New Grad, in desperate need of emotional support!

[yinit9278]

Hi All,

I'm a new grad with a BSN in massachusetts that would ultimately kill to find a job in a hospital setting! However, I couldn't get a job anywhere except in a sub acute rehab facility. I am feeling very overwhelmed and discouraged, and seeking some support!

I am still training but the patient ratio of 14:1 seems extremely overwhelming, they are still on paper med orders, so no emar :-(. All of the meds are written on paper and I have to search for all patient meds in my med cart, narcotics included! I am terrified of making a med error and feel extremely pressured to move at a faster pace, but have no idea how I can possibly give out meds to so many patients any faster and still practice safe nursing. The seasoned nursing staff seems overwhelmed, and dont have time to evaluate for preventative care. So its feels like they are always solving problems with patients if/when they happen instead of assessing for and pro-actively preventing them in the first place. This is not the type of nursing care that I was trained to provide and I leave every day feeling extremely guilty!

I am struggling to see how I can manage my time effectively with meds and also complete every patients treatments. I came home today practically in tears, I cannot imagine doing this on my own three weeks from now! I cannot seem to find the light at the end of this horribly long tunnel...

What makes this worse is that other nurses have expressed that hospitals don't view this job as actual work experience, though I cannot imagine how that is possible! This place takes multi-tasking to a whole new level! Do you guys think I am wasting my time here? Any advice on what I should do to eventually open up pathways that would lead me into a hospital?!?

Any and all advice will be greatly appreciated!

[nurseprnRN, BSN, RN]

Yes, you may be wasting your time there.

Advice: I love the Commonwealth, I live here myself, but I would move in a New York minute (you should pardon the expression) if I were in your shoes. Be bold, be brave! Go West! Go rural! Go Indian Health, go to underserved areas where you will be welcomed with open arms, go to mining, drilling, or logging areas.

Get cracking! There are jobs out there!

[yinit9278]

I wish I could move but it's not an option. My fiance has a stable and steady job and in this economy that is just not something you give up, and we recently purchased a condo together . But thanks for taking time out of your day to reply! Just knowing someone out there cares enough to do so makes me feel a little bit better :)

[lisajtrn]

I don't know if you are wasting your time. Anything is better than nothing I think. I also think that no matter what type of nursing you do at first it can be overwhelming. I have seen many overwhelmed new grads in many different settings with varied nurse/patient ratios. It takes time to get comfortable in any new position, and the real world is a whole lot different than nursing school. This in itself is a huge adjustment no matter where you are working. Keep going after the hospital position that you want take some courses part-time if you have to to give you an edge over other applicants.

There was a time when we had anywhere from 16-18 acute medicine patients to one RN with 1 or 2 RPN's to assist with patient care. All meds and most treatments were done by the RN, and all MAR's were handwritten. There was no computerized mar and every drug was in the med cart somewhere. Each cart had a narcotic drawer and these had to be ordered and counted at the beginning and end of each shift. I actually prefer the hand-written MAR to this day.

In any case best of luck in whatever you do and don't lose hope.

[VANurse2010]

I left sub-acute for a reason - but 14:1 is actually a pretty favorable ratio for that setting. You *will* get faster as you become more familiar with the medications and the work flow. Remember, this isn't a hospital and your assessments do not need to be as detailed. Look at their problem/why they're there and focus on those issues until you become more comfortable with the big picture.

I like the work load/work flow in the hospital much better - but don't assume that the load is easier or you'll have more time with fewer patients. Understaffing is a huge issue in hospitals as well and "reactionary" assessments happen there also.

[Marisette, BSN, RN]

This may not be the ideal work situation, but it sounds like a good experience if you can't leave your home town. Any experience is good experience, in particular sub-acute. I would just take one day at a time, and before you know it, several months will go by. Then you can apply at a hospital with some experience. People tend to be negative and you just can't listen to everyone's opinion about sub-acute experience. I think this experience

will prepare you for hospital nursing and make you more likely to succeed there.

[Leesha]

I think that any experience you get is better than nothing. I have been a nurse for 1 year now working on a sub-acute unit as well. I can have up to 16 patients on my wing and yes at times it can be very demanding and overwhelming. Along with the stress of being overwhelmed I have gained a tremendous amount of experience and am rewarded everyday by grateful patients and their family members. I recently received a job offer to work PRN at a hospital along with my job on the sub-acute unit at a long term care facility...so yes it is possible to get hired at a hospital with only sub-acute experience under your belt. I wish you the best of luck!! Keep moving forward :)

Leesha