Lack of confidence in skills, knowledge, experience... trying to return to nursing..

Nurses General Nursing

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Hi there...

I am an inactive RN interested in returning to practice following five years of being a stay-at-home mommy. My drama is somewhat convoluted and lengthy, so thank you in advance for reading it... and any advice given will be greatly appreciated.

Although I graduated (1997) from nursing school at the top of my class (invited into Sigma Theta Tau and all of that business) I quickly discovered that being a top student did not give me all of the skills necessary to be a successful nurse. I began working for a home-health agency not long after graduation (1998). The owner of the agency assured me that I would be given a good caseload and support would always be a phone call away. At the time, my children were all pretty young but unfortunately, I was married to an abusive man and I feared for their safety while I was working shifts at the local hospital, thus the decision to go to the home health agency (we have since divorced and I am on my own now as a single parent... not that it's any easier, lol!) The promised caseload never materialized with this agency and while I had very good relationships with my clients and fellow RN's/CNA's, it became quite evident that I would have to look elsewhere for employment. I interviewed and accepted a position with the health department, a position that I enjoyed greatly. On my last weekend with this agency, I was assigned to be on-call and I made a visit to a client that I was unfamiliar with. Adult male, spina bifida, bilateral decubiti requiring dressing change, illiostomy... upon arrival at the client's residence, I made my assessment and did the required care up to the dressing change. I was unaware that the family did not maintain a supply of dressings (the agency director neglected to tell me this important bit of information...) so I did the best that I could and volunteered to return later with the dressings which the family declined. I reported the incident to the client's RN, charted my actions, and thought nothing further of it as I began my new position the next Monday. (I do have to admit that I did not give a proper two weeks notice to the agency... something I will never do again!) I would like to point out that this particular agency had a very high turn-over rate for RN's and CNA's, and several of the clients expressed dissatisfaction with the agency director. Also, since I was a new RN, I was frequently asked to provide CNA care to clients because of the high CNA turn-over rate... at a greatly reduced compensation!

Approximately six months later (1999) I received a notice from the board of nursing that my practice was being investigated regarding the previously mentioned incident. I did not have any prior notice from the agency at all, and several of the allegations brought against me was that I falsified my charting and did not perform any of the treatment that I was ordered to do, that I was fired because of this incident (I walked away from that job and was never told that I was fired...) and that the local police department had to assist the agency in the return of equipment issued to me (I returned it two weeks after I left their employment). The board ruled against me... probation with limitations, supervised practice, extra CEU's... In retrospect, I should have stuck it out but I thought the worst and surrendered my license. (My husband was being very abusive to the children and me and the time, and my self-esteem was at an all time low and I doubted everything about myself...)

In 2002, I decided to divorce my husband and return to nursing. The board reinstated my license... with all of the limitations, etc still in place. I accepted this without question. I moved to another state and obtained a license there (with limitations similar to the original state's limitations) and set out to find an RN position. Every hospital that I interviewed for lost interest as soon as I informed them of the limitations... and I gave up trying to find a job in that state. In December, 2004, the original state discontinued the disciplinary case and, according to them, my responsibilities to them were fulfilled and I hold an unencumbered license. The second state, however, has not been so generous... stating that since I have not fulfilled the obligations for supervised employment, the probation will continue indefinitely. I have since allowed that license to expire.

I have discovered that I am very good at doing stupid things, acting without thinking, and burning bridges. My question... what can I do to repair the damage done to my nursing career? I want to go through a refresher course and update my knowledge and skills... and how should I go about explaining the license that I allowed to expire... or is it even necessary? In the letter that the original disciplining board sent to me the district attorney wrote that I was not required to report the case for renewals, etc.

I am still struggling with self-esteem issues... I am an anorexic (went from 175 to 93 pounds) and I am scared to death about returning to nursing. I suppose I am afraid of failure, and I beat myself up on a regular basis regarding how successful I was in school and failed so miserably in practice.

Thank you so much for reading my rather lengthy narrative, and I appreciate any information or advice that I can receive from the participants of this board.

Best wishes for a wonderful weekend, and smile often...

Kathryn :)

I think before you return to nursing, you need to get your eating disorder under control. Nursing is very stressful, and will only exacerbate your problem if you don't deal with it.

Get yourself well first, before you try to take care of others. Patients will always be there!

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

I have to agree with Fab4.

Kathryn, it takes a lot of courage to face yourself, your flaws, and your human limitations. By posting so honestly, you demonstrate courage, and I respect you for that. I am not a nurse, I am a BSN student. I just wanted to write to you to offer my encouragement. I agree with the previous posters that you should find treatment for your eating disorder, because you will be a better health care professional if you are in a healthy state. That being said, many of the rest of us humans also have flaws, so don't judge yourself too harshly regarding past circumstances. Proceed with your dreams by taking one step at a time. Good luck!

Start by dealing with the problems closest to you. Your appetite

would be a good place to start. Once you get to eating again

then your body will get stronger and your mind clearer. Then

when you are under pressure your mind will come up with the

best solution to the current problem that you are working on.

I think that you have a lot of courage because your life has

been very hard after you graduated from nursing school. I pray

that God will turn your life around and get it going in the right

direction.

:balloons:

Hi there...

