First nursing job, making difficult career decision

[HamPawsRN]

Evening all,

I am a new graduate RN who has been working as a developmental/intellectual disabilities nurse at group homes for the past nearly 2 months and was wanting to seek advice from more experienced nurses who perhaps have been in this situation. This job is nice in terms of scheduling, benefits, and patient population....however I am becoming more concerned about losing important nursing skills. I am not passing meds, I seldom do focused assessments, and nursing assessments are done once every 6 months. Most of the job is paperwork, sending emails, scheduling appointments, sorting medical bills, etc. In the future I would like to work in a hospital (I've always liked peri-op) and in the future I can see myself in a same day surgery setting. I am concerned my current job is not going to give me the experience I need to get to a hospital/acute care setting, and I've been considering applying for positions at a LTC facility or rehab unit. I don't want to lose my assessment skills, and I feel like during nursing school I didn't get much exposure to passing meds. On one hand, I like the population I am working with, and I like the other nurses and supervisor as well, but generally everyone works independently. On the other, I am concerned this job isn't going to get me where I want to be in the future. I just want the opportunity that will give me the better experience and potential for growth as a new grad and one that will offer me support as I get my feet under me. I feel alone, and there are days more often than not I am questioning whether I am cut out to be a nurse. I would appreciate any words of wisdom! Also this is my first post here...thanks for bearing with such an involved introduction:-)

[Ruas61, BSN, RN]

You aren't going to get acute care experience in this setting.

If you want that, you will have to find a job that will provide it.

This is pretty black and white.

[HamPawsRN]

Would I be better off landing a job in acute care getting experience in a nursing home (subacute or rehab floor)? Landing a job here in a hospital has been difficult without experience.

[Ruas61, BSN, RN]

TCU's vary by what they provide.

It depends on what the places available in your area can 'handle'.

Here we have/SNF/TCU that may do complex wound care, IV ABT with a lot of surgical f/u care for ortho events while others may not be able to handle more complex ones.

I would guess an active TCU is a better choice than SNF doing rehab care.

Are you in a small town?

[HamPawsRN]

There's a couple I've applied to....one has a ventilator unit, another has a neuro unit and is capable of giving me IV experience. Where I live is more rural, but there are major hospitals within a 30 mile radius of me...the difficulty is the area is competitive for new graduates, there aren't many jobs to pick from at the moment, and I do not have my BSN yet. I'm hoping this little bit of experience I have helps. Thanks for the advice/for listening

[Ruas61, BSN, RN]

Keep trying, maybe a prn job weekends on a SNF. Can you move?

Here they like BSN but they aren't the gate keeper.

Best wishes.

[HamPawsRN]

Thank you. Currently I cannot move, but I do plan on moving next spring. My boyfriend is finishing up his undergrad and will be looking for jobs in his field as well, and we both feel this region doesn't have much opportunity for us. Thanks for the advice again.

[Ruby Vee, BSN]

Evening all,

I am a new graduate RN who has been working as a developmental/intellectual disabilities nurse at group homes for the past nearly 2 months and was wanting to seek advice from more experienced nurses who perhaps have been in this situation. This job is nice in terms of scheduling, benefits, and patient population....however I am becoming more concerned about losing important nursing skills. I am not passing meds, I seldom do focused assessments, and nursing assessments are done once every 6 months. Most of the job is paperwork, sending emails, scheduling appointments, sorting medical bills, etc. In the future I would like to work in a hospital (I've always liked peri-op) and in the future I can see myself in a same day surgery setting. I am concerned my current job is not going to give me the experience I need to get to a hospital/acute care setting, and I've been considering applying for positions at a LTC facility or rehab unit. I don't want to lose my assessment skills, and I feel like during nursing school I didn't get much exposure to passing meds. On one hand, I like the population I am working with, and I like the other nurses and supervisor as well, but generally everyone works independently. On the other, I am concerned this job isn't going to get me where I want to be in the future. I just want the opportunity that will give me the better experience and potential for growth as a new grad and one that will offer me support as I get my feet under me. I feel alone, and there are days more often than not I am questioning whether I am cut out to be a nurse. I would appreciate any words of wisdom! Also this is my first post here...thanks for bearing with such an involved introduction:-)

As a new grad, you really don't have any nursing skills to lose. What you have is a license to learn.

Believe it or not, you are learning in your current job. You're getting to know your patients, and you're developing a sense for when something seems "off" with them -- and that triggers an assessment. You may not be developing focused assessment skills, but you aren't losing them, either. You're learning how to interact with your patients, with their families and with other staff. Paperwork is important, and hopefully you're learning how to deal with it in a clear and timely manner.

Enjoy your job now, and work on increasing your knowledge base through reading current nursing literature and taking whatever classes or seminars are offered in your town. Later on, when you are ready to pursue opportunities in another location, you'll have a solid year of more of experience. A new grad with a year of experience in the same job is a much better candidate for an new position that a new grad with 3 or four months of experience three or four times.

[HamPawsRN]

Thank you for the advice and insight, Ruby.

[ProperlySeasoned]

If you are planning on moving next spring, I do not recommend quitting this job and moving on to another. That would give you two peroids of very short term employment, which will not look good. Agree with others - since this job leaves you with weekends free, a per diem job in a more clinical area could be just the ticket you need. And remember - clinical skills can always be taught, critical thinking must be honed.