Failed orientation, now what?

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I'm a new nurse, graduated last Summer and I was hired on a PCU and didn't make it past my 12 week orientation. I was told to go to nights after being hired on days because I wasn't getting the hang of things on the floor during days. Unfortunately, I have epilepsy so I can't work nights and had to request an accommodation. As much as I would've liked a longer orientation, that wasn't an option, and neither was going to another floor. I'm fortunate my hospital system was able to place me somewhere else, but I'm now working outpatient neuro and it's not as exciting as the floor.

I'm worried that I won't be able to transition to another area of nursing, when I decide I'm ready to look again, because I'm not sure this job really entails much except a lot of phone triage, med refills, and some case mgmt. I thought I knew what I wanted to do as a nurse, but now I'm realizing the floor was too stressful and I didn't feel ready near the end of my orientation. I was hoping to look into wound care or infusion, but many of those jobs require acute care experience, which I lack ?

I am open to different areas, but I'm worried I may not be an ideal candidate given my lack of hands on skills. The only skills I gained were being tele & IV certified. Does anyone have any words of advice for someone like myself who's still pretty new to the profession? Thank you

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Specializes in Psych (25 years), Medical (15 years).
2 minutes ago, jms01 said:

 I'm now working outpatient neuro and it's not as exciting as the floor.

I'm worried that I won't be able to transition to another area of nursing, when I decide I'm ready to look again

"A bird in the hand...", jms, and welcometo allnurses!

As has oft been said, "Sometimes we have to kiss a lot of Warhols before we find our Rembrandt". As a new nurse, any experience is good experience and we sometimes need to try out a lot of different areas until we find our niche.

Things have definitely changed since I got into nursing, but even  at the end of my career, I still saw a lot of nurses, both young and old, moving around.

For example, one nurse in her 50's went from administration to psych to OB in the years that I knew her.

Don't worry. Be happy.

 

 

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

Not making it through orientation will not define your career. People are able to make all sorts of transitions in the world of nursing, it may just be a matter of who you meet while you're gaining experience in your current job. Don't despair. I was fired from my first acute care orientation and just under four years later I've been in the ICU almost three years. Sometimes the fit just isn't there and that's okay. Don't worry too much about moving on from where you are right now. Build up the skills you're developing in your current position, because there are important skills everywhere, and something will come along when the time is right. Good luck!

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Specializes in Mental health, substance abuse, geriatrics, PCU.
9 hours ago, Davey Do said:

 

As has oft been said, "Sometimes we have to kiss a lot of Warhols before we find our Rembrandt".

 

 

Davey, reading this gave me a lot of joy!

OP, I'm sorry your orientation didn't work out, that's a tough break. Even though your outpatient nursing job isn't as exciting, at least you have a nursing job and are obtaining experience to build your resume. This clinic is it owned by the physicians that work there or is it owned by a hospital or company with multiple clinics in your area? If it is part of a network then transferring to a clinic with a little more variety may be an option once you've been with them long enough (usually 6months to 1 year). Since you require daylight hours working outpatient is probably a good path for you to take as it can be really difficult to obtain inpatient dayshift jobs even for seasoned nurses much less newer nurses.

Consider branching out to either family medicine or internal medicine, both of those specialties see a large spectrum of patients and many clinics have a lab where nurses get to draw blood. Since you were getting experience with tele doing a cardiology clinic might interest you, lots of EKG's pacemaker/ICD checks. 

Another thing to consider is looking into outpatient dialysis. It's dayshift hours, a LOT to learn, challenging, and fast paced. It also tends to pay well.

You may also want to just stay where you are for now and continue gaining experience, especially if you're not sure what you want to do. Once again, at least you do have a nursing job, that's the most important thing as a new grad.

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Hi!

I took the first thing I could get, which was tele, and I never had an interest in cardio. That experience confirmed it for me. I was thankful to have had it regardless, but I did like bedside nursing. Eventually I want to go back for my FNP, but I’m worried that having close to no bedside experience is going to hurt me. I’d love to work in the ICU, even if it’s for a bit, I don’t feel like I see myself working in outpatient clinics unless it’s something like ambulatory surgery, urgent care, wound care, dialysis, or infusion (which I’d love to explore!). Should I be worried that because of my lack of bedside experience I have no chance at any of these opportunities?
 

I’ve always heard of nurses bouncing between specialities, so I’m wondering if it’s possible for me. I want nothing more than develop my clinical skills, and I feel like many of options above are great places to consider. 

