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.
Quote from Aunt Slappy
Exactly which "basic nursing skills" did they say you were deficient in?
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 **** 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.
Last edit by dianah on Oct 1
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