Lost newish grad

[Name9335]

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.

[jayNewRN]

Hi everyone!

I really feel for you, OP. I am in a similar situation. I am a new grad about 9 months into my first job...in the ICU. I have had 2 performance evals and the first was "you're doing a good job, you're still new and need to improve on this..." but the most recent one broke my spirit. I racked up overtime (more than other new grads on the floor)...not too ridiculous, I think...like 2-3 hrs per pay period (which is like an avg of 30min per shift) mainly to scramble on charting. Some items mentioned I can completely understand needing to work on- time management, better communication with doctors/charge RN, more proactive with asking for orders/knowing what med to request...but it felt so soul-crushing to hear them say things like they were concerned for a patient's safety under my watch. Also, some negative items on my eval were when I ask experienced RNs for advice on an issue and followed their advice!

I was so heartbroken, disappointed in myself, and also annoyed with certain things that I felt were not my fault. (A nurse complained about my colostomy bag leaking...I watched her replace my bag and she put the new bag on the exact same way I did!)

The hospital is very far from my house...and I recently got an interview for a hospital (also ICU) 5 minutes away from home. (I know I have no offer YET...but I'm just thinking it over...) I'm torn. I don't want to be a sore loser/quitter in leaving my current hospital after a bad eval especially since this hospital is much bigger, probably has more high acuity pts/ better learning experience, (better benefits), and newer technology/equipment, and the team is very knowledgeable and nice (some of them). 5 min drive vs 1.5-2hr drive is tempting though.

Any advice? I've even considered that I'm not cut out for ICU or should go lower acuity to get more experience then switch later if I want?

[Insperation]

OP- Yah it sounds like you have some issues. Obviously you're aware of that. It's not like your on here blaming everyone else, you're consciously aware of your downfalls. Just know that I feel for you. There's no worse feeling that being sat down, and having someone tell you that you're not good enough. Especially after all the sweat and tears that we put into nursing school.

But know this, you're not the only one who failed. You're a new grad, essentially you're a student of the game still. You're a rookie. Your hospital failed, your preceptor failed, your mangers failed, your nursing school failed, your charge nurses failed. They're supposed to be teaching you, not releasing you to the wolves and then sitting back to evaluate your performance based on OTHER people's evaluations.

So yes, you were very sporifice on the details here. Oh well. Remember Steve jobs got fired from his own company. Maybe acute care is just not a good fit for you right now. Shake it off, move on, find something better.

I recommend every manager or nurse or whomever read the book "how to win friends and influence people" by Dale Carnegie.

You don't slam people when they're down, you encourage them and build them up. You put yourselves in their shoes and you show some empathy. So I say don't give up and keep on fightin the good fight.

[Name9335, BSN, RN]

OP- Yah it sounds like you have some issues. Obviously you're aware of that. It's not like your on here blaming everyone else, you're consciously aware of your downfalls. Just know that I feel for you. There's no worse feeling that being sat down, and having someone tell you that you're not good enough. Especially after all the sweat and tears that we put into nursing school.

But know this, you're not the only one who failed. You're a new grad, essentially you're a student of the game still. You're a rookie. Your hospital failed, your preceptor failed, your mangers failed, your nursing school failed, your charge nurses failed. They're supposed to be teaching you, not releasing you to the wolves and then sitting back to evaluate your performance based on OTHER people's evaluations.

So yes, you were very sporifice on the details here. Oh well. Remember Steve jobs got fired from his own company. Maybe acute care is just not a good fit for you right now. Shake it off, move on, find something better.

I recommend every manager or nurse or whomever read the book "how to win friends and influence people" by Dale Carnegie.

You don't slam people when they're down, you encourage them and build them up. You put yourselves in their shoes and you show some empathy. So I say don't give up and keep on fightin the good fight.

Thank you. I LOVE acute care, and it really hurts that I for some reason not able to do that right now, but I am hoping that some day I will be able to return.

[Meriwhen, ASN, BSN, MSN, RN]

I've been in recovery from drugs and alcohol for almost seven years and I've never heard that saying EVER, anywhere.

Funny, I hear it all the time. But recovery's quite the big world.

Ohh but two different hospitals said the same thing? Ok. None of that is based on any actual facts. You don't know this person and you don't know their managers.

