Removed from Nurse Residency Program-Should I Try Psych?

Nurses New Nurse

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Sadly, I became a member of the club no one wants to join two days ago. "Removed from Nurse Residency Program" club.

I'm an older nurse, graduated from an accelerated (16 mnths) BSN program in December of '17. Took NCLEX and passed on first try in March. Accepted spot in a pilot Nurse Residency program in June. Hospital is Level 1 Trauma unit in a large city. My position was in SICU. I really loved critical care and I was learning in leaps and bounds. Unfortunately, I was told on my eighth day on the floor that my basic nursing skills were not sufficient for the fast pace of an ICU. Shadowed in Stepdown/Tele and was told the same thing. Also told there was nothing available in general med/surg. Oddly, even though I was told there was no place for me within the facility, the ICU director wanted me to work the following day and one day the following week. Went home, thought about it, checked out many threads on this site and decided that it would be best to resign, rather than be terminated.

I was surprised at how supportive the ICU director was at this meeting. She gave some suggestions for new employment and said she will give me a good letter of recommendation. She also had high praise for my energy, personality and leadership abilities. She emphasized that it is my basic skills that are lacking and encouraged me to contact my school to see if I can get some remediation. I knew throughout nursing school that I wasn't getting the experience I needed to solidify my basic skills. I made this clear to many instructors and administrators and always got the same reply: "you'll learn those skills on the floor." Not so. I did much continuing education on my own. I got in 45 minutes before my shift every day in order to read my patient's history and familiarize myself with the (pretty antiquated) charting system, I asked many, many questions, I lived, ate and breathed nursing at home. Nurse Sarah RN became my new best friend. YouTube nursing videos became my only form of entertainment. I wrote education articles on disease processes for future use in new nurse orientation. I acted out processes such as blood draws just to build muscle memory. Unfortunately, this wasn't enough.

All of that to ask this question: I've seen some openings for psych and will apply for them. I entered nursing school originally with the goal of becoming a psych NP, but I wanted to get a year of general nursing experience to solidify my skills before considering that route. If I do get an offer (the facility where I did my psych rotation would probably hire me), should I take it? Some nurses have told me that if I make that jump, I won't be able to reenter general nursing. I loved my psych rotation as a student; most of it just consisted of talking to the patients and I really enjoyed it. However, it looked to me like the nurses mostly passed meds and had very little interaction with the patients.

In the meantime, I am looking into nursing skills refresher courses in order to further my basic skills and definitely plan to see what my school can offer me in the way of remediation. I would really like to try psych nursing, but worried it will lock me into that role permanently if I do it now. Any input would be much appreciated.

Specializes in Psych, Addictions, SOL (Student of Life).
Thanks. That's encouraging. In psych, did you get to interact with the patients, or was it just passing meds most of the time?

Every Psych job is different as is every Psych nurse. The nurse/patient relationship has to be carefully balanced. Still I know Psych nurses who never leave the nurses station citing their paper workload. That's not my style. I check in verbally with my patients at least once per shift. These are not lengthy interactions but they help me to see how the patient is progressing in treatment.

Hppy

Thanks!

Many thanks to all of you for your thoughts.

I want to believe that everything happens for a reason and there's something better around the next corner, but I can't get rid of this feeling that I've failed and maybe nursing just isn't for me. Very humbling experience. The reality is that I've invested much into this career and I have to just move forward, for my family as well as myself.

I'll take all of your suggestions into consideration and try to formulate a plan for the immediate future.

As I stated in another post, my experience in CVICU, as a new grad was very similar to yours.

Starting IVs was wasn't a problem, as we never started them, but I had problems with my preceptor, and problems with pumps, and felt as though my preceptor was indifferent towards me.

I am still not great starting IVs because I don't do them often, but I have since learned multiple electronic charting systems, have no problems with pumps, and have gained tremendous confidence as a nurse.

You can do this.

Your past experience was but a glitch in the road called life.

You can succeed. Please don't let this derail your ambitions.

As I stated in another post, my experience in CVICU, as a new grad was very similar to yours.

Starting IVs was wasn't a problem, as we never started them, but I had problems with my preceptor, and problems with pumps, and felt as though my preceptor was indifferent towards me.

I am still not great starting IVs because I don't do them often, but I have since learned multiple electronic charting systems, have no problems with pumps, and have gained tremendous confidence as a nurse.