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Specializes in Mental health, substance abuse, geriatrics, PCU.
2 hours ago, jms01 said:

Hi!

I took the first thing I could get, which was tele, and I never had an interest in cardio. That experience confirmed it for me. I was thankful to have had it regardless, but I did like bedside nursing. Eventually I want to go back for my FNP, but I’m worried that having close to no bedside experience is going to hurt me. I’d love to work in the ICU, even if it’s for a bit, I don’t feel like I see myself working in outpatient clinics unless it’s something like ambulatory surgery, urgent care, wound care, dialysis, or infusion (which I’d love to explore!). Should I be worried that because of my lack of bedside experience I have no chance at any of these opportunities?
 

I’ve always heard of nurses bouncing between specialties, so I’m wondering if it’s possible for me. I want nothing more than develop my clinical skills, and I feel like many of options above are great places to consider. 

Never say never. But not being able to work night shift may very limit your prospects when it comes to acute care. It is really hard especially in competitive settings for a new grad or a nurse with non acute care experience to land a day shift job right off the bat, it's just not realistic in most parts of the country.

That being said, the good news is that being an FNP means you'll be educated in providing primary care for cradle to grave and very likely you would be working in a PCP office, acute care doesn't really line up with that so not having it won't really hurt you. The main thing is to get some type of nursing experience because there is a lot to learn at any nursing job you get. As you get experience it does become easier to change specialties.

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I understand. Sometimes, I question if I should even be a nurse. I think my epilepsy has limited my opportunities at the bedside and home care too, because of the driving. I am feeling pretty down and hopeless as to what I can even do in this field. Maybe I can work from home, but I don’t know how without any experience. 

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Specializes in ICU.

You’re already getting some awesome advice but I’ll just add one thing. If you didn’t really like Tele and are not too interested in cardiac, you probably wouldn’t like ICU. There’s a ton of cardiac medicine in the ICU, so if you think you’d want to do it, go shadow someone for sure.

Sounds like you got a rough draw, I’m sorry to hear you have to go through this with epilepsy. It’s wonderful that you pushed through school with that adversity. Don’t give up being a nurse, you clearly belong here. You will find your way, there are so many options.

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Thank you for your kind words. I constantly beat myself because I don’t think I should be a nurse when I live with this illness. I don’t feel like I’m capable of being an RN, let alone an FNP, my end goal. I don’t know where to start as far as jobs go, I barely have floor experience, so who would even take a chance on me if I wanted to try something else? 

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Specializes in oncology.
On 1/26/2021 at 2:03 PM, jms01 said:

I'm now working outpatient neuro

Think about what you have within you to help patients under your care! You surely are understanding of their health care needs. Explore the teaching side and medication management.

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Specializes in Outpatient Cardiology, CVRU, Intermediate.
On 1/31/2021 at 4:47 PM, jms01 said:

Thank you for your kind words. I constantly beat myself because I don’t think I should be a nurse when I live with this illness. I don’t feel like I’m capable of being an RN, let alone an FNP, my end goal. I don’t know where to start as far as jobs go, I barely have floor experience, so who would even take a chance on me if I wanted to try something else? 

I started as a new RN on the Neuro floor (inpatient, not outpatient or clinic). We had 3 "floors" for Neuro, and one almost exclusively focused on epilepsy patients/diagnoses/pseudoseizures, etc. Having solid experience on the outpatient side could give you connections to the inpatient side of Neuro (if your hospital has one). It also could open some less-bedside and more administrative options for you (I'm thinking Care Coordinator/Case Worker), since you could obtain more familiarity with insurance, outpatient follow-up, community supports, etc. You also may find opportunities open up for you in regards to your personal understanding of epilepsy (if that is something you want to share/focus on professionally).

Try talking with your supervisor or the office manager, or even the NPs/Drs in the office to see what other areas of the clinic/office you can start learning. That might be a motivating goal: I'll see what and where I can make connections/get experience in the next 6 months. Then I'll talk with HR at local health systems/hospitals to see if anything would be a good fit on the inpatient/acute care side.

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I know I'm not interested in case mgmt, but would actually love to explore the idea of working in a neuro ICU or epilepsy monitoring unit (EMU), but with my background, I don't know if I'd be qualified for it. I know most major hospitals have EMU's, so I'm wondering if I could work in an area specialized like that. Would I be qualified to go into infusion with my background as well? I have so many interests, but I really enjoy using my hands-on clinical skills as well and wouldn't want to lose that. Any feedback is appreciated!

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