Just started med surg, feeling that it's not for me

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    Im a new grad nurse, landed a job in spring, passed my boards then started on the floor a couple days ago. This may sound like overreacting too soon to some readers but I truly feel in my gut that I just don't belong on a med surg floor. I never enjoyed them in clinicals and so far I just can't see myself on this one or liking it in long term. No sooner had I left the hospital building that I started balling as soon as I got in my car. The first night was so overwhelming already that I felt like crying the entire time. It doesnt help that I went in thinking Ill get to see my nurse's routine first and then kind of go from there...noo..she would be doing other things while I was trying to document assessments I had done on the computer system I had barely ever used...that doesnt help an inexperienced new grad who has never had to organize and prioritize on the real floor. I know all of the professors, etc. say "do a year in med surg first"....well I really dont want to hate my life and be depressed for a year knowing that I really don't want to work on the floor. I hate feeling almost pressured or obligated to work med surg first because "most people do" and that if you don't you're "less of a nurse."
    I've had an internship and a preceptorship in the ICU and enjoyed them but ultimately thought it'd be too much for me to grasp right out of school since the patients are so critical. I have loved children my whole life and got to shadow the newborn nursery in my last senior clinical rotation for a day and I LOVED it...I knew I would love working in a nursery and that's where I belonged...but being that all jobs are limited I took the first offer I got on this med surg floor. Ultimately I would love to either be transferred to the nursery or start looking at other hospitals for openings or just another setting altogether if I cant get in the nursery right away. I feel maybe a clinic or outpatient setting could be nice or a same day surgery center (for a while I was interested in the OR). I just dont think I can handle a floor, and I am saying this because God forbid anything ever happen to patients that I was caring for on the floor because I was too busy or stressed trying to handle a million other things...I could never live with myself knowing that. What I liked about the ICU was the close patient interaction since you only have 2 patients. I enjoy talking with the patient or the family...on the floor your lucky if you get 1 minute to talk to anyone, even the nurse I am precepting with said "well it would be nice to shoot the sh** with people but you just can't"...I want somewhere where I can have more time with patients...I guess it was kind of a wake up call since in school we only had one or two pts who we did all the care for (yeah our clinicals were not very realistic or good) and the real world is very different. I guess I just needed to vent and get input from people who know where I am coming from...I love my parents to death but trying to explain it to them just makes it sound like I don't want to work or that I need to give it more time...Ive had doubts through nursing school and they're surfacing yet again...sometimes I regret ever going through all of this...I got great grades in school but it's another story when it comes to using them in the real world. I guess I just feel kind of lost and any input or advice would be appreciated. I'm wondering if I should start looking now for another job. and I mean no offense to med surg nurses in posting this, I give you ALL of the credit in the world for what you do, I just don't think it's my niche.
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  3. 12 Comments so far...

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    That's fine. ICU makes me want to scream. Just remember as an ICU nurse, you may only have 2 patients, but those nurses are busy too. It's very high pressure as well with those patients being so critical. You constantly need to be on guard for any subtle signs of crashing.

    Personally, you sound overwhelmed, period. Even nurseries can be very busy. BTDT With missed lunches.

    I'm going to tell you something you might not want to hear, but I think you need to stick this out. If you can work Med/Surg, you can work anywhere. It teaches you to multi task and you learn how to deal with a variety of people. Most if not all jobs, including OB jobs, REQUIRE at least 1-2 years of Med/Surg FOR that reason.

    I have worked all over various fields of hospital nursing, and mother/baby is my first love. However, I don't currently work there, lol. I got out of nursing for 4 yrs for personal reasons and went back in FT 2 yrs ago. I started on a med/surg floor and like you, that first day cried all the way home. Even with 16 yrs of an RN under my belt I was overwhelmed. It's a scary place to be. The computer system was frightening and I didn't think I would ever get my groove back. Well, long story short, a month into it, I did fine and life is fine. I just had to give myself some extra time to re adjust and ask questions if I was stuck on something.

    For the record, those nurses most likely get preceptor pay, so essentially are getting paid to help you get situated.

    Get your year or two under your belt and then move on. You will be glad you did. Trust me on this one.
    Last edit by tokmom on Jul 23, '11
    nolamomx2 likes this.
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    As someone with several years of Med/Surg nursing under my belt, I heartily agree with the above post. Working Med/Surg for any period of time is never a waste of time for a nurse. You see so many different disease processes and you learn so much about so many kinds of people. Just remind yourself each time you work that it will get easier with every shift. I have been told that it takes 6 months to a year to truly get comfortable in any new nursing position, so you aren't giving yourself enough time to get into a routine and really get comfortable with your job.

