Devastated and Depressed
Dear Nurse Beth, I am in desperate need of your guidance. Growing up I was the child of a single parent (who was a CNA) and learned the meaning of handwork early on.
I graduated from nursing school in December of 2013 with honors (magna cum laude, 3.91 GPA, Sigma Theta Tau - the whole works). Unfortunately, like many new grads, I had a hard time finding a job. Finally, 9 months after graduation, I landed a new grad RN residency; however, I always dreamt of being an ICU nurse and was now working in a behavioral health hospital 150 miles away from my home. Either way, I was happy and relieved to have a job vs no job. 9 months into the residency, I began taking RN refresher courses at the local JC in order to prepare transitioning into "acute care." The professor of the program really liked me and offered to help me get into acute care.
Weeks later I found myself with an offer for a med/tele floor. I was beyond excited. Everything that i had worked so hard for finally paid off.
Little did I know, this med/tele floor from nursing would be the textbook version of "nurses eat their young." I was told I would be given 2 weeks (6 12 hour shifts) of orientation. I told them I was still a new grad and needed more training, they refused. The RN orienting me told me she wanted me to "feel the pressure of nursing" and gave me 5 tele patients and 3 med surg patients - I live in the state of California where the ratio for tele is 1:4 so I knew this was wrong but was so overwhelmed on the floor that I didn't realize it until I got home that morning. The nurses on the unit would talk about "black people," "gay people," and "Mexicans" saying how they were beneath them etc. Mind you, I spent my childhood in a lower middle class neighborhood and don't discriminate against ANYONE so this situation was very uncomfortable for me. They also went on to tell me about how awful the other nurses were, and when I would go talk to these "other" nurses, they would tell me how awful my preceptor and her friends were! I was caught in the middle of this historical feud.
I finally mustered up the courage to email the manager. He didn't say anything about the ratio situation - he remained silent. About the politics, he said no matter where you go there will always be politics - i reminded him that when politics interfere with patient safety and care, it is a BIG problem. He asked me for an example, I told him that the nurses who didn't like my preceptor, refused to help ME turn or reposition patients - something that simple. He basically said I should suck it up and reposition them myself.
I realized that the environment there was not conducive for a new grad and began putting the red flags together - i now knew why the nurse educator had said "they haven't had a new grad RN there for over 10 years...."
Nevertheless, I resigned. I informed the professor who got me the interview - only to find out that she had resigned from the hospital 2 days before me due to "out of control politics."
I was extremely disappointed. I felt depressed and broken. Fortunately, my husband continued to support me tirelessly. Within a couple of days I found a job doing nursing case management. I enjoyed it - until i realized that my supervisor (not a nurse) didn't know the difference between an RN and MD. I showed her our scope of practice, I attempted to educate her. She insisted that I see patients and diagnose them, she insisted that I sign off on other nurses assessments - nurses who no longer worked there. Things became really shady very quickly. I felt my license was in danger and wanted to leave. I took PTO in order to avoid resigning.
Nurse Beth, I am no longer optimistic about nursing. I had dreams of becoming an ICU nurse but now I am questioning nursing - why did I become a nurse? Where do I go from here? Is it me? Is something wrong with me?
Devastated and depressed - kind of a new grad.
Dear Devastated and Depressed,
This isn’t about whether or not you should have become a nurse, it’s about the employment you’ve had so far. And also about recognizing red flags that are indicators of bad employers. Don’t give up but do proceed with caution.
Here is the pre-hire red flag that should have served as a Keep Away Warning:
Telling you orientation would be 2 weeks long. I know you were happy to get into acute care, and the opportunity may have blinded you, but what this says is that patient safety is not a priority. They went on to violate California state ratios, and tolerate lateral violence. The attitudes towards other ethnicities and cultures in the workplace that you describe is honestly enough for a hospital to put their accreditation at risk, or be sanctioned by the Department of Health, if formal complaints were made.
When you run into problems of this magnitude on the job, it is better to talk to your manager in person rather than email. Not to say it would have made a difference in your case, as he has no intention of making any changes, but for future consideration. (Also it’s not wise to “remind” your boss that politics is a patient safety problem).
