what to do...

  1. ok, I haven't posted a thread in awhile. As some of you may remember from my previous posts, I work as a Staff RN at a very small hospital, and have since last fall. I graduated last summer.

    Because my hospital is so small, we don't see alot of different conditions. Alot of COPD, CHF, Pneumonia, etc. I feel like I am not learning anything more. I am in no way saying I know it all on those conditions listed above, but I don't feel I am learning much more.

    I am afraid that those who graduated with me that are working in specialty areas or bigger hospitals are more experienced and advanced than I am. I feel I will not be very marketable if I were to try and get into a specialty. I do like the small hospital as the stress level is not near as high as bigger hospitals.

    My goal has always been either OB or Hospice nursing. I know most places want that year of Med/Surg. The thing is, even though I have been in my job almost a year, I don't feel I have that "year's experience" as other nurses have.

    Does this all make sense?

    Anyone have any thoughts or feel the same way?
  2. Visit RNLisa profile page

    About RNLisa

    Joined: Aug '05; Posts: 258; Likes: 9

    11 Comments

  3. by   Imafloat
    A year of experience is a year of experience. Perhaps your experience isn't as lacking as you feel it is, do you think differently than you did when you were brand new, has your time management improved since you were new? Frame your experience in a positive light. I know people who start in speciality areas right out of school (I did) and are doing fine.
  4. by   RNLisa
    Thank you WeebabyRN
  5. by   Daytonite
    Yes, it makes sense. I started working in a community hospital in the boondocks. I worried that I wasn't good enough or had learned enough to be able to work at a huge city medical center. I was wrong, and so are you. And, I'm going to tell you where you are wrong.

    In this past close to a year that you have been out of school you have been learning some very valuable skills. Among them are how to prioritize and organize your work shift. That is just as important as knowing how to manage the care of a patient with COPD, CHF, or Pneumonia. In fact, it is one of the things many employers want you to learn in that first year that so many of them require before letting you transfer intensive care units. How much prioritization and organization did you actually learn in school? Think back over the last year and be honest.

    Now, here's something that you're going to find out when you go to a big city medical center to work on one of their medical units. Most of the patients are probably going to have COPD, CHF or Pneumonia. Surprise! When I finally got up the nerve and went to work at a big city medical center (and I didn't have any problem getting hired even though I thought my Boondocks Community Hospital background was going to work against me--boy! was I wrong) I found that I was getting patients with most of the same kinds of medical diseases. There were a few differences since my big city hospital served the city.
    • We got an awful lot of people who were homeless and indigent. When they came through the door, they were usually pretty sick and sometimes on their last legs. They had multiple medical problems. I got to see what happens first hand when people can't afford health insurance and are truly poor.
    • We had a huge staff of social workers to address all the social problems that came along with the patients. Discharge planning takes on a huge significance. I found out first hand and many times over how to deal with a comatose patient whose family couldn't make decisions on care. I learned what was involved in getting a court order for guardianship for people who had no relatives to make medical decisions for them when they couldn't.
    • We already knew about the "news" in town before it hit the TV and radio because the patients were coming to our hospital.
    • Those diseases that you've never seen in a patient before you're still not likely to see all that often at the big city medical center either!
    • They had great teaching resources and more advanced practice nurses than I ever knew existed. These nurses were constantly having inservices or classes. So, yes, there are learning opportunities.
    • The bigger the hospital, the more your name gets lost among all the other employees and you get to be an "employee number" and a warm body.
    Don't put down your current hospital or the work you do for them. Mark Twain said, "It's not the size of the dog in the fight, it's the size of the fight in the dog." That pretty much sums up the American spirit, I would say. Your practice and how you practice is all up to you. Whether you work in a little rinky dink place or a huge corporate giant, it still is all about how YOU do your job. If you have the capacity to learn, then you will adapt as a situation calls for it.
  6. by   pagandeva2000
    Daytonite, that was worded so well!
  7. by   pagandeva2000
    Quote from RNLisa
    ok, I haven't posted a thread in awhile. As some of you may remember from my previous posts, I work as a Staff RN at a very small hospital, and have since last fall. I graduated last summer.

