Advice for New Grad

[m0ckingbird]

So I'm a new grad nurse and I am looking for some advice on the direction I am going, because I'm feeling a little uneasy about some of the choices I have made and whether they are helpful for me in the long run.

I finished my ADN and took the first job I was offered, at a small rural hospital, after I was turned down by the first three jobs I interviewed for. I live in an area that has lots of big teaching hospitals, but none of them hired me. Most of the other students I knew had NA jobs already and got jobs in those hospitals, but I had done food service work through school. I think my lack of nurse work on my resume was a big factor in that.

So I'm almost done with my orientation at this small country hospital. It's been kind of disorganized and it seems like they are inventing this orientation program for us and testing it out with us. It's 10 weeks and I feel like I'm being rushed off of orientation while the people in ICU and ED get longer orientations than I. They say I am doing great, but I am nervous about being able to do everything that is expected of me. Their census is very low currently, so I only take care of maybe 3 patients at a time right now.

The med surg floor is staffed almost entirely by travel nurses who talk about leaving and not renewing their contracts. There is no charge nurse. There is very rarely a nursing assistant on staff. Some of the travel nurses have been very disgruntled there and outspoken about low satisfaction scores since they were taken over by a private corporation and the full time nurses all left.

I'm just worried I've joined onto a sinking ship, and that I won't have mentorship there. I'm wondering if I should keep applying for jobs at bigger hospitals. I never thought I would do med-surg I thought I would do ED or labor and delivery, but it's very difficult to get new grad positions in those fields unless you had a preceptorship in them.

I'm feeling a little restless and worried that maybe I should have stayed unemployed longer to look for "the right" nursing job at a bigger hospital with more resources. I've seen nurses cut a lot of corners there and sometimes it feels like no one is steering the ship or watching what is going on there. Is it disloyal for me to apply to other places while I work there? Is it ok to explore other options or does that look bad to other orientation programs?

Thanks for any advice.

[rearviewmirror, BSN, RN]

Sorry about the difficulties. To answer your last question, I think it's matter of perspective. I am type of person who thinks that at the end of the day, you have got to fend for yourself. You got to make it for yourself. I am not encouraging you to apply to other places while you are in the orientation program. Personally, I wouldn't, and didn't, but IF that is what it takes to make you happier, joyful and feel more accomplished at work, then so be it. I want to remind you that employers don't care about you, and they will throw anyone under the bus to safeguard the organization. There ain't no loyalty or fidelity. They pay you because you generate revenue for them; this isn't charity. At the end of the day, it is you and your family.

As for as your current job, let me encourage you by saying that after 6 months, you can apply. I don't know where you are, but most of med-surg type floors in my metroplex are lenient when new nurses at least have "some of their feet wet." I spent 6 months at a job I hated, and I moved to another city. Also I don't mean to be offensive when I tell you this but from someone who did medsurg and ER, ER was heck a lot harder than regular floor. The acuity and pace and stress level and challenges from people weren't just the same. Anyways, best of luck to you and let us know how you do.

[Sour Lemon]

So I'm a new grad nurse and I am looking for some advice on the direction I am going, because I'm feeling a little uneasy about some of the choices I have made and whether they are helpful for me in the long run.

I finished my ADN and took the first job I was offered, at a small rural hospital, after I was turned down by the first three jobs I interviewed for. I live in an area that has lots of big teaching hospitals, but none of them hired me. Most of the other students I knew had NA jobs already and got jobs in those hospitals, but I had done food service work through school. I think my lack of nurse work on my resume was a big factor in that.

So I'm almost done with my orientation at this small country hospital. It's been kind of disorganized and it seems like they are inventing this orientation program for us and testing it out with us. It's 10 weeks and I feel like I'm being rushed off of orientation while the people in ICU and ED get longer orientations than I. They say I am doing great, but I am nervous about being able to do everything that is expected of me. Their census is very low currently, so I only take care of maybe 3 patients at a time right now.

The med surg floor is staffed almost entirely by travel nurses who talk about leaving and not renewing their contracts. There is no charge nurse. There is very rarely a nursing assistant on staff. Some of the travel nurses have been very disgruntled there and outspoken about low satisfaction scores since they were taken over by a private corporation and the full time nurses all left.

I'm just worried I've joined onto a sinking ship, and that I won't have mentorship there. I'm wondering if I should keep applying for jobs at bigger hospitals. I never thought I would do med-surg I thought I would do ED or labor and delivery, but it's very difficult to get new grad positions in those fields unless you had a preceptorship in them.

I'm feeling a little restless and worried that maybe I should have stayed unemployed longer to look for "the right" nursing job at a bigger hospital with more resources. I've seen nurses cut a lot of corners there and sometimes it feels like no one is steering the ship or watching what is going on there. Is it disloyal for me to apply to other places while I work there? Is it ok to explore other options or does that look bad to other orientation programs?

Thanks for any advice.

I started out in a big hospital with "more resources" and it was horrific. There were also plenty of people complaining, lots of short staffing, lots of cutting corners, and lots of disorganization. I think floor nursing is disorganized, in general. After all, every day is completely different from the one before.

I'm now working in a tiny, community hospital and it's WONDERFUL. Not perfect, but pretty close. Your job may not be great, but don't romanticize "big" hospitals.

I don't believe in loyalty to any employer and think it's fine to look elsewhere if you're not happy, just make sure your expectations aren't unreasonable. Jumping around too much too soon could make you unattractive as an employee when the right place does come along.

Good luck!

[Meeshie]

My first two years nursing I've done three hospitals. I stuck a year out at a large organization that I hated. It was disorganized, the ratios were awful, management was difficult to work with, turn over was very high. I went to a smaller hospital closer to home and it seemed better for a little while but in many ways it became worse when season hit. Safety just wasn't a priority for that hospital at all and the amount of sentinel events and deaths was a bit terrifying. Since then life has changed. I'm at a large network and I work a pretty high acuity and I'm happy with what I do. A lot of the happy as to do with my co-workers and management. Moral of the story - big and small can all have problems.

In less than three years I hopped through three networks. Is that ideal? Probably not. Still - you do what you can live with. If you're miserable and you can't live with what you're doing? Find something else.

[Nurse SMS, MSN, RN]

10 weeks orientation for med-surg is a huge amount of time. Where I live eight weeks is average.

Be aware that you are comparing your orientation to specialty units (ER and ICU) that typically DO have a longer orientation because the acuity level of the patients and the medical interventions are different than what you will see on Med-surg.

You are also comparing your experience to an ideal that you developed during nursing school that pretty much all new grads have. The cutting corners you are perceiving may be simply how nursing is really done outside of a school environment. It is unlikely you will find it different in a larger hospital. It is also likely that orientation in a larger teaching hospital will also be about the same in terms of scope and time. A "teaching" hospital generally refers to the fact that medical students practice there and has nothing to do with how nurses are oriented.

Hang in there.