    To each their own, but you couldn't pay me enough to work critical care. You may have fewer patients, but remember that there's a reason why you do. Most hospitals today are all about the bottom line, so they would give you more patients in ICU if they could, but those patients are so very, very sick, that most of them are on the verge of crashing at any moment. If, with the requirements that the insurance companies have nowadays, just getting admitted to a Med/Surg floor has to mean that you're pretty sick, what must ICU patients be?

    At the hospital where I work, the ICU nurses get pulled to Med/Surg floors if their census drops, and I hear horror stories about how stressful it is to work there and how they can't take their lunch breaks either. It's just a different (more stressful, IMHO) kind of busy than what we experience in Med/Surg.

    I'm not saying that you are doing this, because you see first hand how busy and demanding Med/Surg can be, but some people act like Med/Surg isn't "real" nursing, and that ICU nurses are somehow more important or something. I'll just say this: who is it who keeps patients who have all kinds of preexisting and underlying conditions and have surgery on top of it out of the ICU? Yep, we Med/Surg nurses do, by knowing what to watch for, and preventing crises from happening. By doing routine things like monitoring vital signs and electrolyte levels, we have the power to control if a patient goes home routinely after a surgical procedure or ends up in critical care...or worse. When you think of it that way, our jobs are pretty important, aren't they?
    #1ME, Savvy20RN, missvictoriat, and 2 others like this.
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    Thanks for your replies. I am just so anxious and upset about it that it's hard for me to go in with an open mind about needing time to adjust. I'm working again 3-11 tonight and Im already crying because I dont want to go! I don't know why I get so upset but it just comes in waves and I can't help it. I think im just going to ask straight out, "can I just follow you this whole shift and see how you do it?" because I dont think it helped when the first night I wasn't able to do that with my nurse. I dont want to suffer through orientation only to have it end and either a) quit or b) get let go because I just didn't "get it." My manager is very nice so I'm sure she'll be tracking my progress and be asking me directly how I'm doing...if I have issues I'll be honest with her. I already grabbed an application to an immediate care facility because I'm just in that mental state where Im thinking its not going to work out...I dont know, this is just very difficult for me to handle. I'm sorry if I sound like a huge baby.
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    I don't think you sound like a huge baby at all. We've all been there. It's overwhelming, it's scary, and it's stressful! When I was a new grad, I felt like crying a lot too.

    It sounds like you aren't getting a very good orientation. Most places care very much if you are happy or if you feel like you're drowning. They obviously liked something about you a lot to hire you, especially in this job market, and they definitely don't want to lose you. I bet if you went to your supervisor and told her some of what you posted here, not only would she understand, but she would probably give you a better orientation. Of course you should have just been able to shadow your preceptor the first night! In fact, as a new grad, you should have been able to do that for several nights. I have years of experience as a Med/Surg float nurse, and when I started a job at a new hospital recently, I needed at least three full shifts before I felt comfortable doing anything on my own. If your supervisor doesn't understand that, then I'm sorry, but she's not much of a supervisor.

    As far as the immediate care facility, if you apply there you are either going to have to leave your present job off of the application, or they will wonder why you want to quit so soon, or you will have to appear that you have no experience at all if you leave it off. If you can talk to your supervisor and explain that you need more time to just follow an experienced nurse and if you can hang in there in Med/Surg for at least several months to a year, you will be in a much better position to get hired somewhere else. They will like that you have recent Med/Surg experience.

    I really feel badly for you. If someone had made me start charting assessments on a computer charting system that I was barely familiar with on my first day of orientation, I would have been in tears and I would have wanted to quit too. Hang in there. It can only get better, right?

    Sending good thoughts and prayers your way during your 3-11 shift tonight. I hope it goes well.
    Aeterna likes this.
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    Are you supposedly off orientation? How long did you get? Did they ever have you just shadowing? Like the above poster said, even though I had 16 yrs an an RN, I had to shadow for a week before I was even allowed to do anything remotely to do with patients. I didn't even get my own patients until I was there a month and was on my own after 6 weeks.

    I don't know what an intermediate care facility is, but if it's like a SNF, it isn't as marketable as med/surg is, and could hurt your chances on working in mother-baby.

