Frustrating start to Nursing - ICU to SNF to ???

[Ready4amiracle]

Dear Allnurses,

If any one has some advice out there, I would greatly appreciate it. My husband is a new grad nurse, who graduated (BSN) with honors and awards, who got accepted into a new grad program, in the ICU, at a prestigious hospital in our area.

During the course of his time in the ICU, he had several preceptors, several of whom were okay, one of whom was terrible and was, by any normal standard, verbally abusive towards him very early on. It was causing him serious anxiety every day at work. I fear that I made things worse for him because I told him that what he was experiencing qualified as a hostile work environment by law, and that he should should say something, because he deserved better treatment than that. He did, and the nursing director reigned holy hell down on him, but ultimately switched him to a preceptor who was AMAZING. She worked him to the brink of collapse, but he was finally getting the fundamental training that he so desperately needed and wanted. (BTW, I had just given birth, so we were dealing with a newborn at the time as well.)

In the second to last week of orientation, his new preceptor said that she thought he would be fine, but that she wanted him to complete one more week so she could have a few more shifts with him. A few days later, he got an email saying they were changing him to another preceptor for his final two shifts. In his second to last shift, he had a med error that the preceptor had missed and signed off on. On his last shift, he was told it wasn't a good fit. They told him to go talk to the nurse recruiter at the hospital on the following Monday. Others in the program had been through this process and were transferred to other units.

He went to his appointment and at that time the nurse recruiter handed him termination papers, stating that the Director refused to recommend him to transfer to another unit. He called the Director later that day, and she responded that she would need to know what unit he wanted to go to, and that he would have to get an interview and then she would consider endorsing him. One of his preceptors was in the room while this call was going on and my husband overheard him say, "Yeah, he would be fine anywhere other than an ICU."

He asked a former teacher who had recommended him originally for the position if he had any insight into the situation after it happened. He told him that he would look into it and get back to him. After several follow up emails, he has never heard from him again. A week later, he got a notice that they had overpaid him by a few hundred dollars and that the Unit had requested that it be paid back immediately. This, after the nurse manager was the one who filled out all of his timesheets, and he had worked so many hours off the clock with his preceptor. So. There we were, me on maternity leave with a newborn, my husband fired from his dream job, trying to figure out if this turn towards nursing was a horrible mistake, and with this bill for salary overpayment that just seemed like a slap in the face, a dig, for a hospital dealing with millions, if not billions of dollars a year.

It took several months, but he ended up finding work at a SNF, for significant reduction in pay. He has learned a lot there, and appreciates the work. Multiple people at the facility have said that they are so appreciative that he is there, and patients have sung his praises. He has been actively working to improve practices at the facility, both for patients and for the workers who were sometimes being taken advantage of. I am so proud of him for this. It just isn't where he wants to spend his career. He wants to get back into a hospital on a Med-Surg or other non-ICU floor. He has aspirations of being a nurse educator, too, and that seems unlikely without the pedigree of a hospital.

So far, he has been applying to other New Grad programs and other SNFs with no luck so far. He is just a few months away from not being a new grad anymore, but he won't have a year of acute care experience that hospital jobs require. I keep telling him to apply anyway to open, non-new grad nursing jobs, because as a manager in my field, I often end up hiring someone that doesn't fit the exact list of requirements, but who demonstrates professionalism and competency. But I don't know nursing, so is that bad advice? Any recommendations on how he should get back on track or how I can support him would be greatly appreciated. Interview help? He had a rocky start, but he is very smart, with a good heart, who has the ability to provide exceptional patient care.

Any guidance would be appreciated.

Sincerely,

Ready4amiracle

[RescueNinjaKy]

I want to say that it takes a certain personality to make it in the icu. I personally believe that icu nurses need to be assertive and direct in what they want. And since your husband spoke to the preceptor after you mentioned and the fact that you're looking up advice for him shows that this might be something he will want to work on.

Now my advice is for him to apply away to everything. He might get lucky. In the mean time keep getting experience in his current job, network and get certifications. There are nurses who transitioned from snf to acute care so it is possible. Be assertive in interviews. Practice interviews, have people look over his resume and cover letter. And definitely make connections.

Now, med surg or even a step down can be a place he might be interested in. Step down units are not as sick as icu but they are sicker than most med surgs.

[hppygr8ful, ASN, RN, EMT-I]

Dear Allnurses,

If any one has some advice out there, I would greatly appreciate it. My husband is a new grad nurse, who graduated (BSN) with honors and awards, who got accepted into a new grad program, in the ICU, at a prestigious hospital in our area.

During the course of his time in the ICU, he had several preceptors, several of whom were okay, one of whom was terrible and was, by any normal standard, verbally abusive towards him very early on. It was causing him serious anxiety every day at work. I fear that I made things worse for him because I told him that what he was experiencing qualified as a hostile work environment by law, and that he should should say something, because he deserved better treatment than that. He did, and the nursing director reigned holy hell down on him, but ultimately switched him to a preceptor who was AMAZING. She worked him to the brink of collapse, but he was finally getting the fundamental training that he so desperately needed and wanted. (BTW, I had just given birth, so we were dealing with a newborn at the time as well.)