You were wise to leave this facility. But I’m concerned about the next employer who hired you to be a case manager, because case management generally, and for good reason, requires a couple years of bedside nursing experience. I think you answered my question of “Why would they hire a non-experienced nurse to be a case manager?” when you went on to describe your supervisor.
It makes sense in an organization where the supervisor is uninformed of correct procedure and nursing scope of practice. A supervisor who is not a nurse is not even qualified to evaluate you on your nursing performance when performance appraisal time rolls around.
It’s understandable you are discouraged at this point because you haven’t yet experienced anything near a normal, well-run facility yet.
With your high GPA, your self-motivation to learn and improve yourself, and your determination to improve yourself, you have all the makings of a good employee. Again, don’t give up all you’ve worked for.
At your next interview, be prepared to ask questions that will help reveal some of these problems ahead of time.
- What kind of orientation will I be provided?
- Who will I be reporting to (my direct supervisor)?
- What is the nurseatient ratio on your unit?
Listen carefully to avoid selective hearing, and cultivate your intuition. Good luck to you, friend.
Last edit by Joe V on Oct 19, '17
Jan 29, '16@ Nurse Beth,
..."With your high GPA, your self-motivation to learn and improve yourself, and your determination to improve yourself, you have all the makings of a good employee."...
The nurse has leadership quality; therefore, should think seriously about a Masters level program such as Healthcare Administration, Nursing Management, or Education.Last edit by JenFad on Jan 29, '16Jan 29, '16Proud of you.Always stand up for your beliefs and patient safety. If you can , go back to school for hospital administration...we need so many changes from the inside. Medical care is a big business, patients are just numbers from California to North Carolina.It has become unsafe in many areas of the nursing world and it seems there is no one there to go to bat for us... as you are told....It's the same everywhere. Jacho comes in , does their perfunctory slap on the wrist and hospitals cover it up for a while and are back at same unsafe deeds they were before. managers take bonuses for keeping staffing at a minimum... or lose their jobs.It is cheaper to pay a law suit than to keep a hospital well staffed. I have been at this 43 years . I traveled from California then back to east coast... Things have been going south in health care for a few years and I am very afraid it will get worse unless our very expensive- to- join state nurse associations get behind us. I never thought I would say I would join a union, but IF it came to my neck of the woods, I'd be right thereJan 29, '16@birdwhisperer
..."Proud of you.Always stand up for your beliefs and patient safety. If you can , go back to school for hospital administration...we need so many changes from the inside."...
Absolutely agree. Management should look for 'talent' among the staff in order to fast track them to leadership programs.
People like the nurse in question find themselves frustrated because they truly aren't meant to be bedside staff but rather mentors and leaders.Jan 30, '16I feel for you...
I am in a very similar situation right now. How frustrating to keep our standard high and practice safe while there is such little support in the environment where "Nurses eat their young" mentality is expected traditional nursing world.
What's even more frustrating is that there seems no way out for most of new Grads. to find a job with proper support systems for safe practice in this horrible job market.