Just a short note of thanks to all of you for posting to my topic. I have to admit that I do feel better now that I have written this down and am having an opportunity to discuss it with other professionals. I would like to think that I am getting the eating disorder under control (I now weigh about 100 pounds rather than the 93 that I was). I've realized that I have to watch the example that I set for my children... my oldest daughter is a promising ballet student, small in stature, but has expressed worry that she is gaining weight... and my younger daughter worries because she is taller and heavier than both of us and has frequently stated that she looks fat... they've both been counselled by their doctor and school nurse/counselor regarding nutrition and because of my own experience, I am very observant of their eating habits. They, in return, are very quick to notice if I am slipping back into old habits and they'll call me on it. Although I have been able to admit that I have an eating disorder, it still rears its ugly head frequently and I guess it's something I'll have to wrestle with on a long term basis.

Once again, many thanks for your words of encouragement, and everything that all of you have written has made perfect sense.

Best wishes for a wonderful evening, and smile often...

Kathryn

Dear Kathryn,

As I'm sure you know, anorexia is not about the food. It's about loving--or rather not loving--yourself enough to provide basic sustenance and nurture. You deserve to live and live well.

After years of being a psych nurse, I got really weary of all the survivor talk. Not because the patients hadn't survived all their trauma and drama but because it seemed to be such a limited definition of who they were going to be for the rest of their lives. I know survivor-ship is a necessary stage of healing but, doggone it, I wanted so much to hear someone--patient or counselor--to take it to the next level. Transcendence.

You seem to be poised on the brink of that step, where you aren't a victim anymore and you've gotten to where the scars have healed over. Now it's time to liberate yourself from the past and start anew.

If you have access to a therapist or counselor, do what you did online with us and put all of your mistakes, wounds, questions, fears, etc., into words. You can't totally control the outcome of a job or school interview but your attitude about yourself and your past mistakes can have a tremendous impact on the other person. If you seem timid or ashamed, they'll most likely pick up on that and decide you aren't a good risk just yet. If, however, you tell your story in a straightforward manner, own the bad moves, list the measures you have taken to put your life back together, and in general projected confident humility, you will exude a maturity that suggests a degree earned in the school of hard knocks. Oh, and make a list of your successes, too. You have to have done a lot right to have made it this far. Don't downplay what you've accomplished.

Taking a refresher course sounds like a good idea. I did one last fall (I'd been away from acute care nursing for 10 years) and it really is a pretty safe way to build confidence and reawaken old skills.

It may be too late to do anything to set the old record straight, but I'd consult an attorney to see if anything can be done regarding the false charges the old agency slapped you with. If there is a statute of limitations for the way they defamed you, it has likely expired. If not, perhaps a scary sounding notice from a lawyer might render them willing to write a letter exonerating you. You don't have to be willing to sue them--you just have to make them think you are. Can't hurt to try.

At any rate, you have permission to eat. You have permission to hug yourself and be on your own team. You have permission to love yourself right this minute and not have to wait until you have wiped up all the spilled milk. You have permission to laugh and sleep and cuddle your kids and want things and not want things and just be you every minute of every day.

I admire you very much for your courage and honesty.

Miranda

I think before you return to nursing, you need to get your eating disorder under control. Nursing is very stressful, and will only exacerbate your problem if you don't deal with it.

Get yourself well first, before you try to take care of others. Patients will always be there!

i agree with this. a few years ago i went through the anorexia thing working for a law firm. (very stressful) long hours and not eating took it's toll. i was standing there one day after lunch (just 3-4 minutes after i stepped out of my car, driving back from lunch) at the copy machine talking to my boss and the other secretary and next thing i know there are paramedics all around and they are sticking iv's in me and all that stuff. I had had a seizurel. Never ever had one before in my life. The really scary thing is, is that I was driving down the highway just a few minutes before doing 60 mph. Can you imagine if i had the seizure while driving? I immediately got help for my anorexia. Nursing will definately cause you stress, and i wouldn't want anything bad like this to happen to you. Good luck.

Thank you, KCrow and Miranda... I appreciate your thoughts and encouragement!

Best wishes for a wonderful evening, and smile often...

Kathryn

:)

Specializes in Nursing assistant.

You sound like someone ready for a new start! You are very honest, and your self awareness is a real plus....I will be praying for you and your future full of possibilities....we all have baggage, and your willingness to be open to help and advise is what will make the difference!

God bless....

Specializes in Med/Surg, ER, L&D, ICU, OR, Educator.

You can do it Kathryn! It will take work, but it sounds like you can do the hard work! It felt good to write all this down, because you are now on the road to recovery, so keep talking, surround yourself with positive people.

Ask for a preceptor/mentor at your next job so that you have someone who can give you the feedback you need to feel confident in your skills again.

The best of luck!

Kathryn,

Your honesty is to be commended. I agree with many other posters who have advised you to seek professional counselling prior to returning to nursing full time. I would speak to an attorney if possible. The board may even be able to help you. I do not know why you would have to mention the state that considered your license conditions unfilled, you let the license lapse, so do a search and see what happens. Use the link on this board, it will be faster and easier.

I do not know where you are but, since your experience is with the health department, why not start there? I know the pay is a little low, and since you are a single parent every penny counts, but it is a job you enjoyed and are familiar with.

I am sure there is a place for you in nursing, there are so many different areas open now. I wish you good luck on the refresher course, here in WV they are few and far between.

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