Career Advice

pkoehler · May 2, 2005

Is the unit your are on too fast pase? It may be that cardiac care is not your thing?! Did the hospital you work at have a new grad program? That might help. When I started 2 years ago my hospital did not have any programs in place but now they are working on it. Is the nurse: patient ratio too much or patient acuity? It might be something to discuss with your nurse manager. Hope things go a little smoother and do not lose confidence in yourself!!!

Hello, I have a question pertaining to career advice for fairly recent grad(dec 04). I am currently on an interventional cardiac unit, and I am finding that the hospital pace is wayyyyy to fast for me to keep up with. It is overwhelming, and I think it affects my ability to think clearly. The last thing I want to do is make a mistake or make someone's family member mad due to my newness (I read as incompetent). I know I shouldn't think that way; I just passed NCLEX . Anyhow, my question is are there any slower paced jobs that a newer grad can look for? Or are all the training jobs in hospitals only. Funny thing, prior to my going to nursing school , I was always the person who said " I can't stand being bored". Now, I would welcome being bored. I think as I hit that big 40, I'm finding I cant keep up now. Do any of you experienced nurses have any advise for this grad, or is the hospital the only setting there is for new grads? Nursing school didn't come close to preparing us for this . Thanks in advance- JR

martymoose, BSN, RN · May 2, 2005

HI pkoehler- thanks for the kind words . I think it is the acuity. Some of these patient I am told should be in ICU's, but their cardiac docs think they get better care on our floor. The ratio's I have seen are up to 6 pts sometimes! usually 4 or 5 tho. I always liked the cardiac focus in school- it fascinated me, but now with sick people like this , frankly it scares the bleep out of me.I would never consider an ICU or anything with that acuity. My thought though is if Im on a med floor, I will have 8 patients, and I cant even be organized with four! I have 2 weeks orientation left, but I think it has been inconsistant with having had many preceptors(once one of my precepters had a load of 4 and was charge, and had me too! guess I didn't learn much that day) I guess I don't want to bring it up to the manager at this time yet- they are already short, and now they have 7 new grads coming on- yikes! I don't know what to do, but I will probably melt down at somepoint, which stinks considering I've only just started in this field. Thanks- Jr.

pkoehler · May 2, 2005

JR

I know what you mean, I work charge a lot and I am currently orienting a new grad! It is not fair to you because this is your chance to learn and have a back up. I always feel like the new grad I am precepting is being short changed! I brought it up to my manager and said it was not fair and that I felt she needed more orientation. Everyone is different and everyone learns at different speeds. I would be afraid of cardiac but people tell me that they would scared of peds, where I work! I think it can't hurt to let someone know how you feel before you melt down. Maybe you can look for support or strength in numbers with the other new grads! Starting out is hard but stick with it I am sure youar ea fabulous nurse!

HI pkoehler- thanks for the kind words . I think it is the acuity. Some of these patient I am told should be in ICU's, but their cardiac docs think they get better care on our floor. The ratio's I have seen are up to 6 pts sometimes! usually 4 or 5 tho. I always liked the cardiac focus in school- it fascinated me, but now with sick people like this , frankly it scares the bleep out of me.I would never consider an ICU or anything with that acuity. My thought though is if Im on a med floor, I will have 8 patients, and I cant even be organized with four! I have 2 weeks orientation left, but I think it has been inconsistant with having had many preceptors(once one of my precepters had a load of 4 and was charge, and had me too! guess I didn't learn much that day) I guess I don't want to bring it up to the manager at this time yet- they are already short, and now they have 7 new grads coming on- yikes! I don't know what to do, but I will probably melt down at somepoint, which stinks considering I've only just started in this field. Thanks- Jr.

KatieBell · May 3, 2005

I can relate to you a bit. As a new grad I started in one of the ICU's at a huge level one trauma center. Even though I had a pretty good orientation, after orientation, it was a bit like sink or swim, and some days I really sank.

Somehow I survived, but actually I think it was only by transferring to the ED where for some reason I was more comfortable (mix of acuity I think).

You are working in an intense environment and have had some poor orientation. It might help to make a list of things you are uncomfortable with as well as things you feel good about (You might be surprised at how much you are doing well) and take that list to the Manager and ask for some extra help. As a manager, I would ALWAYS like to know ahead of time if someone feels like they are really stressed. Much better to try to solve the problem than to have the nurse make a big error or be so stressed they are nasty to patients. He/She might be able to arrange for someone to look out for you as you work on different skills, identify a resource person, not for each moment of care, but for when you are adjusting a drip or something like that.)

You could also consider a Med/Surg type experience even though you would have 8 (!@#!$) patients the acuity would be less. The hospital I used to work at has just made the M/S nurses have a ratio of like 4-5 no more. 8 is probably the norm, but I think it is too much, so maybe a different hospital?

Good Luck, the overwhelmed feeling and the feeling of disorganization is also part of adjusting to the job... but it is really awful while it is happening...