You're right, I don't know the OP or their managers. As fas as actual facts go, I'm going based on what the OP has posted, so whether or not what she posted is true is based on whether OP is telling us the truth. I'm presuming she is.

I'll bet that the managers of those two different hospitals don't know each other either.

And my point is that if both managers at both hospitals came to the same conclusions independent of each other, then there probably is validity to their concerns. How valid? Well, that in part depends on what the OP sees after some honest self-assessment.

Soo you can't tell me there isn't a good reason to be vague sometimes on the internet.

If you read back, you'll see I did say the details were irrelevant. I don't need to know what they are because they really are irrelevant, unless the OP wants specific help in addressing specific concerns. It's the fact that separate entities are seeing the same/similar things that's significant. That's a red flag that the OP should be paying attention to.

[Insperation]

Funny, I hear it all the time. But recovery's quite the big world.

You're right, I don't know the OP or their managers. As fas as actual facts go, I'm going based on what the OP has posted, so whether or not what she posted is true is based on whether OP is telling us the truth. I'm presuming she is.

I'll bet that the managers of those two different hospitals don't know each other either.

And my point is that if both managers at both hospitals came to the same conclusions independent of each other, then there probably is validity to their concerns. How valid? Well, that in part depends on what the OP sees after some honest self-assessment.

If you read back, you'll see I did say the details were irrelevant. I don't need to know what they are because they really are irrelevant, unless the OP wants specific help in addressing specific concerns. It's the fact that separate entities are seeing the same/similar things that's significant. That's a red flag that the OP should be paying attention to.

Oh maybe in like treatment centers or something that is said. But actually the vernacular in meetings is pretty limited actually. You hear the same **** everywhere. And I've been in meetings all over the world. The concept is sound though. Yes, stop blaming others and take a moral inventory.

It doesn't seem like OP is really deflecting on to anyone though. When I mean by limited facts is, there is a large gap of information regarding the premises of the managers sides. Yes, they were having issues with OP. But there's so much "doubt" here. And for some reason, you were giving the benefit of the doubt to her managers, not her. She's saying she's in actual pain over this. She's probably considering whether she wants to stay in the profession at all. And all you can say is.."Well you're a duck" or whatever. That's kind of what baffles me. She's the one on here looking for support, not them.

I'm guessing you must identify more with a manager. Do you work in administration? Have you ever worked on a med surg floor where you have 5-6 patients and people barking at you all day? Doctors, families, patients, techs, nurses, etc. For a new grad, it's hard as **** man.

I guess I just identify more with her actual struggle. I'm just into my second year of med surg nursing and some days just soo hard. It's getting easier though.

Why can't you cuss on this website...who are we really trying to protect here? I mean c'mon, it's the internet.

[Ruby Vee, BSN]

Hi RubyVee,

Thank you for your comment. Let me try to get some additional details. Most of their concerns centered around the fact that I could not handle a full/high acuity load by the time that they wanted without a lot of support from my preceptors. There was one medication administration issue, however, I am not sure that I would have called it an "error". I had scanned in a medication and then it promptly fell on the floor. I scanned the computer to lock it, while having the other medications listed, and went to grab another of the dropped medication, when I came back, instead of rescanning the medication, I just completed the medication that I already scanned (I looked at the new packaging and confirmed that it was the same medication and dosage) Once the preceptor pointed out that I should not do what I did, I immediately stated that I would not do that again. Another situation involved me catheterizing a patient. It is kind of a long story, but the patient was known as a difficult cath. I was unaware that the policy stated that I was only allowed to attempt a certain number of times. In the end, I attempted too many times and it was stated that I caused patient trauma. I was heartbroken. I would NEVER purposely cause trauma to a patient. I learned so much from that incident. These are hopefully a little more details that could help. These are some of the major issues I can think of off the top of my head.

I probably would have done about the same thing you did with the fallen medication; however when you're brand new you need to follow the policy pretty closely. I would have been wrong for not following the policy. First you need to demonstrate that you know the policy and can follow it.

With the straight cath, did you read the policy/procedure before you started? If not, you should have. It takes extra time, I know, and you were probably quite busy. The way I got around that when I was new was taking any downtime I had and studying the procedures for things like that that I might have missed. Our policies are online; I can print them out, send them to my iPhone or read them online from home. That helps. Whenever there's a new policy or procedure, I make sure to familiarize myself with it OR, if it's one we don't use often, print it out or put it on my phone so I can refresh myself when I need to. Not that this advice will help you NOW -- but it might in your next job.