    Because my hospital is so small, we don't see alot of different conditions. Alot of COPD, CHF, Pneumonia, etc. I feel like I am not learning anything more. I am in no way saying I know it all on those conditions listed above, but I don't feel I am learning much more.

    I am afraid that those who graduated with me that are working in specialty areas or bigger hospitals are more experienced and advanced than I am. I feel I will not be very marketable if I were to try and get into a specialty. I do like the small hospital as the stress level is not near as high as bigger hospitals.

    My goal has always been either OB or Hospice nursing. I know most places want that year of Med/Surg. The thing is, even though I have been in my job almost a year, I don't feel I have that "year's experience" as other nurses have.

    Does this all make sense?

    Anyone have any thoughts or feel the same way?
    I can understand how you feel, and if it does not change, then, consider applying for the larger hospitals. But, try not to look at your current position as a negative. Daytonite made excellent comments to consider...I could not word it better myself. But, it is true, there may still be basic diseases you will be dealing with primarily, no matter where you go. Maybe go into a specialty area if you choose. Another thing to consider (at least I would) is that sometimes, less stress IS better. Some people have the type A personality that thrives on stress. This is not a bad thing...but is that YOU?

    I am in sort of a different situation...I am an LPN that got my license last year, and am working in a clinic. I expected to work in med-surg, because my job paid my way through school, so, (while I didn't want to work the floors), I 'just knew' that since I was sponsored, that I would have to pay my dues by working there. Instead, my supervisor wanted me back in the clinic, and made it happen. I had to work in med-surg for 6 weeks for orientation as a new grad nurse, and for me, it was horrible. I did feel similarly as you did that I was not really getting my hands dirty AT FIRST, but, what I did was get my bedside experience doing home care because I really needed that slower pace to build my confidence, and I am constantly taking continuing education classes to build on other skills. I have been applying my teaching skills, still learning basic bedside things without the same stress and pressure of getting it right the first time and I am practicing nursing safely. I feel that I am just as efficient as a nurse as my peers, just in a different area. I hope you do find a medium for yourself. Just know that you can change your situation when you are ready. Good luck!!
  8. by   hlfpnt
    Quote from Daytonite
    Yes, it makes sense. I started working in a community hospital in the boondocks. I worried that I wasn't good enough or had learned enough to be able to work at a huge city medical center. I was wrong, and so are you. And, I'm going to tell you where you are wrong.

    In this past close to a year that you have been out of school you have been learning some very valuable skills. Among them are how to prioritize and organize your work shift. That is just as important as knowing how to manage the care of a patient with COPD, CHF, or Pneumonia. In fact, it is one of the things many employers want you to learn in that first year that so many of them require before letting you transfer intensive care units. How much prioritization and organization did you actually learn in school? Think back over the last year and be honest.

    Now, here's something that you're going to find out when you go to a big city medical center to work on one of their medical units. Most of the patients are probably going to have COPD, CHF or Pneumonia. Surprise! When I finally got up the nerve and went to work at a big city medical center (and I didn't have any problem getting hired even though I thought my Boondocks Community Hospital background was going to work against me--boy! was I wrong) I found that I was getting patients with most of the same kinds of medical diseases. There were a few differences since my big city hospital served the city.
    • We got an awful lot of people who were homeless and indigent. When they came through the door, they were usually pretty sick and sometimes on their last legs. They had multiple medical problems. I got to see what happens first hand when people can't afford health insurance and are truly poor.
    • We had a huge staff of social workers to address all the social problems that came along with the patients. Discharge planning takes on a huge significance. I found out first hand and many times over how to deal with a comatose patient whose family couldn't make decisions on care. I learned what was involved in getting a court order for guardianship for people who had no relatives to make medical decisions for them when they couldn't.
    • We already knew about the "news" in town before it hit the TV and radio because the patients were coming to our hospital.
    • Those diseases that you've never seen in a patient before you're still not likely to see all that often at the big city medical center either!
    • They had great teaching resources and more advanced practice nurses than I ever knew existed. These nurses were constantly having inservices or classes. So, yes, there are learning opportunities.
    • The bigger the hospital, the more your name gets lost among all the other employees and you get to be an "employee number" and a warm body.
    Don't put down your current hospital or the work you do for them. Mark Twain said, "It's not the size of the dog in the fight, it's the size of the fight in the dog." That pretty much sums up the American spirit, I would say. Your practice and how you practice is all up to you. Whether you work in a little rinky dink place or a huge corporate giant, it still is all about how YOU do your job. If you have the capacity to learn, then you will adapt as a situation calls for it.

