First RN job, and I'm having second thoughts

Nurses New Nurse

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I just recently graduated nursing school this past May 2019 from a two year RN program. I like to think I had a good nursing school experience - I got a lot of experience in a hospital setting, and my last semester, my capstone preceptorship was a really good experience. I took my NCLEX mid-July, and then I started job hunting. For 8+ years, I've worked for a senior living community, and thought that this would be a good place to start. They recently opened a new facility with a sub-acute unit, hiring primarily RNs. Unfortunately at the time I applied, they were on a "hiring freeze". The HR manager helped me find a position at another one of their facilities close to my home. The only problem is the position they were looking to fill was an LPN position, and it's in LTC. During my interview, I was under the assumption they did get a fair amount of rehab patients, were I would be able to get a similar experience to a hospital setting (trachs, IVs, G tubes), etc. Well anyway, I accepted the job offer because they were willing to pay me a very good amount of money per hour, it was fairly close to my home and I thought it would be a good place to start considering I had more than 8 years of service in the company. Fast forward to 5 days into orientation. I finally just had a day off and I have to go back tomorrow and I'm on the verge of tears thinking of having to go there for the next 5 days straight. I am taking care of 23+ patients, passing medications all morning and then trying to sit down and learn the whole documentation process and taking orders, and manually putting them into the computer. And the one patient who has a high acuity with a tracheostomy and a g-tube, has a RT that comes and does trach care and suctioning daily during the week, so I don't even deal with that. I honestly feel like I am not utilizing ANY of my nursing skills I acquired in school, and I'm nervous if I don't use them, I'll lose them. I primarily work with LPNs, since it is a LTC facility, and I was told that I was replacing an LPN that just left, and that they technically did not have a position for an "RN". All the RNs there are mostly RN supervisors, so I feel a little out of place. The Administrator at the property has spoken to me about potentially training for a supervisor spot once I am fully trained on the med cart, and with documentation, but I am a little weary about that.

I'm trying to stick this out because a job is better than no job, and the pay is higher than average, but I'm finding it hard to stay positive. The LPNs that have been training me have been pleasant so far, but I can't help but feel everyone there thinks I'm incompetent and just plain stupid. I don't want to just leave because it has been a company I've worked for, for many years, but at the same time I am still bummed and upset about them not being able to hire me at their subacute facility, where I think I would flourish MUCH more. I'm trying to have a good attitude and outlook, but I want to make sure I am happy and gaining all the experience and skills I should be as a brand new RN fresh out of school.

Sorry for the lost post, but any advice? Thanks!!

allnurses Guide

Nurse SMS, MSN, RN

6,843 Posts

Specializes in Critical Care; Cardiac; Professional Development.

Hi there and congratulations on graduating and landing your first position. That is a huge achievement!

There are some things in your post that will be present no matter where you go - the adjustment to passing meds all day, the struggles with learning the documentation system - all comes down to learning the time management of nursing. It won't be identical everywhere but the skillset is pretty much the same.

The rest of it - I would advise you to keep plugging away at this job, but keep putting out applications for new grad positions elsewhere. It is much easier to find a job when you have a job, so don't quit until you have another firm offer.

Its perfectly fine that you don't like this job and want to change. Just go about it smart. I am wishing you well.

Specializes in CCRN, Geriatrics.

I feel the same way a new graduate. I work ltc/sub acute although it is not a bad job i don't feel like i know enough and at times i feel as if i don't fit in.

Finding a hospital position has been a struggle for me. I want to get a full nursing experience my facility does not have any real med surg patients. No trachs, gtubes, picc lines, ivs or anything.

Green Tea, RN

138 Posts

On 9/8/2019 at 8:20 PM, jennsrn said:

but I can't help but feel everyone there thinks I'm incompetent and just plain stupid.

I read your whole topic, but i have hard time understanding why you feel you are incompetent and stupid.