    Talk to your supervisor and get more time shadowing.
  9. 0
    Quote from tokmom
    I don't know what an intermediate care facility is, but if it's like a SNF, it isn't as marketable as med/surg is, and could hurt your chances on working in mother-baby.
    I had to look that one up too. Apparently, it is an urgent care clinic, which would be more like ER nursing, which means that having some background in Med/Surg would increase her chances tremendously of getting them to consider her in the future, as opposed to applying now as a brand new grad with no experience and having quit the Med/Surg job after a few days. OP, I would also be careful about going into a job like that if you ultimately want to work critical care, OB/GYN, or peds. You won't get valuable hospital experience working in a place like that as you will if you can stick with the job that you have now. Honestly, if you want to end up in hospital nursing, stay with hospital nursing. I found out when I went back to work after taking six years off to be home with my kids that recent hospital experience was EVERYTHING when I tried to get back into hospital nursing. I had to work home hospice and LTC before I could get a hospital to look at me again, and now that I'm back in inpatient Med/Surg, I am here to stay!
  10. 0
    Quote from westieluv
    I had to look that one up too. Apparently, it is an urgent care clinic, which would be more like ER nursing, which means that having some background in Med/Surg would increase her chances tremendously of getting them to consider her in the future, as opposed to applying now as a brand new grad with no experience and having quit the Med/Surg job after a few days. OP, I would also be careful about going into a job like that if you ultimately want to work critical care, OB/GYN, or peds. You won't get valuable hospital experience working in a place like that as you will if you can stick with the job that you have now. Honestly, if you want to end up in hospital nursing, stay with hospital nursing. I found out when I went back to work after taking six years off to be home with my kids that recent hospital experience was EVERYTHING when I tried to get back into hospital nursing. I had to work home hospice and LTC before I could get a hospital to look at me again, and now that I'm back in inpatient Med/Surg, I am here to stay!
    Can't agree with you more. I have had nothing but hospital experience, minus a 1 stint in a SNF as an LPN, while working in a hospital. Anyway, like you, it's all I could do to get myself back into a hospital once I got out of it.
    This job might be your golden ticket to OB/ICU a year down the road, so don't be throwing away the chocolate bar.
  11. 0
    thanks everyone for your replies. I actually worked with another nurse tonight as my assigned nurse was not working and I actually had a good night! To answer some of you wondering what I meant- I have just started my orientation period on the floor. I had the whole classroom, computer crap for a week and a half then this past thursday I worked with the CNA on the floor for my first night on the floor, then friday (my birthday nonetheless) was the really crappy day that I described in the OP then tonight my third night with another nurse actually went very well! I'll have 6 weeks on the floor, more if I need it. Now this nurse tonite ASKED me when I got there "do you want to "have (I dont really get what this entails?)" two patients or do you want to follow with me?" and I said with you! so we went through a typical day...I did dressing changes and assessments with her by my side, we pulled and gave meds and we charted together which I had so badly just wanted to do MY FIRST NIGHT! I just felt disconnected from the not so good preceptor and that she wasnt going through explaining much (HELLOOO IM NEW AND DONT KNOW ANYTHING ABOUT THIS FLOOR) for example, the nice nurse tonight when through what she puts in her progress notes and I watched as she typed them, the bad nurse did hers while I watched and said at one point or another "youll have to learn to use abbreviations so you can do it quicker" and something else that just made me feel pressured, the bad nurse made subtle hints throughout the shift how you have to move quickly, etc. and its like Oh my God I just started here, im slow, im inexperienced, Im nervous as HELL and you have the gall to make me feel crappy about how we have to move quickly because we're behind? Also I am not confident with charting, I am unsure of what terms to use because, HEY this is a legal document and I dont want to screw it up, and asking her little questions about what to put made me feel weird because she wanted to get across that some of the things arent so important to get just right or include...Already I can tell that the nurse from the other night is not a good fit for me, she basically just scared the sh** out of me while the nurse tonight, a more mature, older nurse was more my style. NOW the dilemma is that hopefully I can work it out that I can switch my nurse preceptor. I really think that balling my freakin eyes out after the night with the not so great preceptor my first night as opposed to coming home in a good mood the second night after working with a different nurse is a good sign that the root of the majority of my issues is that I need the support that I feel more comfortable with. I just worry that A) the good nurse currently has a nursing student intern (going into her senior yr this fall) working with her so I dont know if maybe due to priority (which is me! sorry intern) that the intern would be switched to following someone else or if I would have to wait to precept with the nurse (luckily the internship is over soon) B) that the not so good nurse is going to take it personally and be a total ***** to me from here on out (she strikes me as the type who would maybe do that, but I wouldnt give a crap because...hey Im looking out for myself here) and C) that my manager (she is very nice) would say "well lets talk with "not so good nurse" and try to work it out" which frankly is just a waste of my time because you can't just change the way someone precepts on a dime. I am working with the not so good one tomorrow and I am using this as the experimental shift...if I leave after the shift feeling crappy, overwhelmed, or that its not working...Im emailing my manager tomorrow night after that shift and asking if I could meet with her privately to discuss switching preceptors. do you all think that is an okay move? I dont want to wait it out and waste my valuable training time to "wait and see" if this chick is going to be okay after all because frankly, going on my gut, I dont see myself feeling comfortable with her for the next 6 weeks. Would you all do the same and contact and talk with your manager asap? how should I explain it to her? I know millions of new grads have switched preceptors but I just want it to be quick and painless. Im jealous because two other new grads on the floor have better preceptors, judging on the vibes I got from them...I got stuck with the young, kind of ****** one and that ain't cool with me. This one I worked with tonight was very nice, made sure I felt comfortable with doing things, and stuck by me if I was uncomfortable or had questions...the other girl was...i cant even describe because that night was such a blur....I cant tell you how many times I held back tears that night and how crazy I sounded crying in the car...should that be mentioned to my manager? again Im not trying to throw the young girl under the bus but I need to get across that she's not my match. anyways just glad to be home tonight and not crying...any suggestions on how I should go about this with my manager would be greatly appreciated...thanks girls/guys
    Last edit by katygw on Jul 24, '11 : Reason: missing details
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    I'm glad that you had a better night. When the nurse you were with asked you if you wanted to take patients, she just meant that you would do everything independently and only come to her if you had questions. I'm glad that you chose the "follow" option, I would have too. In fact, as I mentioned before, I have several years of Med/Surg nursing under my belt and when I started my current job in June and began my orientation on the floor, I also had a couple of my preceptors ask if I wanted to take a couple of patients or just shadow them, and I wasn't afraid to tell them that yeah, I wanted to shadow at least for the first two times or so. The thing for me is that I am very able to do the patient care end of the job, but if I don't know how the paperwork or orders are done, where to file things, where to find supplies, etc. then the patient care becomes very stressful very quickly because I have to take time to learn those things, and we all know that nurses don't really have time to be learning what they need to be doing when they have their own patient load. Also, you won't remember every single thing that you are told, so don't expect that you will, and don't stress out when you don't. I am working independently and taking shifts on one of the four floors that I am being oriented to now (I am going to be a float nurse) and I still have to say things like, "Hey, Trish, can you tell me again where I'm supposed to put these forms after the patient is discharged?", etc. No big deal, no one can remember everything. Don't beat yourself up if this happens to you too.

