new grad is discouraged

JillR · Sep 27, 2000

My heart goes out to you. I remember, not so long ago, feeling very overwhelmed and ready to quit my job daily, if not hourly.

I would have tears in my eyes on the way home. I wanted out so much, but knew that it would not be any easier in another place. I hung in there and it has got easier. I still have days that I feel comletely overwhelmed and frustrated. But they are getting fewer.

It might help if you vebalized you feeling with you supervisor. I don't know if that would help, but it may just let you get some of this off your chest.

I wish I had something to tell you to make this all better. I wish I could say that things will change, but I jsut can't do this because I don't feel that staffing is going to get better in the near future. I feel that the nusing shortage we are feeling is just beginning and that it will fet much worse before it gets better.

Sometimes it just helps to vent to the people who have been there and are there right now. If you think that this might help, then feel free to email me.

Hang in there, and good luck.

Jill

bnjoyful · Sep 27, 2000

I just had to respond after reading your message. I, too, am a new graduate...I graduated in Dec. '99, was licensed and working by April. I was so excited to get my first job on a medical floor in a good hospital. I thought I would get great experience and do very well in my career...I too graduated in the top of my class, with honors. Anyway, reality hit when I started working on that floor...I don't even need to go into it actually...I posted a message similar to yours several months ago! I had to force myself to go to work every day, it was horrible. I made everyone around me miserable too because I would come home and complain about how bad things were at work. Well, I finally got fed up after only 4 months. I tried to stick it out, that's what the veteran nurses will tell you to do...things will get better they all say. I was even starting to question whether I wanted to continue being a nurse. So I put in my resignation, without even having another job. It was a gutsy move, but I knew I couldn't stay where I was and that I had to do SOMETHING. After sending out many resumes, and going on several interviews, I found a great job! I now work in an oncologist's office, administering chemo. I love it! You actually have time to talk to your patients, and listen to their needs, and teach them about expected side effects. We get lunch breaks, overtime, no holidays or weekends, and the staff is wonderful! I do miss having the medical experience behind me, but considering the condition of hospital nursing at this time, it just wasn't "do-able" in my eyes.

So, there is hope, I guess that is why I felt compelled to respond. I am wondering how much experience you have...can you consider searching for a new position?

Good luck...feel free to write me, my e-mail address is [email protected] Joy

alyciaboo · Sep 27, 2000

dear 5scaw,

i have been a nurse for 3 years and started working in a hospital 1 yr ago after doing 2 yrs of long termcare. i felt that i needed the experience that i would get in an acute care setting. i feel overwhelmed more often than not. i work nights 7p to 7a and it is not any easier. often i have 10 pts of my own 6 of which are usually on telemetry sometimes more ( which is well out of state regs) and no aide on the floor. all the other nurses on the floor have the same work load so help from them is minimal. and on top of the pts you already have new admissions are coming in by the hand full. i do wake up everyday that i have to go to work and cringe at the thought of what i might have in store for me that night. the key to handling all that you have to do along with total pt care is prioritizing. if someone only gets the important parts washed then that just has to happen some times. it doesn't alway sound so great and it is not the care that we all want to do when we first graduate but don't kill yourself. also since you are new maybe you dont have the organizational skills yet to get things done quicker try doing all you can do for one pt while you are there with them. this part of it will get easier once you are more used to your job. the experience that you get in an acute care setting is the best you can get and you can take it anywhere, branching out to home care, management or so on. if you really can't hanle it try long term care, not all people think that it is fabulous, it is not, but it is alot less hectic-- most of the time.

RunningSoLate · Sep 27, 2000

I have been a nurse for 31 years and applaud the new graduate speaking out. But here is the deal: Equaled only by the flaming disregard that most hospital administrations have for what nurses actually do, is the blinders that nursing instructors are wearing as to what nurses actually face in the workplace today. They ill-prepare the new grad for what she/he will be forced to deal with if they want to actually work in a hospital today. With few exceptions,the pay is low, there are limited effective standards capping hours of work and these jobs offer limited benefits, provide poor working conditions, have no union representation, and are insecure. With forced mandatory overtime we are given the opportunity to put in long extra hours each week, often keeping us away from interacting with our homes or personal life for weeks at a time. Does this picture not fit the model of the nineteenth-century sweatshop with long hours, low wages, and unsafe working conditions? It is hard to believe that this economic environment can coexist in the modern world with our sleek cities like Atlanta where I work, a prosperous stock market, and high-tech jobs. As young grad nurses find themselves working extremely long hours in an effort to climb their career ladders, they only find themselves burned out early. As professionals, especially the more creative and brilliant ones, have found out, their nursing school instructors have failed to adequately prepare them for the shock of finding the medical profession transformed into an industry where profits are made from sickness and sick people; forces they only too late dimly perceive but which have forced them to take on at times multiple jobs to patch together a career, while struggling to provide themselves with health and retirement benefits.