In the second to last week of orientation, his new preceptor said that she thought he would be fine, but that she wanted him to complete one more week so she could have a few more shifts with him. A few days later, he got an email saying they were changing him to another preceptor for his final two shifts. In his second to last shift, he had a med error that the preceptor had missed and signed off on. On his last shift, he was told it wasn't a good fit. They told him to go talk to the nurse recruiter at the hospital on the following Monday. Others in the program had been through this process and were transferred to other units.

He went to his appointment and at that time the nurse recruiter handed him termination papers, stating that the Director refused to recommend him to transfer to another unit. He called the Director later that day, and she responded that she would need to know what unit he wanted to go to, and that he would have to get an interview and then she would consider endorsing him. One of his preceptors was in the room while this call was going on and my husband overheard him say, "Yeah, he would be fine anywhere other than an ICU."

He asked a former teacher who had recommended him originally for the position if he had any insight into the situation after it happened. He told him that he would look into it and get back to him. After several follow up emails, he has never heard from him again. A week later, he got a notice that they had overpaid him by a few hundred dollars and that the Unit had requested that it be paid back immediately. This, after the nurse manager was the one who filled out all of his timesheets, and he had worked so many hours off the clock with his preceptor. So. There we were, me on maternity leave with a newborn, my husband fired from his dream job, trying to figure out if this turn towards nursing was a horrible mistake, and with this bill for salary overpayment that just seemed like a slap in the face, a dig, for a hospital dealing with millions, if not billions of dollars a year.

It took several months, but he ended up finding work at a SNF, for significant reduction in pay. He has learned a lot there, and appreciates the work. Multiple people at the facility have said that they are so appreciative that he is there, and patients have sung his praises. He has been actively working to improve practices at the facility, both for patients and for the workers who were sometimes being taken advantage of. I am so proud of him for this. It just isn't where he wants to spend his career. He wants to get back into a hospital on a Med-Surg or other non-ICU floor. He has aspirations of being a nurse educator, too, and that seems unlikely without the pedigree of a hospital.

So far, he has been applying to other New Grad programs and other SNFs with no luck so far. He is just a few months away from not being a new grad anymore, but he won't have a year of acute care experience that hospital jobs require. I keep telling him to apply anyway to open, non-new grad nursing jobs, because as a manager in my field, I often end up hiring someone that doesn't fit the exact list of requirements, but who demonstrates professionalism and competency. But I don't know nursing, so is that bad advice? Any recommendations on how he should get back on track or how I can support him would be greatly appreciated. Interview help? He had a rocky start, but he is very smart, with a good heart, who has the ability to provide exceptional patient care.

Any guidance would be appreciated.

Sincerely,

Ready4amiracle

I feel your husband's pain but for what it's worth a lot of new grads are starting off in SNF facilities these days. They usually stay for about a year. It's not acute care but the average SNF patient can be sicker than we think in todays managed care environment. So he can learn a lot there. In the meantime he needs to work on his assertiveness and apply everywhere. If relocation is an option for you as a family focus on the Fly-over states and places where people generally want to move away from. You don't have to make it a permanent move but there are actually some fine teaching hospitals out there that really need good nurses. If a move is not possible then he just needs to hunker down and keep applying locally.

As far as the over payment issue goes - he should set up an affordable payment plan and just send in whatever you guys can - even if only 10 dollars a week. If they try to sue him for the money and he is making a "Good Faith" effort to pay them back they will lose.

Finally tell your husband "Hppy said, Never, never , never and I mean NEVER, work off the clock." It's really tempting especially in SNF to just go with the flow and work over unpaid but that is not what he went to school for. I don't work for free and it's illegal for my employer to ask me too. I made this clear my first week working in a snf and the argument has never been revisited.

Good luck to you and you family - I am 53 and just went back to floor nursing after a 6 year hiatus as a nursing consultant. I am working in a SNF now while I finish my BSN.

One thing I would highly recommend is a seminar in how to interview for jobs. I took one years ago and it was ever so helpful in teaching me what a stellar resume looks like and how to present myself to prospective employers.

Good luck to you and your families.

Hppy.

[nursefor]

Let him just apply as an experienced nurse there is no advantage to new grad programs.

The back biting and bad preceptors you are exposed to as a new grad nurse can be horrible.

Your husband is a prime example of how they abused his status as new grad talk about old eating the young.

If I was him I would not leave the snf out right definitely looking into prn or float pool test the waters of the hospital and if he likes it he can transfer to full time.

[meanmaryjean, DNP, RN]

Re: The fact that critical care takes a certain type of personality - the fact that YOU posted this and not HIM is very, very telling.

Also- it is difficult to offer advice when one gets the story third-hand.