Lost newish grad

Nurses New Nurse

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Hopefully my story does not have too many identifying details, but I am wondering if anyone else has gone through something similar to me? Sorry for the length in advance.

I am a new graduate RN. I graduated at the beginning of May with my BSN. All I ever dreamed of was hospital/med surg nursing..... possibly ICU eventually. The same day I passed NCLEX, I was offered a position on a neuro med-surg floor at a fairly well known hospital that I had interviewed at. I was THRILLED. I started that job about a month and a half later (I had to move and transfer my license, which took some time....), anyways, about two months into the position, i was starting to have management talk to me about some concerns that they had that I was not really progressing as fast as they would like/need for me to go. These went on for about another month, with me trying to fix what they were asking as hard as I could, but alas, eventually we came to the conclusion that this was not the best floor for me to start my career with. The acuity was way too high. I was discouraged/frustrated/angry, ect..... but I decided to apply to the hospital across town.

That hospital was smaller and had more of a general med surg position available. I interviewed, loved the managers and shortly afterwards, got my new job. I was super excited as this position was going to allow me to learn a few more skills than the last place (IV starts, central lines, ect....) Things were going great! at first...... but shortly after my first review (about a month in), preceptors and management were again beginning to bring up some of the same concerns that the last place did. I was angry, heartbroken, ect, but I again put my head down and threw my self 200% into the job to try to fix their concerns. Again, it was not enough, and I again had to resign from my second position in order to avoid termination.

At this point, I am numb, angry, scared, frustrated, and probably a whole host of other emotions. It seems as though at this point, I will not be able to handle hospital nursing which hurts sooooo bad. That is all I ever wanted to do, and honestly the pain that nursing has brought to me these last few short months has made me consider walking from the profession completely. But I LOVE nursing. I honestly don't know where to turn. Currently I am also working PRN at a nursing home, but am looking for other possible areas. I don't know where else to go. Nothing else really interests me, although I have looked into possibly infusion nursing, but I don't know enough about it.

Can you apply for full time at your current nursing home job, they seem to think to are doing a good job and if you work full time you can really start developing as a nurse.

Specializes in 15 years in ICU, 22 years in PACU.

When I first read your comment that you thought it normal for new grads to struggle for a couple of years I concluded you were being delusional. It should NOT take two years working full time to get a handle on basic nursing. But nursing programs have changed and now I'm honestly not sure how much clinical preparation you get in nursing school anymore. The impression I have is: not much.

Employers have to take a very inexperienced new grad and actually finish their education before they are of any real use to a hospital. For people still in "student mode" the push to meet employers' expectations is enormous. Some hospitals are better at providing the needed orientation and preceptorship than others

Since you didn't give too much detail, I will imagine that you were not able to process the reality that you will not get everything done according to nursing schools' ridiculous standards. It ain't pretty but you have to streamline and prioritize your care to get essential tasks and the attendant paperwork done ahead of "niceties". Many times, though, the "niceties" are WHY most of us went into nursing. Who dreams of filling out forms and checking boxes as a career goal?

It is sad, sad, sad that healthcare has degenerated into a business of nurses functioning to get glowing satisfaction surveys from patients. The 4:1, 5:1, even 6:1 ratios of complex, acutely ill patients with little or no ancillary help make it really hard to provide anything but minimal care and can break that conscientious, inexperienced nurse.

I have to give less than excellent care pretty much every day I work to maintain the throughput necessary to keep management off our back. I consistently am forced to sit at my computer and chart without even making eye contact with my patient in order to "move 'em through" and get the next one. Imagine, looking at the person you're talking to as a "nicety".

If you're appreciated at your LTC facility, keep learning and maneuver for a full time job there. Buff up your skills and get your confidence back before you jump back into hospital work. You may just need a little more time.

Yeah, I had a feeling based on some things in your OP.

So, in addition to whatever skills or prioritization critiques they have given you, I would consider the idea that they are also free to question your knowledge base...because they can't get a sense of what you know or what you're thinking.

Introverts can be misunderstood. Those looking on don't have a ton to go on to help judge "where you are" in it all. If you take two people, one very much a verbal processor and out-loud thinker, and the other someone more like yourself, well even if the performance of each are somewhat similar and they are at similar places in their course of learning, the outgoing one may come out ahead by asking questions and verbally displaying interest, enthusiasm, knowledge progression and critical thinking to those in a position to observe. I have seen introverts get the shaft when they are quietly getting the work done and/or progressing just as well as others but aren't outspoken.

Going forward, you have to show interest in terms others can understand and possibly just as importantly, you have to force yourself to interact more in order to build some relationships. Let others know a little bit about you. Exchange pleasantries. ASK QUESTIONS! You have to be willing to speak up just a little to show others that you want to learn and are, in fact, doing the critical thinking.

I suspect some of this has had a fair amount to do with your experiences so far. You can turn that around. You have to "get out there" just a little bit.

Don't despair!

Good luck ~

What you said here is awesome, JKL33!

I wish someone had said this to me years ago. I used to be very introverted too, and had to learn to be more talkative and expressive.

Name9335, I hope everything works out well! Keep your chin up :)

Specializes in Urgent Care, Oncology.

