This a little something I have to get off my chest about new grads "hunting" and even seasoned nurses looking to switch jobs or specialties. A little background on myself at this current time. I am an ADN RN w/ just over 2 yrs of experience under my belt. I started out working in a local NH and worked my way into the rehab wing. After working for over 1 year at the NH I applied at a hospital and got my dream job of working in the ER. The advice and experiences im going to share will hopefully shed some light on the nursing profession from my own experiences and hopefully assist you guys in moving forward with all of these job selection dilemmas I read about on this site.
#1 - As a new grad nurse "hunting" for your first job you have to remember this one little thing that hiring managers and seasoned nurses are not gonna tell you. As a new grad nurse you are a LIABILITY to patients for about your first year, unless you are properly mentored in a new grad orientation program. By LIABILTY I mean you do not have the experience to critically think on your own after a maximum 3 month orientation process and adapt to a rapidly changing situation. If you don't develop this ability and sharpen it quickly after a 1, 2 or 3 month orientation , your gonna kill someone.
All new grad nurses are full of bravado and confidence when searching for jobs and describing themselves on resumes. Watch that same nurse during their first code no matter where they get hired and they have no clue what to do unless properly trained and mentored in multiple codes. It's part of the experience process. You have to be honest with yourself guys. Where would you rather have your first code happen? In a NH where patients are elderly, mostly stable and the most you would have to do is apply O2 and start CPR and have someone call 911? Or would you rather be standing by the bedside in the ER or ICU and have a patient crash on you? Heres the scenario, patient becomes pulseless while your trying to manage 5 pressor drips, orders keep getting shouted to you, MDs are getting ****** cause your not keeping up, family members are yelling cause theyre family member is dying and now you suddenly have to start a code on them and get the crash cart and hope all your other co workers are not tied up with their patients and able to help? After all efforts, patient dies. Could this be a patient that would have died anyway no matter what nurse was caring for them? Seasoned or new grad?Absolutely. But if you looked and acted like you had no clue the entire time you worked on this patient and you really didn't have a clue what to do you were just winging it, guess whos gonna take the heat? Its not the MDs!!!! You can lose your hard earned RN license and catch a case in a heart beat guys.
Nursing is a no joke profession and peoples lives are in your hands, literally Once again, new grads are LIABILTIES to patients if not placed into a new grad orientation program for at least a year. These programs are becoming increasingly fewer and fiercely competitive. Don't plan on getting into one. If you do, I envy you and you will be light years ahead of any RN with the same amount of experience who didn't get into a NG orientation program. Trust me.
#2 - Stop limiting yourselves to only working in certain facilities. Do you think I liked working in the NH. Hell no!!! But it got me the experience needed to move on to the ER after I perfected my basic nursing skills which are not perfected by any means in school. Where ever you get a job, be proud of it. Become the best nurse in the building. Don't ever forget where you started cause you could end up back there if you get fired or laid off, which happens very often by the way. Burning one bridge in nursing closes off at least 10 roads. Your NM in one job could be the NM at two other hospitals. What the first word in Nursing Home? NURSING. Who cares for NH residents? NURSES. A nursing home is a great place to start and perfect your skills before moving on to a hospital setting. Trust me. I realized how much I didn't know when I started in the ER but I also realized how working for atleast a year in a NH allowed me to gain my independence as an RN and perfect my basic skills and just exactly why ER wont take you w/o that experience under your belt.
#3 - Stop bashing psych nursing and other specialties because you wont "get any med-surg skills." This is a fallacy!!! Do you even know what med-surg means? Med-surg skills are not a cub scout badge you earn because you can give an insulin injection at the proper angle or remember not to turn up a COPD patients oxygen therapy above 3l/min. That's nursing common sense!!! Psych and any other specialty are all med-surg. What do you think psych nurses are doing all day/night? Are they assessing patients? Yes. Are they giving out meds and taking vital signs? Yes. Could their patient/s have other co-morbidities along with their bi-polar/schizophrenia? UUmmm yes. Does psych call other departments when a patients BP is too high or their BS is too low? uuumm no. Pscyh nurses have to be able treat and assess patients whos conditions require attention outside the realm of their psych diagnosis while caring for a patient. But just remember who you call when your borderline personality disorder patient trys slitting her wrist with plastic knives at the bedside.
My final words to you new grads. Apply everywhere no matter the facility or demographic of patients. I am not pushing for every new grad to work in a NH, but turning down job offers and not working as a nurse when you have a valid RN license is time being wasted. You could be building up your experience and marketability by working your way up the ranks. When places wont hire you because you don't have the experience, don't be an ass about it and cry over it waling "well how do I get experience?!!!" Most places don't want the liability of having to hire and hopefully train new grads for a maximum of 3 months and cut em loose on their own. That is not your cue to keep applying to the same position and waiting months for it because that's your "dream job" and your "ready" right now. You have to pay your dues in the field of nursing. Every nurse has that moment in their career when they realize they don't know as much as they thought they did. Don't let that moment be a reflection back on how you killed a patient over a med error giving 100units of insulin instead of 10. A new grad did this at the NH and it was ugly. Build your skills slowly and surely and the field of nursing is the most rewarding profession in the world and I wish all you guys the best of luck finding a job.