Time management is nearly always a problem for a new grad -- you'll improve as you gain experience. Critical thinking is trickier -- it's hard to define, but you know it when you see it. Just make sure you understand where you went wrong in every instance where you went wrong. Maybe then you can apply what you've learned the next time.

[Ruby Vee, BSN]

Oh maybe in like treatment centers or something that is said. But actually the vernacular in meetings is pretty limited actually. You hear the same **** everywhere. And I've been in meetings all over the world. The concept is sound though. Yes, stop blaming others and take a moral inventory.

It doesn't seem like OP is really deflecting on to anyone though. When I mean by limited facts is, there is a large gap of information regarding the premises of the managers sides. Yes, they were having issues with OP. But there's so much "doubt" here. And for some reason, you were giving the benefit of the doubt to her managers, not her. She's saying she's in actual pain over this. She's probably considering whether she wants to stay in the profession at all. And all you can say is.."Well you're a duck" or whatever. That's kind of what baffles me. She's the one on here looking for support, not them.

I'm guessing you must identify more with a manager. Do you work in administration? Have you ever worked on a med surg floor where you have 5-6 patients and people barking at you all day? Doctors, families, patients, techs, nurses, etc. For a new grad, it's hard as **** man.

I guess I just identify more with her actual struggle. I'm just into my second year of med surg nursing and some days just soo hard. It's getting easier though.

Why can't you cuss on this website...who are we really trying to protect here? I mean c'mon, it's the internet.

We cannot use profanity on this website because it's against the Terms of Service -- the ones you agreed to when you joined. If this is a great difficulty for you, there are other websites out there that may be more to your liking. However, as professionals, it behooves us to be able to express ourselves without using profanity.

[TAKOO01, BSN]

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 ~

This is an excellent analysis, and its impressive that you saw this personality trait in an online post. Perceptive and helpful!

[Workitinurfava, BSN, RN]

Of course they want you to learn at a rapid speed so you can get off orientation and they can stop spending money on your training. They would rather be making money off of you. Let's face it. Most orientations aren't long enough and most nurses have been made to feel like they are suppose to be ready in such a short span of time. It is unrealistic, the rate of speed at which you are suppose to be ready to work alone. Can you apply to rehab floor or facility? It will offer you some med-surg experience. If you feel you can't manage med-surg. Go slow and build up to being able to. Good luck! There will be plenty of jobs available in medsurg when you are ready. Don't worry. Just hang in there. I started at a nursing home, worked at a rehab facility, and then worked on a oncology med-surg floor. I did quite a bit of medsurgy things when I worked in a rehab facility. Many nurses I worked with left there at went on to work in a hospital on a medsurg floor. Fyi, you will have more patients then you like but it is a good place to start to gain medsurgy skills.

[savyj96]

this sucks and I feel for you! but also the school you graduated from should probably be kicked for having you graduate feeling so unprepared!

[bijou]

Getting critiqued as a new grad and working nurse is a continual process. If you get critiqued in time management and work on that then management may say you need to implement protocols in a more consistent manner. My point being is that I don't really think that either of your employers were going to fire you but were trying to guide you. I say short of anyone actually firing you, you can't forecast that upon yourself and then quit to avoid the possible eventuality of being let go. Don't quit on yourself and I am sure your employers won't quit on you either.

[Name9335, BSN, RN]

Getting critiqued as a new grad and working nurse is a continual process. If you get critiqued in time management and work on that then management may say you need to implement protocols in a more consistent manner. My point being is that I don't really think that either of your employers were going to fire you but were trying to guide you. I say short of anyone actually firing you, you can't forecast that upon yourself and then quit to avoid the possible eventuality of being let go. Don't quit on yourself and I am sure your employers won't quit on you either.

Both facilities were initiating disciplinary action. The second facility, (that I had just left), presented me with a final written warning. I was to have one more shift to correct my deficiencies, and if I didn't, it was made clear that the next step would be termination. I threw myself 200% into that job, and my managers were as supportive as they could be, but it just wasn't enough.