By reading your post, i did not feel much of problems at your workplace. Maybe you are just bored at work? There is not a nursing job which utilizes all the nursing skills taught in nursing school. Like i work in the OR and i dont do head to toe assessment or med pass at all. I do not think you need to worry about loosing nursing skills too much.

jennsrn

23 Posts

Bored? Maybe. I feel stupid and incompetent because at my facility, they mostly employ LPNs... very few RNs. A lot of the LPNs there are wonderful... they have a lot of knowledge so for me to start as an RN there, I feel like I should know “everything” and while I know it’s impossible to know EVERYTHING... I feel like if I passed RN school... I should know a lot! It’s a long term care facility where we take care of the same patients/residents everyday. The LPNs have a routine down. We see very little outside subacute rehab patients so the job I can see becoming VERY routine. While I know I will never use “all” of my nursing skills I learned in nursing school in the workplace (no matter where I work) it’s a little discouraging when you feel like everyday is the same. While it can sometimes make the job easier... I’m more interested in higher acuity patients where I can really utilize my nursing judgement and critical thinking skills. I pass meds to my LTC residents, do some wound tx, document a TON, and then put in any orders the doctors write. It’s also taking care of a lot of patients, up to 30, where a majority of them are fall risks, and we are short staffed on CNA’s.

Forest2

625 Posts

I have never started a new job where I didn't feel incompetent and stupid. It goes with the territory. After awhile, I become more competent and knowledgeable. It's not called a learning curve for nothing. Keep plugging away, keep trying, and keep your eyes open for something better. Good luck.

Hoosier_RN, MSN

3,960 Posts

Specializes in Dialysis.

If you allow yourself, you will learn valuable skills in LTC--time management and critical thinking-at the hospital, there are Drs for any medical questions, in LTC, you learn to follow the signs. Wound care is usually present as well. So stay with the job until you can find another. Believe me, LTC nurses kick a$$, I did it for a few years and still do prn. I've worked in a few other areas of nursing, and it was where I actually used the most skills, and felt the most rewarded

allnurses Guide

Nurse SMS, MSN, RN

6,843 Posts

Specializes in Critical Care; Cardiac; Professional Development.

I did my preceptorship in LTACH during my final semester of nursing school. I remain convinced that experience taught me the time management that saved me from so many of the issues I read about other new grads having here.

stockmanjr, BSN

131 Posts

On 10/9/2019 at 7:57 AM, Nurse SMS said:

I did my preceptorship in LTACH during my final semester of nursing school. I remain convinced that experience taught me the time management that saved me from so many of the issues I read about other new grads having here.

I'm not sure I understand this and the fact that some NYC hospitals are requiring acute care experience in their jobs postings. Have friends who can't leave LTC because hospitals don't seem to value LTC experiences.

allnurses Guide

Nurse SMS, MSN, RN

6,843 Posts

Specializes in Critical Care; Cardiac; Professional Development.
1 hour ago, stockmanjr said:

I'm not sure I understand this and the fact that some NYC hospitals are requiring acute care experience in their jobs postings. Have friends who can't leave LTC because hospitals don't seem to value LTC experiences.

It is not seen, generally, as being comparable. I am unsure why that is, but there is no arguing that it continues to be more difficult to break into acute care after working in subacute.

stockmanjr, BSN

131 Posts

3 minutes ago, Nurse SMS said:

It is not seen, generally, as being comparable. I am unsure why that is, but there is no arguing that it continues to be more difficult to break into acute care after working in subacute.

It's because they can. Hospitals in tight markets can be picky about who they hire. Also, why would you hire an LTC RN who will have to adjust to the hospital when you can hire a traveler who has acute care experience and you don't have to pay benefits long-term. Heck it's the same thing with a new grad vs a traveler. Why choose the new grad you have to invest in when you can have a steady stream of travelers.

allnurses Guide

Nurse SMS, MSN, RN

6,843 Posts

Specializes in Critical Care; Cardiac; Professional Development.
1 minute ago, stockmanjr said:

It's because they can. Hospitals in tight markets can be picky about who they hire. Also, why would you hire an LTC RN who will have to adjust to the hospital when you can hire a traveler who has acute care experience and you don't have to pay benefits long-term. Heck it's the same thing with a new grad vs a traveler. Why choose the new grad you have to invest in when you can have a steady stream of travelers.

Yes, but travelers are extremely expensive, often unreliable and are locked into a contract that the employer must pay except under very limited exception clauses. I don't know any hospital that isn't anxious to try to be rid of travelers all together.

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