Get me out of here!

[gearheadfly]

I'm a new grad (BSN), hired for ICU, and I have finally had enough of my hospital. For the first two months, I was shuffled around to other floors and units with at least 15 different preceptors who were constantly asking me, "Why am I orienting an ICU nurse?" When I finally got to the ICU, things were slightly better as I had two primary preceptors, one of whom has advocated for me as best she can. BUT, in thirty shifts I have had over ten different preceptors. Once I had the same patient three days in a row, but a different preceptor each day. Every day I would be chastised for caring for the patient in the way the previous preceptor had shown me.

Yesterday I worked with the preceptor I like least. She is impatient and snotty. She hates explaining anything, so she will huff and roll her eyes and tell me to "go finish your charting" while she draws labs, initiates tube feeds, changes dressings etc... (everything I need to practice!). I had one patient who should have been a 1 to 1, but I was assigned him and another less acute patient. My preceptor said (huffily), "Since you are going to be on your own soon, I'm just going to stand back and let you do everything today." I guess that might have worked, except that one hour after my shift began the MD's d/c'd fentanyl and ativan on my heavy patient (vented and with etoh withdrawal), who then proceeded to flip out and (even in restraints) yank his foley halfway out and kick me in the head while I tried to prevent him from throwing the lower half of his body over the bedrails. My preceptor then takes over and decides that she is going to do everything for this patient since I am obviously not competent to be left on my own. I, however, will still be in charge of charting, giving report etc... on the patient, whose SBP has dropped to the 60's btw.

Meanwhile my other patient's family is having a meltdown about some unsatisfactory interaction they had with an MD in the ED when dad was admitted. I am trying to help them out, care for dad, and not give them anything else to write complaint letters about. When I finally got around to doing GRASP on my patients, I realize that my first patient's score is 23(!), which means that he should never have been part of a paired assignment. My preceptor is giving meds that I can't even find MD orders for and gets pissed when I tell her that she needs to chart on all of that stuff.

At the end of the day, my preceptor tells me basically that this is what I can expect to deal with and that I should have been able to handle it all by myself (even though she couldn't!). I know from experience that none of the nurses on my unit would have taken that assignment; the first patient was a 1:1 all night. The only reason that the charge nurse gave it to me was because my preceptor was a half hour late as usual that morning and wasn't there to speak up.

Although I have not had problems of this kind with any other preceptor, I have finally had it with that hospital--their disorganization, their randomness, and their unhealthy work atmosphere for new grads (I'm not the only one going through this). I am starting to look for another job. But what am I? I'm set to start working on my own in January. I'm not technically a new grad anymore, but I have virtually no experience (the training program and preceptorship at my hospital is a joke). Do I apply for positions as a new grad? I can't be negative about the job I have now in interviews, but what do I say when I am asked about why I'm leaving? Has anyone else ever been through this? How did you handle it?

[llg, PhD, RN]

Tell the truth, but don't wallow in the negativity. Simply explain to the recruiters that your first experience did not go well because you were shuttled around to different units and never received any consistent orientation to any one unit. That is why you are leaving and you are now looking for a position that will include a reasonable orientation for someone with only a small amount of experieince. Let the recruiters and hiring managers decide whether or not to consider you a "new grad" or not. Don't feel as though you have to make that decision all by yourself ahead of time.

If you see a job posted as a "new grad" job that interests you, apply for it and explain your situation up front. If you see a job posted that's not particularly for new grads, but that interests you -- apply for it and explain your experience level up front. Either way, apply ... explain ...work with those doing the hiring and educating to get the appropriate level of orientation.