    I'm in pretty much the same situation as RNLisa & often feel like I'm falling behind & not learning enough.
    Thank you, Daytonite...I needed to "hear" that!
  9. by   RNLisa
    Thank you everyone who posted replies. I am still feeling that way, but I so feel my heart is OB nursing. I just wish I could get my feet in the door of that specialty. I just am having no luck with getting in that area around here. I cannot relocate as my husband is tied into his job for at least 3 more years and my kids love their school and friends. I am hanging in until I can get where I feel my heart is.
  10. by   RNDude
    Quote from WeeBabyRN
    ...Frame your experience in a positive light. ...
    Great comments, all around. When you are ready to make the jump to your next job, and you want to take the good advice of WeeBabyRN quoted above, just say that you've learned a lot and now want a more challenging environment to learn in.
  11. by   Amiejayrn
    [quote=rnlisa;2218107]ok, i haven't posted a thread in awhile. as some of you may remember from my previous posts, i work as a staff rn at a very small hospital, and have since last fall. i graduated last summer.

    because my hospital is so small, we don't see alot of different conditions. alot of copd, chf, pneumonia, etc. i feel like i am not learning anything more. i am in no way saying i know it all on those conditions listed above, but i don't feel i am learning much more.

    i am afraid that those who graduated with me that are working in specialty areas or bigger hospitals are more experienced and advanced than i am. i feel i will not be very marketable if i were to try and get into a specialty. i do like the small hospital as the stress level is not near as high as bigger hospitals. quote]

    i understand what you are saying...
    i too, graduated last december and went to work at a small community hospital as a "transition nurse". my job is to go to all the deliveries which is anywhere from zero to 5 on my shift and transition the babies (do their cares and make sure they are stablized in extrauterine life). for me, it sounded like a job i would really enjoy, and i do, but, i feel like i am not learning anymore. i dont get a patient assignment and i get exactly the same type of babies. i also work night shift which means even less deliveries. there are no daytime positions available.

    i decided to go into a specialty new grad program to learn more. i will be starting a 6 month rn residency at a children's hospital in their nicu, and it is day shift. the first hospital also has a nicu but only level 2 and thier census is low compared to the higher level. also there is no chance of me getting into the smaller hospitals nicu because they have no openings.
  12. by   RNLisa
    [quote=amiejayrn;2264438

    i understand what you are saying...
    i too, graduated last december and went to work at a small community hospital as a "transition nurse". my job is to go to all the deliveries which is anywhere from zero to 5 on my shift and transition the babies (do their cares and make sure they are stablized in extrauterine life). for me, it sounded like a job i would really enjoy, and i do, but, i feel like i am not learning anymore. i dont get a patient assignment and i get exactly the same type of babies. i also work night shift which means even less deliveries. there are no daytime positions available.

    i decided to go into a specialty new grad program to learn more. i will be starting a 6 month rn residency at a children's hospital in their nicu, and it is day shift. the first hospital also has a nicu but only level 2 and thier census is low compared to the higher level. also there is no chance of me getting into the smaller hospitals nicu because they have no openings.[/quote]

    i think your job sounds amazing and i'd love to have it!! lol you are doing a job i'd love to do someday. i do hope you like your new job, it sounds like a great opportunity as well. congrats!
  13. by   Amiejayrn
    I do enjoy my job very much, but just feel stuck with no more to learn. I am keeping one foot in the door and going per diem day shift as the transition nurse, while I go through the new grad program at the Children's Hospital.

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