    As far as switching preceptors, that's a tricky one. I completely understand where you're coming from, because let's face it, some people are cut out to be teachers, and some aren't. I have had some fantastic preceptors, and then I have had some less than great ones. The thing is, though, that you want your supervisor to see that you can work with all kinds of people, because that is something that is imperative for a nurse to be able to do. If you ask her to switch you because you like the other nurse better or don't think that the assigned preceptor is very good at it, that may not come across very well. I would definitely speak to her, but try being very diplomatic by saying something like, "Wow, I can't believe how much better Saturday night went for me!" She will say something like, "Oh, good. What do you mean?", and you can say something like, "Well, Mary Smith RN allowed me to just shadow her and get a really good feel for the floor, which is something that I really needed. She was also very helpful in explaining things without making me feel rushed or having me do things that I don't feel ready to do independently just yet." That way, you aren't really bashing your assigned preceptor, but you are letting the supervisor know in a subtle way who is the better preceptor and why. Then, she will hopefully ask you if you would like a different preceptor, or tell you that you can definitely ask your assigned preceptor to slow down and let you do things in a more gradual way. I just don't know if I would ask to have a completely different preceptor at this point. Nursing, being a profession that is dominated by women, can lead to some pretty gossipy, catty environments, unfortunately, and if your assigned preceptor finds out that you requested someone else, it might come back to bite you when working with her or her friends in the future. That's just my opinion though, so take it as just that. If you really want to ask for a different preceptor, then you are the only one who really knows what you need to do to get yourself where you need to be with this new job.

    I really do believe that if you can hang out and make this work, it will be much, much better for achieving your long term goal of working in a hospital specialty unit than quitting and going to a non-hospital setting.

    Good luck.
    tokmom likes this.


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