home Health

Health department

Prisons/Jails

Bed Booking

Dialysis

Also, you can "make plans" for before you graduate but doesn't mean that your "plans" will work. Very few new graduates find their dream job right away. When I first started, I found my dream job in the ICU. I hated it. It was not a good environment so I jumped ship back to ER.

[Nurse Grandpa]

Sorry your having a tough time. The writer before has given you a fairly comprehensive mix. I'll add one: Health informartics if you have an IT Background or are interested in technology it could be a great career path. I can also tell you that in my 40 years as a nurse no one has ever asked me about my grades in school or my board scores. Degree? Check, Clean License? Check. BTW Nurses who want to work permenant nights are always in demand. For now just concentrate on jumping through the hoops and getting you diploma. Remember living well is the best revenge.

[emmjayy, BSN, RN]

Tell me more about the incident with this instructor squirting a saline flush in your face, because I'm jumping to all sorts of conclusions. I'd rather hold off on giving my opinion until I know more.

[elkpark]

There are tons of professional options other than inpatient bedside nursing -- the catch is that most of them consider some significant amount of bedside nursing experience necessary in order for applicants to be considered qualified.

[Alisonisayoshi, LVN]

Tell me more about the incident with this instructor squirting a saline flush in your face, because I'm jumping to all sorts of conclusions. I'd rather hold off on giving my opinion until I know more.

Right? Me too!

OP I am an LVN in outpatient case management. Our last 3 new case managers have been RN not LVN because of the new Health Homes requirements. Do not count out clinic nursing as the land of just the LPN/VN or the CMA.

[Here.I.Stand, BSN, RN]

I haven't read through the replies, but if you are truly concerned that you will only pass if you "shift your focus towards other options," who says LTC can't be your...ahem...goal? Goals change all the time. Once you graduate you can then apply anywhere you dang well want to.

Not that you can't explore options for your own planning.