I am so sorry to hear about your story and I hope you find a right job soon.Jan 30, '16Unfortunately, I think many places that hire new grads, do it because they can't get anybody else. Which, of course, is exactly the polar opposite of what a new grad needs. Hang in there, keep trying. Nursing needs you.Jan 30, '16I feel your frustration. I graduated in 2014 from the LPN program. Took the NCLEX a few months later and didn't pass, in the mean time I worked in ED as a CNA, studied my butt off then took it again last year in March and finally passed. I was so excited. I wished I was able to stay in the ED but they didn't hire LPN. So I took my first nursing job at an OB/GYN office in June of last yr. with so much excitement enthusiasm and what a huge difference. I went from being loved by my peers in the ED to being disliked by a lot of the medical assistants because they felt I was there to take their job. smh. I was pretty much thrown in and no other nurse to look to besides my boss who I like but was always busy. Things have gotten better but it's not what I expected. I went from doing triage as a brand new nurse with another MA to having my own schedule where All I do is all the inj. and pregnancy test(plus everything with it), which are all scheduled with me. I feel like I'm losing my clinical skills; skills that I worked so hard for in the nursing program. I'm just not happy. I miss my ED family so much. Times where I wished that I stayed there till I was able to obtain my RN. Times where I thought of going to a nursing home but I don't want to leave the hospital....the dr. office is part of the hosp. Heck, I would love to do a Foley. LOL. I have learned some things from there but you can only go so far. Plus I've had to deal with some bias stuff. There is a woman who has no patience for pt. where english is their second language. I've had pt. complained about her, and have gone to my boss about it but I don't think anything got done because I still see her raising her voice at them and being rude. There was one time where she came to me asking if I can talk to a spanish speaking pt. who is out in the waiting room and since spanish is my second language I said sure, what is her name? Her response, "You can ask her when you see her"....Ok, so because I'm hispanic I'm suppose to know what another hispanic person looks like? Let me just get my radar out and find her. I was so angry. I mean c'mon!! I've been currently looking for positions in the hospital but nothing yet. But now I'm nervous because of the lack of skills I have. But I'm miserable to. Idk. I am going to school trying to get these prereqs out the way so I can get in the RN program. Should I stay and suck it up till I Obtain my RN or get in the hospital setting, I just feel a little lost. I even thought of staying there and getting a per diem position at a nursing home till I got in the RN program. I wish I could do per diem at the hospital but they consider it overtime since the office is a part of them. I feel so sad and alone at times.Jan 30, '16Lil<3LPN It's hard to say because a lot depends on the opportunities for LPNs in your area. You would definitely get to use all your skills in a nursing home, just try to talk to someone who works there first if you can- the workload can be very heavy. Whatever you decide, keep your eye on the long term goal- getting your RN. Everything else is temporary. Good luckJan 31, '16Hi Nurse Beth,
I wrote that letter to you. I wish I could reach out to you and give you the biggest hug ever. I am so grateful to you for taking out your time to help ease my concerns and worries. I just want you to know that your words mean so much to this new nurse and actually give me the strength to go on. When I wrote that letter to you, i was doubting myself and my decision to become a nurse. I felt like a failure and that the universe didn't reward my handwork but since then i have realized that life is a marathon not a sprint and the hard work doesn't end once you have a degree hanging on your wall, it is just starting. Your letter gave me reassurance that I wasn't incompetent, I wasn't a failure, and I didn't do anything to sabotage my future - and most importantly that I shouldn't blame myself and should continue to fight on. Thank you.
Since I wrote that letter to you I have moved on to another employer - its not the greatest job but its a job and it pays the bills. In the meantime, i am still working on finding a position in a hospital. One night, I sat down and read the book called Who Moved My Cheese? I am someone who believes in god and I began to think that maybe my life is destined to be a psychiatric nurse not an ICU nurse. After all, I enjoy being a psych nurse, I am amazed by the talents of the brain, and there is so much work to be done in mental health in our country. I also began to focus on what I DO have versus what I don't have. Part of the reason why I wanted to be an ICU nurse was because I would eventually like to do volunteer work overseas but with the ongoing situation of our world at this time, i think psych nurses will be extremely valuable too. (Despite this, a part of me feels like I am "settling" for psych nursing and this is something I have to overcome because i'm not).
Thank you so much to everyone else who replied. Even though we don't know each other personally, everything you say on here makes a difference in someones life and all of you have been so kind to me and impacted my life in a huge way. I read everything all of you said and even shared it with my wonderful husband. Thank you for the support, I wish I worked on the same unit as all of you, imagine what a wonderful world it would be
no longer devastated and depressed (at least today)Jan 31, '16I am so glad your outlook has changed and even more glad you shared. It really warmed my heart, thank you for your kind words. I really hope someone else who needs encouragement reads your story and it helps them see the possibilities. You will do a great service to behavioral health patients. I have a beautiful daughter with a mental illness. I often say she's my hero, but that's another story . My point is I know the (mental health) system well, and it's people like you who make a difference for people like me. God bless.Feb 1, '16Your experience is one of the new 50 shades of Nursing. Don't give up. Keep looking and follow Nurse Beth's advice. You will find a place that is best fit for you. Don't jump on just any offer, do your research and make sure it is a safe environment for yourself and your license. Good luck
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