Advice for new grad RN, after terminated after 3 1/2 months

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Hello Everyone,

I graduated May 09, passed my boards in August with 75 questions and received RN license. I feel really bad, not to mention discouraged. My first job was in the ER, I was assigned one preceptor, but worked with several. After 3 months, I was still overwhelmed, but was being evaluated by my assigned preceptor as being "on the right track." However, near my orientation, while meeting with the department managers I was informed that my evaluations stated differently, such as "not doing well, poor time management skills, etc." My experience there was so terrible, that my anxiety level was out of control to a point where I started to have migraines on a continuous basis. My preceptor was horrible, ex. telling me company policy was to perform a task one way, but informing me that management said I did this incorrectly. Anyway, I was given two options resign or termination. I had been with the organization before graduating a total of 5 1/2 years, but not performing direct patient care duties. I was not given the option to transfer. However, I did ask to take a leave of absence b/c the migraines were beginning to affect my attendance. I was told I did not qualify for this. So, I was terminated, and told this would not be held against me and I would be in good standing to reapply to this organization once I was well. Later, I contacted the nurse recruiter, and she informed me that I was in good standing and should explain to perspective employers that ER was not a "good fit for a new grad RN."

I was unable to find a job for about 2 months, when I finally received an offer at a ltc facility. This job lasted for 1 1/2 months. I felt totally deceived, being misinformed of the orientation offered. I was told I would be gradually worked up to the amount of pts nurses general cared for daily, but was just thrown out there. I explained all of this to the DON prior to being taken out of orientation, but that did not help. I felt like I was practicing unsafe patient care. My preceptor did not teach me anything. I was just observing her passing meds to 17+ pts (depending on the # of nurses on the unit), and never checking vitals prior to giving certain meds. I also observed her dismissing pt concerns with their health. I was never shown how to do the required paperwork other than in class (which the trainer did not have all of it available to show us), was not shown how to use the computer system for admissions (never given a sign-on for that), and not shown the procedure for doing treatments (treatment log, etc.). I informed my DON of this and of course nothing happened, I was just thrown to the wolves, so I felt. I felt really bad for quitting, but like I HAD to protect my license.

Currently, I have been applying for positions, but every one I apply to comes back "thank you for your interest, we've selected a candidate with qualifications that matched more closely." The only offers that I have been receiving are from ltc facilities, which I dont feel safe working at. I recently applied to a med/surg position within a hospital and the next day went to personally deliver my resume to the department director. I did have a nice conversation with her, but was told that the nursing shortage was over and don't be discouraged. What should I do to improve my chances while I am competing with other new grads? Should I include these experiences on my resume? I have included my ER experience, b/c I feel its relevent, b/c I did learn a lot despite my preceptorship. I don't want to jeopardize my license and place a unstable nurse label on myself. Can any experienced nurses or nurse recruiters or nurse managers, give me any advice to help? Looking forward to hearing from you.

Thank you

Does anybody know where current shortages are the worst? I am graduating in August and want to be able to find a job before finishing! Any advice about the application process would be greatly appreciated!

Specializes in multispecialty ICU, SICU including CV.

I'm sorry about the problems you are having. I have a little insight into the ER position -- sounds like you were probably not coming along in your orientation the way you should have, and perhaps your preceptors didn't know how to break it to you, so it came out on your written eval. And, that is ok. ER would be a hard place for a new grad to start -- something new every HOUR, all age ranges, all acuity levels, all different kinds of procedures. It probably was just too much for you to handle right off the bat. Hell, ER nursing is too much for a lot of nurses to handle with years of experience.

The LTC thing -- many are ran very, very tight staff-wise because of budget concerns. Having that kind of patient ratio IS unreasonable, but, I gotta say, I think a lot of them are ran that way and nurses do keep their head above water in that kind of environment alot. Again, although it isn't high acuity, that kind of patient load isn't something that a new grad that is still needing to develop organizational skills could hack with just a little bit of orientation.

It sounds like you need to find something a little slower paced and someplace that will give you a thorough orientation. I would continue to look at hospitals and just try to play up what you did learn. Crappy experiences are better than zero experiences in my book. Don't be discouraged -- you will find your niche. Sometimes, this takes time. I took a job once I thought I would love and would be super easy (it was in an outpatient procedure center that I went to after I had about 18 months of stepdown experience - I was to do pre-procedure, recovery, and conscious sedation) and I was in way over my head. M-F hours, no weekends or holidays, and I thought I was actually over-qualified. Turns out this was not the case. I had a really hard time getting the hang of everything and eventually I left for somewhere that gave me a better orientation and better experience. Sure, that job would be a piece of cake NOW that I have 8 years of ICU experience -- but not then. I think you are probably in the same boat as I was.

Best of luck to you. Don't give up. You'll get there, just keep at it.

If just one new grad ever said "I want to start in Med surg and work my way up to Er/ICU/CCU I would probably have a heart attack!