We could simplistically blame the managed health care employer for this state of affairs, because it is easy to see who holds the power in this personal dynamic. But if we take a closer look, it is the individual competitiveness embedded in the medical field today that has a dark side; competition breeds winners and losers, and the market, by itself, does not care how they are distributed. It does not matter if competition makes a few winners extremely wealthy while a large number of losers become relatively poor, as long as average wealth increases.

As nurses we provide our employers with tremendous value at a low cost. Low wages and long hours is the mortar which holds hospitals together. Nursing has always drawn the short-straw: it is only within the last years that we have drawn the short straw to subsidize the prosperity of managed health care. It suggests limits to which this kind of competition may push the losers in this field--the nurse. We do not have the power to raise wages substantially or working conditions and we are caught in a race to the bottom.

Whether you realize it or not, nursing is a labor-intensive industry and providing medical care is a commodity in this day and age of managed health care, subject to intense competitive pressure. As long as public policy supports this kind of unbridled competition between hospital services as a blanket solution to our social and economic problems, the problem becomes more complex than a simple struggle between management and labor. In our effort to mix government regulation with market institutions we are throwing the baby (in this case the new grad) out with the bath water.

The new grad today sees people they graduated with in college, have weekends and holidays off, time with their families and not working like dogs every day of their lives. In essence, they see their friends having a life. So what could possibly be there for them to stay in hospital nursing? Went we went to managed health care, it only intensified the lousy working conditions nursing has labored in for years. At the time, we only asked but two questions: Does the policy of managed health care lower prices and improve services, and is that a benefit to the average consumer? But there are other questions:

How does the policy affect wages? How does it influence hours and working conditions? Does it structurally alter the terms of competition to favor one group over another? This matters from a social perspective. We are individuals in pursuit of personal material goods and a society in pursuit of broader goals that require maintenance of both individual and community rights.
Does this policy promote or undermine institutions that provide training and maintain standards? Does it encourage or discourage long-term investment in skills? Does it promote the high road or the low-road to skilled nursing care?
How does the policy affect safety and health? Does competition create an unhealthy work environment and put workers at greater risk of occupational illness or injury? Does the policy make our hospitals safer or more dangerous to be a patient in them? Who pays the cost for the added risks?
Since this policy has been implemented, will we eventually need new regulations and incur additional costs to ensure the public safety and welfare? Do the market incentives that promote cheaper health care actually encourage optimal allocation of those funds?

To our discredit, nurses have been sweating their labor since the days of Florence, in the name of "its the moral and noble thing to do". Only now, can managed health care make money off of that ingrained practice. Three general conditions characterize sweatshops.

First, the wages are so low that they are below subsistence. These wages are so low that if you are a single parent you are unable to support your family well enough to maintain the family's current class position and skill level and reproduce that level in succeeding generations. This leads to sweating your labor to reach target earnings levels.
The second necessary condition of sweatshop conditions as found in the sweatshops of the early 19th century, is overwork, a natural extension of low wage rates, in order to make ends meet. Nursing encourages nurses to extend their work day and extend their work week. Many nurses work the equivalent of two or three full-time jobs. With no real penalty either for assigning nurses long hours of work, there is no disincentive to discourage use of nurses to the maximum extent allowed by law or human endurance. The low-wage rate, encouraged nurses to become complicit in this regime, sweating their labor to reach their desired earnings threshold. When I started nursing, eight hour days were the norm. About 17 years ago, 12 and 14 hour days became commonplace and with forced mandatory overtime, 18 hour days are not uncommon now.
And the third condition of sweating your labor involves unhealthy conditions of work. How many out there work 12 hours with a short break? Some nights in ICU, we work 12 hours non-stop without a break. I mean I think of those women with sewing machines in sweatshops at the turn of the century, crammed into small, poorly lit and ventilated rooms, exposed to high levels of poisonous chemicals, dangerous machinery, and delibitating effects of fatigue. Couple that with the newest trend, labor market churning and skilled labor shortages and we might as well be back in 1900 rather than 2000.

The problem is, is that when the young new grad comes in and complains about the way things are, and the working conditions, we point the finger and call them "Generation W" with the "W" standing for whine. At the turn of the century workers in successful sweatshops collaborated in the sweating process and this condition holds for nursing today. We have sweated our labor for so long, and have been so successful at it, while providing excellent nursing care under the most extreme of conditions, we are hard pressed to know how to duplicate that into the generation pressing to take our place in the nursing workforce of today. In fact, new grads have no desire to duplicate those work conditions. And to top it all off, Administration, clueless beings that they are, cannot understand themselves how we can not duplicate our work philosophy into the new, younger nurse. And in fact, it looks like many of the "older" nurses are getting fed-up also and leaving nursing at the rate of 12,000 a year, never to return. Low wages, carrying few if any retirement benefits, and poor working conditions have created serious consequences for our industry, for employees and for the unsuspecting public.

