Am I doing the right thing?HELP

Nurses General Nursing

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I need some advice, please. Here goes a very long story.

I graduated from nursing school in May 2020. I passed my NCLEX in September and was hired at a community clinic in October.

The training was pretty much "trial by fire" I had one day of looking at a worksheet for how to work with the EHR charting system.  I did travel from clinic to clinic to see the day to day operations,  but with the pandemic, everything was being done over the phone.

Then, I was sent to the clinic where we were seeing patients and started doing COVID testing with very little training- it was okay because it wasn't difficult to do but then in addition to COVID testing twice a week I also had to work triage in the outdoor area of the clinic. I was assessing patients and giving vaccines as well. 

As a new nurse with almost zero experience working in healthcare outside of nursing school, I was very nervous about this.  I did ask questions and made sure I wasn't doing something I wasn't supposed to be doing, but it was really chaotic. I did not have a preceptor or any type of support other than the nurses I was working with the outside. 

At one point, my manager calls me asking why I wasn't following up with the COVID-positive patients. This was never part of my job description, but she made it seem like I  should have known this and that my license could be in jeopardy if I wasn't following up with these patients. I was expected to call and follow up with patients WHILE working the outdoor triage and checking up on testing results, filling out reports for public health, and preparing for the next testing day.

After other unprofessional attitudes from this manager and this final threat to my license, I decided to leave. It's only been three months but I am torn because I am too new, spent too much time and money on nursing school, to lose my license over poor management.

When I gave my two weeks notice, she stated that she was disappointed because I was hired recently and wants me to give reasons why. I want to be as diplomatic as possible when giving my reasons but I am wondering if I am doing the right thing. I accepted a job doing covid testing but without all of the other things that go with working triage at the clinic. I am ultimately hoping for a job at a hospital in a new grad program where I am properly supported and trained. Am I doing the right thing? 

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Specializes in Psych (25 years), Medical (15 years).

From my experience in working in community mental health clinics which also offered medical interventions, I'd say your experience was pretty much par for the course, RNShushain.

It seems that these clinics have the bare bones of staff and equipment and expect the employees to turn the water into wine.

1 hour ago, RNShushain said:

Am I doing the right thing? 

Only you can answer this question. However, given your desires to advance yourself in experience and education, clinics are not always the best facilities in which to do so.

It seems that once the duties and responsibilities are learned and become proficient, more work is delegated. And the work is not all that involved and technical, it merely requires one with good time management skills and a license.

In my six years of experiences at two community clinics, I was a community nurse, carried a large caseload, initiated and ran two medication programs, reviewed patient assessments, acted as the PAS and Mandated Follow-Up agent for the southern region of the county, assisted the psychiatrist in numerous ways, supervised Medical Services and the Methadone Clinic, gave two hour lectures twice a week for court-ordered drug abusers, administered decanoate injections, attended staffings & other meetings, covered for the LPNs when they were off, and other duties that I don't recall at this time or were as required.

What a run-on sentence that was!

Good luck to you, RNShushain!

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Specializes in Hospice, LPN.

I had this experience in my very first job. Community clinic, they invited me to interview, described the job, I said that I didn't think it was a good match because what they were describing was that I would be managing patient care. I told them I was a new grad and not qualified.

They talked me into coming in, said this was going to be scheduling appointments, overseeing the MAs, following up on paperwork and orders. We went through the entire interview process, we all re-itereated that I wouldn't be managing patient care, I accepted and then guess what? They plopped me down on their triage line and, told me to follow up on the medical needs of callers(a lot of peds and pregnant women) and I was now responsible for managing patient care for a very vulnerable population.

I lasted three months (got written up for not smiling enough) and consider myself grateful that I know what I never want to do again.

Clarity is a gift. First job is like the first pancake. 

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Specializes in New Critical care NP, Critical care, Med-surg, LTC.

Sometimes jobs don't work out, for a variety of reasons, and on either the end of the employer or the employee. Sounds like your gut was telling you there was a need to move on. This blip in the road may be a small setback, but you're young in a new career, you can find a better fit. Good luck. 

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I want to thank everyone who has taken the time to respond. I really appreciate your input and it's helping me realize I am doing the right thing, not just for me but for the patients I encounter. This is my second career and although I'm a new nurse, I was a teacher for 12 years so I feel that I really need to make the most of the time I have.

 

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4 hours ago, RNShushain said:

but she made it seem like I  should have known this and that my license could be in jeopardy if I wasn't following up with these patients.

It sounds like you are comfortable with your planned actions. Just know that it is about 99.999% likely that she is FOS with ^ this.

Also:

4 hours ago, RNShushain said:

When I gave my two weeks notice, she stated that she was disappointed because I was hired recently and wants me to give reasons why. I want to be as diplomatic as possible when giving my reasons

Understand that there is no reason for her to ask this question. She is quite capable of figuring it out on her own and this demand for info pretty much seems like attempt to make you roll in the mud with her. Speak carefully and limit your words; whatever you say isn't going to cause her to have an epiphany. Let her know you have decided to accept another opportunity.

Just for fun, though.....are you sure there isn't a salvageable employment relationship here?

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I know it's only giving my own side of the story but even though I am new, I am good at adapting. Seriously, I have a great rapport with the patients, I am a team player, super considerate, polite, and reliable. They threw me into this and I feel that I am doing great but I also feel a tremendous lack of support. I think I am going to say that although I know I can handle it, the threat of my license has been on my mind, and being so new, I don't think that this is for me but for a more seasoned nurse who can handle both the testing, follow-ups and working triage. It's not a cop-out but an acknowledgment of my limitations right now and the lack of support.  I have every confidence that if I had, minimum, a year of experience, I would have no issue handling this.  I want to keep it professional and put it on me and not on them because this is the type of person who resorts to these FOS ( love that) threats and would totally not have an epiphany. The different departments don't communicate with one another and I have a feeling this pandemic didn't just expose these divisions but exacerbated the problems brought about by poor communication. 

7 minutes ago, JKL33 said:

It sounds like you are comfortable with your planned actions. Just know that it is about 99.999% likely that she is FOS with ^ this.

Also:

Understand that there is no reason for her to ask this question. She is quite capable of figuring it out on her own and this demand for info pretty much seems like attempt to make you roll in the mud with her. Speak carefully and limit your words; whatever you say isn't going to cause her to have an epiphany. Let her know you have decided to accept another opportunity.

Just for fun, though.....are you sure there isn't a salvageable employment relationship here?

 

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9 minutes ago, RNShushain said:

I think I am going to say that although I know I can handle it, the threat of my license has been on my mind, and being so new, I don't think that this is for me but for a more seasoned nurse who can handle both the testing, follow-ups and working triage. It's not a cop-out but an acknowledgment of my limitations right now and the lack of support. 

Understood; makes sense.

I'm not trying to change your mind. ?  I just wondered if (knowing that she is giving you a huge line about this loss of license thing) there would be any possibility of talking it through with her; I'm imagining a conversation where the two of you review expected duties and then you just go for it knowing that you are so very unlikely to lose your license in this setting/scenario if you follow regular safeguards and standard practices (for example, speaking with a provider right away if you have a concern about a patient scenario or consulting a fellow RN if you have a process question).

You are not going to lose your license for not completing a particular task that your employer forgot to tell you about. I mean...when pigs fly.

All that said, I am one of the last people who would blindly advocate for staying in a place where people speak and act ridiculously, fear-monger and flat out lie in attempt to transfer their own responsibility.

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I appreciate your insights more than you know.  Thanks for taking the time to respond. You hit the nail on the head with that last paragraph. Well said. 

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