You can do this.

Your past experience was but a glitch in the road called life.

You can succeed. Please don't let this derail your ambitions.

Thank you! All the support here is very helpful. It's easy to get caught up in a culture on a floor and forget that there's more out there.

I work in a large level 1 teaching hosp. I don't start IVs or do phlebotomy. Ortho floor

Same. Well, I do do iv starts but am marginally good at them. I'd think most patients in an icu have central lines. In fact, there was a unit "helper" from our icu once on the floor... I asked if she could help with a difficult stick and she straight up told me that wasnt her forte due to her limited exposure. I did a blood draw off a vein once when I floated to the er.

I'm precepting a new grad right now. It's her third week. I had her prime a line and unfortunately she got lots of air in it. My thought was "I'll have her do more of that" --not "she doesn't belong on the floor."

So anyway, sorry your first job didn't work out. The reasons they let you go were weak. If they don't have another reason for it, their priorities are probably not quite right for newer nurses. Please believe it isn't a reflection of how you good of a nurse you will be.

Specializes in psych.

I started right out of school in an emergency psych setting. I was told the same thing, that I should start on a med-surg floor first, however I knew what I wanted. I had never drawn blood or started an IV in my school either, and yet the only skill I needed to learn for my floor was drawing blood. We do not do anything with IV's as they are a safety risk and if pt's need them, they go back to the ED for them.

I say if you are interested in psych, go for it! I wish you luck!

I do not believe that you were let go for those reasons. At some facilities, nursing assistants can place IV's and draw blood. I'm more inclined to believe that you were just not a good fit for the unit which is why they let you go. There nothing wrong with that, not every unit is going to work for you. Use this time to really reflect , on and move forward.

I do not believe that you were let go for those reasons. At some facilities, nursing assistants can place IV's and draw blood. I'm more inclined to believe that you were just not a good fit for the unit which is why they let you go. There nothing wrong with that, not every unit is going to work for you. Use this time to really reflect , on and move forward.

I tend to agree with you. I got a two-degrees-below-lukewarm reception from the beginning and it just went downhill from there. I tried being friendly, offering my help to other nurses (almost always turned down), joining in general conversations (which often was met with "just focus on what you're doing.") so I just gave up, kept my mouth shut and kept to myself. There were a few people who were very helpful and supportive, but the atmosphere wasn't great.

I will say, though, that the main issue anyone ever pointed out to me was my basic lack of skills. It seems I was always choosing between doing a task right or doing it fast. All this while trying to focus on my patient as a human being. I always chose to do the task right and got many complaints about my lack of speed.

They didn't really want to train you although you are a new grad. You may have pizzed someone off (unknowingly) or made someone jealous due to how well you were doing. Not everyone in this life will be for you.

They didn't really want to train you although you are a new grad. You may have pizzed someone off (unknowingly) or made someone jealous due to how well you were doing. Not everyone in this life will be for you.

God bless you. Would sooooo love to believe that. So I guess I will. I just need to figure out what I did do wrong and fix it for the next job.

2 big ones: I had never drawn blood or started an IV in school. I did each of those things once on the floor--and got the IV on the first try. School tried to tell us that no nursing schools teach blood draws or IV insertion any more due to liability issues, but as threads on this site have indicated, that's not true.

IV line priming: Preceptor said I always had "a sh*t ton" of air in the line. I spent much time on YouTube trying to figure out how to perfect my technique and I think I improved a lot. Secret is in filling the tube before letting the roller clamp out slowly.

Bed-making: Never really got much practice at this b/c at clinicals, CNAs usually did it.

Also had a lot of trouble with the charting system.

I think it depends on the school if you receive IV and blood draw training. I never did but that was many moons ago.

The facility must know what skills you graduated with... decided to fast track you to critical care anyway.

No new nurse, or their patients, should have to go You Tube to learn new skills.

It takes at least 4 weeks of training to learn a charting system.

8 days... is not long enough to learn any of this. Thinking the facility was desperate for a warm body.

If psych is your goal anyway.. go for it

Best wishes.

Specializes in hospice, LTC, public health, occupational health.
If psych is your goal anyway.. go for it

Best wishes.

Totally agree with this. Just go into the field you want to be in and don't listen to the prophets of doom. There will always be people wanting to drag you down, don't let them.

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