Did they have any concerns about patient safety with you?

Specializes in Critical Care; Cardiac; Professional Development.

I find it a little strange that you are concerned about being too transparent so you won't post details, but that you are willing to give the actual dates of your employment. The details would be far more vague than exposing a two hospital town with dates of employment and the types of floors worked on.

If I had to venture a guess from what you have shared thus far, your problems lie in prioritization and letting the techs do their job so it frees you up to do yours. Three low acuity patients taking up all your time is concerning. This means you probably spent a lot of time in the room, a lot of time reviewing your meds, a lot of time toileting and bathing and fetching things for the patient. In other words, all good stuff in nursing school but not terribly realistic for a floor nurse.

In any case, I think you have gotten the best advice possible with the little bit we have to go on. Being a new nurse is humbling as heck, as you realize how little you really know combined with how much you are responsible for and the concern about being "good enough" pervading it all. I hope you find full time work soon. Just know this too will pass by. It will never be a funny or okay memory, but it won't always feel this awful.

I suggest thinking back to your clinicals. What allowed you to be successful in that realm? I know you were successful becasue you graduated :). Was it the smaller patient load? Having someone to process/think out loud with? Confidence?

My clinical...... ok, I came from a pretty small school and their clinical site selection wasn't the best. I know they did the best that they could,. The hospital where I did all my med surg clinicala was a fairly small community hospital with not a lot going on. Then there was a bunch of confusion each semester on what we were and were not allowed to do as students..... it was frustrating, but I made it through. The most patients I ever had was I believe 2? But most of the time it was 1

I find it a little strange that you are concerned about being too transparent so you won't post details, but that you are willing to give the actual dates of your employment. The details would be far more vague than exposing a two hospital town with dates of employment and the types of floors worked on.

If I had to venture a guess from what you have shared thus far, your problems lie in prioritization and letting the techs do their job so it frees you up to do yours. Three low acuity patients taking up all your time is concerning. This means you probably spent a lot of time in the room, a lot of time reviewing your meds, a lot of time toileting and bathing and fetching things for the patient. In other words, all good stuff in nursing school but not terribly realistic for a floor nurse.

In any case, I think you have gotten the best advice possible with the little bit we have to go on. Being a new nurse is humbling as heck, as you realize how little you really know combined with how much you are responsible for and the concern about being "good enough" pervading it all. I hope you find full time work soon. Just know this too will pass by. It will never be a funny or okay memory, but it won't always feel this awful.

I was wondering about that. I'm going to go back and edit that ( I hope). I wasn't spending a bunch of time doing tech duties, especially at the second hospital, no more than what my preceptors did.

Here is a little more information, although again, I am trying to be somewhat vague as I do not want to identify myself or the facilities involved. Some of the concerns centered around time management/prioritization, critical thinking, delegation/asking for help, and general lack of progression. Maybe I just have blinders on and am in denial, but I thought a lot of these were things that new grads struggle with for their first couple of years

Is there not a way to edit posts?

Can you apply for full time at your current nursing home job, they seem to think to are doing a good job and if you work full time you can really start developing as a nurse.

I am in discussions with the DON. Unfortunatly they don't have anything at the moment, but I think if something does come, I can get it

Did they have any concerns about patient safety with you?

There was one, but the details are too revealing. Be assured I have learned from that mistake and won't do it again.

Specializes in Neuroscience.

I'm confused how the details are too revealing. It sounds to me like you don't want to own up to mistakes.

Too revealing: on 2/2/18, I gave Mrs. Smith in room 201 50 mg of labetalol when it should have be 25 mg of labetalol, causing her heart rate to decrease to a rate of 30-32 bpm. Dr. Onery suggested we move her to the ICU in room 178, which she stayed until 2/4/18.

Okay: I made a medication error by doubling the dose of labetalol. Looking back, I know I was hurried and didn't take my time to scan the medication. I'm taking steps A, B, and C to fix the issue.

See the difference? Until you are willing to admit your faults, tell us what the specific issue is, we can't help you. All I know is what you are doing right now is not working.

The post about nursing being different than nursing school is spot on, and you would do well to read that a few times. I'm sorry that you are going through this and I do wish you well.

I'm confused how the details are too revealing. It sounds to me like you don't want to own up to mistakes.

Too revealing: on 2/2/18, I gave Mrs. Smith in room 201 50 mg of labetalol when it should have be 25 mg of labetalol, causing her heart rate to decrease to a rate of 30-32 bpm. Dr. Onery suggested we move her to the ICU in room 178, which she stayed until 2/4/18.

Okay: I made a medication error by doubling the dose of labetalol. Looking back, I know I was hurried and didn't take my time to scan the medication. I'm taking steps A, B, and C to fix the issue.

See the difference? Until you are willing to admit your faults, tell us what the specific issue is, we can't help you. All I know is what you are doing right now is not working.

The post about nursing being different than nursing school is spot on, and you would do well to read that a few times. I'm sorry that you are going through this and I do wish you well.

I already posted their concerns in other comments. That's about as specific as they got. As far as the patient safety/concern, again, I have learned from that mistake and won't do it again

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