A New Nurse's Dilemma...

[nurse23jo]

as a new grad i applied to several places hoping that i would land a job where team work, leadership, and evidence based practice is used on a daily basis. just like i learned in nursing school.

i've been working on a medical surgical floor for almost a year now and feel like the practice that is used is not the same as the kind i learned while in school. i feel like on a daily basis i am asking questions, and every time i get a different response. many times i am uncertain of what to do. i am starting to feel very lost and hopeless.

my ultimate goal is to become use my critical thinking skills to maximum capacity but i feel that instead i am forgetting everything i've learned. at this moment i am afraid that i will lose all the knowledge that i have learned. i am starting to think that perhaps i need to go work at a different hospital. a hospital that promotes learning and provides one with resources and support.

my greatest challenge at the moment is that; one i am unable to get an interview, or anyone to look at my resume, and second; is that i am helping my parents with my siblings as my father who has lost his job and my mother's hours have been cut back. i cannot afford to just quit, but i also fear that i am not going to be at the level i should be a year after practicing. in addition i always fear that my license is at risk....

i would have loved to enter a new grad program upon graduation but unfortunately that is not the case...

i do not know what to do? any suggestions?

[tcvnurse, BSN, RN]

I've been working on a medical surgical floor for almost a year now and feel like the practice that is used is not the same as the kind I learned while in school. I feel like on a daily basis I am asking questions, and every time I get a different response. Many times I am uncertain of what to do. I am starting to feel very lost and hopeless.

My ultimate goal is to become use my critical thinking skills to maximum capacity but I feel that instead I am forgetting everything I've learned. At this moment I am afraid that I will lose all the knowledge that I have learned. I am starting to think that perhaps I need to go work at a different hospital. A hospital that promotes learning and provides one with resources and support.

Well, I think this is called 'Reality Shock'. Being a nurse is a LOT different from being in school. They teach you the ivory tower perfect way of doing things in school. When you have a six patient load, reality can be much different. Also there can be a LOT of different ways of doing something, and none of them are WRONG! Just different.

Regarding knowledge--it's kind of like use it or lose it. If you are taking care of COPDers/CHFers day in and day out you will get to be an expert on those conditions. If you worked on a tele floor, you'd be able to instantly identify AFib/RVR and treat it appropriately.

Every day will have opportunities for critical thinking however.

You've only been a nurse for a year, in one unit. Do you really know how the entire hospital operates already? Most hospitals offer tuition reimbursement. Take advantage of it! Continue to educate yourself! Study for the MS cert exam if that is your thing. Think about specialties you'd like to try.

Perhaps a more proactive approach might get you the results you are looking for.

[Lifeofanurse]

My interviewer today pointed the ivory tower perfect way out is never practiced. Sure we'd like to. But even in school...you have a max of what? 3 patients...and your not even solo in giving care and you run your tushy off...imagine 6 ... no way not possible.

If they could give us 6 and have us pull it off perfectly they would do it...they know it's an impossible task.

You do the best you can. Give quality care to every patient but it doesn't have to be exactly step by step by the textbook.

I hope to be able to adjust from school textbook nursing/clinical nursing to real world care.