In an effort to problem-solve this crisis, Administration has decided once again not to improve working conditions or work on retention factors to retain the nurses they have. While complaining about a severe labor shortage, they continue to hire the lowest wage they can find from wherever they can find them, which drives wages down further throughout the labor market and exacerbates the skilled nursing shortage. The overall effect is to crank wages down tighter, paradoxically making the job less desirable.

This unfettered market for nursing labor from the third world nations produces a continuous and destructive slide that will threaten nursing instead. Managed health care simply cannot recruit, hire, train and retain nurses who can both do the job, pass stringent drug tests and have the education and know-how to do their job--work performed under difficult conditions at the wages companies are willing and now, able to pay. The continual infusion of new employees into the business of nursing in the hospital, however temporary can break any work situation. Nursing, it seems, has a seemingly inexhaustible well of new grads, even if it grinds them up and spits them out a fearful rate. Now our industry is embarking on a new project: to permanently replace this situation with nurses from far-flung communities, willing to work for less. At the same time that Administration complains about a severe labor shortage, they continue to hire the lowest wage workers they can find from wherever they can find them, which drives wages down further throughout the labor market and exacerbates the skilled nursing shortage. As long as the market for nursing remains unstable, someone will take that low-wage nursing job--if only on a temporary basis. As wages drop, it becomes irrational for individual workers, to invest in their human capital--what they have built up in skills and marketablity over years working in the business. This furter devalues their labor and ends up attracting to nursing those workers with the fewest employment alternatives, mainly from third world nations. I wonder if Administration will ever wring their hands over the trap in which they see themselves, a trap they set themselves, unable to raise wages or working conditions to the level needed to attract the kind of nurses they want and need.

[This message has been edited by RunningSoLate (edited September 27, 2000).]

newgrad · Sep 28, 2000

I really glad to see that I am not the only person feeling this way. I am a new grad and just started my job about two months ago. Everday I feel like I'm not giving the best patient care like I should be. Everday I walk out the the hosptial hoping that I did everthing and charted everthing I was suppose to do. I understand what you are saying and I hope things get better at least that is what everyone says will happen. Well good luck and I hope things get better

------------------

Deanna

teamrn · Sep 28, 2000

Its been about 20 years since I've been a new grad, but I won't forget those days before, during and after work. The scenarios were different, but at that time, working conditions had not deteriorated to what they are now. My suggestion would be to be open w/ your supervisor about the problems and any potential help, but if that didn't work, I'd be prepared to move on-don't 'throw the baby out w/ the bathwater', but look for a different nursing position, like the gal now really enjoying her oupatient oncology position suggested. From your post, it sounds like you'd LOVE to work in nursing, but that this is NOT the work you want, and committed to. It doesn't need to be forever what you explained. I'm pretty passionate about the hospice work that I've been doing for nearly 9 years, but I had to try alot of different fields 'on for size' before I settled on and found my desire here. I DO feel that nursing and health care will improve as long as we keep nudging it along in the right direction, but that is the topic of another post. Please keep on truckin'....

maeve · Sep 29, 2000

Running so late, you are SOOOOOO articulate & right on the money! Please consider organizing a million nurse march group in Alabama & writing to [email protected] regarding the health/care nursing issues you posted. See the Million Nurse March area on this web site. We need the assistance of people like you. Thanks

justanurse · Sep 29, 2000

5scaw, you are not alone. I felt just like that when I started nursing. 14 years ago. I came in at the beginning of total patient care in my area. I had some very scary experiences. Just know you are not alone in your feelings. Unfortunately, they are quite common. Keep your chin up and keep at it. You've been given some good advice, and I really can't add much more. Be patient with yourself, take the advice given. And, if you just can't stick it out where you are, try some place else, transfer to a different floor or start putting those resumes in again. Do what you need to do.