I am a recent RN grad (previously a CMA) and would love to start out in Med Surg and work my way up! The only problem is they want 3-5 years experience for all of the acute care positions in my area. I am still applying to these positions, but it's been almost 4 months and nothing from the hospitals. I did however just have my 2nd interview with a doctor's office. I don't know what to do. I really want to work in the hospital but everyone is telling me to take what I get right now. I'm not sure what the average starting wage is for a doctor's office in Michigan is either. The hospital positions are starting at 22.65.

You have had 2 interviews for a position in a Doctors office, and the topic of salary never came up? Or if they quoted a salary, you did not immediately start posting and calling to find out if it was lowball or not?

I know things are tough out there (I guess; it seems like OLDER experienced nurse are the ones having a tough time in Ca.,) but put yourself out thier as a professional, and ask for what you are worth! No one will have respect for you if you don't regard yourself as worthy of your profession in terms of pay.

Figure out a rate that you feel comfortable with in terms of your education , experience, and abilities and stick to it.

I am a recent RN grad (previously a CMA) and would love to start out in Med Surg and work my way up! The only problem is they want 3-5 years experience for all of the acute care positions in my area. I am still applying to these positions, but it's been almost 4 months and nothing from the hospitals. I did however just have my 2nd interview with a doctor's office. I don't know what to do. I really want to work in the hospital but everyone is telling me to take what I get right now. I'm not sure what the average starting wage is for a doctor's office in Michigan is either. The hospital positions are starting at 22.65.

This is so ironic! As an ICU nurse with 14 years of experience, applying to my newly local hospital, I found I could'nt even GET an interview with the Manager, (after being positively interviewed with the charge nurse and nurse educator) "because we are still looking at the new grads". HUH? And how am I in the same barrel with a new grad?

General concesus- They cost less and are more amenable to doing things according to core outlines, whether it suits a particular pt. or not. Wow.

Specializes in ICU, ER, EP,.

ok, first I want to comment on your experiences. I'm going to be blunt, but it's not meant to be nasty. New grads in the ER.. struggle and struggle. The ER is all skill and quick assessment based... all of which a new grad lacks.

Now those out there... this isn't the time to argue about how you did it successfully... our OP didn't, and very many don't. This does NOT reflect on the type of nurse you CAN be. You choose a very challenging, fly by the seat of your pants start to your career. I moved and took an ICU float position with 7 years ICU exp. which included then the ER... and I drowned. I learned to adapt and love it, but it took months and I was very uncomfortable, out of my element and with all that exp..... I did not transition well. So first off do NOT be hard on yourself.

Secondly you then picked the next worse job... long term care... again others just hush... because a new grad has no skills, no assessment skills, and you may be giving 15 meds to a single person out of 30 at a time. It's crazy!!!!

Keep applying, but look for step down positions if available in your area. You'll have 6 at the most, can concentrate on them and orientation is generally better in a step down unit than the ER or nursing home. Six to me is overwhelming, but after what you've been through... I feel you'll fly just fine.

So keep those jobs on the resume and explain what you've learned so quickly about yourself in your nursing career. Use those "failures" as a... "I have learned who I am, and where I need to be the hard way". Any nurse recruiter will understand and respect that. Hiding it is a very bad idea. Grow from it and explain your growth, it really does help you once you land that face to face interview.

Specializes in Oncology, LTC, Rehabilitation.

LuvnursingRN, I am sorry u are doubting yourself. Orientation is more of a disorientaton, we have all been there. It is true that nurses eat their young, and while we are in college, the intent is to have you graduate and be able to enter the nursing work force, and be able to start practicing (they call it "practice" for a reason) and to think of patient safety first. The first year is the hardest, and i agree with the nurse that said you have to continually read and learn. Let's say that you are able to find a job in med/surge. Anything that comes up during your shift, that you are not familiar with, you have to educate yourself on. And observing nurses you respect is so important. Any lab work, test, diagnosis, medication, procedures, ect, that you are unfamiliar with, you have to look it up. It helps to write things down throughout your shift, and look it up while the details are fresh in your mind. We all think that after nursing school, we are ready to be nurses, nothing could be further from the truth....it is a lifetime of learning. It really helps if you know someone, in the hospital you are trying to work for, but that isn't usually the case. You have to fight for a job in this job market. Make yourself standout. Convince someone in HR, that you only want to work for that paticular hospital. Ask them if you can job shadow on a med/surge floor of the hospital for a few weeks, yeah it sucks because you are not getting paid, but it only shows how committed you are to "their facilty". Be friendly to everyone, be interested in everything. Spend those 2 weeks looking everything up. Get your foot in the door, be willing to work any shift (if u get hired, it doesn't take long to get the shift you want, people are always coming and going). Learn how to interview well, practice with someone. Learn how to shine your passion and abilities. Keep yourself job searching, no matter how many people say no, someone will say yes. And yes, use the experience in the ER, don't blame preceptors, your DON, just say that it was a bad fit. That you really want med/surge experience before you decide what specialty, if any, you want. Maybe med/surge is where you want to be. I hope u hang in there, I know it is tough, especially when it's a tough job market. Just be confident, focus on your stenghths. Remember that they r the ones who are lucky to have u. Make them believe in you, focus on your integrity, serving, excellence, teamwork. Everything happens for a reason! Good luck and God bless! !

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