Good luck and God bless you.

shami · Sep 29, 2000

5scaw,

I empathize with you completely. It was just about a month or two ago that I had posted a similar post. (I have been a working RN for 6 months now, med-surg). I also talked to managers and some veteran RN's about my feelings of being overwhelmed. They all pretty much told me the same thing; that I would get used to it. Many times I worked (unpaid overtime)over an hour to 3 hours just to make sure that I completed all that I felt needed to be done. Working 10-12 hours but getting paid for 8. Never mind about trying to write in those hours of overtime, even the veteran nurses complained about getting the third degree from management when doing so. (They're trying to keep the costs down!!)Basically they're trying to cram as much work out of us as they can, but thats another story altogether. There were days I would come home crying to my fiance and being miserable everyday I have to think about going into work. (I still do) I agree with one of the earlier posts about finding another area of nursing that might be more satisfying with better hours suitable for family/social life. (I missed my 10 year high school reunion because they wouldn't give me the night off from work.) I am trying to stick it out for at least another 6 months so that hopefully it may open doors in other areas. (If my sanity lasts that long ). Also if I could afford to financially I would quit today. On a more positive note I don't stay at work as late as I used to. I still go in half an hour early to get a good report on my patients. Although I feel like I have to make shortcuts and there is never enough time to give the kind of nursing care I would like to, thats the reality of nursing now that I'm trying to get used to. I wish you the best of luck!! Feel free to email me, we're all in the same boat.

Shami

babs_rn · Sep 30, 2000

Newgrad,

EVERY area of hospital nursing can be overwhelming on a regular basis. I am not a new grad by any means, but I have pulled a few floor shifts in the past several years (after making sure I got the credentials needed so I'd never work the floor again!) and it is actually worse now than it was 12 years ago - and that's saying a lot. Floor nurses are viewed by many patients, families, and much of adminstration as "glorified waitresses". The only areas of the hospital I can stand to work in are PACU, ED, and CCU. The nurses there have much more respect from all of the above (and the doctors) and in ED, there is always a doctor there so you don't have to worry about calling them at home to clarify an order. In my experience, ED physicians are usually more down-to-earth than attendings are anyway. PACU is the primo assignment, if you ask me. Monitor them for an hour, wake them up and make them feel better, then send them to the floor. One-on-one or maybe 0ne-on-two. And if you work PACU in Ambulatory Surgery, you get nice hours to boot (and no call).

So my point is, start to look around. One of the advantages of the nursing shortage is that now many hospitals have put aside that "one year of med-surg experience" requirement to fill the positions and will train you adequately (demand that. firmly.) There is much, much more to nursing than the med-surg floor. I am among a large number of nurses who out and out refuse to work med-surg purely due to the conditions. Sure, I get overwhelmed in the ED, but I am fortunate enough to (finally!) work in a hospital where the ED nurse manager is fair in her judgements and backs the nurses. (which is all too rare, unfortunately).

Just passing the torch because I'm on my way out of the field altogether. I do hope you find what you are looking for. Keep in mind that having a job you hate will kill you. Usually it will kill you mentally long before it kills you physically, but it will kill you. So keep your ear to the ground, keep being the excellent nurse I know you are inside, and network,network,network!! Get your ACLS and PALS (and maybe NALS) certifications and doors will start to open for you. NEVER settle for less than you can be, or for being perceived as less than you are. Give it your all, but if that's not good enough for them, GET OUT. Move on. For your own sake.

Be well.

Babs

LaurieCRNP2002, MSN, RN, APRN · Sep 30, 2000

Hello all! :-)

I can sympathize with all of you expressing your dismay and frustration at the current state of nursing today, especially in hospitals. The "profits before patients" mentality has really taken flight and it's going to take DRASTIC action for things to turn around. About 2 1/2 years ago, I decided that I enjoyed nursing enough to stay in it, and started working on a graduate degree with the hope of becoming a nurse practitioner. Sad to say there are days when I wonder why I am getting an advanced degree. However, a friend that I vented to on this topic pointed out that national staffing guidelines are not far off; they already passed a law in CA (the DHS still has to set the levels, which of course the hospitals are trying to influence, to the detriment of nurses!).

For any of you new grads who feel your license is truly endangered, don't sacrifice all that you've worked for up till now! If you have to, leave. Think about it this way: it would be far easier to explain a little "job hopping" rather than having to explain a license suspension or revocation because you were involved in a patient being harmed due to short staffing (which of course would be difficult to truly prove). It may hearten you all to know that there was a lawsuit in Kansas that sought to put the responsibility for the short staffing where it belongs---in the laps of the administrators who made the decisions! (It was mentioned in the Chicago Tribune series on nursing errors that ran earlier this month).

You all might want to consider getting involved in the "Million Nurse March" movement---there is a whole forum dedicated to trying to organize a march to draw attention to the problems going on and how patient care is being affected. This would be a great way to channel your frustration and anger at the administrators and HMO execs who have contributed greatly to the state of healthcare today. You all sound like very dedicated, conscientious people and all the things happening now wouldn't bother you so much if you didn't care. So consider putting your energies towards a good cause, one that could make a huge difference, not just for the patients, but for the workers as well.

Laurie